Associations Between Compliance With Non-pharmaceutical Interventions and Social-distancing Policies in Korea During the COVID-19 Pandemic.

OBJECTIVES: This study explored changes in individuals' behavior in response to social distancing (SD) levels and the "no gatherings of more than 5 people" (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chi-square test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission. RESULTS: In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance. CONCLUSIONS: SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.

On the assessment of arterial compliance from carotid pressure waveform.

In a progressively aging population, it is of utmost importance to develop reliable, noninvasive, and cost-effective tools to estimate biomarkers that can be indicative of cardiovascular risk. Various pathophysiological conditions are associated to changes in the total arterial compliance (CT), and thus, its estimation via an accurate and simple method is valuable. Direct noninvasive measurement of CT is not feasible in the clinical practice. Previous methods exist for indirect estimation of CT, which, however, require noninvasive, yet complex and expensive, recordings of the central pressure and flow. Here, we introduce a novel, noninvasive method for estimating CT from a single carotid waveform measurement using regression analysis. Features were extracted from the carotid wave and were combined with demographic data. A prediction pipeline was adopted for estimating CT using, first, a feature-based regression analysis and, second, the raw carotid pulse wave. The proposed methodology was appraised using the large human cohort (N = 2,256) of the Asklepios study. Accurate estimates of CT were yielded for both prediction schemes, namely, r = 0.83 and normalized root mean square error (nRMSE) = 9.58% for the feature-based model, and r = 0.83 and nRSME = 9.67% for the model that used the raw signal. The major advantage of this method pertains to the simplification of the technique offering easily applicable and convenient CT monitoring. Such an approach could offer promising applications, ranging from fast and cost-efficient hemodynamical monitoring by the physician to integration in wearable technologies.NEW & NOTEWORTHY This article introduces a novel artificial intelligence method to estimate total arterial compliance (CT) via exploiting the information provided by an uncalibrated carotid blood pressure waveform as well as typical clinical variables. The major finding of this study is that CT, which is usually acquired using both pressure and flow waveforms, can be accurately derived by the use of the pressure wave alone. This method could potentially facilitate easily applicable and convenient monitoring of CT.

Programa Gestão Pessoal da Carreira para Universitários: Análise Qualitativa do Processo / Career Self-Management Program for College Students: Qualitative Analysis of the Process / Programa de Gestión Personal de la Carrera para Universitarios: Análisis Cualitativa del Proceso

A avaliação do processo das intervenções de carreira é uma lacuna da investigação vocacional. Este estudo apresenta a avaliação qualitativa do processo de um programa de gestão pessoal da carreira para universitários, com seis sessões semanais de 120 minutos cada, realizadas com oito grupos distintos. Participaram 42 estudantes, três psicólogas e uma supervisora. Analisou-se o conteúdo das respostas a questões abertas, no início, durante e final do processo de intervenção. As expectativas dos estudantes foram satisfeitas, sobretudo, quanto ao fomento do apoio e à adaptabilidade de carreira. As primeiras sessões satisfizeram expectativas de maior conhecimento de si, do meio e de certeza vocacional e, as últimas, de projeção futura e planejamento. A avaliação do processo demonstra o impacto do programa.

The evaluation of the career intervention process is a research gap. This study presents the qualitative evaluation of the process of a career self-management program for university students, with six weekly sessions of 120 minutes each, held with eight distinct groups. Forty-two students, three psychologists and one supervisor participated. The content of the answers to open questions at the beginning, during and at the end of the intervention process was analyzed. The students’ expectations were met, above all, in terms of fostering support and career adaptability. The first sessions satisfied expectations of greater knowledge of oneself, of the environment and of career certainty, and the last ones of future projection and planning. The evaluation of the process demonstrates the impact of the program.

La evaluación del proceso de intervenciones en la carrera es una laguna en la investigación vocacional. Este estudio presenta la evaluación cualitativa del proceso de un programa de gestión personal de la carrera para estudiantes universitarios, con seis sesiones semanales de 120 minutos cada una, celebradas con ocho grupos distintos. Participaron 42 estudiantes, tres psicólogos y un supervisor. Se analizó el contenido de las respuestas a las preguntas abiertas al principio, durante y al final del proceso de intervención. Las expectativas de los estudiantes se cumplieron, sobre todo, en lo que respecta a la promoción del apoyo y la adaptabilidad de la carrera. Las primeras sesiones satisficieron las expectativas de un mayor conocimiento de sí mismo, del entorno y de la certeza vocacional, y las últimas de proyección y planificación futuras. La evaluación del proceso demuestra el impacto del programa.

Assessment of Upper Extremity Venous Compliance in Patients With Abdominal Aortic Aneurysms.

OBJECTIVE: Abdominal aortic aneurysm (AAA) is associated with morphological and functional changes in both aneurysmal and non-aneurysmal arteries. However, it remains uncertain whether similar changes also exist in the venous vasculature. The aim of this study was to evaluate global venous function in patients with AAA and controls. METHODS: This experimental study comprised 31 men with AAA (mean ± standard deviation age 70.0 ± 2.8 years) and 29 male controls (aged 70.6 ± 3.4 years). Venous occlusion plethysmography (VOP) was used to evaluate arm venous compliance at venous pressures between 10 and 60 mmHg in steps of 5 mmHg. Compensatory mobilisation of venous capacitance blood (capacitance response) was measured with a volumetric technique during experimental hypovolaemia induced by lower body negative pressure (LBNP). RESULTS: The VOP induced pressure-volume curve was significantly less steep in patients with AAA (interaction, p < .001), indicating lower venous compliance. Accordingly, the corresponding pressure-compliance curves displayed reduced venous compliance at lower venous pressures in patients with AAA vs. controls (interaction, p < .001; AAA vs. control, p = .018). After adjusting for arterial hypertension, diabetes mellitus, hyperlipidaemia, chronic obstructive pulmonary disease, and smoking, VOP detected differences in venous compliance remained significant at low venous pressures, that is, at 10 mmHg (p = .008), 15 mmHg (p = .013), and 20 mmHg (p = .026). Mean venous compliance was negatively correlated with aortic diameter (r = -.332, p = .010). Mobilisation of venous capacitance response during LBNP was reduced by approximately 25% in patients with AAA (p = .030), and the redistribution of venous blood during LBNP was negatively correlated with aortic diameter (r = -.417, p = .007). CONCLUSION: Men with AAA demonstrated reduced venous compliance and, as a result, a lesser capacity to mobilise peripheral venous blood to the central circulation during hypovolaemic stress. These findings imply that the AAA disease may be accompanied by functional changes in the venous vascular wall.

A modelling framework for assessment of arterial compliance by fusion of oscillometry and pulse wave velocity information.

BACKGROUND AND OBJECTIVES: Measurement of arterial compliance is recognized as important for clinical use and for enabling better understanding of circulatory system regulation mechanisms. Estimation of arterial compliance involves either a direct measure of the ratio between arterial volume and pressure changes or an inference from the pulse wave velocity (PWV). In this study we demonstrate an approach to assess arterial compliance by fusion of these two information sources. The approach is based on combining oscillometry as used for blood pressure inference and PWV measurements based on ECG/PPG. Enabling reliable arterial compliance measurements will contribute to the understanding of regulation mechanisms of the arterial tree, possibly establishing arterial compliance as a key measure relevant in hemodynamic monitoring. METHODS: A measurement strategy, a physiological model, and a framework based on Bayesian principles are developed for measuring changes in arterial compliance based on combining oscillometry and PWV data. A simulation framework is used to study and validate the algorithm and measurement principle in detail, motivated by previous experimental findings. RESULTS: Simulations demonstrate the possibility of inferring arterial compliance via fusion of simultaneously acquired volume/pressure relationships and PWV data. In addition, the simulation framework demonstrates how Bayesian principles can be used to handle low signal - to - noise ratio and partial information loss. CONCLUSIONS: The developed simulation framework shows the feasibility of the proposed approach for assessment of arterial compliance by combining multiple data sources. This represents a first step towards integration of arterial compliance measurements in hemodynamic monitoring using existing clinical technology. The Bayesian approach is of particular relevance for such patient monitoring settings, where measurements are repeated frequently, context is relevant, and data is affected by artefacts. In addition, the simulation framework is necessary for future clinical-study design, in order to determine device specifications and the extent to which noise affects the inference process.

Life satisfaction and its contributors among noninstitutionalized older people in Tabriz, Islamic Republic of Iran

Background: With the rising growth of the older population, the well-being of older people is an important objective for both economic and health policy.Aims: This study investigates levels of life satisfaction among older people living at home and the factors that influence it.Method: Applying probability proportional to size, a cross-sectional survey was conducted of 1067 older people living in Tabriz, Islamic Republic of Iran. The Satisfaction with Life Scale and the Multidimensional Scale of Perceived Social Sup-port questionnaires were administered. The data were analysed using chi-squared tests and logistic regression.Results: More than half of the participants were dissatisfied with their lives. Female, educated, and active older people reported greater satisfaction than others. Conclusion: The significant positive effects of perceived social support and physical activity rate indicated that social interaction may be as vital as physical activity for the well-being of older people, and that these qualities should be actively promoted among older people in the Islamic Republic of Iran.

Contexte : Compte tenu de l’augmentation croissante de la population âgée, le bien-être de cette tranche d’âge constitue un objectif important pour les politiques économique et sanitaire.Objectifs : La présente étude portait sur les niveaux de satisfaction à l’égard de la vie chez les personnes âgées vivant à domicile et les facteurs qui l’influencent.Méthode : En appliquant une probabilité proportionnelle à la taille, une étude transversale a été menée auprès de 1067 personnes âgées résidant à Tabriz. Les questionnaires correspondant à l’Échelle de satisfaction dans la vie et à l’Échelle multidimensionnelle de soutien social perçu ont été administrés. Les données ont été analysées à l’aide de tests du khi carré et de la régression logistique.Résultats : Plus de la moitié des participants étaient insatisfaits de leur vie. Les femmes âgées, actives et éduquées faisaient état d’un niveau de satisfaction plus élevé que les autres. Conclusion : Les effets positifs significatifs du soutien social perçu et du taux d’activité physique indiquaient que l’interaction sociale peut jouer un rôle aussi essentiel que l’activité physique pour le bien-être des personnes âgées. De ce fait, ces qualités devraient être activement encouragées parmi les personnes âgées en République islamique d’Iran.

Development of MyCheckTime® software for perioperative safety based on Toyota's Lean Methodology / Desarrollo del software MyCheckTime® para seguridad perioperatoria con base en la metodología Lean de Toyota

Abstract Introduction: In the age of healthcare safety, compliance with checklists and time tracking in surgery continue to be a gray zone in care processes. The technology applied to approach this issue and other scenarios, may contribute to solve a problem that impacts welfare and the healthcare sector economics. Objective: To introduce the design and construction of the MyCheckTime® software that incorporates Toyota's Lean methodology under the concept of Bundles. Materials and methods: Using a conceptual map, 5 measures were incorporated into the bundle; the MyCheckTime® platform was built based on a software code developed in Java8, PHP, Javascript, HTML5, Angular4, MongoDB-MySQL databases, and Docker, Ionic, VertX, Laravel-implemented technologies. Results: A software (MyCheckTime®) was constructed based on an App available for tablets and IOS and Android system-based mobile devices; a web-based platform and a database. The software captures the patient's circuit in the surgical area in real time, and records the times in which the checklists were conducted. Conclusion: MyCheckTime® is a Lean Methodology-based software that potentially enables the surgical team to deliver more efficient, safer, and timely care, allowing real time recording of the patient's circuit in the surgery area.

Resumen Introducción: En la era de la seguridad en la atención en salud, la de atención. La tecnología aplicada a esta problemática, al igual que adherencia a las listas de verificación y el seguimiento de tiempos otros escenarios, podrá contribuir a solucionar un problema que en el área de cirugía, continúan siendo puntos grises en los procesos de atención. La tecnología aplicada a esta problemática, al igual que otros escenarios, podrá contribuir a solucionar un problema que impacta el bienestar y la economía en el sector salud. Objetivo: Presentar el diseño y construcción del software MyCheckTime® que incorpora la metodología Lean de Toyota, bajo el concepto Bundles. Materiales y métodos: Mediante un mapa conceptual se incorporaron cinco medidas al paquete y se construyó una plataforma llamada MyCheckTime® con un código de software desarrollado en Java8, PHP, Javascript, HTML5, Angular4, bases de datos MongoDB-MySQL y tecnologías implementadas Docker, Ionic, VertX, Laravel. Resultados: Se construyó un software (MyCheckTime® ), compuesto por una App disponible para tabletas y móviles con sistema IOS o Android; una plataforma en la web y una base de datos. El software captura en tiempo real el circuito del paciente en el área de cirugía y registra los momentos en que se realizaron las listas de verificación. Conclusión: MyCheckTime® es un software basado en la Metodología Lean que potencialmente permitirá al equipo quirúrgico brindar una atención más eficiente, segura, y oportuna, permitiendo el registro en tiempo real del circuito que el paciente hace en el área de cirugía.

El derecho a la alimentación y la justicia de género en Venezuela. Indicadores de Progreso / The Right to Food and Gender Justice in Venezuela. Progress Indicators

Se establecieron Indicadores estructurales, de procesos y de resultados, como indicadores de procesos basados en los establecidos en el Protocolo de San Salvador, para el monitoreo del derecho a la alimentación en Venezuela bajo el principio transversal de igualdad y no discriminación: la justicia de género. Al determinar Indicadores estructurales, se estableció que en Venezuela no se contempla el derecho a la alimentación adecuada, bajo una declaración expresa en la Constitución de la República Bolivariana de Venezuela y/o las Leyes establecidas para tal fin, debiendo establecerse su declaración expresa bajo el orden jurídico legal del país, así como su vinculación con poblaciones en situación de vulnerabilidad, atendiendo lo concerniente al derecho a la alimentación y la población con justicia de género. Los Indicadores de procesos establecidos determinaron una elevada opacidad estadística en instituciones oficiales y gubernamentales sobre los alcances del establecimiento de las denominadas misiones sociales y programas de ayuda alimentaria, así como el alcance desglosado de los programas por grupos tradicionalmente excluidos como el enfoque de justicia de género. Al determinar indicadores de resultados, no se evidenciaron en los portales oficiales de los entes del Estado, la existencia de estadísticas de tasa de desnutrición de forma general o para distintos sectores poblacionales (niños, niñas, jóvenes, mujeres, adultos mayores, personas con discapacidad, grupos étnicos) sobre la base de la Tasa de desnutrición global. La aplicación de estos indicadores determinaron el no cumplimiento por parte del estado, de la garantía de un derecho a la alimentación adecuada, requiriéndose una profunda transformación estructural y de procesos, bajo la premisa de los derechos humanos, a los fines de poder establecer una significativa y necesaria mejora en los indicadores de resultados, así como generar soluciones para transformar las desigualdades de género, ante la creciente tendencia del establecimiento de una feminización de la pobreza en Venezuela(AU)

Structural, process and result indicators were established, as process indicators based on those established in the Protocol of San Salvador, for monitoring the right to food in Venezuela, under the cross-cutting principle of equality and non-discrimination: gender justice . When determining structural indicators, it was established that in Venezuela the right to adequate food is not contemplated, under an express declaration in the Constitution of the Bolivarian Republic of Venezuela and / or the Laws established for that purpose, and its express declaration must be established under the legal order of the country, as well as its relationship with populations in vulnerable situations, taking into account the right to food and the population with gender justice. The indicators of established processes determined, a high statistical opacity in official and governmental institutions regarding the scope of the establishment of the so-called social missions and food aid programs, as well as the disaggregated scope of the programs by traditionally excluded groups, such as the gender justice approach. When determining results indicators, the existence of statistics on the malnutrition rate in general or for different population sectors (boys, girls, youth, women, older adults, people with disabilities, ethnic groups) based on the Global Malnutrition Rate, was not evidenced in the official portals of the State entities. The application of these indicators determined the non-compliance by the state with the guarantee of a right to adequate food, requiring a profound structural and process transformation, under the premise of human rights, in order to establish a significant and necessary improvement in the results indicators, as well as generating solutions to transform gender inequalities, given the growing trend of the establishment of a feminization of poverty in Venezuela(AU)

Modelos Mentales de Clima Escolar en Docentes y Estudiantes de Básica Primaria / Mental Models of School Climate in Elementary School Teachers and Students

Las conductas violentas en el noviazgo de adolescentes han sido objeto de especial interés en las últimas décadas. En su estudio se han abordado diversos factores individuales, relacionales, familiares y sociales. En el caso de los aspectos familiares, se ha sugerido que la vivencia de experiencias negativas en el seno familiar podría funcionar como factor de riesgo para la aparición de conductas violentas. Por ello, el presente estudio explora las diferencias por sexo en cuanto a la violencia sufrida y cometida, así como la posible asociación entre la cohesión y la adaptabilidad familiar con la frecuencia de conductas violentas cometidas o sufridas en una muestra participantes. Participaron 161 mujeres y 151 hombres, con edades entre los 15 y 19 años (M= 16.73; DT=1.093), originarios del estado de Colima, México. Entre los diversos resultados obtenidos destaca que no se hallaron diferencias estadísticamente significativas en los diversos tipos de violencia evaluados, aunque los hombres señalaron haber sufrido más violencia que las mujeres. Añadido a ello, ambos sexos señalaron mayor frecuencia en conductas específicas de control hacia su pareja y presión para sostener relaciones sexuales. Con respecto a la asociación teórica entre funcionamiento familiar, evaluado a través de la cohesión y adaptabilidad, y la violencia cometida y sufrida, solo se hallaron correlaciones muy débiles. Se discuten los resultados enfatizando la prevención de la minimización o normalización de conductas específicas de control entre los y las jóvenes.

Violent behavior in adolescent dating has been an object of special interest in recent decades. Individual, relational, family and social factors have been prioritized in its research. In the case of family aspects, it has been suggested that the experience of negative experiences in the family could work as a risk factor for the manifestation of violent behavior. Therefore, the present study explores the differences by sex in terms of violence suffered and committed, as well as the possible association between cohesion and family adaptability with the frequency of violent behaviors committed or suffered in the participating sample. 161 women and 151 men participated, aged between 15 and 19 years (M = 16.73; DT = 1.093), originating in the state of Colima, Mexico. Among the various results obtained, it is pointed out that no statistically significant differences were found in the different types of violence evaluated, although men indicated that they suffered more violence than women. Besides, both sexes indicated greater frequency in specific behaviors of control towards their partner and pressure to sustain sexual relations. With respect to the theoretical association between family functioning, assessed through cohesion and adaptability, and the violence committed and suffered, only very weak correlations were found. The results are discussed emphasizing the prevention of the minimization or normalization of specific control behaviors among young people

Funcionamiento familiar y violencia de pareja en adolescentes: Un estudio exploratorio / Family functioning and partner violence in adolescents: An exploratory study

Las conductas violentas en el noviazgo de adolescentes ha sido objeto de interés en las últimas décadas. En su estudio se han priorizado diversos factores individuales, relacionales, familiares y sociales. En el caso de los aspectos familiares, se ha sugerido que la vivencia de experiencias negativas en el seno familiar podría funcionar como factor de riesgo para la aparición de conductas violentas. Por ello, el presente estudio explora las diferencias por sexo en cuanto a la violencia sufrida y cometida, así como la posible asociación entre la cohesión y la adaptabilidad familiar con la frecuencia de conductas violentas cometidas o sufridas en la muestra participante. Participaron 161 mujeres y 151 hombres, con edades entre los 15 y 19 años (M= 16.73; DT=1.093), originarios del estado de Colima, México. Entre los diversos resultados obtenidos destaca que no se hallaron diferencias estadísticamente significativas en los diversos tipos de violencia evaluados, aunque los hombres señalaron haber sufrido más violencia que las mujeres. Añadido a ello, ambos sexos señalaron mayor frecuencia en conductas específicas de control hacia su pareja y presión para sostener relaciones sexuales. Con respecto a la asociación teórica entre funcionamiento familiar, evaluado a través de la cohesión y adaptabilidad, y la violencia cometida y sufrida, solo se hallaron correlaciones muy débiles. Se discuten los resultados enfatizando la prevención de la minimización o normalización de conductas específicas de control entre los y las jóvenes.

Violent teen dating behavior has been the subject of interest in recent decades. In his study, various individual, relational, family and social factors have been prioritized. In the case of family aspects, it has been suggested that the experience of negative experiences within the family could function as a risk factor for the appearance of violent behaviors. Therefore, the present study explores the differences by sex in terms of violence suffered and committed, as well as the possible association between cohesion and family adaptability with the frequency of violent behaviors committed or suffered in the participating sample. 161 women and 151 men participated, aged between 15 and 19 years (M = 16.73; SD = 1,093), originally from the state of Colima, Mexico. Among the various results obtained, it stands out that no statistically significant differences were found in the various types of violence evaluated, although men reported having suffered more violence than women. Added to this, both sexes reported a higher frequency in specific behaviors of control towards their partner and pressure to have sexual relations. Regarding the theoretical association between family functioning, evaluated through cohesion and adaptability, and the violence committed and suffered, only very weak correlations were found. The results are discussed emphasizing the prevention of the minimization or normalization of specific control behaviors among young people.

Feasibility and Validity of Geographically Explicit Ecological Momentary Assessment With Recall-Aided Space-Time Budgets.

We employ data from the Adolescent Health and Development in Context Study-a representative sample of urban youth ages 11-17 in and around the Columbus, OH area-to investigate the feasibility and validity of smartphone-based geographically explicit ecological momentary assessment (GEMA). Age, race, household income, familiarity with smartphones, and self-control were associated with missing global positioning systems (GPS) coverage, whereas school day was associated with discordance between percent of time at home based on GPS-only versus recall-aided space-time budget data. Fatigue from protocol compliance increases missing GPS across the week, which results in more discordance. Although some systematic differences were observed, these findings offer evidence that smartphone-based GEMA is a viable method for the collection of activity space data on urban youth.

Inteligencias y sabidurías organizacionales: Redes de conocimiento en torno al aprendizaje de la complejidad / Organizational intelligences and wisdoms: Knowledge networks focus on learning complexity

Resumen Objetivo: Explicar el desempeño de una red de conocimiento, entendida desde la psicología de la inclusión como un sistema de gestión, producción y transferencia entre las demandas del entorno y las capacidades de la organización. Método: Se realizó un estudio no experimental, transversal y correlacional con una selección muestral no probabilística de 300 administrativos, docentes y estudiantes de una universidad pública, considerando su interacción en prácticas profesionales. Se utilizó la Escala de Complejidad Organizacional de García (2016), la cual es una síntesis de 1) Inventario de Estrategias de Pensamiento (Torkamani & Mahmoudi, 2016); 2) Escala de Inteligencia Competitiva (Saleh, Rahimi & Amirnejad, 2015); 3) Cuestionario de Aprendizaje Organizacional (Erfani & Jafari, 2013), los cuales se procesaron con la técnica Delphi. Resultados: El grado de aprendizaje de la red de conocimiento siguió un patrón selectivo, ya que las posibles combinaciones de las redes de conocimiento sugieren que la capa de entrada al estar regulada por la capa intermedia refleja, en la capa de salida, una gestión, producción y transferencia de conocimiento en función de las tareas más que de los objetivos o las metas. Se advierte la emergencia de una inteligencia organizacional centrada en cuatro factores: Autorregulación, disipación, adaptabilidad y dinamismo. Conclusión: Se advierten líneas de investigación alusivas a las posibles relaciones entre factores tales como la motivación al logro, la utilidad esperada o la facilidad de llevar a cabo una tarea en red como determinantes del clima de tareas, principal factor emergente de la red de conocimiento.

Abstract Objective: To explain the performance of a knowledge network, understood as a system of management, production and transfer between the demands of the environment and the capabilities of the organization. Method: A non-experimental, cross-sectional and correlational study was carried out with a non-probabilistic sample selection of 300 administrative staff, teachers and students of a public university, considering their interaction in professional practices. The Organizational Complexity Scale de García (2016) was used, which is a synthesis of 1) Inventory of Thinking Strategies (Torkamani & Mahmoudi, 2016); 2) Scale of Competitive Intelligence (Saleh, Rahimi & Amirnejad, 2015); 3) Organizational Learning Questionnaire (Erfani & Jafari, 2013) which were processed with the Delphi technique. Results: The degree of learning of the knowledge network followed a selective pattern because, the possible combinations of the knowledge networks suggest that the input layer, when regulated by the intermediate layer, reflects in the output layer; management, production and transfer of knowledge in terms of tasks rather than objectives or goals. One can see the emergence of an organizational intelligence centered on four factors: self-regulation, dissipation, adaptability and dynamism. Conclusion: There are lines of research alluding to the possible relationships between factors such as the motivation to achieve, the expected utility or the ease of carrying out a network task as determinants of the task climate, the main emerging factor of the knowledge network.

In Vivo Assessment of Ascending and Arch Aortic Compliance.

BACKGROUND: Dynamic compliance (Cd) of the adult thoracic ascending and arch aorta has had limited in vivo evaluation in patients with aortic disease. This study evaluates aortic compliance using intravascular ultrasound (IVUS) across a range of thoracic aortic diseases. METHODS: Seventy-nine patients undergoing thoracic aortic endovascular procedures had Cd measurements of the ascending aorta proximal to the origin of the brachiocephalic trunk and distal to the origin of the left common carotid artery using IVUS before endograft deployment. Cd was calculated for each segment using the following equation, Cd = ΔD/(D • ΔP) where ΔD = change in aortic diameter, D = diameter in diastole, and ΔP = pulse pressure. RESULTS: Mean Cd of the ascending aorta in all patients (18.4%/mm Hg) and aortic arch (16.5 %/100 mm Hg) did not differ significantly. Compliance was significantly lower in patients being treated for thoracic aortic aneurysm and penetrating ulcer than in patients with traumatic rupture, acute and chronic dissection (P = 0.009). Compliance was significantly higher in patients with aortic transection compared with thoracic aneurysm or penetrating ulcer (P = 0.001). Compliance decreased with age by 0.44 ± 0.06 (P = 0.001) per year in the ascending aorta and 0.41 ± 0.05 (P = 0.001) per year in the aortic arch. Compliance did not increase with diameter when adjusted for age (P = 0.65). Compliance measured in the ascending aorta in 7 patients after descending thoracic aortic endograft repair decreased to 12.6%/100 mm Hg, although not significant (P = 0.18). CONCLUSIONS: Ascending and aortic arch compliance is significantly higher than reported for peripheral vessels. Thoracic aortic compliance decreases with age and is not related to aortic diameter. The results of the present study are important when considering the development of endoprosthesis devices and long-term effects on the thoracic aorta.

Bedside Ultrasound Assessment of Jugular Venous Compliance as a Potential Point-of-Care Method to Predict Acute Decompensated Heart Failure 30-Day Readmission.

Background Heart failure is one of the most costly diagnosis-related groups, largely because of hospital readmissions. Objective assessment of volume status to ensure optimization before hospital discharge could significantly reduce readmissions. We previously demonstrated an ultrasound method of quantifying percentage of cross-sectional area ( CSA ) change of the right internal jugular vein with Valsalva that reliably estimates central venous pressure. Methods and Results Patients admitted with acute decompensated heart failure ( ADHF ) underwent ultrasound measurements of the right internal jugular vein at end-expiration and during the strain phase of Valsalva to determine a percentage of CSA change. An initial subgroup of patients with right heart catheterization and accompanying ultrasound measurements of the right internal jugular vein identified a percentage of CSA change predictive of right atrial pressure ( RAP ) ≥12 mm Hg. Images of admitted ADHF patients were obtained at admission and discharge for final analysis. Simultaneous right heart catheterization and right internal jugular vein ultrasound measurements demonstrated that a <66% CSA change predicted RAP ≥12 mm Hg (positive predictive value: 87%; P<0.05, receiver operating characteristic curve). Elevated admission RAP by percentage of CSA change normalized by discharge ( P<0.05), indicating that this test is significantly responsive to therapeutic interventions. Using the cutoff value of 66% CSA change, normal RAP at discharge had 91% predictive value for patients avoiding 30-day readmission ( P<0.05). Conclusions This bedside ultrasound technique strongly correlates to invasive RAP measurement in ADHF patients, identifies restoration of euvolemia, and is predictive of 30-day ADHF readmission. This tool could help guide inpatient ADHF treatment and may lead to reduced readmissions.

[Current status of noninvasive hemodynamics in hypertension]. / Estado actual de la hemodinamia no invasiva en hipertensión arterial.

Hypertension is a haemodynamic disorder resulting from a persistent mismatch between cardiac output and peripheral resistance. Hypertension undergoes haemodynamic progression during its natural history. Impedance cardiography is a method of evaluating the cardiovascular system that obtains haemodynamic information from beat to beat through the analysis of variations in the impedance of the thorax on the passage of an electric current. Impedance cardiography unmasks the haemodynamic deterioration underlying the increase in blood pressure as age and systolic blood pressure increases. This method may help to improve blood pressure control through individualized treatment with reduction of peripheral resistance, maintenance of cardiac output or its increase, improvement of arterial compliance and preservation of organ-tissue perfusion. It is useful in the management of patients with resistant hypertension, since a greater percentage of patients controlled with changes in the treatment in relation to the haemodynamic measurements are obtained. Impedance cardiography is important and has prognostic utility in relation to a haemodynamic deterioration pattern and increased cardiovascular events.

Implantação do E-SUS: percepção dos profissionais enfermeiros das equipes de estratégia da saúde da família em Rio Verde-GO / Implantation of the E-SUS: perception the professional nurses of the teams of family health strategy in Rio Verde-GO

O estudo pretende conhecer a percepção dos enfermeiros em relação a implantação do e-SUS e traçar o perfil dos enfermeiros na ESF. Trata-se de estudo descritivo, exploratório, de abordagem qualitativa, realizado com enfermeiros de equipes de ESF do município de Rio Verde - Goiás. Na variável sexo, 7 (87,5%) são do sexo feminino, e 1 (12,5%) do sexo masculino, a faixa etária dos profissionais predominou entre 30 e 39 anos com (50%), o estudo apontou que 25% dos entrevistados concentram-se na faixa etária de 20 a 29 anos e 25% estão acima dos 40 anos de idade. Na variável formação, 100% dos enfermeiros são especialistas (Lato sensu); Em relação a percepção dos enfermeiros, apresentou maior significância a variável "Regular" (50%); Na variável "bom" (37%) consideraram que o sistema tem seus aspectos positivos e (13%) consideraram que a adaptabilidade ao novo sistema foi ruim. Apesar das dificuldades relatadas, (50%) dos enfermeiros consideram que o e-Sus ao ser comparado com o SIAB melhorou bastante. Mas nas variáveis piorou" e "continua igual" houve semelhança (25%) para cada. Em plena era digital e de tecnologia avançada sabe-se que muitos profissionais ainda permanecem distantes desta realidade e não conseguem adaptar-se às novas tecnologias de informação. A dificuldade de preenchimento manual das fichas interfere, pois, se as mesmas forem preenchidas de forma incompleta' as informações chegarão ao sistema inconclusivas. O personagem principal neste cenário é o enfermeiro, que deve proporcionar educação continuada para o aprimoramento profissional e pessoal de sua equipe diante da evolução tecnológica

Objective: To know the perception of the nurses regarding the implementation of e-SUS and trace the profile of nurses in the FHS. Method: It is a descriptive, exploratory, of qualitative approach study held with nurses from FHS teams of the city of Rio VerdeGoiás. Result: The variable sex, 7 (87,5%) are female, and 1 (12,5%) male, the age group of professionals predominated between 30 and 39 years old with (50%), the study pointed that 25% of the interviewed concentrated in the age group of 20 to 29 years old and 25% are over 40 years old. The variable training, 100% of the nurses are specialists (Lato sensu); regarding the perception of nurses, it is showed the highest significance of the variable "Regular" (50%); The variable "good" (37%) consider that the system has its positive aspects and (13%) consider that the adaptability to the new system was bad. Despite the difficulties reported, (50%) of the nurses consider that the e-SUS being compared to the SIAB has improved a lot. But the variables "worsened" and "remains the same" were similar (25%) for each. Conclusion: In the digital age and advanced technology it is known that a lot of professionals still remain distant of this reality and are unable to adapt to new information technologies. The difficulty of manual filling of records interferes, so, if they are filled in an "incomplete? way the information reaches the system inconclusive. The main character of this scenario is the nurse that should provide continuing education for professional and personal development of the team in the face of technological change

Avaliação da Função Diastólica Utilizando Ecocardiografia Doppler e Strain Bidimensional / Diastolic Function Assessment with Doppler Echocardiography and Two-Dimensional Strain

Fundamento: A avaliação da disfunção diastólica do ventrículo esquerdo (VE) apresenta significativo número de disfunções indeterminadas, principalmente quando a fração de ejeção (FE) está preservada. O strain longitudinal global (SLG), e o strain rate sistólico (SRs) e diastólico precoce (SRd), pode ser útil para reclassificar os pacientes assim diagnosticados. Objetivo: Avaliar, com SLG, SRs e SRd, pacientes com disfunção diastólica, comparar com indivíduos saudáveis e verificar o valor aditivo do método. Métodos: Estudados 149 pacientes (idade 62,2 ± 10,6 anos) com disfunção diastólica (49,7% grau 1; 15,4% grau 2; 18,1% grau 3 e 16,8% indeterminada) e 189 indivíduos sadios (idade 44,5 ± 13,3 anos). Aferidas dimensões e função do VE e átrio esquerdo (AE), velocidades Doppler mitral e tecidual e suas relações, SLG, SRs e SRd do VE. Avaliação dos dados pelos testes de Kolmogorov-Smirnoff, Kruskal-Wallis, análise de regressão múltipla e área sob a curva ROC. Dados significativos quando p < 0,05. Resultados: Na disfunção diastólica as dimensões e espessura do VE estavam aumentadas e verificou-se menor FE. O Doppler mitral e tecidual estava alterado e o volume do AE e a velocidade de refluxo tricúspide estavam aumentados. O SLG e SRs estavam diminuídos na disfunção grau 2 e 3 e o SRd diminuído já na disfunção grau 1, correlacionando-se melhor com a disfunção diastólica. O valor de corte da curva ROC para o SRd foi 1,0 s-1 . Conclusão: A disfunção diastólica complementada com strain rate miocárdico parece acrescentar sensibilidade e especificidade nos casos em que a função diastólica é indeterminada, podendo ser usado para reclassificar estes pacientes

Background: The evaluation of left ventricular (LV) diastolic dysfunction presents a significant number of indeterminate dysfunctions, especially when ejection fraction (EF) is preserved. Global longitudinal strain (GLS) and systolic strain rate (SSR) and early diastolic strain rate (EDSR) may be useful for reclassifying diagnosed patients. Objective: To evaluate, using GLS, SSR and EDSR, patients with diastolic dysfunction, compare with healthy individuals, and determine the additive value of the method. Methods: The study included 149 patients (age 62.2 ± 10.6) with diastolic dysfunction (49.7% grade 1; 15.4% grade 2; 18.1% grade 3 and 16.8% unspecified) and 189 healthy individuals (age 44.5 ± 13.3). Left ventricular (LV) and left atrial (LA) dimensions and function, mitral and tissue Doppler velocities and their ratios, GLS, SSR and EDSR have been determined. Data evaluation using the Kolmogorov-Smirnoff, KruskalWallis tests, multiple regression analysis and area under the ROC curve. Data were considered significant when p < 0.05. Results: In diastolic dysfunction, LV dimensions and thickness were increased and EF was lower. Mitral and tissue Doppler revealed abnormalities and LA volume and tricuspid regurgitation velocity were increased. GLS and EDSR were decreased in dysfunction grade 2 and 3 and EDSR was decreased in dysfunction grade 1, correlating better with diastolic dysfunction. The ROC cutoff value for the EDSR was 1.0 s-1. Conclusion: Diastolic dysfunction supplemented with myocardial strain rate seems to add sensitivity and specificity where the diastolic function is indeterminate and may be used for reclassifying these patients

Bedside Assessment of the Microvascular Venous Compartment in Cardiac Surgery Patients With Valvular Diseases Undergoing Cardiopulmonary Bypass.

OBJECTIVE: Blood volume reserve for venous return and the effects of cardiopulmonary bypass (CPB) on microvascular bed partitioning and blood flow were examined in patients with valvular diseases. DESIGN: Prospective, consecutive, case-control study. SETTING: Single university hospital. PARTICIPANTS: The study comprised 20 adult cardiac surgery patients and 20 healthy volunteers. INTERVENTIONS: Cardiovascular and microvascular variables were collected soon after the induction of anesthesia, after commencement of CPB, 20 minutes after separation from CPB, and in the intensive care unit. MEASUREMENTS AND MAIN RESULTS: The unstressed and stressed volumes (Vu, Vs) and pressures therein (Pit, Ps) were measured in the brachioradial muscle with near-infrared spectroscopy, applying incremental venous occlusions. At the first time point, Vs and Pit showed lower and higher values, respectively, than those of control patients, but Vs increased with Vu during the study, whereas Pit remained unchanged. Fluid balance correlated with Pit (r = 0.83, p<0.001) and hemoglobin (r = 0.78, p = 0.004). A nonlinear regression was found between fluid balance and ΔVu (r = 0.90, p<0.001) [y = 1.85+37.43(-0.01×x)]. The Vu/Pit and Vs/Ps ratios were lower than those of the control patients. Blood flow correlated to Vs/Ps (r = 0.75, p<0.001). The time constant was lower than reference (p = 0.005) and increased 10 times after CPB. CONCLUSIONS: Cardiac surgery patients have a limited blood volume reserve for venous return due to a reduced microvascular bed capacitance. This study demonstrated that during CPB a positive fluid balance induced an extravascular pressure increase and further reduced blood volume reserve.

Noninvasive Evaluation of Bladder Wall Mechanical Properties as a Function of Filling Volume: Potential Application in Bladder Compliance Assessment.

PURPOSE: We propose a novel method to monitor bladder wall mechanical properties as a function of filling volume, with the potential application to bladder compliance assessment. The proposed ultrasound bladder vibrometry (UBV) method uses ultrasound to excite and track Lamb waves on the bladder wall from which its mechanical properties are derived by fitting measurements to an analytical model. Of particular interest is the shear modulus of bladder wall at different volumes, which we hypothesize, is similar to measuring the compliance characteristics of the bladder. MATERIALS AND METHODS: Three experimental models were used: 1) an ex vivo porcine model where normal and aberrant (stiffened by formalin) bladders underwent evaluation by UBV; 2) an in vivo study to evaluate the performance of UBV on patients with clinically documented compliant and noncompliant bladders undergoing UDS; and 3) a noninvasive UBV protocol to assess bladder compliance using oral hydration and fractionated voiding on three healthy volunteers. RESULTS: The ex vivo studies showed a high correlation between the UBV parameters and direct pressure measurement (R2 = 0.84-0.99). A similar correlation was observed for 2 patients with compliant and noncompliant bladders (R2 = 0.89-0.99) undergoing UDS detrusor pressure-volume measurements. The results of UBV on healthy volunteers, performed without catheterization, were comparable to a compliant bladder patient. CONCLUSION: The utility of UBV as a method to monitor changes in bladder wall mechanical properties is validated by the high correlation with pressure measurements in ex vivo and in vivo patient studies. High correlation UBV and UDS in vivo studies demonstrated the potential of UBV as a bladder compliance assessment tool. Results of studies on healthy volunteers with normal bladders demonstrated that UBV could be performed noninvasively. Further studies on a larger cohort are needed to fully validate the use of UBV as a clinical tool for bladder compliance assessment.