Meta-análisis: Intervalos de confianza e Intervalos de predicción / Meta-analysis: Confidence intervals and Prediction intervals

En los informes meta-analíticos se suelen reportar varios tipos de intervalos, hecho que ha generado cierta confusión a la hora de interpretarlos. Los intervalos de confianza reflejan la incertidumbre relacionada con un número, el tamaño del efecto medio paramétrico. Los intervalos de predicción reflejan el tamaño paramétrico probable en cualquier estudio de la misma clase que los incluidos en un meta-análisis. Su interpretación y aplicaciones son diferentes. En este artículo explicamos su diferente naturaleza y cómo se pueden utilizar para responder preguntas específicas. Se incluyen ejemplos numéricos, así como su cálculo con el paquete metafor en R.(AU)

Several types of intervals are usually employed in meta-analysis, a fact that has generated some confusion when interpreting them. Confidence intervals reflect the uncertainty related to a single number, the parametric mean effect size. Prediction intervals reflect the probable parametric effect size in any study of the same class as those included in a meta-analysis. Its interpretation and applications are different. In this article we explain in de-tail their different nature and how they can be used to answer specific ques-tions. Numerical examples are included, as well as their computation with the metafor Rpackage.(AU)

Analysis of medication errors in Neonatal Intensive Care: A systematic review.

Medication errors, potentially causing harm and causing harm, increase significantly in newborns cared for in intensive care settings. In this sense, this work carries out a systematic review to analyze the most current evidence in relation to medication errors in neonatal intensive care, discussing the topics that refer to health technology from smart pumps, cost-effectiveness of medications, the practice of nursing professionals on the medication administration process and quality improvement models. In this way, it could be considered a useful tool to promote quality and safety in neonatal intensive care.

Differential rates of induced abortion in Spain: educational attainment and age among native and immigrant women.

OBJECTIVE: Analyzing the variations in induced abortion (IA) rates across different subpopulations in Spain based on country of origin, while considering educational and age composition. METHOD: Using 2021 Voluntary Termination of Pregnancy register and 2021 Spanish Census microdata, we calculated crude IA rates and age-specific abortion rates. We used age-standardized IA rates (ASIAR) to account for the confounding effect of age composition. We compared seven subpopulations residing in Spain, taking into account simple ages and educational levels aggregated into four categories. RESULTS: Immigrant women, especially those from Sub-Saharan and Latin American countries, consistently had higher IA rates compared to native Spanish women. According to age-specific IA rates, university-educated women had considerably fewer abortions than women with other education levels at any age. Age-standardized rates stratified by migratory origin revealed that native Spanish women with primary education or less had higher IA rates than their immigrant counterparts. There was a clear non-linear, association between educational level and IA rates among immigrants. The highest propensity for IA was found among secondary school graduates, while university graduates had the lowest IA rate. CONCLUSIONS: The study demonstrated that variability in sociodemographic characteristics had an impact on IA rates. Young women with middle educational attainment and immigrant background had a higher likelihood of undergoing IA in Spain. The relationship between educational level and IA rates was complex, with variations observed among different groups and changes over time.

Primary tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET/CT for the prediction of biochemical recurrence in prostate cancer.

PURPOSE: The aim of this study is to research the value of the texture analysis of primary tumors in pre-treatment [68Ga]Ga-PSMA PET in the prediction of the development of biochemical recurrence (BCR) in prostate cancer patients who underwent definitive therapies. METHODS: 51 patients with prostate adenocarcinoma who had a pre-treatment [68Ga]Ga-PSMA-11 PET/CT and underwent definitive radiotherapy (RT) or radical prostatectomy (RP) were included in the study. Demographics, clinicopathologic features, the presence of BCR, and the last follow-up date of patients were recorded. Textural and conventional PET parameters (maximum standardized uptake value (SUVmax), total lesion-PSMA (TL-PSMA), and PSMA-tumor volume (PSMA-TV)) were obtained from PET/CT images using LifeX program. Parameters were grouped using the Youden index in ROC analysis. Factors predicting the BCR were determined using Cox regression analyses. RESULTS: 29 (56.9%) patients have received primary curative RT, while the remaining 22 (43.1%) patients have undergone RP. 5 (22.7%) patients with RP and 3 (10.3%) patients with curative RT have developed BCR during the follow-up. INTENSITY-BASED-minimum grey level (P=.050), GLCM-sum variance (P=.019), and GLCM-cluster prominence (P=.050) were associated with BCR in univariate analysis. INTENSITY-BASED-minimum grey level (P=.009) and GLCM-sum variance (P=.004) were found as independent predictors of BCR in the multivariate analysis. CONCLUSION: Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.

Latent transition analysis on post-traumatic stress and post-traumatic growth among firefighters.

Background: Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.Objective: This study investigated the longitudinal impact of trauma incidents during duty on firefighters using latent transition analysis.Method: Data from 346 firefighters in South Korea who had experienced trauma events while on duty were utilized. Initially, latent groups were identified based on the relationship between post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). Groups were labelled based on the analysis of differences in PTSD, mental health, and growth-related factors among classified groups. Subsequently, transition probabilities and patterns from Time 1 to Time 2 were examined, followed by an investigation into variances based on demographic factors (gender, age) and occupational factors (work experience, shift pattern) using variance analysis and multinomial logistic regression analysis.Results: First, at Time 2, a five-group model was classified into 'Growth,' 'Resilience or Numbness,' 'Struggle,' 'Partial Struggle,' and 'PTSD' groups. Second, upon examining the transition patterns between latent groups, four patterns emerged: 'continued distress,' 'growth,' 'adaptation,' and 'escalated distress.' Third, the 'Struggle' group showed a 0% probability of transitioning to the 'Growth' group, whereas it displayed the highest probability among the groups transitioning to the 'PTSD' group. Fourth, latent transition analysis results showed a strong tendency for the 'Growth' group and 'Resilience or Numbness' group to remain in the same category. Fifth, age was found to be a significant factor affecting the transition of latent groups.Conclusion: This research represents the inaugural attempt to longitudinally investigate the interplay between PTSD and PTG among firefighters.

Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.The transition patterns of firefighters between latent groups revealed at Time 1 and Time 2 were examined, revealing four transition patterns: 'continued distress,' 'growth,' 'adaptation,' and 'escalated distress.'This research represents the inaugural attempt to longitudinally investigate the interplay between post-traumatic stress disorder and post-traumatic growth among firefighters.

Cluster analysis of prolonged grief, posttraumatic stress, and depression symptoms in bereaved asylum seekers and refugees.

Background: Refugees and asylum seekers (ASRs) are frequently exposed to loss in addition to a variety of other stressors and often display high levels of various psychological symptoms.Objective: The study aimed to primarily determine clusters of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression symptoms in bereaved ASRs and secondly identify predictors of cluster membership. Sociodemographic  - and flight-related variables were investigated in exploratory analyses.Method: ASRs in Germany (N = 92) with interpersonal loss exposure, i.e. at least one missing or deceased relative or friend, were assessed with interview-based questionnaires for PGD, PTSD, and depressive symptoms. We used k-means cluster analysis to distinguish symptom profiles and logistic regression analyses to identify predictors of cluster membership.Results: We found a three-cluster-solution. The PGD-cluster (30%) was characterised predominantly by PGD symptoms, while the PGD/PTSD-cluster (32%) had high PGD and PTSD and moderate depressive symptoms. The resilient cluster (38%) showed low symptoms overall. insecure residence status predicted membership in the PGD and PGD/PTSD clusters relative to the resilient cluster, whilst higher attachment anxiety predicted membership in the PGD/PTSD cluster relative to the other clusters. Explorative analysis revealed duration of stay as a significant predictor.Conclusion: Findings can extend the current knowledge about different symptom profiles among bereaved ASRs in Europe. Insights to attachment  - and migration-related variables distinguishing between these profiles offer starting points for interventions.

Bereaved asylum seekers and refugees in Germany can be grouped into three symptom clusters: (1) predominantly prolonged grief, (2) high prolonged grief, high posttraumatic stress, and moderate depressive symptoms, and (3) low symptom load.Attachment  ­ and migration-related variables (i.e. residence status, duration of stay, and attachment anxiety) distinguish between cluster membership.Results highlight the importance of attending to profiles and not only single categories of symptoms and attachment features in bereaved asylum seekers and refugees.

Spanish heart transplant registry. 35th official report of the Heart Failure Association of the Spanish Society of Cardiology.

INTRODUCTION AND OBJECTIVES: Our aim was to describe the characteristics and outcomes of heart transplants in Spain. METHODS: We analyzed trends in recipient and donor characteristics, recipient-donor interaction, surgical procedures, immunosuppression, and outcomes of patients included in the Spanish heart transplant registry from 2014 to 2023. Changes in survival were analyzed using the Kaplan-Meier method. RESULTS: In 2023, 325 cardiac transplants were performed (4.5% more than in the previous year), with a total of 2987 procedures from 2014 to 2023. There was a trend toward performing more transplants in women (29.2%), with etiologies other than cardiomyopathy (32.6%), and with better pretransplant status (less hepatic [12.5%], renal [glomerular filtration rate, 81.5mL/min/1.73 m2], and respiratory [8.7%] involvement). In 2023, the number of urgent transplants increased (44% of the total), especially those performed after circulatory support with extracorporeal membrane oxygenation (36% of total assistance), and transplants performed with donation after circulatory death (17.9%). Survival improved in the triennium from 2020 to 2022 compared with 2014 to 2016 (83.0% at 1 year from 2020-2022 vs 79.0% from 2014-2016). CONCLUSIONS: The number of transplants performed in Spain showed an upward trend, with recipients with better clinical status and an increasing use of donation after circulatory death. Survival improved in the last triennium.

Using comparative extinction risk analysis to prioritize the IUCN Red List reassessments of amphibians.

Assessing the extinction risk of species based on the International Union for Conservation of Nature (IUCN) Red List (RL) is key to guiding conservation policies and reducing biodiversity loss. This process is resource demanding, however, and requires continuous updating, which becomes increasingly difficult as new species are added to the RL. Automatic methods, such as comparative analyses used to predict species RL category, can be an efficient alternative to keep assessments up to date. Using amphibians as a study group, we predicted which species are more likely to change their RL category and thus should be prioritized for reassessment. We used species biological traits, environmental variables, and proxies of climate and land-use change as predictors of RL category. We produced an ensemble prediction of IUCN RL category for each species by combining 4 different model algorithms: cumulative link models, phylogenetic generalized least squares, random forests, and neural networks. By comparing RL categories with the ensemble prediction and accounting for uncertainty among model algorithms, we identified species that should be prioritized for future reassessment based on the mismatch between predicted and observed values. The most important predicting variables across models were species' range size and spatial configuration of the range, biological traits, climate change, and land-use change. We compared our proposed prioritization index and the predicted RL changes with independent IUCN RL reassessments and found high performance of both the prioritization and the predicted directionality of changes in RL categories. Ensemble modeling of RL category is a promising tool for prioritizing species for reassessment while accounting for models' uncertainty. This approach is broadly applicable to all taxa on the IUCN RL and to regional and national assessments and may improve allocation of the limited human and economic resources available to maintain an up-to-date IUCN RL.

Uso del análisis comparativo del riesgo de extinción para priorizar la reevaluación de los anfibios en la Lista Roja de la UICN Resumen El análisis del riesgo de extinción de una especie con base en la Lista Roja (LR) de la Unión Internacional para la Conservación de la Naturaleza (UICN) es clave para guiar las políticas de conservación y reducir la pérdida de la biodiversidad. Sin embargo, este proceso demanda recursos y requiere de actualizaciones continuas, lo que se complica conforme se añaden especies nuevas a la LR. Los métodos automáticos, como los análisis comparativos usados para predecir la categoría de la especie en la LR, pueden ser una alternativa eficiente para mantener actualizados los análisis. Usamos a los anfibios como grupo de estudio para predecir cuáles especies tienen mayor probabilidad de cambiar de categoría en la LR y que, por lo tanto, se debería priorizar su reevaluación. Usamos las características biológicas de la especie, las variables ambientales e indicadores climáticos y del cambio de uso de suelo como predictores de la categoría en la LR. Elaboramos una predicción de ensamble de la categoría en la LR de la UICN para cada especie mediante la combinación de cuatro algoritmos diferentes: modelos de vínculo acumulativo, menor número de cuadros filogenéticos generalizados, bosques aleatorios y redes neurales. Con la comparación entre las categorías de la LR y la predicción de ensamble y con considerar la incertidumbre entre los algoritmos identificamos especies que deberían ser prioridad para futuras reevaluaciones con base en el desfase entre los valores predichos y los observados. Las variables de predicción más importantes entre los modelos fueron el tamaño de la distribución de la especie y su configuración espacial, las características biológicas, el cambio climático y el cambio de uso de suelo. Comparamos nuestra propuesta de índice de priorización y los cambios predichos en la LR con las reevaluaciones independientes de la LR de la UICN y descubrimos un buen desempeño tanto para la priorización como para la direccionalidad predicha de los cambios en las categorías de la LR. El modelo de ensamble de la categoría de la LR esa una herramienta prometedora para priorizar la reevaluación de las especies a la vez que considera la incertidumbre del modelo. Esta estrategia puede generalizarse para aplicarse a todos los taxones de la LR de la UICN y a los análisis regionales y nacionales. También podría mejorar la asignación de los recursos humanos y económicos limitados disponibles para mantener actualizada la LR de la UICN.

A network perspective on posttraumatic stress disorder and comorbid borderline personality disorder symptoms.

Background: Comorbidity between posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) is surrounded by diagnostic controversy and although various effective treatments exist, dropout and nonresponse are high.Objective: By estimating the network structure of comorbid PTSD and BPD symptoms, the current study illustrates how the network perspective offers tools to tackle these challenges.Method: The sample comprised of 154 patients with a PTSD diagnosis and BPD symptoms, assessed by clinician-administered interviews. A regularised partial correlation network was estimated using the GLASSO algorithm in R. Central symptoms and bridge symptoms were identified. The reliability and accuracy of network parameters were determined through bootstrapping analyses.Results: PTSD and BPD symptoms largely clustered into separate communities. Intrusive memories, physiological cue reactivity and loss of interest were the most central symptoms, whereas amnesia and suicidal behaviour were least central.Conclusions: Present findings suggest that PTSD and BPD are two distinct, albeit weakly connected disorders. Treatment of the most central symptoms could lead to an overall deactivation of the network, while isolated symptoms would need more specific attention during therapy. Further experimental, longitudinal research is needed to confirm these hypotheses.Trial registration: ClinicalTrials.gov identifier: NCT03833453.

A network analysis of PTSD and BPD symptoms.PTSD and BPD symptoms largely clustered into separate communities.Intrusive memories, loss of interest and physiological cue reactivity seem valuable treatment targets.

Construct validity and reliability of the BARRIERS scale in the Spanish context.

OBJECTIVE: To establish the construct validity of the Spanish version of the BARRIERS scale. METHOD: Methodological study of validation of a measurement instrument based on data from previously published studies. The study population consisted of nurses from the Basque Health Service and the Canary Health Service. The following variables were extracted and unified: Years of professional experience, possession of a specialist nursing degree, possession of a doctorate, type of activity performed by the professional and field of work. For construct validation, a confirmatory factor analysis (CFA) was performed based on the initial model proposed for the scale and RASCH analysis. A polychoric correlation matrix, factor extraction by unweighted least squares and PROMIN oblique rotation were used. For the RASCH analysis, the Joint Maximun Likelihood estimation (JMLE) method was used; the fit of the items and persons were estimated by means of outfit - Unweighted Mean Square fit statistic (UMS) and infit -Weighted Mean Square Fit Statistic (WMS), as well as the reliability and separation of items and persons. RESULTS: A total of 1200 nurses and midwives made up the final validation sample (n = 1200), with a mean professional experience of 21.22 ± 9.26 years. The CFA presented a good fit to the data (KMO = 0.935 [95% CI: 0.921-0.945]), changing the factorial assignment in 6 items, while 5 items received factorial scores in more than one factor. The fit values for the 4-factor solution were RMSEA = 0.026 [95% CI: 0.026-0.027] and GFI = 0.991 [95% CI: 0.986-0.991]. In the RASCH analysis most items presented infit-WMS and outfit-UMS values with a good fit. CONCLUSIONS: The Spanish version of the BARRIERS scale has adequate construct validity although there are changes in the assignment of items to the dimensions compared to the original model. The RASCH analysis indicates adequate fit for both persons and items.

Analysis of the image and corporate identity of the Colegio Mexicano de Reumatologia: Is it time to redefine it?

INTRODUCTION AND OBJECTIVES: The Colegio Mexicano de Reumatología (CMR) is a corporation whose brand has two elements-image and identity-that differentiate it from other corporations. We evaluated aspects of CMR's corporate image and identity. SUBJECTS AND METHODS: To assess corporate image, we designed a survey using proof-of-concept and discrete-choice-experiments approaches. It assessed which definition (orthopedist, rheumatologist, or rehabilitator) was most meaningful in four pain scenarios in healthy adults from the country's Western region. We used discourse analysis and five readability indices of the CMR website to assess corporate identity. RESULTS: In total, 700 respondents were included. For every rheumatologist chosen in the hand scenario, respondents chose 1.13 orthopedists and 0.70 rehabilitators. For every rheumatologist chosen in the knee scenario, respondents chose 2.36 orthopedists and 0.64 rehabilitators, whereas 0.85 orthopedists and 0.58 rehabilitators were chosen in the arthritis scenario. Only 38% of the respondents preferred the CMR's definition of a rheumatologist to describe a rheumatologist. The younger age group preferred orthopedists to rheumatologists (50% vs. 31%, p<0.001). In the arthritis scenario, the choice of rheumatologist increased from 27% in the elementary school group to 49% in the university group (p<0.001). Mother was the most influential in healthcare seeking. The discursive analysis revealed that the CMR is positioned as a "we" restricted to "colleagues;" the patient did not have agentive representation. The semiotic structure of the CMR's mission/vision was deemed imprecise and lacking in statements of value and purpose; the readability scores indicated that the text was challenging and dry. CONCLUSIONS: The CMR's corporate image does not differentiate it from other health providers. CMR's identity seems ambiguous with restricted directionality. It seems pertinent to redefine the CMR.

Adverse childhood experiences of Korean mothers with young children: a latent class analysis.

Background: Adverse childhood experiences (ACEs) have negative impacts on women with children, including psychosocial and general health problems. However, there is limited research investigating ACEs identifying the characteristics of distinct subgroups according to the frequency of ACEs.Objective: Utilizing the national dataset of the Family with Children Life Experience 2017, this study aimed to classify patterns of ACEs based on the total number of types of ACEs and the types of predominant events, and to examine differences in general and psychological characteristics, as well as experiences of violence in adulthood among the classes identified.Method: A total of 460 Korean mothers raising infants or toddlers participated. Latent class analysis was performed to classify the patterns of ACEs, while t-tests and Chi-square tests were used to examine differences in general and psychological characteristics and experiences of violence between the ACEs subgroups.Results: The participants were classified into two subgroups: the 'high-ACEs group' and the 'low-ACEs group'. The high-ACEs group exhibited higher rates of child abuse, workplace violence perpetration and victimization, as well as lower self-esteem, higher depression levels, and increased suicidal thoughts compared to those of the low-ACEs group.Conclusion: The findings highlight the significant role of ACEs on the formation of an individual's psychological characteristics and their propensity to experience additional violence even into adulthood, as perpetrators and as victims. It is noteworthy how the influence of ACEs extends across generations through child abuse. These findings offer insights for developing interventions aimed at mitigating the negative effects of experiences of violence on mothers raising young children.

Two distinct subgroups were identified according to the frequency of ACEs: the 'high-ACEs group' and the 'low-ACEs group'.Compared to those of the low-ACEs group, the high-ACEs group presented higher rates of child abuse, workplace violence perpetration and victimization, lower self-esteem, higher depression levels, and increased suicidal thoughts.The low self-esteem induced by ACEs may contribute to the amplification of psychological vulnerabilities and the occurrence of additional violent experiences even in adulthood.

Control de Calidad de las Plantas Medicinales de la Farmacia Natural del CAMEC

Objectives. To evaluate the quality of twenty medicinal plants that are dispensed in the Natural Pharmacy of the CAMEC of the Hospital III Chimbote - Red Asistencial Ancash - EsSalud. Materials and methods. Analytical-descriptive research. Twenty medicinal plants were analyzed: Berberis vulgaris, Bixa orellana, Chuquiraga rotundifolia, Culcitium canescens, Desmodium mollicum, Equisetum arvense, Eupatorium triplinerve, Gentianella alborosea, Geranium ayavacense, Maytenus laevis, Melissa officinalis, Minthostachys setosa, Muehlenbeckia volcanica, Peumus boldus, Phyllanthus niruri, Senecio tephrosioides, Smallanthus sonchifolius, Tiquilia paranychioides, Uncaria tomentosa, Valeriana officinalis. The samples were selected at random (1 bag of 100 g) to which organoleptic analyses such as smell, taste, color, surface characteristics, and texture were carried out, as well as the physical-chemical analysis (phytochemical test). Likewise, it was carried out the aqueous extraction of each plant (infuse or decoct), according to the dose indicated to the patients. Mayer, Wagner, Dragendorff, Fehling, ferric trichloride, Shinoda, and foam tests were also carried out. Finally, total ashes, moisture content, and the determination of heavy metals (lead and cadmium) were analyzed by the atomic absorption spectrometry method. Results. Each of the twenty plants analyzed has the organoleptic characteristics of its species. In the qualitative phytochemical analysis, the highest presence of phenols was found. In the total ashes, two plants were found to exceed the limits allowed by the WHO (14%), Eupatorium triplinerve "asmachilca" with 22.027%, and Berberis vulgaris "agracejo" with 15.2843%. In humidity, the values obtained are within the limits allowed by the WHO (12%). In heavy metals, none of the samples showed concentrations higher than the limit value: lead (10 mg/kg), cadmium (0.3 mg/kg), proposed for medicinal herbs by the WHO. Conclusions. The medicinal plants dispensed in the Natural Pharmacy of CAMEC Chimbote comply with the quality parameters established by the WHO.

Objetivos. Evaluar la calidad de veinte plantas medicinales que se dispensan en la Farmacia Natural del CAMEC del Hospital III Chimbote - Red Asistencial Ancash - EsSalud. Materiales y métodos. Investigación analítica-descriptiva. Se analizaron veinte plantas medicinales: Berberis vulgaris, Bixa orellana, Chuquiraga rotundifolia, Culcitium canescens, Desmodium mollicum, Equisetum arvense, Eupatorium triplinerve, Gentianella alborosea, Geranium ayavacense, Maytenus laevis, Melissa officinalis, Minthostachys setosa, Muehlenbeckia volcanica, Peumus boldus, Phyllanthus niruri, Senecio tephrosioides, Smallanthus sonchifolius, Tiquilia paranychioides, Uncaria tomentosa, Valeriana officinalis. Las muestras fueron seleccionadas al azar (1 bolsa de 100 g) a las cuales se les realizaron los análisis organolépticos como olor, sabor, color, características superficiales y textura, así como el análisis físico-químico (ensayo fitoquímico). Asimismo, se realizó la extracción acuosa de cada planta (infuso o decocto), según la dosis indicada a los pacientes. También se llevaron a cabo las pruebas de Mayer, Wagner, Dragendorff, Fehling, tricloruro férrico, Shinoda y espuma. Finalmente se analizaron las cenizas totales, el contenido de humedad y la determinación de metales pesados (plomo y cadmio) por el método de espectrometría de absorción atómica. Resultados. Cada una de las veinte plantas analizadas tiene las características organolépticas propias de su especie. En el análisis fitoquímico cualitativo se encontró la mayor presencia de fenoles. En las cenizas totales se encontraron dos plantas que sobrepasan los límites permitidos por la OMS (14%), Eupatorium triplinerve «asmachilca¼ con 22,027 % y Berberis vulgaris «agracejo¼ con 15,2843 %. En humedad, los valores obtenidos están dentro de los límites permitidos por la OMS (12%). En metales pesados, ninguna de las muestras evidenció concentraciones superiores al valor límite: plomo (10 mg/kg), cadmio (0,3 mg/kg), propuesto para hierbas medicinales por la OMS. Conclusiones. Las plantas medicinales que se dispensan en la Farmacia Natural del CAMEC Chimbote cumplen con los parámetros de calidad establecidos por la OMS.

Metas. Avaliar a qualidade de vinte plantas medicinais que são dispensadas na Farmácia Natural CAMEC do Hospital III Chimbote - Red Asistencial Ancash - EsSalud. Materiais e métodos. Pesquisa analítico-descritiva. Foram analisadas vinte plantas medicinais: Berberis vulgaris, Bixa orellana, Chuquiraga rotundifolia, Culcitium canescens, Desmodium mollicum, Equisetum arvense, Eupatorium triplinerve, Gentianella alborosea, Geranium ayavacense, Maytenus laevis, Melissa officinalis, Minthostachys setosa, Muehlenbeckia volcanica, Peumus boldus, Phyllanthus niruri , Senecio tephrosioides, Smallanthus sonchifolius, Tiquilia paranychioides, Uncaria tomentosa, Valeriana officinalis. As amostras foram selecionadas aleatoriamente (1 saco de 100 g) às quais foram realizadas análises organolépticas como odor, sabor, cor, características de superfície e textura, além de análises físico-químicas (teste fitoquímico). Da mesma forma, foi realizada a extração aquosa de cada planta (infusão ou decocção), de acordo com a dose indicada aos pacientes. Também foram realizados testes de Mayer, Wagner, Dragendorff, Fehling, tricloreto férrico, Shinoda e espuma. Por fim, as cinzas totais, o teor de umidade e a determinação de metais pesados ​​(chumbo e cádmio) foram analisados ​​pelo método de espectrometria de absorção atômica. Resultados. Cada uma das vinte plantas analisadas possui as características organolépticas de sua espécie. Na análise fitoquímica qualitativa foi encontrada maior presença de fenóis. Nas cinzas totais foram encontradas duas plantas que ultrapassam os limites permitidos pela OMS (14%), Eupatorium triplinerve "asmachilca" com 22,027% e Berberis vulgaris "barberry" com 15,2843 %. Na umidade, os valores obtidos estão dentro dos limites permitidos pela OMS (12%). Nos metais pesados, nenhuma das amostras apresentou concentrações superiores ao valor limite: chumbo (10 mg/kg), cádmio (0,3 mg/kg), proposto para ervas medicinais pela OMS. Conclusões. As plantas medicinais dispensadas na Farmácia Natural CAMEC Chimbote cumprem os parâmetros de qualidade estabelecidos pela OMS.

Análisis psicométrico de la escala de evaluación de la percepción del teletrabajo femenino durante situaciones de confinamiento familiar: el caso del COVID-19 / Psychometric analysis of the female teleworking perception scale during situations of family confinement: the case of COVID-19 / Análise psicométrico e validade da escala de percepção do teletrabalho feminino em situações de confinamento familiar: o caso da COVID-19

El estudio examina las características psicométricas de una escala que mide la percepción sobre el teletrabajo femenino en la población chilena en situación de confinamiento familiar, construida durante la pandemia por COVID-19. El cuestionario explora la interacción entre los ámbitos del trabajo y la familia, centrándose específicamente en la salud mental, las actitudes hacia el teletrabajo femenino, las dinámicas familiares relacionadas con el teletrabajo femenino y las dinámicas laborales en el contexto del teletrabajo femenino durante la pandemia. Los resultados indican una fuerte coherencia interna tanto para la escala global como para sus cuatro dimensiones diferenciadas: Salud Mental, ámbito laboral, teletrabajo femenino y ámbito familiar. El análisis factorial exploratorio (AFE) revela índices de ajuste favorables gl = 17; p<0.183; x 2 /gl = 22.211; CFI = 0.995; NNFI = 0.983; RMSEA = 0.052 para los 12 ítems en las cuatro dimensiones, alineándose bien con la estructura teórica respaldando los fundamentos del constructo balance trabajo/familia.

The study examines the psychometric characteristics of a scale that measures the perception of female teleworking in the Chilean population in a situation of family confinement, built during the COVID-19 pandemic. The questionnaire explores the interaction between the spheres of work and family, specifically focusing on mental health, attitudes towards female teleworking, family dynamics related to female teleworking, and work dynamics in the context of female teleworking during the pandemic. The results indicate strong internal coherence both for the global scale and for its four differentiated dimensions: Mental Health, work environment, female teleworking and family environment. The exploratory factor analysis (EFA) reveals favorable adjustment indices df = 17; p<0.183; χ 2 /df = 22.211; CFI = 0.995; NNFI = 0.983; RMSEA = 0.052 for the 12 items in the four dimensions, aligning well with the theoretical structure supporting the foundations of the work/family balance construct.

O estudo examina as características psicométricas de uma escala que mede as percepções do teletrabalho feminino na população chilena em confinamento familiar, construída durante a pandemia da COVID-19. O questionário explora a interação entre os domínios do trabalho e da família, concentrando-se especificamente na saúde mental, nas atitudes em relação ao teletrabalho feminino, na dinâmica familiar relacionada ao teletrabalho feminino e na dinâmica do trabalho no contexto do teletrabalho feminino durante a pandemia. Os resultados indicam uma forte consistência interna tanto para a escala geral quanto para suas quatro dimensões distintas: saúde mental, ambiente de trabalho, teletrabalho feminino e ambiente familiar. A análise fatorial exploratória (AFE) revela índices de ajuste favoráveis gl = 17; p<0,183; χ 2 /gl = 22,211; CFI = 0,995; NNFI = 0,983; RMSEA = 0,052 para os 12 itens nas quatro dimensões, alinhando-se bem com a estrutura teórica que sustenta os fundamentos do conceito de equilíbrio entre trabalho e família.

Comunicação de más notícias em cuidados paliativos: estudo bibliométrico / Communication of bad news in palliative care: bibliometric study / Comunicación de malas noticias en cuidados paliativos: estudio bibliométrico

Os cuidados paliativos compreendem a melhora da qualidade de vida e o alívio dos sintomas de pacientes que enfrentam doenças que ameaçam a continuidade da vida e de seus familiares. Para tal, é necessário habilidade comunicativa, a fim de uma boa condução ao transmitir uma má notícia. Buscou-se compreender como se configura a produção científica nacional e internacional que aborda a comunicação de más notícias em cuidados paliativos. A pesquisa de revisão, de análise bibliométrica, analisou 25 artigos dos últimos cinco anos (entre 2016 e 2020) disponíveis na Biblioteca Virtual em Saúde (BVS/Bireme). Os resultados revelaram publicações de 134 autores em 16 periódicos de diferentes países. Parte dos estudos foi realizadacom profissionais de saúde em hospitais e apresentam abordagem quantitativa. A comunicação de más notícias ainda se mostra um desafio para profissionais, pacientes e familiares.

The palliative care comprises improving the quality of life and relieving the symptoms of patients facing illnesses that threaten the continuity of life and their families. For this, communicative ability is necessary, in order to conduct well when transmitting bad news. We sought to understand how the national and international scientific production on communication of bad news in palliative care is configured. The literature review research, based on bibliometrics, analysed 25 articles from the last five years (between 2016 and 2020) available in the Virtual Health Library (BVS/Bireme). The results revealed publications by 134 authors in 16 journals from different countries. Some of the studies were carried out with health professionals in hospitals and have a quantitative approach. Communicating bad news is still a challenge for professionals, patients and their families.

Los cuidados paliativos comprenden mejorar la calidad de vida y aliviar los síntomas de los pacientes que enfrentan enfermedades que amenazan la continuidad de vida y sus familias. Para ello es necesaria la habilidad comunicativa, a fin de poder transmitir adecuadamente las malas noticias. Buscamos comprender cómo se configura la producción científica nacional e internacional que aborda la comunicación de malas noticias en cuidados paliativos. La investigación de revisión de literatura, basada en el análisis bibliométrico, analizó 25 artículos de los últimos cinco años (entre 2016 y 2020) disponibles en la Biblioteca Virtual en Salud (BVS/Bireme). Los resultados revelaron publicaciones de 134 autores en 16 revistas de diferentes países. Parte de los estudios se realizaron con profesionales de la salud en hospitales y tienen un enfoque cuantitativo. La comunicación de malas noticias sigue siendo un desafío para profesionales, pacientes y sus familiares.

Mal do século: meio ambiente e doença no filme "Safe" (1995) de Todd Haynes / Evil of the century: environment and disease in the film "Safe" (1995) by Todd Haynes / El mal del siglo: medio ambiente y enfermedad en la película "Safe" (1995) de Todd Haynes

O filme "Safe" (1995), dirigido por Todd Haynes, conta a história de Carol White, dona de casa de classe média alta em Los Angeles, que começa a sofrer de uma misteriosa alergia aos frutos da "modernidade" (alimentos ultraprocessados, produtos sintéticos e poluição). Realizado décadas atrás, o filme é atual para criticar a sociedade contemporânea, explorando a desconexão e o vazio existencial nas crises ambientais. A resenha se aprofunda nos dilemas sofridos pela personagem que, apesar de viver em um ambiente abastado, sente-se alienada e busca refúgio em um grupo que oferece uma solução pseudocientífica para seu mal. O filme se posiciona como uma crítica à sociedade de consumo e às consequências das políticas neoliberais, questionando a eficácia de soluções superficiais para problemas profundos e sistêmicos.

The film "Safe" (1995), directed by Todd Haynes, tells the story of Carol White, an upper-middle-class housewife in Los Angeles, who begins to suffer from a mysterious allergy to the fruits of "modernity" (ultra-processed foods, synthetic products and pollution). Despite being made decades ago, the film is current in criticizing contemporary society, exploring the disconnection and existential void in environmental crises. The review delves into the dilemmas suffered by the character who, despite living in a wealthy environment, feels alienated and seeks refuge in a group that offers a pseudoscientific solution to her illness. The film positions itself as a critique of consumer society and the consequences of neoliberal policies, questioning the effectiveness of superficial solutions to deep, systemic problems.

La película "Safe" (1995), dirigida por Todd Haynes, cuenta la historia de Carol White, una ama de casa de clase media alta de Los Ángeles, que comienza a sufrir una misteriosa alergia a los frutos de la "modernidad" (alimentos, productos ultraprocesados, productos sintéticos y contaminación). A pesar de haber sido realizada hace décadas, la película está vigente en su crítica a la sociedad contemporánea, explorando la desconexión y el vacío existencial en las crisis ambientales. La reseña profundiza en los dilemas que sufre el personaje que, pese a vivir en un entorno acomodado, se siente alienada y busca refugio en un grupo que ofrece una solución pseudocientífica a su enfermedad. La película se posiciona como una crítica a la sociedad de consumo y las consecuencias de las políticas neoliberales, cuestionando la efectividad de soluciones superficiales a problemas sistémicos profundos.

The utility of 18F-FDG-PET/CT in detecting extracranial large vessel vasculitis in rheumatic polymyalgia or giant cell arteritis. A systematic review and meta-analysis.

OBJECTIVE: Systematic review of current evidence to analyze the prevalence of extracranial large vessel vasculitis (LVV) using 18F-FDG PET/CT in patients with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA). MATERIALS AND METHODS: PubMed and EMBASE were searched and the results were screened by two reviewers. Study quality was assessed using a modified version of the Newcastle-Ottawa scale. Heterogeneity between studies was assessed using the I2 statistic and the Q test. Further subgroup analyses were performed by disease type, study quality, and 18F-FDG PET/CT uptake criteria. Publication bias was assessed by funnel plot and Egger's test. RESULTS: 268 publications were identified, of which 17 met the selection criteria and were included in the meta-analysis. The overall pooled prevalence of extracranial LVV by 18F-FDG PET/CT was 54.5% [95% CI: 42.6%-66.1%]. In patients with GCA the prevalence was significantly higher than in patients with PMR (60.1% vs. 41.8%, P = 0.006). Likewise, studies with a lower risk of bias reported a higher prevalence of extracranial LVV (61.1% vs. 46.9%; P = 0.010). No publication bias was observed. CONCLUSIONS: The 18F-FDG PET/CT test may be useful in the detection of extracranial LVV, both in patients with PMR or GCA. Such involvement is more frequent in patients with GCA, and may vary depending on the quality of the studies.

Combined effect of compassionate and uncompassionate self-responding on Chinese college students' mental health during the initial wave of the COVID-19 pandemic: a response surface analysis.

Background: The initial wave of the COVID-19 pandemic significantly deteriorated mental health, especially among college students. Self-compassion has demonstrated benefits for psychological outcomes such as depressive symptoms, life satisfaction, posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG). Notably, existing literature suggests that the protective and vulnerable aspects within the Self-Compassion Scale, namely, compassionate and uncompassionate self-responding (CSR and USR), can coexist within individuals and influence their mental health through various coexisting patterns. However, this process has not been sufficiently explored.Objective: This study aimed to explore the combined effects of CSR and USR on college students' depressive symptoms, life satisfaction, PTSS, and PTG during the initial wave of the pandemic.Method: In this cross-sectional study, 4450 Chinese college students (51.9% females, Mage = 20.58 years, SD = 1.49) completed self-report measures amid the COVID-19 pandemic's initial wave in 2020. Response surface analyses were utilised to investigate the combined effects of CSR and USR.Results: Simultaneously increased CSR and USR were associated with a slight increase in depressive symptoms, PTSS, and life satisfaction, but a substantial increase in PTG. Conversely, increased CSR and decreased USR were associated with a considerable decrease in depressive symptoms and PTSS, a significant increase in life satisfaction, and a moderate increase in PTG.Conclusions: CSR and USR demonstrated protective and vulnerable impacts, respectively. It is imperative to analyse their combined effects as an interactive system and consider the specific characteristics of different psychological responses.

Increased CSR and decreased USR were associated with less depressive symptoms and PTSS as well as more life satisfaction.CSR mitigated the negative effects of USR on depressive symptoms, life satisfaction, and PTSS.Simultaneously increased CSR and USR were associated with a substantial increase in PTG.

Moral injury appraisals and posttraumatic stress symptoms in trauma-exposed police officers: a latent class analysis.

Background: Police officers encounter various potentially traumatic events (PTEs) and may be compelled to engage in actions that contradict their moral codes. Consequently, they are at risk to develop symptoms of Posttraumatic Stress Disorder (PTSD), but also moral stress or moral injury (MI). To date, MI in police officers has received limited attention.Objective: The present study sought to identify classes of MI appraisals and PTSD symptoms among police officers exposed to PTEs, while also investigating potential clinical differences between these classes.Method: For this study, 421 trauma-exposed police officers were assessed on demographics and several clinical measurements including MI appraisals (self-directed and other-directed), PTSD severity, and general psychopathology. Latent class and regression analyses were conducted to examine the presence of different classes among trauma-exposed police officers and class differentiation in terms of demographics, general psychopathology, PTSD severity, mistrust, guilt, self-punishment, and feelings of worthlessness.Results: The following five classes were identified: (1) a 'Low MI, high PTSD class' (28%), (2) a 'High MI, low PTSD class' (11%), (3) a 'High MI, high PTSD class' (17%), (4) a 'Low MI, low PTSD class' (16%), and (5) a 'High MI-other, high PTSD class' (27%). There were significant differences between the classes in terms of age, general psychopathology, PTSD severity, mistrust, guilt, and self-punishment but no differences for gender and feelings of worthlessness.Conclusion: In conclusion, we identified five classes, each exhibiting unique patterns of cognitive MI appraisals and PTSD symptoms. This underscores the criticality of measuring and identifying MI in this particular group, as it allows for tailored treatment interventions.

This study identified classes differing in terms of endorsement of MI appraisals and posttraumatic stress disorder (PTSD) symptoms among police officers exposed to potentially traumatic events.Five classes were identified, each exhibiting unique patterns of MI appraisals and PTSD symptoms.It is important to measure the presence of MI appraisals in addition to PTSD symptoms in traumatized police officers as it can inform treatment interventions.

Identification, spatial distribution, and associated factors of urban protected areas in China.

The increasing proximity between protected areas (PAs) and urban areas, which can lead to urban protected areas (UPAs), is now commonplace. Use of Euclidean distance to measure the distance between PAs and cities has not correctly portrayed the spatial relationship between PAs and cities. We devised an isochronous circle model to accurately measure the distance between 2706 national PAs in 5 categories and 2844 cities in China based on human accessibility to identify urban human activity-influenced protected areas (UHAIPAs) and to quantitatively analyze their distribution patterns and relationships with China's economy, population distribution patterns, and urban development indicators. Most of the PAs in China were established near cities. Of 2746 PAs in China, 18.35% (n = 504) became UPAs, and 58.27% (n = 1600), 16.72% (n = 459), and 3.31% (n = 91) of PAs were within 0-30, 30-60, and 60-90 min, respectively. Both UPAs and UHAIPAs in China in general exhibited obvious spatial aggregation characteristics (e.g., wetland parks and scenic areas), and there was a significant spatial dependence effect among characteristics. The degree of spatial distribution and aggregation of UPAs was correlated with 16 indicators across urban economic development, urban natural substrate, and urban policy support factors. Based on the results of our study, we call for various governments and scholars to focus on areas where wetland parks and PAs overlap with urban boundaries. It is important to emphasize the potential link between the development of agriculture, forestry, livestock and fisheries industries, and UPAs. Overall, we believe that examining the accessibility of PAs can more accurately measure the distance between PAs and cities, and more realistically reflect the possible impacts of urban human activities on PAs, which is helpful for strengthening the conservation and management of PAs.

Identificación, distribución espacial y factores asociados de las áreas urbanas protegidas en China Resumen La creciente proximidad entre las áreas protegidas (AP) y las áreas urbanas, que puede derivar en áreas urbanas protegidas (AUP), es muy común hoy en día. La distancia euclidiana no ha representado correctamente la distancia entre las AP y las ciudades. Por lo anterior, diseñamos un modelo de círculo isócrono para medir con certeza la distancia entre 2706 AP nacionales en cinco categorías y 2844 ciudades de China con base en la accesibilidad humana para identificar las áreas urbanas protegidas con influencia de actividad humana (AUPIAH). También lo usamos para analizar cuantitativamente los patrones de distribución y su relación con la economía china, los patrones de distribución poblacional y los indicadores de desarrollo urbano. La mayoría de las AP en China están establecidas cerca de las ciudades. De las 2746 AP, el 18.35% (n = 504) se convirtieron en AUP y el 58.27% (n = 1600), 16.72% (n = 459) y 3.31% (n = 91) se encontraban de 0­30 minutos, 30­60 y de 60­90 minutos de una ciudad, respectivamente. Tanto las AUP y las AUPIAH exhibieron características obvias de agregación espacial (p. ej.: parques de humedales y áreas escénicas) y hubo un efecto significativo de dependencia espacial entre dichas características. El nivel de distribución y agregación espacial de las AUP tuvo correlación con 16 indicadores de desarrollo económico urbano, sustrato natural urbano y factores de apoyo para las políticas urbanas. Con base en los resultados de nuestro estudio, hacemos un llamado para que diferentes gobiernos y académicos se enfoquen en las áreas en donde se traslapan las AP y los parques de humedales con los límites urbanos. Es importante resaltar la conexión potencial entre el desarrollo de la agricultura, silvicultura, ganadería y pesquería y las AUP. En general, consideramos que analizar la accesibilidad de las AP puede medir de forma más certera la distancia entre las AP y las ciudades, además de que refleja de forma más realista el posible impacto de las actividades humanas sobre las AP, lo cual es útil para fortalecer la conservación y gestión de las AP.