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BACKGROUND: To assess the influence of diagnosis and referral provided by specialists in oral diagnosis on disease-free survival and overall survival of patients with oral cancer. METHODS: A cohort of 282 patients with oral cancer treated at a regional cancer hospital from 1998 to 2016 was analyzed retrospectively. The referral register of the patients was analyzed and assigned to two groups: (1) those referred by oral diagnosis specialists (n = 129), or (2) those referred by nonspecialized professionals (n = 153). The cancer treatment evolution was assessed from the patients' records, and the outcome was registered concerning cancer recurrence and death. Sociodemographic and clinicopathological variables were explored as predictors of disease-free survival and overall survival. RESULTS: Group 1 exhibited lower T stages and a reduced incidence of regional and distant metastases. Surgery was performed in 75.2% of cases in Group 1, while in Group 2, the rate was 60.8%. Advanced T stages and regional metastases reduced the feasibility of surgery. Higher TNM stages and tumor recurrence were associated with decreased disease-free survival, while surgical intervention was a protective factor. Higher TNM stage had a negative impact on the overall survival. CONCLUSION: Specialized oral diagnosis did not directly impact disease-free survival and overall survival and did not influence the indication of surgery in oral cancer; however, it was associated with the diagnosis of early tumors and better prognosis.
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Neoplasias Bucais , Encaminhamento e Consulta , Humanos , Neoplasias Bucais/patologia , Neoplasias Bucais/mortalidade , Neoplasias Bucais/terapia , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Taxa de Sobrevida , Estadiamento de Neoplasias , Recidiva Local de Neoplasia , Intervalo Livre de Doença , Adulto , Estudos de Coortes , Idoso de 80 Anos ou mais , Diagnóstico BucalRESUMO
Worldwide, with the decline of natural habitats, species with reduced niche breadth (specialists) are at greater risk of extinction as they cannot colonise or persist in disturbed habitat types. However, the role of thermal tolerance as a critical trait in understanding changes in species diversity in disturbed habitats, e.g., due to forest replacement by tree plantations, is still understudied. To examine the role of thermal tolerance on the responses of specialist and generalist species to habitat disturbances, we measured and compared local temperature throughout the year and thermotolerance traits [upper (CTmax) and lower (CTmin) thermal limits] of the most abundant species of spiders from different guilds inhabiting pine tree plantations and native Atlantic Forests in South America. Following the thermal adaptation hypothesis, we predicted that generalist species would show a wider thermal tolerance range (i.e., lower CTmin and higher CTmax) than forest specialist species. As expected, generalist species showed significantly higher CTmax and lower CTmin values than specialist species with wider thermal tolerance ranges than forest specialist species. These differences are more marked in orb weavers than in aerial hunter spiders. Our study supports the specialisation disturbance and thermal hypotheses. It highlights that habitat-specialist species are more vulnerable to environmental changes associated with vegetation structure and microclimatic conditions. Moreover, thermal tolerance is a key response trait to explain the Atlantic Forest spider's ability (or inability) to colonise and persist in human-productive land uses.
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Ecossistema , Florestas , Aranhas , Termotolerância , Árvores , Animais , Aranhas/fisiologiaRESUMO
Introducción: Para el desarrollo de cualquier sociedad es importante el recurso humano competente, lo que implica enrumbar los esfuerzos hacia el mejoramiento del desempeño profesional en aras de lograr que su impacto contribuya al progreso y desarrollo humanos. Objetivo: Caracterizar el desempeño profesional en Histología Humana de los especialistas en formación de Anatomía Patológica del Hospital Universitario General Calixto García durante el período 2015-2020. Métodos: Se realizó un estudio descriptivo-observacional con enfoque mixto. Coincidieron el universo y la muestra, compuestos por 13 especialistas en formación que se encontraban en el primer semestre del primer año de la especialidad y 8 profesores de la especialidad de Anatomía Patológica. El muestreo fue por conveniencia. Se utilizaron métodos teóricos y empíricos. Se empleó una Estadística descriptiva, en particular el análisis porcentual, y la frecuencia absoluta y relativa, a partir de los programas Microsoft Excel y el SPSS, los que permitieron el procesamiento cuantitativo de los instrumentos aplicados. Se empleó la tecnología para la determinación de problemas y potencialidades de la Educación Avanzada. Conclusiones: La aplicación de la tecnología antes mencionada permitió caracterizar el estado actual del desempeño profesional en Histología Humana del especialista en formación de Anatomía Patológica, lo cual reveló carencias y dificultades en las dimensiones: conocimiento teórico-práctico en Histología Humana, comportamiento humano, y comportamiento ético y bioético. La triangulación metodológica aplicada a los resultados de los instrumentos contribuyó a la identificación del inventario de problemas y potencialidades(AU)
Introduction: Competent human resources are important for the development of any society, which implies directing efforts towards the improvement of professional performance in order to achieve their impact on and such contribution to human progress and development. Objective: To characterize the professional performance in Human Histology of specialists being trained in Pathological Anatomy at Hospital Universitario General Calixto García during the period 2015-2020. Methods: A descriptive-observational study with a mixed approach was conducted. The study universe and the sample coincided, composed of 13 specialists being trained in their first semester of the specialty's first academic year and 8 professors of the Pathological Anatomy specialty. The sampling was by convenience. Theoretical and empirical methods were used. Descriptive statistics were used, particularly the percentage analysis, as well as absolute and relative frequency, by using the programs Microsoft Excel and SPSS, which allowed the quantitative processing of the applied instruments. Technology was used for determining problems and potentialities of advanced education. Conclusions: The application of the aforementioned technology allowed characterizing the current state of professional performance in Human Histology of the specialist being trained in Pathological Anatomy, which revealed deficiencies and difficulties in the dimensions theoretical-practical knowledge in Human Histology, human behavior, as well as ethical and bioethical behavior. The methodological triangulation applied to the results of the instruments contributed to the identification of the inventory of problems and potentialities(AU)
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Humanos , Capacitação Profissional , Histologia/educação , Anatomia/educação , EspecializaçãoRESUMO
Introducción: La Medicina Natural y Tradicional (MNT) tiene como objetivo integrar conocimientos de sus modalidades a la práctica médica, a partir de una adecuada selección y fundamentación científica. Desde su desarrollo en el proceso de superación profesional en especialidades como la Ortopedia y Traumatología logra atención médica de calidad, se ajusta a las condiciones sociohistóricas actuales y al desarrollo de nuevos estilos de actuación, mejora las relaciones interpersonales y fomenta los valores ético-morales en íntima interrelación con la comunidad. Objetivo: Exponer fundamentos que sustentan el diseño y la aplicación de una estrategia de superación profesional en especialistas de Ortopedia y Traumatología para la aplicación de la Medicina Natural y Tradicional. Métodos: Se realizó un estudio pedagógico, prospectivo, que utilizó métodos teóricos y empíricos. Para la elaboración de la Estrategia de Superación Profesional se utilizó la modelación, que posibilitó el proceso de concreción-abstracción con sus interrelaciones y vínculos con la aplicación de la Medicina Natural y Tradicional. Se asumieron los criterios utilizados por la Dra. C. Yerina Figueredo. La población fue de 43 especialistas de Ortopedia y Traumatología del Hospital Juan Bruno Zayas Alfonso, de Santiago de Cuba, entre julio y diciembre de 2021. Resultados: Se demostró alto nivel de satisfacción con la aplicación de la estrategia y la consulta de expertos evidenció mejora en el desempeño de estos profesionales. Conclusiones: La actualización en las modalidades de la Medicina Natural y Tradicional en la superación de los Especialistas de Ortopedia y Traumatología aportó un grupo de regularidades a la formación permanente y continuada, que enriquecen las ciencias de la educación médica(AU)
Introduction: Natural and traditional medicine aims at integrating knowledge within its modalities to medical practice, based on an adequate selection and scientific foundation. Since its development as part of the professional improvement process in specialties such as Orthopedics and Traumatology, it achieves quality medical care, adjusts itself to the current sociohistorical conditions and the development of new action styles, improves interpersonal relationships, as well as promotes ethical and moral values in close relationship with the community. Objective: To present the foundations that support the design and application of a professional improvement strategy with Orthopedics and Traumatology specialists for the application of natural and traditional medicine. Methods: A pedagogical and prospective study was carried out, using theoretical and empirical methods. Modeling was used for the elaboration of the professional improvement strategy, which made possible the concretion-abstraction process with its interrelations and links in view of the application of natural and traditional medicine. The criteria used by Yerina Figueredo, Ph.D., were assumed. The population was 43 Orthopedics and Traumatology specialists from Hospital Juan Bruno Zayas Alfonso, of Santiago de Cuba, between July and December 2021. Results: A high level of satisfaction with the application of the strategy was demonstrated and the consultation with experts evidenced an improvement in the performance of these professionals. Conclusions: The updating in the modalities of natural and traditional medicine for the training of Orthopedics and Traumatology specialists contributed a group of regularities to permanent and continuous training, which enriches the sciences of medical education(AU)
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Humanos , Ensino/educação , Conhecimentos, Atitudes e Prática em Saúde , Competência Clínica , Capacitação Profissional , Medicina Tradicional/métodos , Naturologia/métodos , Ortopedia/educação , Traumatologia/educação , Estudos Prospectivos , Educação MédicaRESUMO
El nivel de competencia de los profesionales, ha constituido una preocupación en los sistemas de salud para incrementar la calidad de los servicios y de las universidades médicas, y aportar así un profesional con adecuado desempeño. Ante las tendencias actuales, los autores se trazaron como objetivo revisar los fundamentos teóricos que sustentan la formación y desarrollo de competencias profesionales en los especialistas en cirugía general, en correspondencia con las exigencias del sistema de salud cubano. Se realizó una búsqueda de información actualizada, entre enero y mayo de 2022, utilizando recursos disponibles a través de Infomed. Se consultaron las bases de datos electrónicas PubMed, SciELO y LILACS, así como Google Académico. El proceso de sistematización y análisis documental permitió, como resultado, la fundamentación teórica para la formación y desarrollo de las competencias profesionales de los especialistas en cirugía general. Como conclusión se consideró que, dadas las funciones y acciones que deben cumplimentar los cirujanos generales, es imprescindible que estos posean las competencias requeridas, y constituye una prioridad la formación y desarrollo de las mismas para perfeccionar el desempeño, lo que enriquece a las ciencias de educación médica.
The level of competence of the professional staff has been a concern in health systems to increase the quality of services and medical universities, thus providing a professional with adequate performance. Given the current trends, the authors set out as an objective to review the theoretical fundaments that support the training and development of professional skills in general surgery specialists, in accordance with the requirements of the Cuban health system. An updated information search was conducted between January and May 2022, using resources available through Infomed. Electronic databases PubMed, SciELO and LILACS, as well as Google Academic, were consulted. The process of systematization and documentary analysis allowed, as a result, the theoretical foundation for the training and development of the professional skills of specialists in general surgery. In conclusion, it was considered that, given the functions and actions that general surgeons must perform, it is essential that they possess the required competencies, and it is a priority to train and develop them to improve performance, which enriches medical education sciences.
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Introducción: El proceso de formación y superación de profesionales de las ciencias médicas para alcanzar el segundo grado de las especialidades constituye una prioridad y objetivo del MINSAP en el año 2021. Objetivo: Diseñar una estrategia de superación que prepare a los profesionales de las ciencias médicas para lograr el segundo grado de las especialidades en la atención primaria de salud del municipio Sagua la Grande. Métodos: Se realizó un estudio descriptivo transversal en la Facultad de Ciencias Médicas de Sagua la Grande durante el período comprendido entre 2019 y 2021. La población de estudio estuvo constituida por la totalidad de especialistas de primer grado médicos y estomatólogos de la Atención Primaria de Salud (247). La muestra fue seleccionada por un muestreo no probabilístico por criterios. La muestra quedó finalmente constituida por 173 profesionales. La información fue recogida a través de una encuesta, análisis documental y empleando la triangulación de fuentes. Resultados: De los profesionales de la atención primaria estudiados, 0,8 por ciento tenía título de especialista de segundo grado y 2,9 por ciento con los requisitos para optar por el segundo grado. Conclusiones: La estrategia de superación que prepare a los profesionales de las ciencias médicas para lograr el segundo grado contó de un conjunto de cursos y talleres que contribuirán a la superación de los profesionales en temas identificados como necesidades de aprendizaje. La totalidad de los expertos valoraron la estrategia como bastante adecuada(AU)
Introduction: The training and upgrading process for medical sciences professionals to achieve the second degree of their respective specialties is a priority and objective of the Ministry of Public Health in the year 2021. Objective: To design an upgrading strategy that provides training for medical sciences professionals to achieve the second degree of their respective specialties in primary healthcare in Sagua la Grande Municipality. Methods: A cross-sectional and descriptive study was carried out in the School of Medical Sciences of Sagua la Grande, during the period from 2019 to 2021. The study population consisted of all the first-degree medical and dental specialists from the primary healthcare sector (247). The sample was selected using nonprobabilistic sampling by criteria. The sample finally consisted of 173 professionals. The information was collected by means of a survey, documentary analysis and triangulation of sources. Results: 0.8 percent of the studied primary care professionals had a diploma of second-degree specialist, while 2.9 percent had the requirements to opt for the second degree. Conclusions: The upgrading strategy aimed at medical sciences professionals, in order for them to achieve the second degree in their respective specialties, included a set of courses and workshops that contributed to professional upgrading in topics identified as learning needs. All the experts assessed the strategy as quite adequate(AU)
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Humanos , Masculino , Feminino , Atenção Primária à Saúde , Especialização , Publicações Científicas e Técnicas , Capacitação Profissional , Epidemiologia Descritiva , Estudos TransversaisRESUMO
This work is mainly aimed at the detection, visualization and description of the scientific collaboration patterns in the Nursing field in Latin America as a response to the lack of evidence on the implications of collaboration and its effects on the scientific influence in the Nursing field. For this purpose, a retrospective quantitative analysis was conducted by including all the publications classified under the code 2900 in All Science Journal Classification Codes of Scopus, corresponding to the field of General Nursing during 2005-2020. A total of 40 countries and 362,354 unique publications were analyzed, although the main subset herein consists of 18,371 unique publications authored by Latin-American institutions. World proportion of Latin-American publications in Nursing is higher than all the publications in the region. This increase is especially remarkable in the latest year of the studied period, which may result from the progressive increase in the numbers of nursing schools, the diversity in the graduate and specialization programs, the creation of scientific societies, and the many conferences carried out recently on Nursing.
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Abstract Introduction: Burnout Syndrome is the term used to describe the psychological response to patient care-related chronic work stress. Studies have found that the prevalence of practitioner burnout in Colombia ranges between 17.6% and 45%. Given the importance of this phenomenon in our setting, we decided to carry out a validation and reliability study of the Spanish Burnout Inventory (SBI). Objective: To assess the validity and reliability of the SBI in medical surgical specialists working in fourteen health care facilities in Antioquia (Colombia) in 2018. Methods: The study was conducted in 14 healthcare institutions among 8 surgical specialties. The tool consists of 20 items collected by means of face-to-face interviews under the supervision of a psychologist, and maintaining confidentiality. The psychometric assessment included content validity (CV), construct validity using confirmatory factor analysis (CFA) and reliability using Cronbach's Alpha. Results: The study sample consisted of 234 participants. CV of the tool was 0.82. The CFA showed acceptable model fit, with the results of goodness-of-fit being X2=384.578 (p<0.00i; df: 165), RMSEA = 0.075 [90% CI: 0.066 - 0.085], CFI = 0.953, TLI = 0.946 and WRMR=1.074. The SBI Cronbach's alpha was 0.79. Conclusions: The SBI showed acceptable CV levels for all the items and domains. The SBI is a valid tool with adequate reliability for use in medical surgical specialists of healthcare institutions in Antioquia-Colombia.
Resumen Introducción: El síndrome de Quemarse por el Trabajo es la respuesta psicológica al estrés laboral crónico relacionado con la atención de pacientes. La prevalencia del síndrome en médicos colombianos varía entre el 17 % y el 45 %, usando cuestionarios no validados. Objetivo: Evaluar la validez y fiabilidad del Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT), en médicos especialistas quirúrgicos que laboraban en instituciones de salud de Antioquia, Colombia en 2018. Métodos: El estudio se realizó en 14 instituciones hospitalarias con 8 especialidades quirúrgicas, el instrumento consta de 20 ítems cuya recolección se hizo presencial, supervisado por una psicóloga, manteniendo la confidencialidad; la evaluación psicométrica incluyó validez de contenido (VC), validez de constructo mediante análisis factorial confirmatorio (AFC) y fiabilidad con alfa de Cronbach. Resultados: Se encuestaron 234 especialistas. La VC del instrumento fue de 0,82. Los índices de bondad de ajuste en el AFC fueron: X2=384,578 (p < 0,001; gl: 165), RMSEA = 0,075 [IC 90 %: 0,066-0,085], CFI = 0,953, TLI = 0,946 y WRMR = 1,074. El alfa de Cronbach fue 0,79. Conclusiones: El CESQT tiene niveles aceptables de VC para los ítems y sus dimensiones. El CESQT es un instrumento válido con adecuada fiabilidad para ser utilizado en médicos especialistas quirúrgicos de instituciones de salud de Antioquia, Colombia.
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Pâncreas DivisumRESUMO
PURPOSE: Exposure to ionizing radiation, especially during childhood, is a well-established risk factor for thyroid cancer. The vast majority of radiation-induced cancers are papillary carcinomas (PTCs). These tumors typically have gene fusions in contrast to point mutations prevalent in sporadic PTCs. The aim of this study was to investigate the molecular profiles of PTC patients with workplace exposure to ionizing radiation. METHODS: A retrospective review of 543 patients who underwent surgery with diagnosis of PTC was performed. A cohort of nine healthcare specialists previously exposed to radiation sources during their professional practice was selected and analyzed using the ThyroSeq mutation panel for point mutations and gene fusions associated with thyroid cancer. RESULTS: The molecular analysis of surgical samples of PTCs was informative and revealed genetic alterations in five patients. BRAF V600E was found in four (67%) cases whereas RET/PTC1 fusion in one (17%) and one sample (17%) was wild type for point mutations and fusions. One sample completely failed molecular analysis while two others were negative for genes fusions but failed DNA analysis; these three samples were excluded. CONCLUSIONS: In this limited cohort of healthcare workers exposed to low dose of ionizing radiation at the workplace and developed PTC, the molecular profiling determined BRAF V600E point mutation as the most common event, arguing against the role of workplace radiation exposure in the etiology of these tumors.
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Carcinoma Papilar , Neoplasias da Glândula Tireoide , Carcinoma Papilar/patologia , Pessoal de Saúde , Humanos , Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/genética , Local de TrabalhoRESUMO
Naturally fragmented landscapes are adequate systems for evaluating patterns and mechanisms that determine species distribution without confounding effects of anthropogenic fragmentation and habitat loss. We aimed to evaluate an ant metacommunity's spatiotemporal patterns in montane forest islands amid a grassland-dominated matrix. We assessed these patterns by deconstructing the ant metacommunity into forest-dependent and habitat generalist species. We sampled twice a year (summer and winter) over 2 years (2014 and 2015), using soil and arboreal pitfall traps, in fourteen forest islands (varying in size, shape, and connectivity) in the Espinhaço Range Biosphere Reserve, Brazil. We evaluated the relationship between ant species richness, composition (ß-diversity), and predictor variables of forest island structure (canopy cover and understory density) and landscape structure (forest amount, number of forest islands, and shape). We sampled 99 ant species, 66.7% of which were classified as forest-dependent and 33.3% as habitat generalist species. We found that ant ß-diversity was higher in space than in time, and that species composition variation in time (temporal ß-diversity) differed between ant species groups. Both ant groups responded differently to forest island and landscape structure characteristics. Landscape structure seems to act as a spatial filter and the forest islands' local characteristics as an environmental filter, which jointly determine the local and regional diversity. We demonstrate the importance that forest archipelagos pose to ant metacommunity's structure and dynamics in montane tropical regions. Mountaintop conservation and management strategies must consider the forest island archipelago to maintain the biodiversity and the functioning of these systems.
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Formigas , Animais , Biodiversidade , Ecossistema , Florestas , ÁrvoresRESUMO
A monographic contribution is presented on the species of the genus Calleida Dejean, 1825 at the BIOLAT Biological Station, Rio Manu, Pakitza, Peru, sampled by Terry Erwin and his co-workers. The following seven new species are described: C. solitaria sp. nov., C. manuensis sp. nov., C. anomala sp. nov., C. demathani sp. nov. (type locality: Peru, Tarapoto, but sampled also at Rio Manu), C. erwini sp. nov., C. marginithorax sp. nov., and C. maxima sp. nov. Relationships of each species are discussed, and a preliminary survey is presented of the genus Calleida in Peru.
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RESUMEN La coordinación motriz se define como la capacidad neuromuscular de trabajar conjuntamente diferentes componentes de la preparación deportiva, de los sentidos y segmentos corporales con precisión. Por ello, mejorar los alcances y limitaciones teóricas de los entrenadores nacionales, en términos de utilidad e importancia del entrenamiento coordinativo en general y la capacidad de diferenciación de los gestos técnicos en particular, posibilita potenciar prospectivamente el proceso docente-educativo. El objetivo de esta investigación consiste en validar teóricamente algunos indicadores que rigen la importancia y la prioridad del entrenamiento coordinativo y de diferenciación de los gestos técnicos en futbolistas sub-12. Esta investigación descriptivo-explicativa es de orden correlacional y se basa en cuatro indicadores teóricos, evaluados por 22 especialistas nacionales e internacionales, clasificados en dos grupos independientes (grupo 1: especialistas nacionales; grupo 2: especialistas internacionales). De forma general, no se evidencian diferencias significativas en las calificaciones de dos indicadores estudiados (ImC: p=0.974 y PeC: p=0.923), existiendo diferencias significativas en el resto (ImD: p=0.000 y PeD: p=0.003); en estos dos últimos, se obtiene un mayor rango promedio, a favor del grupo 2 (grupo 1: ImD=6.92; grupo 2: ImD=17.00; grupo 1: PeD=7.83; grupo 2: PeD=15.90). La validación por especialista evidencia la importancia teórica que reviste el entrenamiento de la capacidad de coordinación en futbolistas de iniciación. Además, se evidencia un nivel significativo de importancia y prioridad en los especialistas internacionales en el entrenamiento de la diferenciación del fútbol sub-12, con respecto a los especialistas nacionales.
RESUMO A coordenação motora é definida como a capacidade neuromuscular de trabalhar em conjunto diferentes componentes da preparação desportiva, dos sentidos e dos segmentos corporais com precisão. Assim, a melhoria do âmbito e das limitações teóricas dos treinadores nacionais, em termos de utilidade e importância da formação de coordenação em geral e da capacidade de diferenciar gestos técnicos em particular, torna possível melhorar prospectivamente o processo ensino-educativo. O objetivo desta investigação é validar teoricamente alguns indicadores que regem a importância e a prioridade da formação coordenadora e a diferenciação dos gestos técnicos nos jogadores de futebol sub-12. Esta investigação descritiva-explicativa é de ordem correlativa e baseia-se em quatro indicadores teóricos, avaliados por 22 especialistas nacionais e internacionais, classificados em dois grupos independentes (grupo 1: especialistas nacionais; grupo 2: especialistas internacionais). Em geral, não há diferenças significativas nas classificações de dois indicadores estudados (ImC: p=0,974 e PeC: p=0,923), com diferenças significativas no resto (ImD: p=0,000 e PeD: p=0,003); nos dois últimos, obtém-se um intervalo médio mais elevado, a favor do grupo 2 (grupo 1: ImD=6,92; grupo 2: ImD=17,00; grupo 1: PeD=7,83; grupo 2: PeD=15,90). A validação por especialistas evidencia a importância teórica da formação da capacidade de coordenação em jogadores de futebol principiantes. Além disso, é evidenciado um nível significativo de importância e prioridade nos especialistas internacionais no treino de diferenciação no futebol sub-12, no que diz respeito aos especialistas nacionais.
ABSTRACT Motor coordination is defined as the neuromuscular capacity to work together different components of sports training, senses and body segments with precision. Therefore, improving the theoretical scope and limitations of national coaches in usefulness and importance terms of coordination training in general, and the capacity to differentiate technical gestures in particular, makes it possible to prospectively enhance the teaching-educational process. The objective of this work is theoretically validate some indicators that govern the importance and priority of coordination training and differentiation of technical gestures in U-12 soccer players. This is a descriptive-explanatory correlational research, studied four theoretical indicators evaluated by 22 national and international specialists classified into two independent groups (Group 1: National Specialists; Group 2; International Specialists), comparing results and deducing future national strategies to improve the coordinating component and the differentiation of technical gestures in U-12 players. In general, there are no significant differences in the scores of two indicators studied (ImC: p=0.974 and PeC: p=0.923), with significant differences in the rest (ImD: p=0.000 and PeD: p=0.003); in the latter two, a higher average range is obtained, in favor of group 2 (group 1: ImD=6.92; group 2: ImD=17.00; group 1: PeD=7.83; group 2: PeD=15.90). The validation by specialist evidences the theoretical importance of the training of the coordination capacity in initiation soccer players. In addition, a significant level of importance and priority is evidenced in the international specialists in the training of differentiation in U-12 soccer, with respect to the national specialists.
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Information concerning arbuscular mycorrhizal (AM) fungal geographical distribution in tropical and subtropical soils from the Atlantic Forest (a global hotspot of biodiversity) are scarce and often restricted to the evaluation of richness and abundance of AM fungal species at specific ecosystems or local landscapes. In this study, we hypothesized that AM fungal diversity and community composition in subtropical soils would display fundamental differences in their geographical patterns, shaped by spatial distance and land-use change, at local and regional scales. AM fungal community composition was examined by spore-based taxonomic analysis, using soil trap cultures. Acaulospora koskei and Glomus were found as generalists, regardless of mesoregions and land uses. Other Acaulospora species were also found generalists within mesoregions. Land-use change and intensification did not influence AM fungal composition, partially rejecting our first hypothesis. We then calculated the distance-decay of similarities among pairs of AM fungal communities and the distance-decay relationship within and over mesoregions. We also performed the Mantel test and redundancy analysis to discriminate the main environmental drivers of AM fungal diversity and composition turnover. Overall, we found significant distance-decays for all land uses. We also observed a distance-decay relationship within the mesoregion scale (< 104 km) and these changes were correlated mainly to soil type (not land use), with the secondary influence of both total organic carbon and clay contents. AM fungal species distribution presented significant distance-decays, regardless of land uses, which was indicative of dispersal limitation, a stochastic neutral process. Although, we found evidence that, coupled with dispersal limitation, niche differentiation also played a role in structuring AM fungal communities, driven by long-term historical contingencies, as represented by soil type, resulting from different soil origin and mineralogy across mesoregions.
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Micobioma , Micorrizas , Biodiversidade , Ecossistema , Florestas , Fungos , Micorrizas/genética , Solo , Microbiologia do SoloRESUMO
RESUMO A função de controlador aéreo exige várias horas de visualização de ecrãs, o que torna esses profissionais um grupo particularmente exposto à astenopia digital. Procuramos, com este artigo de revisão, compreender quais os métodos quantitativos e qualitativos usados atualmente para diagnosticar e avaliar a fadiga ocular em controladores de tráfego aéreo. Trata-se de pesquisa bibliográfica utilizando as bases de dados PubMed® e ClinicalKey®, usando palavras-chave, tendo sido selecionados artigos de revisão e estudos observacionais com publicação posterior ao ano 2000, de modo que os termos buscados estivessem no título e/ou resumo do trabalho. Excluímos artigos em línguas que não inglesa. Existem vários métodos para melhor caracterizar a astenopia digital, destacando-se os subjetivos, como questionários, e os objetivos, que procuram, por um lado, diagnosticar o olho seco, bem como alterações da acomodação e da convergência. Da análise efetuada, ressaltou-se uma escassez de estudos prospectivos com Níveis de Evidência moderados e altos relacionados com a aplicação dos vários métodos de diagnóstico. A Computer-Vision Symptom Scale parece ser um questionário confiável e que pode ser aplicado aos controladores de tráfego aéreo, para diagnóstico de astenopia digital. Vários métodos objetivos podem também ser utilizados para essa avaliação, sendo importante, numa fase posterior, aplicar esses dois tipos de métodos de diagnóstico para avaliar a prevalência dessa patologia em controladores de tráfego aéreo.
ABSTRACT The work of air traffic control specialists require several hours looking at screens, and they comprise a group particularly exposed to digital-related eye strain. In this review we aim to understand the quantitative and qualitative methods currently used to diagnose and evaluate asthenopia in air traffic control specialists. A bibliographic search was carried out at the databases PubMed® and ClinicalKey®, using keywords, and selecting review articles and observational studies, dated after 2000, containing the keywords in the title and/o abstract. Articles not published in English were excluded. There are several subjective and objective methods to better describe digital-related eye strain, including questionnaires, aiming to make diagnosis of dry eye disease or changes in accommodation and convergence. From our analysis, there are few prospective studies with moderate and high levels of evidence regarding these diagnostic methods. The Computer-Vision Symptom Scale seems to be a reliable questionnaire to be applied to air traffic control specialists, for diagnosis of digital-related eye strain. Several objective methods can also be employed in this evaluation, and, in a later stage, it will be important to apply both diagnostic methods to evaluate the prevalence of this condition in air traffic control specialists.
Assuntos
Síndromes do Olho Seco/diagnóstico , Astenopia/diagnóstico , Terminais de Computador , Aeroportos , Doenças Profissionais , Portugal , Estudos de Avaliação como Assunto , Estudo ObservacionalRESUMO
BACKGROUND: Medical surgeons specialists are exposed to risk factors, the most frequent being those of the psychosocial type, where burnout syndrome is included due to the type of exposure and diversification of their activities as a member of the health team and the legal and socio-labor repercussions. OBJECTIVE: To determine the prevalence and risk factors of burnout in medical surgeons. METHOD: Observational, descriptive and cross-sectional study in 296 specialists. The data was processed descriptively and inferentially with the support of the SPSS 15.0 and Epi-infoV6.1 program. RESULTS: There was a response in 92.5% of the interviewees and the burnout was found in 40.2%. Significant differences were detected in age under 40 years, not having a stable partner, and < 15 years with your partner, being a medical oncologist, having < 10 years of professional seniority and in the workplace. CONCLUSIONS: Burnout is frequent (40.2%), as risk factors are, being: woman; under 40 years old; not having a stable partner, under 15 years with her and not working this, without children; surgical medical oncologist; < 10 years of professional seniority and job position, night shift; definitive hiring; not having another job and more than 4 h in it. The involvement of the subscales behaves like the syndrome. There was a negative correlation with burnout between emotional exhaustion and depersonalization, and positive with lack of personal fulfillment at work.
ANTECEDENTES: Los médicos cirujanos especialistas están expuestos a factores de riesgo, siendo los más frecuentes los de tipo psicosocial, incluyendo el síndrome de desgaste profesional (burnout) por el tipo de exposición y la diversificación de sus actividades como miembros del equipo de salud, y las repercusiones jurídicas y sociolaborales. OBJETIVO: Determinar la prevalencia y los factores de riesgo del burnout en médicos cirujanos especialistas. MÉTODO: Estudio observacional, descriptivo y transversal, en 296 especialistas. Los datos se procesaron descriptivamente y de manera inferencial con apoyo de los programas SPSS 15.0 y Epi-infoV6.1. RESULTADOS: Hubo respuesta en el 92.5% de los entrevistados y el burnout se encontró en el 40.2%. Se detectaron diferencias significativas en edad menor de 40 años, no tener pareja estable o menos de 15 años con pareja, ser médico oncólogo quirúrgico, y tener menos de 10 años de antigüedad profesional o en puesto de trabajo. CONCLUSIONES: El burnout es frecuente (40.2%) y como factores de riesgo están ser mujer, ser menor de 40 años, no tener pareja estable o menos de 15 años con pareja y que esta no trabaje, no tener hijos, ser médico oncólogo quirúrgico, tener menos de 10 años de antigüedad profesional o en puesto de trabajo, trabajar en turno nocturno, tener contratación definitiva, no tener otro trabajo y trabajar más de 4 horas en él. La afectación de las subescalas se comporta como el síndrome. Hubo correlación negativa con el burnout entre agotamiento emocional y despersonalización, y positiva con falta de realización personal en el trabajo.
Assuntos
Esgotamento Profissional/epidemiologia , Cirurgiões/psicologia , Adulto , Atitude do Pessoal de Saúde , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Estudos Transversais , Emoções , Características da Família , Feminino , Humanos , Masculino , Casamento , Oncologia , México/epidemiologia , Pessoa de Meia-Idade , Médicos/psicologia , Prevalência , Fatores de Risco , Autorrelato , Jornada de Trabalho em Turnos/psicologia , Equilíbrio Trabalho-Vida , Local de Trabalho/psicologiaRESUMO
RESUMEN Introducción: la formación en el trabajo garantiza la competencia y desempeño adecuado del futuro especialista en la atención no solo del individuo, sino también de la familia y la comunidad. Objetivo: identificar el nivel de conocimientos que poseen los especialistas de Medicina General Integral sobre su rol de tutor en la formación de futuros especialistas del Policlínico Jimmy Hirzel. Bayamo. 2019. Método: se utilizaron métodos teóricos, empíricos y estadísticos. Fueron estudiadas las variables: edad, sexo, años de graduados en función de la tutoría, categoría docente en relación a los años como tutor, nivel de conocimientos sobre el rol del tutor. Se aplicó el coeficiente alfa de Cronbach para medir la confiabilidad del cuestionario aplicado. El universo quedó constituido por todos los especialistas pertenecientes al policlínico Jimmy Hirzel y la muestra por 38 que estaban ejerciendo como tutores en el año 2019. Resultados: predominaron las féminas sobre los masculinos con un 63,2%. El grupo etario más representativo fue de 35 a 39 años con un 31,6%, los especialistas carecen de experiencia y no se han enfrentado a la tutoría, obteniéndose un 52,6%. El 89.5% fueron especialistas sin categoría docente. El nivel de conocimientos de los tutores sobre su rol en la formación de especialistas de Medicina General Integral fue bajo con un 50%. Conclusiones: se demuestra que existen insuficiencias en el conocimiento del rol del tutor en la formación de especialistas en Medicina General Integral y marca un reto para la preparación del claustro en cada institución.
ABSTRACT Introduction: on-the-job training guarantees the competence and adequate performance of the future specialist in the care not only of the individual, but also of the family and the community. Objective: to identify the level of knowledge that the specialists in Comprehensive General Medicine possess about their role as tutor in the training of future specialists of the Jimmy Hirzel Polyclinic. Bayamo. 2019. Method: theoretical, empirical and statistical methods were used. The variables were studied: age, sex, years of graduates depending on the tutoring, teaching category in relation to the years as tutor, level of knowledge about the role of the tutor. Cronbach's alpha coefficient was applied to measure the reliability of the applied questionnaire. The universe was made up of all the specialists belonging to the Jimmy Hirzel polyclinic and the sample of 38 who were working as tutors in 2019. Results: females predominated over males with 63.2%. The most representative age group was 35 to 39 years old with 31.6%, specialists lack experience and have not faced tutoring, obtaining 52.6%. 89.5% were specialists without a teaching category. The level of knowledge of the tutors about their role in the training of specialists in Comprehensive General Medicine was low with 50%. Conclusions: it is shown that there are insufficiencies in the knowledge of the role of the tutor in the training of specialists in Comprehensive General Medicine and marks a challenge for the preparation of the faculty in each institution.
RESUMO Introdução: o treinamento no local de trabalho garante a competência e o desempenho adequado do futuro especialista no cuidado não apenas ao indivíduo, mas também à família e à comunidade. Objetivo: identificar o nível de conhecimento que os especialistas em Medicina Geral Compreensiva possuem sobre seu papel de tutor na formação de futuros especialistas da Policlínica Jimmy Hirzel. Bayamo. 2019. Método: foram utilizados métodos teóricos, empíricos e estatísticos. As variáveis estudadas foram: idade, sexo, anos de egressos, dependendo da tutoria, categoria de ensino em relação aos anos de tutor, nível de conhecimento sobre o papel do tutor. O coeficiente alfa de Cronbach foi aplicado para medir a confiabilidade do questionário aplicado. O universo foi composto por todos os especialistas pertencentes à policlínica Jimmy Hirzel e a amostra de 38 que estavam trabalhando como tutores em 2019. Resultados: o sexo feminino predominou sobre o masculino, com 63,2%. A faixa etária mais representativa foi de 35 a 39 anos, com 31,6%, os especialistas não têm experiência e não enfrentaram aulas particulares, obtendo 52,6%. 89,5% eram especialistas sem categoria de ensino. O nível de conhecimento dos tutores sobre o seu papel na formação de especialistas em Medicina Geral Integral foi baixo, com 50%. Conclusões: mostra-se insuficiente o conhecimento do papel do tutor na formação de especialistas em Medicina Geral Compreensiva e marca um desafio para a preparação do corpo docente em cada instituição.
RESUMO
Objective: to determine the global offer of Massive Open Online Courses (MOOCs) in health and nursing, and to know the characteristics of its content, for continuing education in nursing professionals in Peru. Method: exploratory study was carried out on the websites: Coursera, edX, FutureLearn, XuetangX and Udacity, Class Central and MOOC List. The courses were classified according to the five nursing areas recognized by the Peruvian College of Nurses (Colegio de Enfermeros del Perú, CEP). From each course, data was collected on institution and country of origin, hours per week and total duration in weeks, audio and subtitle language. Results: a total of 654 courses in this modality are offered in health were found, covering the five areas contemplated by the Peruvian College of Nurses. Fourteen courses were specifically developed for nursing with an average duration of five weeks (3.2 hours per week of activities). Eleven came from Anglo-Saxon institutions, with content in English. Only two courses were offered in Spanish and one in Turkish. Conclusion: Massive Open Online Courses would be a useful tool for the continuing education of the Peruvian nurse given the wide offer, including some specifically for nurses, in the different areas of nursing. The content of the course is mostly in English. Expanding the range of languages or subtitles would facilitate the participation of a larger audience.
Objetivo: determinar a oferta global de Massive Open Online Courses (MOOCs) em saúde e enfermagem e conhecer as características de seu conteúdo para a educação continuada em profissionais de enfermagem. Método: estudo exploratório realizado nos sites Coursera, edX, FutureLearn, XuetangX e Udacity, Class Central e MOOC List. Os cursos foram classificados de acordo com as cinco áreas de enfermagem reconhecidas pelo Colégio Peruano de Enfermeiros (Colegio de Enfermeros del Perú, CEP). Para cada curso foram coletadas as variáveis instituição e país de origem, horas semanais e duração total em semanas, idioma do áudio e das legendas. Resultados: foram encontrados 654 cursos nessa modalidade em saúde, cobrindo as cinco áreas contempladas pelo Colégio Peruano de Enfermeiros. Quatorze cursos foram desenvolvidos especificamente para enfermagem, com duração média de cinco semanas (3,2 horas por semana de atividades). Onze procediam de instituições anglo-saxônicas, com conteúdo em inglês. Apenas dois cursos foram oferecidos em espanhol e um em turco. Conclusão: Massive Open Online Courses é uma ferramenta útil para a educação continuada do enfermeiro peruano, dada a ampla oferta, incluindo alguns especificamente para enfermeiros, nas diferentes áreas da enfermagem. O seu conteúdo é oferecido principalmente em inglês. Expandir a variedade de idiomas ou incluir legendas facilitaria a participação de um público maior.
Objetivo: determinar la oferta global de Massive Open Online Courses (MOOCs) en salud y enfermería, y conocer las características de su contenido, para la educación continua de profesionales de enfermería en Perú. Método: estudio exploratorio se llevó a cabo en sitios web Coursera, edX, FutureLearn, XuetangX y Udacity, Class Central y MOOC List. Los cursos se clasificaron según las cinco áreas de enfermería reconocidas por el Colegio de Enfermeros del Perú (CEP). De cada curso se recopilaron datos sobre institución y país de origen, horas por semana y duración total en semanas, idioma de audio y de subtítulos. Resultados: se encontró un total de 654 cursos en esta modalidad en salud, que abarcaron las cinco áreas contempladas por el Colegio de Enfermeros del Perú. Catorce cursos fueron elaborados específicamente para enfermería con una duración promedio de cinco semanas (3,2 horas semanales de actividades). Once procedían de instituciones anglosajonas, con contenido en inglés. Solo dos se ofrecieron en español y uno en turco. Conclusión: Massive Open Online Courses es una herramienta útil para la educación continua del enfermero peruano dada la amplia oferta, incluyendo algunos específicamente para enfermeros, en las distintas áreas de la enfermería. El contenido de los cursos se ofrecen mayoritariamente en inglés. Ampliar la oferta de idiomas o subtítulos facilitaría la participación de un mayor público.
Assuntos
Especialidades de Enfermagem , Instrução para Enfermeiros , Educação em Enfermagem , Educação Continuada em Enfermagem , Educação de Pós-Graduação em Enfermagem , Enfermeiros EspecialistasRESUMO
RESUMEN Fundamento: develar las representaciones sociales del cáncer mamario puede acercar a profesionales de las ciencias psicológicas a comprender actitudes, conductas y las influencias que ejercen en pacientes, familiares y especialistas. Objetivo: determinar la estructura de las representaciones sociales (actitud, información, campo representacional) del cáncer mamario en los sujetos del estudio. Métodos: estudio exploratorio, transversal, de metodología mixta, en el período comprendido entre mayo 2014 a diciembre de 2015. Se aplicaron como técnicas: formulario datos sociodemográficos y clínicos, entrevista semiestructurada, composición, asociación libre. Las variables analizadas fueron: direccionabilidad de la actitud hacia el diagnóstico del cáncer mamario, direccionabilidad de la actitud hacia los tratamientos, en la dimensión información: conocimientos sobre conceptualización de la enfermedad, conocimientos de los síntomas, conocimientos sobre tratamientos, creencias sobre factores de riesgo, opiniones sobre las consecuencias del cáncer mamario, opiniones sobre necesidad de brindar conocimientos de la enfermedad a pacientes, familiares. Se efectuó análisis estadístico descriptivo de frecuencias. Se procesó la información de las variables en la base de datos del paquete estadístico SPSS 15.0 para Windows. Los resultados se expresaron en frecuencias absolutas y relativas. Resultados: pacientes, familiares mostraron direccionabilidad de la actitud negativa hacia el diagnóstico y tratamientos. Prevalencia de respuestas ajustadas en las áreas exploradas de la dimensión información, aunque con nivel de profundidad homogéneo los familiares. El campo representacional del cáncer mamario dio cuenta de modelos mayoritariamente de desafío a la enfermedad en los sujetos del estudio. Conclusiones: cómo se comportaron el conocimiento de la estructura de las representaciones sociales del cáncer mamario en los sujetos del estudio, contribuye al análisis del marco de referencia de la actuación sanitaria, desde un abordaje integral, holístico, por coexistir sentido común y ciencia.
ABSTRACT Background: unveiling the social representations of breast cancer can bring professionals in the psychological sciences to understand attitudes, behaviors and the influences they exert on patients, family members and specialists. Objective: to determine the structure of the social representations (attitude, information, representational field) of breast cancer in the study subjects. Methods: exploratory, cross-sectional study, of mixed methodology, in the period from May 2014 to December 2015. Applied as techniques: sociodemographic and clinical data form, semi-structured interview, composition, free association. The variables analyzed were: addressability of the attitude towards the diagnosis of breast cancer, addressability of the attitude towards treatments, in the information dimension: knowledge about disease conceptualization, knowledge of symptoms, knowledge about treatments, beliefs about risk factors , opinions on the consequences of breast cancer, opinions on the need to provide knowledge of the disease to patients, relatives. Descriptive statistical analysis of frequencies was performed. The information of the variables in the database of the statistical package SPSS 15.0 for Windows was processed. The results were expressed in absolute and relative frequencies. Results: patients, relatives showed addressability of the negative attitude towards diagnosis and treatment. There was a prevalence of adjusted responses in the explored areas of the information dimension, although with a homogeneous level of depth, in family members. The representative field of breast cancer accounted for mostly models of disease challenge in the study subjects. Conclusions: the subjects of the study in relation to breast cancer showed a negative attitude, there was a predominance of adjusted answers about the pathology information and mostly models of disease challenges.
RESUMO
Latin American immigrants make up 49% of the total immigrant population in Spain, yet little is known about their eye health. The aim of this study is to determine if there are differences in self-perceived eye health, access to eye care specialists, and use of lenses between a sample of Latin American immigrant workers from Colombia and Ecuador, and native-born workers in Spain. We used data from the PELFI cohort (Project for Longitudinal Studies of Immigrant Families). The sample consisted of 179 immigrant workers born in Colombia or Ecuador, and 83 Spanish-born workers. The outcome variables were self-perceived eye health, access to eye specialists, and use of lenses. A descriptive analysis of the sample was carried out, and the prevalence of the three outcome variables in immigrants and natives was calculated and adjusted for explanatory variables. Random effects logistic regression models examined eye health outcomes by workers' country of birth. Immigrants are less likely to report poor self-perceived eye health than native-born (ORc 0.46; CI 95%, 0.22-0.96). Furthermore, they have less access to specialists (ORc 2.61; CI 95%, 1.32-5.15) and a higher probability of needing lenses but not having them (ORc 14.14; CI 95%, 1.77-112.69). This latter variable remained statistically significant after adjusting for covariates (ORa 34.05; CI 95%, 1.59-729.04). Latin American immigrants may not value the use of lenses, despite eye care specialists indicating that they need them. Eye health education is required to recognize the importance of using lenses according to their visual needs.
Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Lentes/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Grupos Populacionais/estatística & dados numéricos , Especialização/estatística & dados numéricos , Adolescente , Adulto , Colômbia , Estudos Transversais , Equador , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Espanha , Adulto JovemRESUMO
INTRODUCCIÓN: No hay datos recientes en México sobre el estado de los médicos especialistas que permitan diseñar políticas de formación y empleo de los recursos humanos para la salud. OBJETIVO: Analizar el estado actual de los médicos especialistas en México: número, distribución (geográfica, por sexo y especialidad), vigencia de la certificación (por sexo y especialidad) y tasa de especialistas por 100 000 habitantes. MÉTODO: estudio transversal descriptivo. Se consultaron múltiples fuentes disponibles en México: consejos, asociaciones, colegios, instituciones hospitalarias, universidades y otros. RESULTADOS: Se contabilizaron 147 910 especialistas para una población de 123 518 272 habitantes; 69 % contaba con certificación vigente de la especialidad. Se obtuvo una tasa de 119 especialistas por 100 000 habitantes; 54.2 % se encontraba en la Ciudad de México, Estado México, Jalisco y Nuevo León. En promedio había 1.7 especialistas varones por cada mujer. CONCLUSIONES: El número de especialistas es inferior al recomendado internacionalmente e insuficiente para cubrir las necesidades en salud del país. La distribución por género está cambiando hacia una más equitativa. Los especialistas están agrupados mayormente en zonas urbanas. Es el primer censo de especialistas con base en el número comprobable de médicos, que permitirá el diseño de políticas de planificación de recursos humanos en salud. INTRODUCTION: There are no recent data in Mexico about the state of medical specialists that allow the design of policies for training and use of human resources for health. OBJECTIVE: To analyze the current state of medical specialists in Mexico: number, distribution (geographical, by gender and specialty), certification validity (by gender and specialty) and the rate of specialists per 100 000 population. METHOD: Cross-sectional, descriptive study. Multiple sources available in Mexico were consulted: councils, associations, schools, hospital institutions, universities, and others. RESULTS: A total of 147,910 specialists were counted for a total population of 123,518,272 inhabitants; 69 % had current specialty certification. A rate of 119 specialists per 100 000 population was obtained; 54.2 % are in Mexico City and in the States of Mexico, Jalisco and Nuevo León. On average, there are 1.7 male specialists per female specialist. CONCLUSIONS: The number of specialists is lower than that internationally recommended and insufficient to cover the health needs of the country. Gender distribution is shifting towards a more equitable one. Specialists are mainly grouped in urban areas. This is the first census of specialists based on total verifiable number of physicians, which will allow the design of policies for human resources planning in health.