Measurement properties of the EQ-5D-Y administered through a smartphone app in children with asthma: a longitudinal questionnaire study.

BACKGROUND: Asthma impacts children's physical, emotional, and psychosocial Health-Related Quality of Life (HRQL). The EQ-5D-Y is a generic econometric instrument developed to measure HRQL in children. OBJECTIVE: Evaluation of feasibility, validity, reliability, and responsiveness of EQ-5D-Y descriptive system and utility index to allow the assessment of HRQL in children with asthma, aged 8-11 years (self-response version) or under 8 years old (proxy-response version). METHODS: We used data from baseline to 10 months of follow-up of an observational, prospective study of children with persistent asthma recruited by pediatricians in Spain (2018-2020). HRQL instruments were administered through a smartphone application: ARCA app. The EQ-5D-Y is composed of a 5-dimension descriptive system, a utility index ranging from 1 to - 0.5392, and a general health visual analogue scale (EQ-VAS). The Pediatric Asthma Impact Scale (PROMIS-PAIS) includes 8 items, providing a raw score. Construct validity hypotheses were stated a priori, and evaluated following two approaches, multitrait-multimethod matrix and known groups' comparisons. Reliability and responsiveness subsamples were defined by stability or change in EQ-VAS and the Asthma Control Questionnaire (ACQ), to estimate the intraclass correlation coefficient (ICC) and the magnitude of change over time. RESULTS: The EQ-5D-Y was completed at baseline for 119 children (81 self-responded and 38 through proxy response), with a mean age of 9.1 (1.7) years. Mean (SD) of the EQ-5D-Y utility index was 0.93 (0.11), with ceiling and floor effects of 60.3% and 0%, respectively. Multitrait-multimethod matrix confirmed the associations previously hypothesized for the EQ-5D-Y utility index [moderate with PROMIS-PAIS (0.38) and weak with ACQ (0.28)], and for the EQ-5D-Y dimension "problems doing usual activities" [moderate with the ACQ item (0.35) and weak with the PROMIS-PAIS item (0.17)]. Statistically significant differences were found in the EQ-5D-Y between groups defined by asthma control, reliever inhalers use, and second-hand smoke exposure, with mostly moderate effect sizes (0.45-0.75). The ICC of the EQ-5D-Y utility index in the stable subsamples was high (0.81 and 0.79); and responsiveness subsamples presented a moderate to large magnitude of change (0.68 and 0.78), though without statistical significance. CONCLUSIONS: These results support the use of the EQ-5D-Y as a feasible, valid, and reliable instrument for evaluating HRQL in children with persistent asthma. Further studies are needed on the responsiveness of the EQ-5D-Y in this population.

Training periodization for a world-class 400 meters individual medley swimmer.

We present a case study of the periodized training by a world-class 400-m Individual Medley (IM) swimmer (4th in 2019 World Championships) in the season leading to a bronze medal in the 2018 European Championship. The complexity of this IM preparation was based on the experiences, observations and innovations of an Olympic swimming coach. Over 52 weeks, a traditional periodization model was employed using three macrocycles. A total of 15 competitions were completed in the season increasing in frequency in the third macrocycle. The training intensity distribution (TID) followed the pattern of a traditional pyramidal model in general training and polarized and threshold models during specific training before competitions. Weekly training volume ranged from 25 to 79 km, 24 to 87 km, and 25 to 90 km in each of the three macrocyles. Altitude training comprised 23% of total training weeks. Haemoglobin [Hb] increased from 14.9 to 16.0 g/100 ml and haematocrit from 45.1 to 48.1% after altitude training. Heart rate (HR) and [La-] decreased at submaximal swimming intensities, while swimming velocity increased in the 8 × 100 m incremental swimming test in A2 (1.4%) and in AT (0.6%). Pull up power was increased 10% through the season.

The expansion of brown rot disease throughout Bolivia: possible role of climate change.

Bacterial wilt is a devastating plant disease caused by the bacterial pathogen Ralstonia solanacearum species complex and affects different crops. Bacterial wilt infecting potato is also known as brown rot (BR) and is responsible for significant economic losses in potato production, especially in developing countries. In Bolivia, BR affects up to 75% of the potato crop in areas with high incidence and 100% of stored potatoes. The disease has disseminated since its introduction to the country in the mid-1980s mostly through contaminated seed tubers. To avoid this, local farmers multiply seed tubers in highlands because the strain infecting potatoes cannot survive near-freezing temperatures that are typical in the high mountains. Past disease surveys have shown an increase in seed tubers with latent infection in areas at altitudes lower than 3000 m a.s.l. Since global warming is increasing in the Andes Mountains, in this work, we explored the incidence of BR in areas at altitudes above 3000 m a.s.l. Results showed BR presence in the majority of these areas, suggesting a correlation between the increase in disease incidence and the increase in temperature and the number of irregular weather events resulting from climate change. However, it cannot be excluded that the increasing availability of latently infected seed tubers has boosted the spread of BR.

Leveraging technology to improve access to medical education in anatomy and physiology in resource-limited settings: A mixed methods study.

This study assesses the acceptability, appropriateness, feasibility, and efficacy of a novel asynchronous video-based intervention for teaching respiratory physiology and anatomy to medical students in resource-limited settings. A series of short video lectures on pleural anatomy, pulmonary physiology, and pathophysiology was created using Lightboard and screen capture technology. These were uploaded to YouTube and Google Drive and made available to 1st-3rd year medical students at two Latin American universities for 1 week. Employing a parallel-convergent mixed methods design, we conducted surveys, focus groups, interviews, and pre/post testing for qualitative and quantitative data. Thematic Analysis was used to analyze qualitative data and McNemar's test for quantitative analysis. Seventy-six students participated. The videos' short format, interactivity, and Lightboard style were highly valued for their flexibility, time efficiency, and educational impact. Students recognized their clinical relevance and trusted their content, suggesting potential applicability in similar settings. Despite infrastructure and connectivity challenges, the use of flexible streaming and downloadable options facilitated learning. Survey results indicated high levels of feasibility (99%), appropriateness (95%), and acceptability (95%), with significant knowledge gains observed (37% correct pre-test answers vs. 56% post-test, p < 0.0001). Our findings demonstrate high acceptability, appropriateness, feasibility, and efficacy of a targeted asynchronous education centered on short-format videos in resource-limited settings, enabling robust learning despite local barriers. Flexible access is key for overcoming localized barriers. Taking an adaptive, learner-centered approach to content creation and delivery to address constraints was pivotal to success. Our modular videos could serve as versatile models for flexible education in resource-constrained settings.

External carotid artery-radial artery-vertebral artery bypass for surgical treatment of radiculopathy caused by an extracranial vertebral artery aneurysm: A case report and review of the literature.

Background: Vertebral artery (VA) aneurysm is a rare etiology of cervical radiculopathy and there is a paucity of case reports described in the literature. Case Description: We describe a case of a patient with no history of trauma presenting with a large right VA aneurysm at the C5-C6 level compressing the C6 nerve root and causing a painful radiculopathy. The patient underwent successful external carotid artery-radial artery-VA bypass followed by trapping of the aneurysm and decompression of the C6 nerve root. Conclusion: VA bypass is an effective tool for treatment of symptomatic large extracranial VA aneurysms and a rare cause of radiculopathy.

Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma.

Background: Respiratory multimorbidities are linked to asthma, such as allergic rhinitis (AR) with early allergic asthma and chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) with late nonallergic asthma. Objective: Our aim was to investigate the association of asthma severity and control with specific upper airway phenotypes. Method: Patients with asthma were prospectively recruited from 23 pulmonology and ear, nose, and throat clinics. Asthma severity and control, as well as upper airway comorbidities (AR and non-AR [NAR], CRSwNP, and CRS without nasal polyps [CRSsNP]) were assessed according to international consensus guidelines definitions. Results: A total of 492 asthmatic patients were included. Half of the asthmatic patients (49.6%) had associated rhinitis (37.0% had AR and 12.6% had NAR) and 36.2% had CRS (16.7% had CRSsNP and 19.5% had CRSwNP), whereas 14.2% had no sinonasal symptoms. Most cases of AR (78%) and NAR (84%) were present in patients with mild-to-moderate asthma, whereas CRSwNP was more frequent in patients with severe asthma (35% [P < .001]), mainly nonatopic asthma (44% [P < .001]). Patients with severe asthma with CRSwNP had worse asthma control, which was correlated (r = 0.249 [P = .034]) with sinus occupancy. Multiple logistic regression analysis showed that late-onset asthma, intolerance of aspirin and/or nonsteroidal anti-inflammatory drugs, and CRSwNP were independently associated with severe asthma. Conclusion: Severe asthma is associated with CRSwNP, with sinus occupancy affecting asthma control. This study has identified 2 main different upper airway treatable traits, AR and CRSwNP, which need further evaluation to improve management and control of patients with asthma.

Competition and Training Strategies for Developing World Class 200- and 400-m Individual Medley Swimmers.

Swimming performance achieved in 50-m, 100-m and 200-m events in each swimming stroke can have an influence on the final performance in individual medley (IM) events. We attempted to quantify the relative contributions of performance in individual stroke events to top-10 world ranked IM competition performance. We examined competition results of top-10 world ranked IM swimmers (90 males and 90 females) between 2012 and 2018. A general linear model was developed to examine association between the 200-m and 400-mIM and predictor variables of competition performance in other 50-m, 100-m, and 200-m events. The main predictor variable for 200-mIM medalist status was having scored more than 900 FINA points in at least one 100-m event. Scoring more than 800 FINA points in at least two 200-mIM events, and more than 900 FINA points in at least one 100-m event, was important for success in the 400-mIM. Top-10 world ranked 200-mIM and 400-mIM swimmers require a world class standard in one or more individual stroke event(s).

Impact of incident comorbidity on functional loss in elderly chronic kidney disease patients undergoing hemodialysis.

The incidence of end stage renal disease in older persons has been increasing progressively over the last 10 years. Improved survival rates with renal replacement therapy are making this increased prevalence even more pronounced. The usual risks of morbidity and requirements for specialized care associated with older people increase dramatically when they have chronic kidney disease (CKD). It has been seen that the majority of patients in hemodialysis units are over the age of 60, and have significant co-morbidities. The relationship between older age, chronic disorders and functional dependence (FD) is well known. Accordingly, nursing care planning must be designed with this in mind. The aim of this study was to assess whether the comorbidity associated with CKD modifies FD in patients on hemodialysis. We undertook a prospective longitudinal cohort study of hemodialysis outpatients in Málaga, Spain, using the Barthel test to establish FD and the Charlson comorbidity index to quantify comorbidity. All health events were analyzed to select those study patients with incident comorbidity, understood as the appearance of a new disease that could modify the Charlson comorbidity index, and determine the change in FD. Multivariate linear regression showed that the best model for predicting functional loss was that which considered comorbidity adjusted for age, particularly when it occurred as a result of hospital admission, as it was shown to have an important predictive value for the onset of a decrease in functional dependency scores in patients with CKD.

Tell me who your friends are?! The mediating role of friends' use in cannabis abuse.

OBJECTIVES: To evaluate the relationship between age at onset of cannabis use and cannabis abuse in a sample of Portuguese cannabis users, testing the mediating role of the number of friends using cannabis and comparing these relationships between male and female subsets. METHOD: A sample of 529 Portuguese cannabis users comprising 276 males and 244 females aged from 14 to 21 years completed a sociodemographic questionnaire, the Cannabis Abuse Screening Test (CAST), and answered four questions related to cannabis use. Data were analyzed using the PROCESS macro in SPSS version 26.0. RESULTS: Age at onset of cannabis use was negatively related to the number of friends using cannabis, while the number of friends using cannabis had a positive relationship with cannabis abuse. As predicted, the number of friends using cannabis seems to have a mediating role in the relationship between cannabis onset age use and cannabis abuse, since the indirect effect was found to be significant. The pattern of the relationships among the variables observed was found to be similar for both male and female subsets of the sample. However, males reported higher cannabis abuse than females. CONCLUSION: The results highlight the mediating role of friends' use of cannabis in the relationship between age at onset of cannabis use and users' abuse. These results highlight the importance of early intervention in cannabis use. In particular, the pattern of the relationships observed among the studied variables emphasizes the need to monitor and conduct peer training interventions or interventions to promote of social skills.

Demographic and socioeconomic disparities of pituitary adenomas and carcinomas in the United States.

INTRODUCTION: Growth of some pituitary tumors is driven by hormones which vary in concentration along the lines of patient socioeconomic status. Thus, pituitary tumors may exhibit disparities in incidence upon stratification by socioeconomic variables. Exploring for these disparities could provide direction in tumor etiology elucidation and identification of healthcare inequalities. METHODS: To investigate pituitary adenoma and carcinoma incidence (per 100,000) with respect to sex, age, income, residence, and race/ethnicity, we searched the largest American administrative dataset (1997-2016), the National (Nationwide) Inpatient Sample (NIS), which surveys 20% of United States (US) discharges. RESULTS: Annual national incidence was 2.80 for adenomas and 0.046 for carcinomas. For adenomas, males had an incidence of 2.63, similar (p = 0.17) to females at 2.78; likewise, for carcinomas, males had a statistically equivalent (p = 0.24) incidence at 0.051 to females at 0.041. Amongst age groups, for adenomas incidence progressively rose, peaking 65-84 years old (6.12), before declining. For adenomas and carcinomas respectively, patients with low income had an incidence of 2.66 and 0.044, similar (p = 0.11; p = 0.72) to the 3.01 and 0.041 of middle/high income patients. Incidence was greatest for adenomas amongst urban centers (3.47), followed by rural (3.16) and suburban (3.01) communities. Examining race/ethnicity (p = 0.0000016), for adenomas, incidences amongst Blacks, Asian/Pacific Islanders, Hispanics, and Whites were as follows, respectively: 3.64, 2.57, 2.54, 2.44. Annually, incidence for adenomas was increasing (τ = 0.63, p = 0.00021), but decreasing (τ = -0.60, p = 0.00085) for carcinomas. Specifically, for carcinomas incidence was only decreasing for females and the middle/high income. CONCLUSION: In the US, time-enduring healthcare disparities were identified for pituitary adenomas and carcinomas, against the background of sociodemographic strata. For carcinomas, annual incidence was declining only for middle/high income patients and females, which supporting prior investigations that low income patients and males are experiencing barriers to definitive treatment for pituitary adenomas. Incidence was also found to be greatest Blacks and urban residents.

Periodization and Programming for Individual 400 m Medley Swimmers.

Knowledge in the scientific domain of individual medley (IM) swimming training over a competitive season is limited. The purpose of this study was to propose a detailed coaching framework incorporating the key elements of a periodized training regimen for a 400 m IM swimmer. This framework was based on the available coaching and scientific literature and the practical experience and expertise of the collaborating authors. The season has been divided in two or three macrocycles, further divided in three mesocycles each (six or nine mesocycles in total), in alignment with the two or three main competitions in each macrocycle. The principal training contents to develop during the season expressed in blood lactate zones are: aerobic training (~2 mmol·L-1), lactate threshold pace (~4 mmol·L-1) and VO2max (maximum oxygen uptake) (~6 mmol·L-1). Strength training should focus on maximum strength, power and speed endurance during the season. Altitude training camps can be placed strategically within the training season to promote physiological adaptation and improvements in performance. A well-constructed technical framework will permit development of training strategies for the 400 m IM swimmer to improve both training and competitive performance.

Social networks as tools for the prevention and promotion of health among youth.

The emergence of information and communication technologies (ICT) has generated a number of research questions, related to their use and potential risk, but also potentials for prevention or health promotion. Online social networks have become an important source of information for users as well as a tool for social relations. As traditional social networks, they can act as vehicles to improve the health of adolescents and youth, as well as play a key role in an educational context. The aim of this work is then to explore the theoretical relevance of ICT, particularly on online social networks, on disease prevention and health promotion of communicable diseases. Literature review points out the role of online social networks, particularly in the field of sexual health, body image, especially eating habits and overweight, as well as smoking and alcohol dependence. Data allow us to understand how online social network behavior and interaction is related to their burden and interventions developed in sexual health and addiction show positive results. More efforts in body image are needed in order to use these tools for prevention and promotion of health from early age.

Cumulative activation of voltage-dependent KVS-1 potassium channels.

In this study, we reveal the existence of a novel use-dependent phenomenon in potassium channels, which we refer to as cumulative activation (CA). CA consists of an increase in current amplitude in response to repetitive depolarizing step pulses to the same potential. CA persists for up to 20 s and is similar to a phenomenon called "voltage-dependent facilitation" observed in some calcium channels. The KVS-1 K+ channel, which exhibits CA, is a rapidly activating and inactivating voltage-dependent potassium channel expressed in chemosensory and other neurons of Caenorhabditis elegans. It is unusual in being most closely related to the Shab (Kv2) family of potassium channels, which typically behave like delayed rectifier K+ channels in other species. The magnitude of CA depends on the frequency, voltage, and duration of the depolarizing step pulse. CA also radically changes the activation and inactivation kinetics of the channel, suggesting that the channel may undergo a physical modification in a use-dependent manner; thus, a model that closely simulates the behavior of the channel postulates the existence of two populations of channels, unmodified and modified. Use-dependent changes in the behavior of potassium channels, such as CA observed in KVS-1, could be involved in functional mechanisms of cellular plasticity such as synaptic depression that represent the cellular basis of learning and memory.

Safety of rupatadine administered over a period of 1 year in the treatment of persistent allergic rhinitis: a multicentre, open-label study in Spain.

BACKGROUND: Rupatadine (Rupafin), a novel antihistamine approved recently in Europe for the treatment of allergic rhinitis (AR) and chronic idiopathic urticaria in patients aged>or=12 years, has been shown to be highly efficacious, and as safe and well tolerated as other commonly employed antihistamines in the treatment of allergic disease. There are, however, few data on the long-term safety of these antihistamines derived in accordance with the clinical safety recommendations of the European Agency for the Evaluation of Medicinal Products (EMEA) and the International Conference on Harmonisation (ICH) of Technical Requirements for Registration of Pharmaceuticals for Human Use Guideline. OBJECTIVE: To assess the safety and tolerability of treatment with rupatadine 10 mg/day for 12 months in subjects with persistent AR (PER). METHODS: A multicentre, open-label, phase IV study in patients recruited from 33 centres in Spain, from September 2002 to November 2005. The study enrolled 324 male and female patients (aged 12-70 years) with a medical history of PER for at least 12 months and a documented positive skin-prick test to an appropriate allergen. On 4 of the 7 days prior to start of treatment, the patients were required to have a minimum total nasal symptom score (TNSS [for sneezing, rhinorrhoea, nasal obstruction/congestion and nasal itching]) of >or=5. Of the 324 eligible patients starting treatment, 120 needed to be treated for more than 6 months and were followed up until the end of 12 months. All patients received rupatadine 10 mg/day and were allowed to continue their normal concomitant medication for all conditions, other than rhinitis, for up to 6 or 12 months. Safety was assessed by means of adverse events (AEs) reported by patients or detected by investigators, scheduled centralized ECG with special attention to Bazzet corrected QT interval (QTcB) and standard laboratory investigations. RESULTS: Assessment of treatment compliance rates indicated 90% and 83% of patients to be compliant during the 1-6 months and 1-12 months treatment periods, respectively, with compliance rates>80% being associated with the majority of the study population reporting at least one AE. Overall, 74.1% and 65.8% of the patients reported at least one AE during the 1-6 months and 1-12 months treatment periods, respectively, compared with 20.4% and 10.8% of patients reporting at least one treatment-related AE during these periods. Disorders of the nervous system and respiratory thoracic and mediastinal system, in particular headache, somnolence and catarrh, were the three most common AEs reported by >5% of the patients during both treatment periods. Detailed ECG assessments demonstrated no clinically relevant abnormal ECG findings, nor any QTcB increases >60 msec or QTcB values>470 msec for any patient at any time during treatment. Serious AEs were reported in seven patients, of whom six were considered as unlikely to be related to rupatadine treatment, whereas one involving increased blood enzyme levels was considered as possibly related to rupatadine treatment. CONCLUSION: This study confirmed the good long-term safety and tolerability of rupatadine at the therapeutic dose of 10 mg/day in patients with PER.

[Use and abuse of the Internet in university students]. / Uso y abuso de Internet en jovenes universitarios.

AIM: To adapt a questionnaire for assessing the use and abuse of Internet, as well as the relationship between this resource and psychosocial profile in a group of university students. METHOD: 391 students filled out the questionnaires; 26.1% were men and 73.9% were women, with a mean age of 19.59 years (DT = +/- 2.83; Range: 18-47 years). We used a sociodemographic questionnaire, Social skills questionnaire (Caballo, 1993, EMES-C and EMES-M), Personality questionnaire (E.P.I., Eysenck and Eysenck, 1982), and an Internet and Use and Abuse of Internet questionnaire (adapted from Bruner, 1997, Suler, 1996 and Young, 1996a, Garcia del Castillo y Terol, 2007). RESULTS: 73.91 % of students connect for an average of 84.81 minutes (DT = +/- 2.05) per week. Except for one subscale of the Internet use and abuse questionnaire, all the subscales showed reliability coefficients > or = . 70 and mean scores lower than the average of the score range. Internet use and abuse showed a relationship with psychosocial variables such as cognitive social skills (r =.14; p =.016) and neuroticism (r =.-13, p =.01).

Allogeneic mesenchymal stem cell transplantation in healthy equine superficial digital flexor tendon: A study of the local inflammatory response.

The superficial digital flexor tendon (SDFT) is a structure frequently affected by injuries in high-performance athletic horses, and there are limited therapeutic options. Regenerative medicine has evolved significantly in treating different illnesses. However, understanding the cellular behaviour during mesenchymal stem cell (MSC) transplantation in healthy tissues is not fully known yet. To address the inflammatory response induced by allogeneic MSC transplantation, this study evaluated the local inflammatory response after the application of allogeneic adipose tissue-derived mesenchymal stem cells (AT-MSCs) in the equine tendon compared to an autologous transplant and the control group. Eighteen thoracic limbs (TL) in nine animals were divided into three groups and subjected to the application of AT-MSCs in the healthy tendon. In the allogeneic group (Gallog), the animals received an allogeneic AT-MSC application in the TL. The autologous group (Gauto) received an application of autologous cells in the TL, and in the control group (Gcont), phosphate-buffered saline (PBS) was applied. There were no significant differences among the evaluated groups in the physical, morphological, thermography, and ultrasonography analyses. A higher number of CD3-positive lymphocytes was observed in the Gauto group compared to the control (P < 0.05). Additionally, we did not observe different expressions of CD172 and microvascular density among the groups. The allogeneic transplantation of AT-MSCs did not result in an adverse or inflammatory reaction that compromised the use of these cells in this experiment. Their behaviour was similar to that of autologous transplantation.

Tell me who your friends are?! The mediating role of friends' use in cannabis abuse

Abstract Objectives To evaluate the relationship between age at onset of cannabis use and cannabis abuse in a sample of Portuguese cannabis users, testing the mediating role of the number of friends using cannabis and comparing these relationships between male and female subsets. Method A sample of 529 Portuguese cannabis users comprising 276 males and 244 females aged from 14 to 21 years completed a sociodemographic questionnaire, the Cannabis Abuse Screening Test (CAST), and answered four questions related to cannabis use. Data were analyzed using the PROCESS macro in SPSS version 26.0. Results Age at onset of cannabis use was negatively related to the number of friends using cannabis, while the number of friends using cannabis had a positive relationship with cannabis abuse. As predicted, the number of friends using cannabis seems to have a mediating role in the relationship between cannabis onset age use and cannabis abuse, since the indirect effect was found to be significant. The pattern of the relationships among the variables observed was found to be similar for both male and female subsets of the sample. However, males reported higher cannabis abuse than females. Conclusion The results highlight the mediating role of friends' use of cannabis in the relationship between age at onset of cannabis use and users' abuse. These results highlight the importance of early intervention in cannabis use. In particular, the pattern of the relationships observed among the studied variables emphasizes the need to monitor and conduct peer training interventions or interventions to promote of social skills.

Competencias profesionales para la atención prehospitalaria: Instituto Ecuatoriano de Seguridad Social. Guayaquil 2019 / Professional competencies for pre-hospital care. Ecuadorian Institute of Social Security. Guayaquil 2019

La Atención Prehospitalaria (APH) es uno de los pilares fundamentales de los Sistemas de Emergencias Médicas que intenta brindar la mejor asistencia, en el menor tiempo y al menor costo. Para eso requiere componentes principales como recursos humanos y recursos físicos. Objetivo: Determinar si las competencias profesionales del personal del Instituto Ecuatoriano de Seguridad Social (IESS) de la Ciudad de Guayaquil responden al Servicio de Atención Prehospitalaria de acuerdo con los perfiles legales de contratación. Materiales y métodos: La investigación es de enfoque cuantitativo, de diseño observacional, prospectivo y de corte transversal. El tipo de estudio es descriptivo; gracias a que permitió recoger información y medir de manera individual o grupal la variable estudiada. La población de este estudio se constituyó por los profesionales con cargo de paramédicos del Instituto Ecuatoriano de Seguridad Social de la Ciudad de Guayaquil, los cuales son un total de 32 profesionales. Resultados: Una vez obtenido los datos se reflejó que, el 56,3% de los profesionales son de sexo femenino. Con respecto al título de los profesionales registrado en el Senescyt, solo el 56,3% lo posee de manera incompleto. El 56,3% de los profesionales tienen el puesto de paramédico 1. El 81,3% cumple con su tiempo de experiencia en el trabajo equivalente. En el aseguramiento de la escena el 46,9% cumple lo requerido. Los procedimientos en la atención Prehospitalaria del IESS es uno de los puntos de suma importancia en este estudio, ya que se identificó que el 65,6% cumple de manera parcial este procedimiento de atención. Conclusión: En la revisión de las competencias deducimos que no todo el personal fue contratado de acuerdo al perfil de contratación emitido por el MDT. Se Pudo observar una clara diferencia entre los perfiles de contratación entre paramédico 1 al paramédico 5, lo cuales tienen diferentes tipos de relevancia, lo que nos demuestra que hay una falta de formación a todos los niveles(AU)

Prehospital Care (PHC) is one of the fundamental pillars of Emergency Medical Systems that attempts to provide the best assistance, in the shortest time and at the lowest cost. For this purpose, it requires main components such as human resources and physical resources. Objective: To determine if the professional competencies of the personnel of the Ecuadorian Institute of Social Security (IESS) in the city of Guayaquil respond to the Prehospital Care Service in accordance with the legal hiring profiles. Materials and methods: The research has a quantitative approach, observational, prospective and cross-sectional design. The type of study is descriptive, since it allowed the collection of information and the individual or group measurement of the studied variable. The population of this study consisted of 32 professionals working as paramedics at the Ecuadorian Institute of Social Security in the city of Guayaquil. The results: Once the data were obtained, 56.3% of the professionals were female. With respect to the degree of the professionals registered in Senescyt, only 56.3% of them have incomplete degrees. For the professionals, 56.3% have the position of paramedic 1. 81.3% have the equivalent amount of work experience. In securing the scene, 46.9% meet the requirements. Pre-hospital care procedures at the IESS is one of the most important points in this study, since 65.6% of the patients were found to be partially compliant with these care procedures. Conclusion: In the review of competencies, we deduced that not all personnel were hired according to the hiring profile issued by the MDT. We could observe a clear difference between the hiring profiles between paramedic 1 to paramedic 5, which have different types of relevance, which shows that there is a lack of training at all levels(AU)