RESUMEN
Introducción. La percepción del dolor es un fenómeno complejo y subjetivo. Comprender los factores que afectan en la percepción del dolor es crucial en el contexto de la toma de decisiones clínicas durante el proceso de rehabilitación kinesiológica. Objetivo. Exponer los factores que afectan la percepción del dolor, desde la perspectiva del modelo biopsicosocial y discutir sus implicancias para la toma de decisiones clínicas. Métodos. Se describen factores que afectan la percepción de dolor, separados en biológicos como la injuria, sexo, genética y edad, psicológicos como creencias, catastrofismo, kinesiofobia, afectividad negativa, calidad de sueño, atención, afrontamiento y autoeficacia; y socio-culturales como soporte social, rol de género, etnia, aculturación y estatus socioeconómico. Luego se discute cómo estos factores impactan en las decisiones clínicas del profesional kinesiólogo. Finalmente, se entregará un análisis de las barreras y facilitadores descritos por la literatura científica respecto al uso del modelo biopsicosocial.
Background. The perception of pain is a complex and subjective phenomenon. Thus, understanding the factors that influence pain perception is crucial in the context of clinical decision-making during the kinesic rehabilitation process. The objective of this article is to expose the factors that affect the perception of pain, from the perspective of the biopsychosocial model and discuss its implications for clinical decision making during this process. Initially, the biological, psychological and sociocultural factors that affect the perception of pain with the greatest presence in the scientific literature are described. It is discussed how these factors impact the clinical decisions of the kinesiologist professional. Finally, an analysis of the barriers and facilitators described by the scientific literature regarding the use of the biopsychosocial model will be provided.
RESUMEN
Tidal disruption events (TDEs) are bursts of electromagnetic energy that are released when supermassive black holes at the centres of galaxies violently disrupt a star that passes too close1. TDEs provide a window through which to study accretion onto supermassive black holes; in some rare cases, this accretion leads to launching of a relativistic jet2-9, but the necessary conditions are not fully understood. The best-studied jetted TDE so far is Swift J1644+57, which was discovered in γ-rays, but was too obscured by dust to be seen at optical wavelengths. Here we report the optical detection of AT2022cmc, a rapidly fading source at cosmological distance (redshift z = 1.19325) the unique light curve of which transitioned into a luminous plateau within days. Observations of a bright counterpart at other wavelengths, including X-ray, submillimetre and radio, supports the interpretation of AT2022cmc as a jetted TDE containing a synchrotron 'afterglow', probably launched by a supermassive black hole with spin greater than approximately 0.3. Using four years of Zwicky Transient Facility10 survey data, we calculate a rate of [Formula: see text] per gigapascals cubed per year for on-axis jetted TDEs on the basis of the luminous, fast-fading red component, thus providing a measurement complementary to the rates derived from X-ray and radio observations11. Correcting for the beaming angle effects, this rate confirms that approximately 1 per cent of TDEs have relativistic jets. Optical surveys can use AT2022cmc as a prototype to unveil a population of jetted TDEs.
RESUMEN
The origins of the high-energy cosmic neutrino flux remain largely unknown. Recently, one high-energy neutrino was associated with a tidal disruption event (TDE). Here we present AT2019fdr, an exceptionally luminous TDE candidate, coincident with another high-energy neutrino. Our observations, including a bright dust echo and soft late-time x-ray emission, further support a TDE origin of this flare. The probability of finding two such bright events by chance is just 0.034%. We evaluate several models for neutrino production and show that AT2019fdr is capable of producing the observed high-energy neutrino, reinforcing the case for TDEs as neutrino sources.