Representaciones sociales acerca de Instagram: Estudio cualitativo con adultos emergentes con diferente bienestar psicológico y autoestima corporal

Antecedentes existe una relación entre el uso de Instagram y diferentes influencias e interacciones con el bienestar y salud mental de este grupo etario. Objetivo Reconstruir las representaciones sociales acerca de la red social Instagram de adultos emergentes con diferentes niveles de bienestar psicológico y autoestima corporal. Método redes semánticas naturales y entrevistas semiestructuradas fueron aplicadas a N=12 adultos emergentes (19 - 27 años) divididos en dos grupos según sus niveles de autoestima corporal y bienestar psicológico. El análisis de datos estuvo basado en análisis de redes semánticas naturales y algunos procedimientos de codificación teórica. Resultados se muestra la presencia del concepto de "acoso" como núcleo central de la representación social de Instagram en el grupo con baja autoestima corporal y bajo bienestar psicológico, a diferencia del grupo con alta autoestima corporal y alto bienestar psicológico en donde el núcleo central fue "red social". Conclusiones en los grupos estudiados, se encontraron dos representaciones sociales diferentes respecto de Instagram. Estos resultados pueden ser relevantes para aportar a llenar el vacío de conocimiento sobre los significados subjetivos colectivos de los adultos emergentes, teniendo implicancias en la mejor comprensión de las diversas formas de relación que establecen con esta y otras redes sociales.

Background There is a relationship between the use of Instagram and various influences and interactions with the well-being and mental health of this age group. Objective To reconstruct the social representations of the Instagram social network among emerging adults with different levels of psychological well-being and body esteem. Method Natural semantic networks and semi-structured interviews were conducted with N=12 emerging adults (19 - 27 years old) divided into two groups based on their body self-esteem and psychological well-being levels. Data analysis relied on natural semantic network analysis and theoretical coding. Results The concept of "harassment" is revealed as the central core of the social representation of Instagram in the group with low body self-esteem and low psychological well-being, unlike the group with high body esteem and high psychological well-being where the central core was the "social network" itself. Conclusions Two different social representations of Instagram were found in the studied groups. These results could contribute to filling the knowledge gap about the collective subjective meanings of emerging adults, impacting the better understanding of the diverse relationships they establish with this and other social networks.

Ultrabroadband high-resolution silicon RF-photonic beamformer.

Microwave photonics aims to overcome the limitations of radiofrequency devices and systems by leveraging the unique properties of optics in terms of low loss and power consumption, broadband operation, immunity to interference and tunability. This enables versatile functions like beam steering, crucial in emerging applications such as the Internet of Things (IoT) and 5/6G networks. The main problem with current photonic beamforming architectures is that there is a tradeoff between resolution and bandwidth, which has not yet been solved. Here we propose and experimentally demonstrate a novel switched optical delay line beamformer architecture that is capable of achieving the desired maximum resolution (i.e., 2M pointing angles for M-bit coding) and provides broadband operation simultaneously. The concept is demonstrated by means of a compact (8 × 3 mm2) 8 (5-bit) delay line Silicon Photonic chip implementation capable of addressing 32 pointing angles and offering 20 GHz bandwidth operation.

Crosslinking of membrane CD13 in human neutrophils mediates phagocytosis and production of reactive oxygen species, neutrophil extracellular traps and proinflammatory cytokines.

Aminopeptidase N, or CD13, is a cell membrane ectopeptidase highly expressed in myeloid cells. Through its enzymatic activity, CD13 regulates the activity of several bioactive peptides, such as endorphins and enkephalins, chemotactic peptides like MCP-1 and IL-8, angiotensin III, bradikinin, etc. In recent years, it has been appreciated that independently of its peptidase activity, CD13 can activate signal transduction pathways and mediate effector functions such as phagocytosis and cytokine secretion in monocytes and macrophages. Although neutrophils are known to express CD13 on its membrane, it is currently unknown if CD13 can mediate effector functions in these cells. Here, we show that in human neutrophils CD13 can mediate phagocytosis, which is dependent on a signaling pathway that involves Syk, and PI3-K. Phagocytosis mediated by CD13 is associated with production of reactive oxygen species (ROS). The level of phagocytosis and ROS production mediated by CD13 are similar to those through FcγRIII (CD16b), a widely studied receptor of human neutrophils. Also, CD13 ligation induces the release of neutrophil extracellular traps (NETs) as well as cytokine secretion from neutrophils. These results support the hypothesis that CD13 is a membrane receptor able to activate effector functions in human neutrophils.

Establishment and validation of surface model for biodosimetry based on γ-H2AX foci detection.

INTRODUCTION: In the event of a radiation accident detecting γ-H2AX foci is being accepted as fast method for triage and dose assessment. However, due to their disappearance kinetics, published calibrations have been constructed at specific post-irradiation times. OBJECTIVES: To develop a surface, or tridimensional, model to estimate doses at times not included in the calibration analysis, and to validate it. MATERIALS AND METHODS: Calibration data was obtained irradiating peripheral mononucleated cells from one donor with radiation doses ranging from 0 to 3 Gy, and γ -H2AX foci were detected microscopically using a semi-automatic method, at different post-irradiation times from 0.5 to 24 h. For validation, in addition to the above-mentioned donor, blood samples from another donor were also used. Validation was done within the range of doses and post-irradiation times used in the calibration. RESULTS: The calibration data clearly shows that at each analyzed time, the γ-H2AX foci frequency increases as dose increases, and for each dose this frequency decreases with post-irradiation time. The γ-H2AX foci nucleus distribution was clearly overdispersed, for this reason to obtain bidimensional and tridimensional dose-effect relationships no probability distribution was assumed, and linear and non-linear least squares weighted regression was used. In the two validation exercises for most evaluated samples, the 95% confidence limits of the estimated dose were between ±0.5 Gy of the real dose. No major differences were observed between donors. CONCLUSION: In case of a suspected overexposure to radiation, the surface model here presented allows a correct dose estimation using γ-H2AX foci as biomarker. The advantage of this surface model is that it can be used at any post-irradiation time, in our model between 0.5 and 24 h.

Identidad profesional en las prácticas tempranas: estudio cualitativo con estudiantes de pedagogía / Professional identity in early practices: qualitative study with pedagogy students

Antecedentes: Lograr una formación docente de calidad requiere que los profesores tengan la oportunidad de desarrollar no solo competencias profesionales, sino que, fundamentalmente, su identidad profesional. Objetivo: Describir e interpretar las teorías subjetivas de los estudiantes de Pedagogía de Educación General Básica de una universidad pública del norte de Chile sobre la construcción de la identidad profesional en las prácticas tempranas. Método: Se utilizó metodología cualitativa, un diseño de estudio de casos y un muestreo teórico que integró a 9 estudiantes de Pedagogía General Básica de una universidad pública del norte de Chile. Los datos se obtuvieron de entrevistas episódicas y una entrevista grupal y se analizaron en base a la Teoría Fundamentada. Resultados: Se encontraron (a) distintos sentidos sobre la práctica temprana y una evaluación que incluye aspectos positivos y negativos del proceso, (b) una asociación entre el desarrollo de la identidad profesional y la experiencia de cursar prácticas tempranas, (c) un conjunto de condiciones que reúnen las prácticas tempranas para favorecer la construcción de la identidad profesional y (d) la propuesta de planificar las prácticas tempranas como una experiencia distinta del funcionamiento de las otras asignaturas de la carrera. Lo anterior se integró en una teoría comprensiva del desarrollo de la identidad profesional docente en las prácticas tempranas. Discusión: En la discusión se analizan estos resultados desde la literatura existente. Palabras clave: identidad profesional; profesorado; formación inicial; subjetividad; formación práctica.

Background: Achieving high-quality teacher training requires teachers to have the opportunity to develop not only professional skills but also, fundamentally, their professional identity. Objective: To describe and interpret the subjective theories of Basic General Education Pedagogy students from a public university in northern Chile regarding the construction of professional identity in early practices. Method: A qualitative case study methodology was used with a theoretical sample of nine Basic General Education Pedagogy students from a public university in northern Chile. The data, obtained from episodic interviews and a group interview, was analyzed based on the grounded theory. Results: The following was found: (a) different meanings about early practice and an evaluation that includes positive and negative aspects of the process, (b) an association between the development of professional identity and the experience of implementing early practice, (c) a set of conditions that gather early practices to favor the construction of the professional identity and (d) the proposal for planning early practices as an experience different from the operation of the other subjects of the degree program. The foregoing was integrated into a comprehensive theory of the development of professional teacher identity in early practices. Discussion: In the discussion section, these results are analyzed from the existing literature. Keywords: professional identity; teaching; initial training; subjectivity; practical education.

Teorías Subjetivas sobre disciplina parental: perspectiva de los profesionales en trabajo social y psicología / Subjective Theories on Parental Discipline: A Perspective of Social Workers and Psychologists

Resumen Objetivo. Reconstruir las teorías subjetivas de profesionales en trabajo social y psicología sobre la disciplina parental. Método. Es una investigación cualitativa con diseño descriptivo. Se realizaron entrevistas individuales a siete profesionales en trabajo social y siete en psicología de la cuarta región de Chile. El análisis de datos utilizó codificaciones mediante el software ATLAS.ti. Resultados. Se demostró que los consejos de disciplina parental se conforman por la formación profesional de pre y posgrado, la experiencia laboral en programas con familias y elementos personales relacionados con historia de vida y parentalidad. Es así que los consejos se basan principalmente en teorías subjetivas y profesionales que se relacionan con teorías formales. Se observan diferencias en los consejos que entregan ambas profesiones.

Abstract Objective. To reconstruct the subjective theories of social workers and psychologists regarding parental discipline. Method. The following research is qualitative, and it was carried out through a descriptive type of design. Individual interviews were conducted to seven social workers and seven psychologists from the fourth region of Chile. The analysis of the collected data was performed through the grounded theory using encodings from the ATLAS.ti. software. Results. It is shown that the pieces of advice regarding parental discipline are strongly influenced by the professional training, the working experience, and some personal elements and conceptions of the interviewed professionals. Some differences are observed regarding the pieces of advice provided from both professional perspectives.

Generating Subjective Theories After a Disaster: The Role of Personality / Generando Teorías Subjetivas Después del Desastre: El Rol de la Personalidad

Abstract The role of people's beliefs in their perception of disasters has been scarcely studied. This study, we analyzed how people who experienced an earthquake and a subsequent tsunami employ subjective theories (ST) to explain their traumatic experience. This study aimed to interpret the explanations developed by a group of people about the earthquake and tsunami that took place in Chile in 2015. Thirteen episodic interviews were conducted as part of a qualitative case study. The participants' theories were grouped into four categories: the impact of personality on one's reaction to hardships; the existence of a link between personality and coping styles; the limited influence of personality on one's way of coping with difficulties; and changes in personality after experiencing hardships. These findings are discussed analyzing whether the participants' explanations could foster personal growth and psychological well-being after the catastrophe.

Resumen El rol de las creencias en la experiencia del desastre ha sido poco investigado. En este estudio se analizó cómo personas que experimentaron un terremoto y posterior tsunami, utilizan teorías subjetivas (TS) para explicar la experiencia traumática. El propósito de este estudio fue interpretar las explicaciones que algunas personas elaboraron respecto al terremoto y tsunami vivido en la zona norte de Chile el año 2015. Se realizaron trece entrevistas episódicas, en el marco de un estudio de caso con metodología cualitativa. Como hallazgos interesantes de las teorías surgen cuatro categorías: implicancias de la personalidad en la reacción ante dificultades; existencia de relación entre personalidad y estilo de afrontamiento; poca importancia de la personalidad al momento de afrontar dificultades, y cambio en la personalidad luego de experimentar una dificultad. Estos hallazgos se discuten analizando si estas explicaciones podrían favorecer -o no- el crecimiento y bienestar psicológico posterior a la catástrofe.

Mortality associated with non-melanoma skin cancer in Spain from 1979 to 2018: trends and age-adjusted rates.

Non-melanoma skin cancers (NMSCs) are the most frequent group of malignant tumours worldwide. Objectives: The aim of the present research was to analyse mortality associated with NMSC in Spain between 1979 and 2018 and highlight changes regarding trend in mortality and differences according to age groups and gender. Death records and mid-year population data were collected from the National Statistics Institute. Age-standardized mortality rates were calculated. Significant changes in mortality trends were identified using Joinpoint regression. The independent effects of age, period and cohort and potential years of life lost due to NMSC were also analysed. Mortality rates associated with NMSC in Spain were reported as 2.49 per 100,000 inhabitants in 1979 (95% CI: 2.24-2.77) and 1.27 per 100,000 inhabitants in 2018 (95% CI; 1.16-1.39) for the overall population. Women who were born after the 70 s showed a significant increase in relative risk of death due to NMSC. Mortality associated with NMSC in Spain shows a decreasing overall trend that appears to have stabilized since 2005, with the exception of women between 35 and 64 years old.

Neutrophils: Many Ways to Die.

Neutrophils or polymorphonuclear leukocytes (PMN) are key participants in the innate immune response for their ability to execute different effector functions. These cells express a vast array of membrane receptors that allow them to recognize and eliminate infectious agents effectively and respond appropriately to microenvironmental stimuli that regulate neutrophil functions, such as activation, migration, generation of reactive oxygen species, formation of neutrophil extracellular traps, and mediator secretion, among others. Currently, it has been realized that activated neutrophils can accomplish their effector functions and simultaneously activate mechanisms of cell death in response to different intracellular or extracellular factors. Although several studies have revealed similarities between the mechanisms of cell death of neutrophils and other cell types, neutrophils have distinctive properties, such as a high production of reactive oxygen species (ROS) and nitrogen species (RNS), that are important for their effector function in infections and pathologies such as cancer, autoimmune diseases, and immunodeficiencies, influencing their cell death mechanisms. The present work offers a synthesis of the conditions and molecules implicated in the regulation and activation of the processes of neutrophil death: apoptosis, autophagy, pyroptosis, necroptosis, NETosis, and necrosis. This information allows to understand the duality encountered by PMNs upon activation. The effector functions are carried out to eliminate invading pathogens, but in several instances, these functions involve activation of signaling cascades that culminate in the death of the neutrophil. This process guarantees the correct elimination of pathogenic agents, damaged or senescent cells, and the timely resolution of the inflammation that is essential for the maintenance of homeostasis in the organism. In addition, they alert the organism when the immunological system is being deregulated, promoting the activation of other cells of the immune system, such as B and T lymphocytes, which produce cytokines that potentiate the microbicide functions.

Direct-to-consumer, store-and-forward teledermatology with dermoscopy using the pharmacist as patient point-of-contact.

OBJECTIVE(S): To evaluate the frequency of nonmelanoma skin cancer (NMSC), NMSC precursors, and melanoma on a store-and-forward dermatology model featuring the pharmacist as the patient's point-of-contact. The secondary objective was to define lesion changes and symptoms perceived by patients (clinical prediction rules by nonexpert observers) that can be predictive of malignity. METHODS: A cross-sectional study of teledermatology consultation was performed. All patients who underwent a teledermatology consultation between September 2018 and March 2020 were included. A patient could have more than 1 lesion per consultation. The object of the study was a defined dermatologic lesion. The differences between the variables were analyzed using a univariate model based on the chi-square test for independent qualitative variables and Fisher exact test in cases when the expected values in any of the cells of a contingency table were less than 5. Statistical significance was set at P < 0.05 (2-tailed). RESULTS: A total of 225 lesions in 218 patients were considered for this study; 53.8% (n = 121) of the lesions were classified as benign, 16.4% (n = 37) as dubious, 23.1% (n = 52) as NMSC precursors, 5.8% (n = 13) as NMSC, and 0.9% (n = 2) as melanomas. Of the reported clinical lesion changes, spontaneous pain, pruritus, surface texture changes, color changes, or form changes had no statistically significant relationship with the diagnostic group, whereas the presence of spontaneous bleeding (P = 0.015) and size changes (P = 0.026) were more frequently observed in the "dubious lesion" and "of oncological relevance lesion" groups. CONCLUSION: This "direct-to-consumer," store-and-forward teledermatology with dermoscopy model featuring the pharmacist as the patient's point-of-contact is useful for the diagnosis of melanoma, NMSC, and NMSC precursors when backed by a robust dermatology service.

Teorias subjetivas da convivência escolar: o que os pais dizem? / Teorías subjetivas de la convivencia escolar: ¿qué dicen los padres / Subjective theories about school coexistence: what do parent say?

El objetivo de este trabajo fue describir e interpretar las TS de la convivencia escolar, de un grupo de padres y madres de una escuela de educación primaria chilena. Se utilizó un muestreo teórico y se aplicaron grupos de discusión y entrevistas episódicas a 16 padres y madres de una escuela de educación primaria. Los datos se analizaron mediante la técnica de la teoría fundamentada, encontrando (a) teorías subjetivas simples, pero que disponen a los padres a educar a sus hijos en convivencia; (b) factores asociados a la CE y propuestas para su mejora, (c) además de un rol parental educativo que se organiza en tres niveles para enseñar a sus hijos a convivir en la escuela. En la discusión se analiza la implicancia de estas teorías subjetivas en la convivencia escolar y el rol parental.

O objetivo deste trabalho foi descrever e interpretar as teorias subjetivas (TS) da convivência escolar (CE), de um grupo de pais e mães de uma escola de educação primária chilena. Uma amostragem teórica foi utilizada e se aplicaram grupos de discussão e entrevistas episódicas em 16 pais e mães de uma escola de educação primária. Os dados foram analisados através da técnica da teoria fundamentada (Grounded Theory), encontrando: (a) teorias subjetivas simples, mas que proporcionam aos pais educar seus filhos na convivência; (b) fatores associados à CE e propostas de melhoria; (c) além de um papel educativo dos pais que se organiza em três níveis para ensinar seus filhos a conviver na escola. Na discussão é analisada a implicação das teorias subjetivas na convivência escolar e no papel parental.

The aim of this work was to describe and to interpret subjective theories about school coexistence in a group of parents from a Chilean primary school. A theoretical sample was used, group discussions and episodic interviews were conducted to 16 parents from a primary school. Data was analyzed through grounded theory, finding (a) simple subjective theories lead parents to raise their children on an environment-based approach; (b) associated factors with school coexistence environment and emerging proposals to improve them; (c) as well as a schooling parental role that it organizes around three levels of climate schooling teaching. In the discussion section, we analyze implications of these subjective theories into schooling environment and parental role.

Intraoperative Ketamine and Magnesium Therapy to Control Postoperative Pain After Abdominoplasty and/or Liposuction: A Clinical Randomized Trial.

PURPOSE: This study aimed to compare the effects of ketamine and ketamine associated with magnesium on opioid consumption and pain scores in patients undergoing abdominoplasty and/or liposuction compared to standard treatment. PATIENTS AND METHODS: A total of 63 patients were included and randomized as follows: 21 patients in the Control group, 20 patients in the Ketamine group (Ket), and 22 patients in the Ketamine-magnesium group (KetMag). The KetMag group received an IV bolus of 0.3 mg/kg of ketamine and 50 mg/kg magnesium, followed by continuous infusion of ketamine (0.15 mg/kg/h) and magnesium (10 mg/kg/h) until extubation. The Ket group received the same bolus and infusion of ketamine, together with a bolus and continuous infusion of placebo instead of magnesium. The Control group received saline instead of ketamine and magnesium. The groups were compared in morphine consumption during the first 12h, body-postoperative pain and disability scale until the 90th day, the time until the first morphine request on the PCA pump, pain scores, and the adverse effects related to the use of study drugs. RESULTS: The KetMag group had a lower morphine consumption by almost 50% during the first 12h than the Control and the Ket groups. In addition, the KetMag group required the first dose of morphine later than the other two groups. There were no differences in the adverse effects of the proposed treatments. Finally, multiple linear regression and a nonlinear approach analysis indicated that the Control group experienced a higher degree of pain and increased morphine consumption per hour than Ket and KetMag groups. CONCLUSION: Co-administration of intraoperative ketamine plus magnesium and ketamine alone are an effective and easy regime for reducing pain and opioid consumption in the postoperative period.

COVID-19 y comportamiento psicológico: revisión sistemática de los efectos psicológicos de las pandemias del siglo XXI

The aim of this work was to conduct a systematic review on psychological behavior in the context of pandemic scenarios during the twenty-first century. We focused on empirical works and brief case reports of H1N1 flu and COVID-19. Our review included 32 papers published both in English or Spanish. We built a set of tables that allowed us to classify the information in four main categories, namely the psychological impact of the pandemic, whether people follow or not official measures to protect themselves against the pandemic, psychological adherence considerations implied as mediators to respect official strategies, and relevant methodological characteristics of the pandemic research. Results show that there are significant impacts on the psychological behavior of people, social groups and organizations in several dimensions, namely emotion, cognition, behavior, mental health, organization and psychosocial factors. In addition, we found that certain social groups experienced a critical psychosocial impact likely due to the pandemic. Psychosocial factors affecting adherence were also identified, which allow us to better understand how health strategies are followed by the population. Different psychosocial suggestions, which emerged from the papers reviewed, were systematized and should be considered as possible pandemic strategies to be implemented.

[COVID-19 and psychological behavior: a systematic review of the psychological effects of 21st century pandemics]. / COVID-19 y comportamiento psicológico: revisión sistemática de los efectos psicológicos de las pandemias del siglo XXI.

The aim of this work was to conduct a systematic review on psychological behavior in the context of pandemic scenarios during the twenty-first century. We focused on empirical works and brief case reports of H1N1 flu and COVID-19. Our review included 32 papers published both in English or Spanish. We built a set of tables that allowed us to classify the information in four main categories, namely the psychological impact of the pandemic, whether people follow or not official measures to protect themselves against the pandemic, psychological adherence considerations implied as mediators to respect official strategies, and relevant methodological characteristics of the pandemic research. Results show that there are significant impacts on the psychological behavior of people, social groups and organizations in several dimensions, namely emotion, cognition, behavior, mental health, organization and psychosocial factors. In addition, we found that certain social groups experienced a critical psychosocial impact likely due to the pandemic. Psychosocial factors affecting adherence were also identified, which allow us to better understand how health strategies are followed by the population. Different psychosocial suggestions, which emerged from the papers reviewed, were systematized and should be considered as possible pandemic strategies to be implemented.

Teorias subjetivas de docentes sobre a inserção laboral de seus alunos cegos / Teorias subjetivas de docentes sobre la inserción laboral de sus alumnos con ceguera / Teachers' subjective theories about the employment integration their blind students

La inserción laboral de las personas con ceguera ha sido investigada, pero no existen trabajos que indaguen sobre lo que piensan y conocen los docentes que forman a estas personas y sobre las dificultades de sus estudiantes para insertarse laboralmente después de su educación. El objetivo de esta investigación cualitativa fue comprender las teorías subjetivas de seis docentes de un establecimiento educacional de La Serena, Chile. El método de recolección de datos utilizado fue la entrevista en profundidad y el estudio de los datos se realizó a través de los procedimientos de codificación de la grounded theory y el análisis del contenido de las teorías subjetivas. Se encontró, como principal resultado que, para los participantes la educación inadecuada del ciego es la principal causa de la dificultad para la inserción laboral. Esta investigación puede aportar información valiosa para aquellos encargados de las políticas públicas entorno a la discapacidad visual.

A inserção laboral das pessoas com cegueira foi pesquisada, mas não existem estudos que perguntem sobre o que pensam e conhecem os docentes que formam estas pessoas e sobre as dificuldades de seus estudantes para inserir-se no mercado laboral depois de sua educação. O objetivo desta pesquisa qualitativa foi compreender as teorias subjetivas de seis docentes de um estabelecimento educacional de La Serena, Chile. O método da coleta de dados utilizado foi a entrevista em profundidade e o estudo dos dados realizou-se por intermédio dos procedimentos de codificação da grounded theory e a análise do conteúdo das teorias subjetivas. Encontrou-se, como principal resultado, que para os participantes a educação inadequada do cego é a principal causa da dificuldade para a inserção laboral. Esta pesquisa pode aportar informação valiosa para aqueles encarregados das políticas públicas entorno à incapacidade visual.

Even though research has been conducted on the employment integration at blind people, studies have failed to consider what teachers think and know about their blind students' difficulties entering the workforce after completing their education. The aim of this qualitative study was to understand the subjective theories of six teachers from a school in La Serena, Chile. In-depth interviews were used to collect data, which were subsequently studied using grounded theory coding procedures and subjective theory content analysis. The main finding of this study was that participants regarded the inadequate education of blind people as the key reason for their employment difficulties. This study can provide valuable information for policymakers focusing on visual impairment.

Caracterización del uso de fuentes de información para el acceso a criterios diagnósticos por parte de fonoaudiólogas y fonoaudiólogos en Chile / Characterizing the use of information sources for accessing diagnostic criteria by speech and language therapists in Chile

En el modelo de la Práctica Basada en la Evidencia el fonoaudiólogo debe conocer los criterios diagnósticos y el nivel de evidencia de los procedimientos de intervención para ofrecer un tratamiento adecuado. En la literatura se describe un bajo grado de formación académica y un escaso uso de la Práctica Basada en la Evidencia como fuente de acceso a diagnósticos y tratamientos. Este estudio investigó las dificultades de los fonoaudiólogos para acceder a los criterios para el diagnóstico fonoaudiológico. Se realizó una encuesta masiva online a 384 fonoaudiólogos, usando un método cuantitativo, descriptivo y transeccional. Los resultados indican que, independiente de los años de ejercicio laboral, un 79,7% de los encuestados utiliza fuentes secundarias para el acceso a criterios para el diagnóstico fonoaudiológico, un 46% no conoce fuentes de información fiables para acceder a diagnósticos y un 73,4% afirma haber tenido dificultades para acceder a criterios diagnósticos. Los sujetos encuestados no utilizan fuentes primarias que les permitan acceder a criterios que apoyen los diagnósticos fonoaudiológicos. Por lo anterior, se considera relevante educar sobre Práctica Basada en la Evidencia en el contexto universitario.

In the Evidence-Based Practice model, the speech and language therapist must know the diagnostic criteria and be aware of the evidence supporting the intervention procedures, to provide an effective treatment. However, the literature describes both low levels of academic training and scarce use of evidence-based practices as a base of speech and language diagnosis and treatments. This study probes into the difficulties speech and language therapists face to access the diagnostic criteria and their bibliographic references. A massive online survey was conducted with 384 speech therapists, using a quantitative, descriptive and transectional method. Results show that 79.7% of respondents use secondary sources to access criteria on which subsequently base their speech and language diagnoses, 46% do not know reliable sources of information to access criteria for diagnoses and 73.4% maintain that they had difficulties in accessing diagnostic criteria. These difficulties do not recede with years of practice. Based on these results it is possible to conclude that surveyed therapists presented difficulty to find information on which to establish their diagnostic criteria and they do not use primary sources for access information. All of this supports training students on Evidence Based Practice when in their University programs.

Development and validation of a questionnaire to measure empowerment in adult patients with atopic dermatitis. The DATEMP questionnaire.

BACKGROUND AND OBJECTIVES: In recent years, the hypothesis that increasing the empowerment of patients can help to improve health outcomes and rationalize the use of health services has become relevant, especially for chronic diseases. Developing validated measurement tools is necessary to achieve this goal. In the field of dermatology, there are few studies related to empowerment of the patient. The aim of the present research is to develop and validate a self-administered questionnaire for adult patients diagnosed with atopic dermatitis (AD) in order to measure their level of empowerment. METHODS: After a literature review and the establishment of consulting groups of patients and dermatologists, a large battery of 35 items was generated, based on the dimensions included in previous empowerment descriptions. A multidisciplinary group selected the 20 most suitable items to include in the questionnaire. A cross-sectional study was carried out with the items included in the questionnaire as well as demographic and clinical characteristics. To reduce the number of items and measure the construct validity, an exploratory factorial analysis (EFA) of the primary components and varimax rotation were used. Cronbach's α was used to measure the reliability of the individual scales and the global questionnaire. RESULTS: 242 valid questionnaires were included. After completion of the EFA, the final Dermatitis Atópica EMPoderamiento (DATEMP) questionnaire was composed of 17 items that converged on four factors. The four scales had adequate reliability: "Knowledge" (Cronbach's alpha = 0.808), "Abilities" (Cronbach's alpha = 0.744), "Intention to change" (Cronbach's alpha = 0.798) and "Coping skills" (Cronbach's alpha = 0.772). The overall Cronbach's α of the questionnaire was 0.764. CONCLUSIONS: The DATEMP questionnaire is the first specific empowerment measurement instrument developed for patients with AD that has demonstrated adequate levels of reliability and construct validity. It is a self-administered questionnaire that is simple and quick to answer.

Pseudo skin flash on VMAT in breast radiotherapy: Optimization of virtual bolus thickness and HU values.

PURPOSE: Optimisation strategies for volumetric modulated arc therapy (VMAT) in most treatment planning systems for breast cancer do not account for patient positioning, breathing, or anatomical changes. To overcome this limitation, a pseudo-skin flash strategy using a virtual bolus has been proposed. Using this strategy, we determined optimal thickness and value of Hounsfield units (HU) assigned to the virtual bolus to ensure adequate CTV irradiation. MATERIALS AND METHODS: We modified the original computed tomography data (CT0) by adding combinations of thicknesses and densities of a virtual bolus on PTVs (CT') of seven bilateral breast cancer patients. Using a single optimization objective template, we obtained a VMAT plan on CT' and recalculated this on the CT0. Optimal CT' parameters were defined as those that minimized dose differences between CT' and CT0 plans regarding PTV and OAR dose-volume parameters. We studied bolus parameters regarding robustness by shifting the isocenter 5 and 10 mm in the breathing direction for each CT0 plan. RESULTS: The minimal dosimetric impact was between -400 and -600 HU depending on bolus thickness. OARs doses were not significantly affected. Best robustness was found for -500 HU and 15 mm bolus thickness against shifts of up to 10 mm in the breathing direction. CONCLUSION: Our results support a bolus thickness equal to the CTV-PTV margin plus 5 mm and a virtual bolus HU value around -500 and -400 depending on the bolus thickness chosen. These findings could play a useful role in maximisingrobustness and minimising the need for plan renormalization.