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Resumen Las redes sociales virtuales atraen a diferentes usuarios por las múltiples potencialidades e impactos característicos de esta sociedad tecnológica. El propósito de este estudio es identificar las redes sociales virtuales más usadas por los jóvenes, los motivos personales de uso y la relación de su utilización con la percepción de soledad y las habilidades de autoexpresión en escenarios sociales. En particular, se evalúan las diferencias de tales usos en función de la edad, el nivel de escolaridad y el género. En el estudio participaron 251 jóvenes adultos españoles con edades comprendidas entre los 18 y 40 años (X = 26.33, D.T. = 5-91) contactados a través de un muestreo no probabilístico por conveniencia. Se observó que el uso de las redes sociales virtuales se ve aumentado en los participantes con bajas habilidades sociales, altos niveles de soledad y más jóvenes. Destacan los motivos de aburrimiento y evasión o escape para usar los espacios digitales y se registra una tendencia en los jóvenes de la generación Z (18 a 28 años) a utilizar más las redes sociales virtuales, en comparación con los de la generación Y (29 a 40 años). Como conclusiones, se señala la conveniencia de controlar el uso problemático de las redes sociales virtuales y de entrenar las habilidades sociales para mejorar las relaciones interpersonales.

Abstract Virtual social networks are attracting different types of users thanks to the multiple potentialities and impacts characteristic of this technological society. The aim of this study is to identify the virtual social networks most used by young people, as well as the personal reasons for use and their negative effects in relation to the perception of loneliness and their self-expression skills in social settings. As specific objectives, it is proposed to determine the differences in such uses depending on age, level of education and gender. A non-probabilistic convenience sampling was carried out so that 251 young Spanish adults between the ages of 18 and 40 years old participated (X = 26.33, DT. = 5-91). It has been verified that the use of social networks is increased when presenting low social skills, having high levels of loneliness and the younger one is. The reasons for boredom and evasion or escape in the use of these digital spaces stand out, and a tendency is observed in the young people of Generation Z (young people between 18 and 28 years old) to use VSN more in comparison with the previous Generation Y (with a range of 29 to 40 years old). It emphasizes the convenience of controlling the problematic use of social networks, training social skills to improve interpersonal relationships and strengthening emotionally.

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ABSTRACT Blood purification as an adjunctive therapy has been studied for several decades. In this review, we will focus on the most recent studies, particularly on adsorption techniques. These include hemofilters with adsorptive membranes, both endotoxin-specific and non-specific. In addition, we will discuss sorbents that target endotoxins, as well as devices that non-selectively capture viruses and bacteria. For each technique, we will also explore the reasons why blood purification methods have thus far failed to improve survival. Conventionally, reasons for the lack of success in blood purification techniques have been attributed to the need for better patient stratification through bedside measurements of interleukins and endotoxins. The choice of assay is also crucial, with endotoxin activity assays being preferable to other forms of limulus amoebocyte lysate assays. Another critical factor is timing, as administering blood purification at the wrong moment can potentially harm the patient. Mechanistic studies are still lacking for most devices, leaving us to treat patients blindly, except in endotoxin cases. In the context of viruses, especially COVID-19, we require a deeper understanding of the complexities involved in viral replication, as this could significantly impact the efficacy of blood purification techniques. The failures highlighted for each device should be viewed as potential areas for improvement. Despite the challenges, we remain hopeful that these techniques will eventually succeed and prove beneficial in the future.

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Blood purification as an adjunctive therapy has been studied for several decades. In this review, we will focus on the most recent studies, particularly on adsorption techniques. These include hemofilters with adsorptive membranes, both endotoxin-specific and non-specific. In addition, we will discuss sorbents that target endotoxins, as well as devices that non-selectively capture viruses and bacteria. For each technique, we will also explore the reasons why blood purification methods have thus far failed to improve survival. Conventionally, reasons for the lack of success in blood purification techniques have been attributed to the need for better patient stratification through bedside measurements of interleukins and endotoxins. The choice of assay is also crucial, with endotoxin activity assays being preferable to other forms of limulus amoebocyte lysate assays. Another critical factor is timing, as administering blood purification at the wrong moment can potentially harm the patient. Mechanistic studies are still lacking for most devices, leaving us to treat patients blindly, except in endotoxin cases. In the context of viruses, especially COVID-19, we require a deeper understanding of the complexities involved in viral replication, as this could significantly impact the efficacy of blood purification techniques. The failures highlighted for each device should be viewed as potential areas for improvement. Despite the challenges, we remain hopeful that these techniques will eventually succeed and prove beneficial in the future.

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Migration is a complex process associated with a range of social, economic, and political reasons. In the U.S., almost one-quarter of the total population of parents are immigrant parents of children ages 0-10. Immigrant parents transmit values from their culture of origin as well as their language to their children. Additionally, they may undergo a process of cultural and psychological change known as acculturation. Research has shown that acculturation can be linked to parenting styles and adolescents' psychological well-being and behavioral problems. However, little is known about the associations among immigrant parents' acculturation, their home language and literacy practices, and their bilingual children's language skills. This study explores the relationships among reasons for migration, parental acculturation, home language and literacy practices, and child expressive vocabulary in English and their heritage language (HL). A group of 190 Spanish-English (N = 66) and Chinese-English (N = 124) dual language learners (DLLs) (mean age = 48.98 months) and their Chinese and Mexican parents (mean age of migration = 18.57 and 21.38 years old respectively participated. Frequency counts revealed that Mexican American families migrated to the U.S. mostly for multiple reasons, including joining family members, getting married, and looking for better education or job opportunities, whereas most Chinese American families migrated for family reasons only. Path analysis models showed that, for both cultural groups, language input in Spanish and Chinese mediated the relationship between parents' cultural orientations and DLLs' HL expressive vocabulary. These findings emphasize that despite the heterogeneity of immigrant families and the variability in DLLs' vocabulary skills in preschool, there exist some similarities across immigrant parents and bilingual children. A deeper understanding of acculturation practices and home language use can help educators better support children from diverse backgrounds and promote cultural awareness and sensitivity in the classroom.

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Resumen La soledad individualista humana impele a vivir en pareja y a alcanzar complementariedad hombre/mujer, afecto y reci procidad. El periodismo científico de este artículo parafrasea el contenido de su bibliografía al revisar la elección de pareja, su satisfacción y complicaciones e instrucción preventiva de circunstancias que ocasionan ruptura. La falla -desde la elección-, desconoce los mecanismos entre razón e instinto sexual. El problema del amor no es ser amado sino desarrollar tal capacidad, pues lo extingue la inadaptación y monotonía. Se describe el acto elector/elegido y sus razones simultáneas: conscientes (homogeneidad/heterogeneidad del encuentro; emulación del modelo animal; tipo, dinámica vincular y redes sociales; aspectos sociodemográficos; ubicación geográfica y accesibilidad; compartición sexual y expectativas inmediatas/ futuras), e inconscientes (problemática electora, interacción diádica y antecedentes parentales; mecanismos de defensa, intercambio de disociaciones; idealización; reciprocidad negativa, lucha de poder, identificación proyectiva, búsqueda de aprecio por el otro; narcisismo, falso sí mismo, mecanis mos de dilación/evasión de responsabilidad, inseguridad, intrusión y colusión). Una pareja saludable, entiende/atiende la creación y mantenimiento del "nosotros", elimina la lucha de poder y produce conciliación permanente. El acuerdo y comprensión tolerante son indispensables para una relación emocional satisfactoria, estable y duradera.

Abstract Human individualistic loneliness impels us to live as a couple and achieve complementarity between man and woman, af fection, and reciprocity. The science journalism of this article reviews the choice of partner, their satisfaction and complications, and preventive instruction of circumstances that cause rupture. The failure from the election ignores the mechanisms between reason and sexual instinct. The problem of love is not to be loved but to develop such a capacity, for it is extinguished by maladjustment and monotony. The voting/elected act and its simultaneous reasons are described: Conscious (homogeneity/heterogeneity of the encounter; emulation of the animal model; type, dynamic link and social networks; Sociodemographic aspects; sexual sharing and immediate/future expectations). Unconscious (electoral problems, dyadic interaction, and parental background; defense mechanisms, exchange of dissociations; idealization; negative reciprocity, power struggle, projective identification, search for appreciation for the other; narcissism, false self, mecha nisms of procrastination/evasion of responsibility, insecurity, intrusion, and collusion). A healthy couple, understands/at tends to the creation and maintenance of the "we", eliminates the power struggle and produces permanent conciliation. Tolerant agreement and understanding are indispensable for a satisfying, stable, and lasting emotional relationship.

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Introduction: In Peru, a high proportion of fully immunized people against COVID-19 has been achieved, which has mitigated the severity of the disease. Thus, under the recommendation of experts, the Peruvian government issued Supreme Decree 118-2022-PCM, which indicated that the use of masks is optional in open and ventilated enclosed spaces as of October 1, 2022. Objective: The aim of the present study was to find out the reasons why people continued to wear masks even though it was not mandatory in outdoor environments. Methods: A total of 335 people participated, with an average age of 26.11 years (73.1% women). A data collection form was prepared where sociodemographic and health information was requested; in addition, the question "Why do you continue to wear mask despite it being optional in open and closed ventilated spaces?" was included. The data obtained from the last open question of the instrument was analyzed by means of a discursive textual analysis (DTA) and an exploratory analysis through IRAMUTEQ. Results: Results indicate that people continue to wear masks, despite the lifting of the restrictions, to avoid contagion of COVID-19 and other respiratory diseases. In addition, the prevention of possible infection and transmission of the virus also focused on the family and vulnerable people. Discussion: It is concluded that the practice of wearing masks may be influenced by individual perceptions of risk and interpretations of responsibility and solidarity towards others.

Introducción: En el Perú, se logró una alta proporción de personas completamente inmunizados contra COVID-19 que ha mitigado la severidad de la enfermedad. Es así que, bajo la recomendación de expertos el gobierno peruano emitió el Decreto Supremo 118-2022-PCM, donde se indicó que el uso de la mascarilla es opcional en espacios abiertos y espacios cerrados ventilados a partir del 1 de octubre del 2022. Objetivo: El presente estudio fue conocer las razones por las cuales las personas continuaron usando mascarilla a pesar de que no era obligatorio en ambientes exteriores. Metodología: Participaron un total de 335 personas con un promedio de edad de 26.11 años (73.1% mujeres). Se elaboró una ficha de recolección de datos donde se solicitó información sociodemográfica y de salud; además, se incluyó la pregunta "¿por qué sigue utilizando la mascarilla a pesar de que es opcional en espacios abiertos y cerrados ventilados?" Los datos obtenidos de la última pregunta abierta del instrumento se analizaron mediante un análisis textual discursivo (ATD) y un análisis exploratorio a través de IRAMUTEQ. Resultados: Los resultados indicaron que, las personas seguían utilizando mascarillas, a pesar de estar levantadas las restricciones, para evitar contagios de la COVID-19 y de otras enfermedades respiratorias. Además, esta prevención de una posible infección y transmisión del virus es enfocada también a la propia familia y personas vulnerables. Discusión: Se concluye que, la práctica de usar mascarillas puede estar influenciada por las percepciones individuales del riesgo y las interpretaciones de responsabilidad y solidaridad frente a los demás.

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A depressão pode ser desenvolvida, agravada e/ou prevenida em função de alguns fatores como suporte familiar e motivos para viver, além da possibilidade de ser concebida como traço e estado depressivo. O objetivo principal desta pesquisa foi testar um modelo teórico preditivo (path analysis) do suporte familiar sobre traço/estado depressivo e sobre os motivos para viver, em uma amostra de 123 participantes, composta por dois grupos: pacientes do CAPS-AD e da ESF e, posteriormente, verificar as diferenças desses aspectos na amostra estudada. Foram aplicados uma ficha sociodemográfica, a Escala Baptista de Depressão - Adulto (EBADEP-A), Inventário de Percepção de Suporte Familiar (IPSF), Escala de Traço e Estado Depressivo (ETED) e Escala Brasileira de Motivos para Viver (BEMVIVER). O resultado da path analysis indicou que os motivos para viver são explicados pelo estado e traço depressivo e pelo suporte familiar. Os pacientes do CAPS-AD, tinham maiores níveis de sintomatologia depressiva e estado depressivo do que o grupo do ESF. Pacientes do ESF apresentaram médias maiores de suporte familiar e motivos para viver. Conclui-se que investir em estratégias que potencializem os motivos para viver e o suporte familiar podem reduzir os riscos de sintomatologia depressiva.

Depression can be developed, worsened and/or prevented depending on some factors such as: family support and reasons for living, in addition to the possibility of being conceived with a depressive trait and state. The main objective of this research was to test a predictive theoretical model (path analysis) of family support on the depressive trait/state and reasons for living, in a sample of 123 participants, composed of two groups: patients from the Psychosocial Care Center- Alcohol and Drugs (CAPS-AD) and the Family Health Strategy (ESF) and verify the differences of these aspects in the studied sample. A sociodemographic form, the Baptista Depression Scale -Adult (EBADEP-A), the Perceived Family Support Inventory (IPSF), Trait and Depressive State Scale (DTS) and the Brazilian Scale of Reasons to Live (BEMVIVER) were applied. The result of the path analysis indicated that the reasons for living are explained by the depressive state and trait and family support. CAPS-AD patients had higher levels of depressive symptoms and depressive state than the ESF group. ESF patients presented higher means of family support and reasons to live. It is concluded that investing in strategies that enhance the reasons to live and family support can reduce the risks of depressive symptoms.

La Depresión puede desarrollarse, agravarse y prevenirse dependiendo de factores como: apoyo familiar y razones para vivir, además puede de ser concebido con un rasgo y estado depresivo. El objetivo de esta investigación fue probar un modelo teórico predictivo del apoyo familiar sobre el rasgo/estado depresivo y las razones de vivir y verificar las diferencias de esos aspectos en la muestra estudiada, de 123 participantes compuesta por dos grupos: pacientes del Centro de Atención Psicosocial - Alcohol y Drogas (CAPS-AD) y la Estrategia de Salud de la Familia (ESF). Se aplicó un formulario sociodemográfico, Escala de Depresión de Baptista - Adulto (EBADEP-A), Inventario de Apoyo Familiar Percibido (IPSF), Escala de Rasgo y Estado Depresivo (DTS), Escala Brasileña de Razones para Vivir (BEMVIVER). El resultado del análisis indicó que las razones para vivir a ser explicadas por el estado y rasgo depresivo y por el apoyo familiar. Los pacientes CAPS-AD tenían niveles más altos de síntomas y estado depresivo que el grupo ESF. Los pacientes ESF presentaron mayores medios de apoyo familiar y razones para vivir. Se concluye que invertir en estrategias que potencien estas razones y apoyo familiar puede en la reducción de los riesgos de síntomas depresivos.

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Background: Patients with hematological malignancies have significant and diverse palliative care needs but are not usually referred to specialist palliative care services in a timely manner, if at all. Objective: To identify the characteristics of patients with hematological malignancies referred to the palliative care service in a tertiary hospital in Mexico City. Patients: Retrospective study including consecutive patients with hematological malignancies referred to palliative care services at Mexico's National Cancer Institute. Results: Between 2011 and 2019, 5,017 patients with hematological malignancies were evaluated for first time at Mexico's National Cancer Institute. Of these, 9.1% (n = 457) were referred to palliative care. Most were male (53.4%), with a median age of 58 years. The most frequent diagnosis was non-Hodgkin lymphoma (54.9%). The primary indication for referral to palliative care was for cases wherein chemotherapy was no longer an option (disease refractory to treatment, 42.8%). The median time of referral to the palliative care service occurred 11.2 months after the first evaluation at the National Cancer Institute and death occurred on median 1.1 months after the first palliative care evaluation. Conclusion: Patients with hematological neoplasms are infrequently referred to Palliative Care at the Institute (9.1%). We found no clear referral criteria for Palliative Care referral and note that hematologists' optimism regarding a cure can delay referrals. Clearly, we have a long way to go in improving the number of patients referred, and we still saw frequent referrals near the end of life, but the high rate of outpatient referrals is encouraging.

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A literatura suporta a importância da relação entre os jovens e as figuras parentais para um desenvolvimen-to adaptativo, nomeadamente capacidades pró-sociais e menor envolvimento em comportamentos de risco. A qualidade das relações com os pares pode também desempenhar um papel protetor no que respeita ao consumo de álcool. O objetivo deste estudo foca-se na análise do efeito dos estilos parentais e da vinculação aos pares nos motivos de consumo de álcool. Participaram 1.044 estudantes universitários de ambos os sexos com idades compreendidas entre os 18 e 25 anos (m= 19.78; dp= 1.68). De forma a recolher os dados recorreu-se a um questionário sociodemográfico, ao Parenting Styles & Dimensions Questionnaire: Short Version (psdq), ao Inventory of Peer and Parental Attachment (ippa-peer), ao Drinking Motives Questionnaire ­ Revised (dmq-r) e ao Alcohol Use Disorders Identification Test (audit). Os resultados apontam para um efeito preditor positivo dos estilos parentais autoritários e permissivos e da alienação aos pares face aos motivos de consumo de álcool e um efeito preditor negativo do estilo parental democrático e de uma vinculação aos pares pautada por comunicação e confiança. As mulheres apresentam maior qualidade relacional com os pares comparativa-mente com os jovens do sexo masculino. Os rapazes apre-sentam uma maior diversidade de motivos de consumo de álcool. Os resultados são discutidos considerando a relevância dos estilos parentais e qualidade das relações com os pares no desenvolvimento pessoal e as motivações dos jovens adultos, em contexto universitário, para a assunção de comportamentos de risco.

La literatura apoya la importancia de la relación entre los jóvenes y las figuras parentales para un desarrollo adaptativo, es decir, habilidades prosociales y menor involucramiento en conductas de riesgo. La calidad de las relaciones con los compañeros también puede desempeñar un papel protector con respecto al consumo de alcohol. El objetivo de este estudio es analizar el efecto de los estilos de crianza y el apego entre pares, sobre las razones para el consumo de alcohol. Participaron 1.044 estudiantes universitarios de ambos sexos con edades comprendidas entre 18 y 25 años (m= 19.78; ds= 1.68). Para la recolección de datos se utilizó un cuestionario sociodemográfico, el Parenting Styles & Dimensions Questionnaire: Short Version (psdq), el Inventory of Peer and Parental Attachment (ippa-peer), el Drinking Motives Questionnaire ­ Revised (dmq-r) y el Alcohol Use Disorders Identification Test (audit). Los resultados indican un efecto predictivo positivo de los estilos parentales autoritarios, permisivos y de alienación de los pares ante los motivos del consumo de alcohol, y un efecto predictivo negativo del estilo paren-tal democrático y de apego a los pares basado en la comunicación y la confianza. Las mujeres tienen más calidad relacional con sus compañeros que los hombres jóvenes. Los hombres tienen una mayor diversidad de motivos para el consumo de alcohol. Los resultados se discuten considerando la relevancia de los estilos de crianza y la calidad de las relaciones con los pares en el desarrollo personal, y las motivaciones de los jóvenes en un contexto universitario para asumir con-ductas de riesgo.

The importance of the relationship between young people and their parental figures for adaptative de-velopment has been supported by literature, namely prosocial capacities and less involvement in risk beha-viors. The quality of peer relationships may also play a protective role regarding alcohol consumption. The aim of this study was to analyze the effect of parenting styles and peer attachment on the reasons for alcohol consumption. Participants were 1.044 university stu-dents of both sexes, between 18 and 25 years of age (m = 19.78; sd = 1.68). For data collection, a socio-demographic questionnaire, the Parenting Styles & Dimensions Questionnaire: Short Version (psdq), the Inventory of Peer and Parental Attachment (ippa-peer), the Drinking Motives Questionnaire ­ Revised (dmq-r), and the Alcohol Use Disorders Identification Test (audit) were used. The results reveal a positive predictive effect of negative parenting styles (authoritarian and permissive) and alienation with peers on the reasons for alcohol consumption and a negative predictive impact on democratic parenting style and peer attachment ba-sed on communication and trust. Women have a better relational quality with their peers compared to males. Men have a greater diversity of reasons for consuming alcohol. Results are discussed considering the relevance of parenting styles, the quality of peer relationships in personal development, and the motivations of young adults, in a university context, for risk-taking behavior.

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This systematic review aims at offering a comparative analysis of the leading reasons for encounters (RFEs) of patients presenting to primary care facilities. A systemic search was carried out using MEDLINE/PUBMED, CINAHL, Google Scholar, LILACS, and PROQUEST to identify the studies relevant to RFEs in primary health care in June 2020. Fifteen studies met the eligibility criteria which included originality, published between 2015 and 2020, listed two to five RFEs at a primary health care facility, and included patients with acute and/or chronic conditions. The mean total RFEs recorded were 6753.07 (Standard deviation = 17446.38, 95% Confidence Interval 6,753.0667 ± 8,829.088 [± 130.74%]). The most common RFE chapters recorded were Respiratory and Digestive chapters. The patients recorded fever as the most frequently reported RFE while cough was ranked as most common. The physicians reported hypertension as the most frequently reported and most common RFE. The most frequently physician and patient reported RFEs to the primary health care are hypertension and fever. Respiratory and Digestive were the most frequently reported chapters. The findings are useful for the proper implementation of services, facilities, and equipment utilized in Trinidad and Tobago primary health care.

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BACKGROUND: It is unclear why patients with low back pain seek care in emergency departments. OBJECTIVES: We aim to describe the demographic, physical, and psychological characteristics, and reasons for seeking care at emergency departments due to an episode of low back pain. METHODS: This is a cross-sectional study conducted in an emergency department of a public hospital in São Paulo, Brazil, from September 2018 to May 2019. All patients who presented with a new episode of low back pain as the main complaint for seeking care at the emergency department on regular weekdays were invited to participate. We collected data on sociodemographic characteristics, general health characteristics, psychosocial risk factors, and reasons for visiting the emergency department. RESULTS: A total of 200 patients participated. We observed that most patients (68%) were women, with a mean age of 55 years, and who had previous episodes of low back pain (86%). Most patients went to the emergency department because they were worried about their pain (78%) and because they could not control their pain (73%). Patients also choose the emergency department because it is always available, it is free, and provided them good care. CONCLUSIONS: Most patients with low back pain seek care at emergency departments because they were worried about their pain and because the department is always open and does not require appointment. Understanding these reasons is an important step for the implementation of future public policies to make health care more efficient, to reduce unnecessary expenses and to avoid low-value care.

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Objetiva-se investigar o sofrimento de meninas adolescentes na perspectiva da psicologia psicanalítica concreta, referencial que se define pelo uso do método psicanalítico e de teorizações de tipo relacional. Justifica-se na medida em que há indícios de que a adolescência feminina corresponde a uma fase potencialmente vulnerável ao sexismo e à violência, que geram efeitos traumáticos. Organiza-se metodologicamente por meio do estudo psicanalítico da série televisiva 13 reasons why, que tematiza manifestamente a questão. Exposições ao material, em estado de atenção flutuante e associação livre de ideias, permitiram a interpretação de dois campos de sentido afetivo-emocional: "Vadias ou certinhas" e "Sem aprovação não sou ninguém". O quadro geral revela imaginários conservadores e opressores que, ao incitarem a submissão feminina, atacam a tendência humana básica de posicionar-se de modo espontâneo diante da própria existência, determinando efeitos nocivos sobre a subjetividade da menina adolescente.

This study's objective was to investigate suffering among adolescent girls from the concrete psychoanalytic psychology perspective, a theoretical framework that adopts the psychoanalytic method and theorizations from a relational perspective. It is a relevant endeavor considering evidence that adolescence among girls is a phase potentially vulnerable to sexism and violence, which may cause traumatic effects. It is methodologically organized in a psychoanalytic study of the television series 13 reasons why, which manifestly addresses this research topic. The material was addressed in a freefloating-attention state, from which two affective-emotional meaning fields emerged: "sluts or prudes" and "I am a nobody without approval". In general, the plot reveals conservative and oppressive imaginaries, inciting female submission, attacking the basic human tendency to spontaneously express toward life, harmfully affecting the subjectivity of adolescent girls

El objetivo es investigar el sufrimiento de las adolescentes desde la perspectiva de la psicología psicoanalítica concreta, referencia que se define por el uso del método psicoanalítico y teorizaciones de tipo relacionales. Hay indicios de que la adolescencia femenina corresponde a una fase potencialmente vulnerable al sexismo y violencia, que pueden generar efectos traumáticos. Se organiza metodológicamente mediante el estudio psicoanalítico de la serie televisiva Por trece razones, que aborda claramente el tema. Las exposiciones al material, en estado de atención fluctuante y libre asociación de ideas, permitieron la interpretación de dos campos del sentido afectivo-emocional: "Perras o comportadas" y "Sin aprobación no soy nadie". El panorama general revela imaginarios conservadores y opresivos que, al incitar a la sumisión femenina, atacan la tendencia humana básica a posicionarse espontáneamente antes de su propia existencia, determinando los efectos nocivos en la subjetividad de la adolescente.

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OBJECTIVES: To assess the reasons to use, reasons they liked, satisfaction with, and possibilities of recommendation to other women of the levonorgestrel 52-mg intrauterine system (LNG-IUS) by users. MATERIALS AND METHODS: A cross-sectional study was conducted at the University of Campinas, Campinas, Brazil from January to July 2021. We enrolled users who came to the clinic, and we applied a pre-tested structured questionnaire with open-ended questions. We performed descriptive analyses of the variables, assessing the level of satisfaction with, and the reasons regarding the possibility of continuing to use, the IUS. RESULTS: Of the 517 enrolled women, 251 (48%) were aged 35 years or older (mean age 33.9 ± 9.0 years), 276 (53%) were white, 14 (3%) were adolescents, 155 (30%) were nulligravidas, and 307 (59.4%) reported experiencing amenorrhea in the last 90 days. Common reasons why women liked to use the LNG-IUS included both the reduction of menstrual bleeding (419 women; 81%) and dysmenorrhea (290 women; 56.1%). Nine out of 10 users (517 women; 91%) were satisfied with the method, and the majority would recommend it to other women. CONCLUSION: We found a high satisfaction rate among LNG-IUS users mainly due to the reduction of both menstrual bleeding and dysmenorrhea.

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OBJECTIVE: To assess the reasons provided by women for choosing the use of the 52 mg levonorgestrel intrauterine system (LNG-IUS) as a contraceptive method. METHODS: We conducted a cross sectional study from January 2021 to August 2021 at the University of Campinas, Campinas, SP, Brazil. Women who had never used the 52 mg LNG-IUS and were requesting it for contraception answered a questionnaire asking for their sociodemographic characteristics, the last contraceptive method in use, how they received information about the device, and their main reasons for choosing the method. RESULTS: We enrolled 516 women, 365 (70.7%) of whom were under the age of 35 and 352 (68.2%) of whom were parous. The last contraceptive method in use was a short-acting reversible method among 387 (80.8%) women, 454 (88%) reported that they wanted to use the IUS only for contraception, and the main source of information was their health care providers. The main reported reasons for choosing the method were because it is safe, has high contraceptive efficacy, and reduces menstrual bleeding. CONCLUSION: Health care providers should continue their efforts to provide guidance about the LNG-IUS, including the non-contraceptive benefits, which may contribute to a reduction in the number of unplanned pregnancies.

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Resumen La realización de actividad física desde la infancia y a lo largo de la vida adulta, permite que se mantenga un perfil de riesgo bajo respecto a numerosos padecimientos. El objetivo de este estudio fue identificar las dificultades que generan la inactividad física en niños, para lo cual se contó con una muestra de 2,621 niños y niñas de 13 ciudades del país, 3,754 padres de estos niños, y 134 entrenadores de diferentes escuelas presentes en la República Mexicana. Para obtener la información de esta población, se utilizó un cuestionario de 17 preguntas abiertas y cerradas, el cual fue una adaptación del instrumento: State of Play: Youth Sports Survey (The Aspen Institute, 2018), mientras que a los padres y madres de familia se les preguntó cuáles consideraban que podrían ser las principales dificultades que enfrentaban para fomentar la actividad física y/o deportiva en sus hijos e hijas, finalmente a sus entrenadores se les preguntaron las razones principales por la que los niños no practican deportes o actividad física. Los resultados mostraron que, en la muestra general de niños, el aspecto principal que genera su inactividad física se relaciona con el cumplimiento de responsabilidades; los padres mencionaron como causa principal la falta de tiempo, y los entrenadores el mal uso de la tecnología.

Abstract Physical activity from childhood and throughout adult life allows a low-risk profile to be maintained compared to many conditions. This study aimed to identify the difficulties that lead to physical inactivity in children. For the study, there was a sample of 2,621 children from 13 cities in the country, 3,754 parents of these children, and 134 coaches from different schools in the Mexican Republic. A questionnaire of 17 open and closed questions was used to obtain children's information; the questionnaire was an adaptation of the instrument State of Play: Youth Sports Survey (The Aspen Institute, s.f.). Parents were asked what they felt might be the main challenges they had in fostering physical and/or sporting activity in their children. Finally, coaches were asked the main reasons why children do not play sports or physical activity. In the general sample of children, the results showed that the main aspect of their physical inactivity relates to responsibilities; parents mentioned, as the main cause, the lack of time, and coaches reported misused the technology.

Resumo A realização de atividade física desde a infância e ao longo da vida adulta, permite que seja mantido um perfil de baixo risco em relação a muitas doenças. O objetivo deste estudo foi identificar as dificuldades que a inatividade física gera nas crianças, para a qual houve uma amostra de 2.621 crianças de 13 cidades do país, 3.754 eram os pais dessas crianças, e 134 eram treinadores de diferentes escolas presentes na República Mexicana. Para a obtenção das informações das crianças, foi utilizado um questionário com 17 questões abertas e fechadas, que foi uma adaptação do instrumento: Estado do jogo: Youth Sports Survey (The Aspen Institute, sd), enquanto os pais eram questionados sobre o que eles consideravam ser as principais dificuldades que enfrentavam para promover a atividade física e/ou esportiva entre seus filhos, e finalmente, os treinadores foram questionados sobre os principais motivos pelos quais as crianças não participam de esportes ou atividade física. Os resultados mostraram que, na amostra geral de crianças, o principal aspecto que gera sua inatividade física está relacionado ao cumprimento de responsabilidades; os pais citaram a falta de tempo como a principal causa e o uso indevido da tecnologia pelos treinadores.

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OBJECTIVE: To determine the reasons for hospitalisation in patients with systemic lupus erythematosus (SLE) admitted to the Hospital de Clínicas "José de San Martín" Buenos Aires, Argentina. METHODS: We retrospectively analysed the clinical histories of SLE patients (SLICC 2012) during or prior to hospitalisation, from 1-2014 to 12-2017. Demographic data, reasons for hospitalisation, treatments, SLEDAI-2 K and comorbid conditions. RESULTS: 121 hospitalisations corresponding to 72 patients, 25 patients (34.7%) were hospitalised more than once. Females (83.3%), the median length of disease until admission was 5 years. There was more than one reason for hospitalisation in 32, a total of 164 reasons. The main reason was relapse of disease (52.4%). The most frequent manifestations were renal involvement, serositis and pulmonary involvement. Infections were the second reason for hospitalisation (26.8%); urinary tract, pneumonia and soft tissue. Cardiovascular involvement 4.9%. Hospitalisation in a closed unit 14.05%, mortality 2.48%. CONCLUSION: Relapse of disease and infections were the main reasons for hospitalisation; admission secondary to infection was higher than that reported in other series.

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We investigated the relationship between Brazilian women's reported reasons for pretending orgasm, their performance of mate retention behaviors, and their relationship satisfaction. Additionally, we secured evidence of the validity and reliability of a Brazilian-Portuguese adaptation of the Reasons to Pretend Orgasm Inventory (RPOI). Participants were 295 Brazilian women in a heterosexual relationship (Mage = 24.9 years, SDage = 5.4 years). Participants completed a Brazilian-Portuguese adaptation of the Mate Retention Inventory-Short Form, and the translated RPOI (the Escala de Razões para Fingir Orgasmo; ERFO). The resulting 47-item ERFO represents well the original 63-item RPOI. The frequency with which Brazilian women pretend orgasm was negatively associated with their relationship satisfaction. Our sample size may not be sufficient to detect small effects. In addition, due to the exploratory nature of the study, the results should be interpreted with caution and future research may attempt to replicate these findings with larger samples and in other countries.

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INTRODUCCIÓN: La anticoncepción hormonal, a través de implantes subdérmicos, es uno de los métodos anticonceptivos reversibles de larga duración más eficaces en la actualidad que está disponible en nuestro país en forma gratuita en el sistema público. OBJETIVO: Reconocer los efectos adversos y los motivos de retiro del Implante Jadelle® en usuarias del Hospital de Clínicas, así como evaluar la información recibida por las usuarias al momento de la colocación. MATERIAL Y MÉTODOS: Un total de 160 pacientes participaron en el estudio a través de una encuesta previo consentimiento informado. Se utilizó la estadística descriptiva en números absolutos y porcentuales. Resultados: Previo al uso, recibieron información sobre los probables efectos adversos del método el 83% de ellas, y acerca de la efectividad del método el 89 %. En cuanto a efectos adversos los presentaron el 80,6% de las usuarias, siendo la irregularidad de la menstruación la causa más frecuente constituyendo un 61%. CONCLUSIONES: Es alta la frecuencia de pacientes que presentan efectos adversos y que solicitan retiro del implante antes del tiempo a causa de ello, 35% de las usuarias, siendo el principal motivo la irregularidad menstrual en un 43% de los casos. Es recomendable realizar un correcto asesoramiento previo a la colocación e incentivar a las pacientes a concurrir a los controles médicos, luego de la colocación, para brindar asesoramiento y tratamiento si se presentara algún efecto adverso, con el fin de obtener una mejor continuidad de uso del método.

INTRODUCTION: Hormonal contraception, through subdermal implants, is one of the most effective long active reversal contraceptive methods currently available in our country for free in the public system. OBJETIVE: Recognize the adverse effects and the reasons for its withdrawal in users of the Hospital de Clínicas as well as to evaluate the information received by the users at the time of placement. METHODOLOGY: A total of 160 patients participated in the work with prior informed consent through a survey. Descriptive statistics were used in absolute and percentage numbers. They received information on the probable adverse effects of the 83% pre-use method, about the effectiveness of the 89% method. RESULTS: Regarding adverse effects, they were present in 80.6% of the users; the being irregularity of menstruation is the most frequent, constituting 61%. Concluding that the frequency of patients presenting with adverse effects and requesting removal of the implant before the time is high because of it, 35% of the users who requested removal menstrual irregularities were the main reason for 43% of patients. CONCLUSIONS: It is advisable to make a correct advice prior to placement and encourage patients to attend medical controls, after placement, to provide advice and treatment if any adverse effect occurs, in order to give better use in terms of method time.

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Background Rheumatoid arthritis is a chronic, autoimmune disease in which treatment has evolved with a variety of therapeutic classes. Biological disease-modifying antirheumatic drugs have improved therapy; however, the continued long-term use of these drugs with sustained safety and efficacy remains a challenge. ObjectiveThe objective of this study was to analyze time of use and reasons for discontinuation of biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis.SettingIt is as part of REAL (Rheumatoid Arthritis in Real Life), a multicenter project that evaluated Brazilian patients with rheumatoid arthritis in a real-life setting. Eleven referral centers for the treatment in the public network participated in the study.MethodsWe conducted a cross-sectional analysis of data collected in the REAL study from August to October 2015 study. The patients were submitted to clinical evaluation and analysis of medical records.Results1125 patients were included (89.5% women; median age: 56.6 years; and disease time: 12.8 years). A total of 406 (36.09%) participants were on a biological disease-modifying antirheumatic drugs. Infliximab was the drug with the longest time of use (12 years). Most (64.4%) drug suspension episodes were due to inefficacy. Adalimumab and certolizumab had a greater number of suspensions due to primary inefficacy, while discontinuations for abatacept were due more to secondary inefficacy. Infliximab had fewer suspensions due to primary inefficacy and golimumab had fewer episodes of secondary inefficacy. Regarding side effects, infliximab was suspended a greater number of times because of clinical and laboratory side effects. Abatacept and adalimumab had fewer suspensions due to clinical side effects, and certolizumab, rituximab and tocilizumab had fewer laboratory adverse effects. Conclusion Among the biological disease-modifying antirheumatic drugs being used for long periods, infliximab had greater time of use. Most drug suspensions (64%) were due to primary or secondary inefficacy. Number of discontinuations due to clinical and laboratory adverse effects for each drug was analyzed, and these data should be confirmed by other real-life studies. Knowledge of what is happening in real life is essential to health professionals, who need to be aware of the most common adverse effects and to health managers, who aim for greater cost-effectiveness in the choice of medications.

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