Presence of metabolic syndrome markers in very low birth weight ex-premature infants during early adolescence.

OBJECTIVES: To investigate the association of growth patterns with overweight/obesity and markers of metabolic syndrome in ex-premature adolescents; to assess the relationship between the increase (1 SD) in Z-score weight at term and at 2 years with outcomes in adolescents with or without intrauterine growth restriction; and to evaluate the association between the Cook criteria and overweight/obesity according to body mass index. METHODS: Cohort, retrospective, analytical study. Population: adolescents born weighting<1,500 g. RESULTS: One hundred twenty-seven adolescents (11.3 years) were included. There is an association between the 1 SD increase in the percentile (Pc) of weight at 40 weeks and at 2 years in the population with adequate birth weight (PCA) with insulin levels, resistance, and sensitivity at 11 years. Catch-up at 2 years was associated with significantly higher proportion of HDL value<41 (18.75 vs. 5.36 %) OR 4.08 95% CI (1.04-16.05) p=0.031. Overweight/obesity was associated with waist circumference index>0.5, HDL<41, and with blood pressure greater than Pc 90 for sex and height. CONCLUSIONS: In preterm infants, a 1 SD increase in weight Z score at 40 weeks and 2 years was predictive of metabolic and cardiovascular disorders in adolescence.

Epidural administration of ropivacaine and midazolam is superior to intra-articular administration as postoperative analgesia after isolated arthroscopic anterior cruciate ligament reconstruction with hamstrings autograft: a randomized controlled clinical trial.

OBJECTIVE: Reconstructive surgery of the anterior cruciate ligament (ACL) is quite common, previous studies have documented that adequate pain control in the early phases of the postoperative period translates into early mobility and a rapid start of rehabilitation. Therefore, the search for new strategies for postoperative pain control is justified. The aim of this study was to compare intra-articular to the epidural administration of ropivacaine and midazolam as postoperative analgesia after arthroscopic ACL reconstruction with hamstring autograft (HA). MATERIAL AND METHODS: Double-blinded, prospective randomized clinical trial included 108 consecutive patients aged from 18 to 50 years that had undergone arthroscopic ACL reconstruction with HA. The patients were randomly assigned to 2 groups. The first group received intraarticular ropivacaine and midazolam. The second group received epidural ropivacaine and midazolam. The need for rescue analgesia, the postoperative pain experienced, side effects and complications of the analgesic drugs were evaluated. RESULTS: The intra-articular group received statistically significantly higher mean doses of rescue analgesia on the first two days (2.8 â€‹± â€‹1.0 vs. 1.3 â€‹± â€‹0.6 in the epidural group; p â€‹= â€‹0.001). Visual Analogue Scale scores at flexion were statistically significantly higher in the intra-articular group over the entire study period. The intra-articular group also reported a statistically significantly lower range-of-motion 87 â€‹± â€‹15 vs. 102 â€‹± â€‹11 in the epidural group (p â€‹= â€‹0.001). CONCLUSIONS: Epidural administration of ropivacaine combined with midazolam in patients undergoing primary ACL reconstruction with HA was clinically and significantly better relative to rescue analgesia and the intensity of pain in the first 48 postoperative hours when compared to intraarticular administration. There was no difference in terms of adverse effects and complications.

Coincidence energy spectra due to the intrinsic radioactivity of LYSO scintillation crystals.

BACKGROUND: Lutetium oxyorthosilicate or lutetium yttrium oxyorthosilicate (LYSO) scintillation crystals used in most current PET scanner detectors contain 176Lu, which decays by beta emission to excited states of 176Hf accompanied by the emission of prompt gamma rays or internal conversion electrons. This intrinsic radioactivity can be self-detected in singles mode as a constant background signal that has an energy spectrum whose structure has been explained previously. In this work, we studied the energy spectrum due to the intrinsic radioactivity of LYSO scintillation crystals of two opposing detectors working in coincidence mode. The investigation included experimental data, Monte Carlo simulations and an analytical model. RESULTS: The structure of the energy spectrum was completely understood and is the result of the self-detection of beta particles from 176Lu in one crystal and the detection of one or more prompt gamma rays detected in coincidence by the opposing crystal. The most probable coincidence detection involves the gamma rays of 202 and 307 keV, which result in two narrow photopeaks, superimposed on a continuous energy distribution due to the beta particle energy deposition. The relative intensities of the gamma ray peaks depend on crystal size and detector separation distance, as is explained by the analytical model and verified through the Monte Carlo simulations and experiments. CONCLUSIONS: The analytical model used in this work accurately explains the general features of the coincidence energy spectrum due to the presence of 176Lu in the scintillation crystals, as observed experimentally and with Monte Carlo simulations. This work will be useful to those research studies aimed at using the intrinsic radioactivity of LYSO crystals for transmission scans and detector calibration in coincidence mode.

[Occupational therapy in oncology: experiences in academic practices and literature review]. / Terapia ocupacional en oncología: experiencias en prácticas académicas y revisión de literatura.

OBJECTIVE: To inquire about the training of occupational therapists in oncology in a university program, and to identify updated literature as evidence for training and professional practice. MATERIALS AND METHODS: Cross-sectional exploratory study, with a sample of 29 students of occupational therapy from the National University of Colombia. Systematic review of literature 2010-2015 on occupational therapy interventions in oncology. Results In the survey, less than a quarter of the students reported having received training on clinical management of this diagnosis, and on the intervention of the occupational therapist with such cases (24.1%). Little more than this percentage (27.6%), has had users with cancer in their academic practices. In the literature review no national publications were found, although there were unpublished products from Colombian universities. Fifty-four international publications were recovered, especially in rehabilitation, it followed by psychosocial and socio-occupational areas. The palliative care, the multidisciplinarity, the subjective experience of the patient in relation to the diagnosis and treatment, the humanized and integral care from the different areas of the therapeutic task and work with caregivers are considered as relevant issues in the oncological patient's approach. CONCLUSIONS: Reference points are made for the occupational therapy curriculum development and for professional updating processes, which are both competence of the academy and of the guild. It is important to intervene in cancer not only during, but in the preparation to treatment and subsequently with survivors. Professional publications should be encouraged, making sure they provide powerful evidence of the impact of occupational therapy and oncological rehabilitation.

OBJETIVO: Indagar sobre la formación de terapeutas ocupacionales en oncología en un programa universitario, e identificar literatura actualizada como evidencia para la formación y práctica profesional. MATERIALES Y MÉTODOS: Estudio exploratorio transversal, con una muestra integrada por 29 estudiantes de terapia ocupacional de la Universidad Nacional de Colombia. Revisión sistemática de literatura 2010-2015, sobre intervenciones de terapia ocupacional en oncología. RESULTADOS: En la encuesta, menos de una cuarta parte de los estudiantes respondió haber recibido formación sobre manejo clínico de dicho diagnóstico, y sobre la intervención del terapeuta ocupacional con tales casos (24,1%). Poco más de dicho porcentaje (27,6%), ha tenido usuarios con cáncer en sus prácticas académicas. En la revisión de literatura no se encontraron publicaciones nacionales, aunque sí productos inéditos de universidades colombianas. Se recuperaron 54 trabajos internacionales, especialmente en rehabilitación, seguido de las áreas psicosocial y sociolaboral. El cuidado paliativo, la multidisciplinariedad, la experiencia subjetiva del paciente frente al diagnóstico y tratamiento, la atención humanizada e integral desde las diferentes áreas del quehacer terapéutico y el trabajo con cuidadores, se plantean como temas de relevancia profesional en el abordaje del paciente oncológico. CONCLUSIONES: Se aportan referentes para el desarrollo curricular de terapia ocupacional y para procesos de actualización profesional, de competencia de la academia y gremial. Es importante la intervención en cáncer no sólo durante, sino también mientras el tratamiento y posteriormente con supervivientes. Deben incentivarse las publicaciones profesionales, asegurando que arrojen evidencias potentes del impacto de la terapia ocupacional y de la rehabilitación oncológica.

Terapia ocupacional en oncología: experiencias en prácticas académicas y revisión de literatura / Occupational therapy in oncology: experiences in academic practices and literature review

RESUMEN Objetivo Indagar sobre la formación de terapeutas ocupacionales en oncología en un programa universitario, e identificar literatura actualizada como evidencia para la formación y práctica profesional. Materiales y Métodos Estudio exploratorio transversal, con una muestra integrada por 29 estudiantes de terapia ocupacional de la Universidad Nacional de Colombia. Revisión sistemática de literatura 2010-2015, sobre intervenciones de terapia ocupacional en oncología. Resultados En la encuesta, menos de una cuarta parte de los estudiantes respondió haber recibido formación sobre manejo clínico de dicho diagnóstico, y sobre la intervención del terapeuta ocupacional con tales casos (24,1%). Poco más de dicho porcentaje (27,6%), ha tenido usuarios con cáncer en sus prácticas académicas. En la revisión de literatura no se encontraron publicaciones nacionales, aunque sí productos inéditos de universidades colombianas. Se recuperaron 54 trabajos internacionales, especialmente en rehabilitación, seguido de las áreas psicosocial y sociolaboral. El cuidado paliativo, la multidisciplinariedad, la experiencia subjetiva del paciente frente al diagnóstico y tratamiento, la atención humanizada e integral desde las diferentes áreas del quehacer terapéutico y el trabajo con cuidadores, se plantean como temas de relevancia profesional en el abordaje del paciente oncológico. Conclusiones Se aportan referentes para el desarrollo curricular de terapia ocupacional y para procesos de actualización profesional, de competencia de la academia y gremial. Es importante la intervención en cáncer no sólo durante, sino también mientras el tratamiento y posteriormente con supervivientes. Deben incentivarse las publicaciones profesionales, asegurando que arrojen evidencias potentes del impacto de la terapia ocupacional y de la rehabilitación oncológica.(AU)

ABSTRACT Objective To inquire about the training of occupational therapists in oncology in a university program, and to identify updated literature as evidence for training and professional practice. Materials and Methods Cross-sectional exploratory study, with a sample of 29 students of occupational therapy from the National University of Colombia. Systematic review of literature 2010-2015 on occupational therapy interventions in oncology. Results In the survey, less than a quarter of the students reported having received training on clinical management of this diagnosis, and on the intervention of the occupational therapist with such cases (24.1%). Little more than this percentage (27.6%), has had users with cancer in their academic practices. In the literature review no national publications were found, although there were unpublished products from Colombian universities. Fifty-four international publications were recovered, especially in rehabilitation, it followed by psychosocial and socio-occupational areas. The palliative care, the multidisciplinarity, the subjective experience of the patient in relation to the diagnosis and treatment, the humanized and integral care from the different areas of the therapeutic task and work with caregivers are considered as relevant issues in the oncological patient's approach. Conclusions Reference points are made for the occupational therapy curriculum development and for professional updating processes, which are both competence of the academy and of the guild. It is important to intervene in cancer not only during, but in the preparation to treatment and subsequently with survivors. Professional publications should be encouraged, making sure they provide powerful evidence of the impact of occupational therapy and oncological rehabilitation.(AU)

Objetos virtuales para el aprendizaje autorregulado de estudiantes de terapia ocupacional / Virtual objects for self-regulated learning of occupational therapy students

RESUMEN Objetivos Identificar las relaciones entre las características de los estudiantes, su ambiente de aprendizaje, su ocupación, y los objetos virtuales para el aprendizaje autorregulado a través de la observación participante. Aspectos importantes para la formación de profesionales de la salud. Métodos Estudio cualitativo aplicado a estudiantes que participaron en la asignatura Educación y Terapia Ocupacional. Se emplearon dos herramientas: Cuestionario Objetos Virtuales para el aprendizaje en el campo educativo y Observación participante. Al primer instrumento se le realizó pilotaje y revisión por experto. Resultados El estudio dio cuenta de datos demográficos y antecedentes de educación media similares, con relación a: procedencia, acceso al computador y exclusividad para estudiar; así como desarrollo de estudios de educación media en Bogotá y en instituciones privadas. En los ambientes de aprendizaje hay una tendencia a evidenciar que están de acuerdo con el programa de la asignatura: en cumplimiento de objetivos explícitos escogidos para el estudio en un 75 % e implícitos en un 60 %. En la ocupación, se encontró que el objeto virtual permitió profundizar sobre el tema que desarrollaron los estudiantes y poner en práctica conocimientos previos sobre tecnologías de la información y la comunicación. La observación participante arrojó particularidades en los elementos motivación, eficacia y aprendizaje autorregulado. Conclusiones La implementación de los Objetos Virtuales de Aprendizaje favorece en los estudiantes la motivación, el aprendizaje autorregulado y la apropiación de conceptos y conocimientos relacionados con la asignatura; por lo que se propone como estrategia de aprendizaje.(AU)

ABSTRACT Objective To identify the relationship between the characteristics of students, their learning environment, their occupation, and the virtual objects for self-regulated learning. In addition, to establish connections with participant's observation. Important aspects for the training of health professionals. Methods A qualitative study was applied to students who participated in the Education and Occupational Therapy subject. Two tools were used: virtual Objects Questionnaire for the educational field learning and Participant Observation. The first instrument was piloted and reviewed by experts. Results The study reported similar demographic data and background of similar education in relation to: origin, access to the computer and exclusivity to study; as well as the development of secondary education studies in Bogotá and in private institutions. In the learning environments, there is a tendency to show that they agree with the program of the subject in fulfillment of explicit objectives chosen for the study in 75 % and implicit in 60 %. With regards to the occupation, it was found that the virtual object allowed to deepen on the subject that the students developed and put into practice previous knowledge on communication technologies. The Participant Observation tool found particularities in the elements of motivation, efficacy and self-regulated learning. Conclusions The implementation of the Virtual Learning Objects favor the students' motivation, self-regulated learning and their appropriation of concepts and knowledge related to the subject; therefore, it is proposed as a learning strategy.(AU)

Cultura de seguridad del paciente en la prestación de servicios profesionales de Terapia Ocupacional / Patient safety culture in the provision of professional Occupational Therapy services

Resumen Objetivo: Caracterizar el ambiente de seguridad del paciente en un servicio de Terapia Ocupacional donde se desarrollan actividades docentes y asistenciales para el programa de la Universidad Nacional de Colombia. Materiales y métodos: Estudio descriptivo transversal, con aplicación de la Encuesta sobre clima de seguridad del paciente en servicios del área de la salud (versión para Colombia, adaptada y en formato electrónico), a tres terapeutas ocupacionales vinculadas durante 2013 a 2015 en un escenario docente asistencial de la Universidad Nacional de Colombia. Consulta de reportes y estadísticas del servicio correspondientes al periodo de análisis. Resultados: Entre los hallazgos de la encuesta resaltan el subregistro de eventos, aunque no haya una percepción punitivafrente a su reporte; se percibe comunicación abierta, con necesidad de mejorar la retroalimentación ante los errores; considerable rotación e insuficiencia de personal; se aprecia apoyo institucional al tema; y se evalúa como positivo el aprendizaje organizacional y mejoramiento continuo del servicio. Conclusiones: En términos globales, las profesionales valoran bien el ambiente de seguridad del paciente en el servicio analizado, pero debe trabajarse en pro de los aspectos claves que evidenciaron debilidades en las categorías analizadas, donde preocupa la aparente falta de registro de eventos y la consiguiente debilidad para establecer medidas correctivas. Además, es importante capitalizar estas experiencias y procesos sobre gestión de la calidad y seguridad del paciente, articulando con las actividades de formación y docencia que también se llevan a cabo allí.

Abstract Objective: Characterize the patient's safety environment in an Occupational Therapy service where teaching and care activities are developed for the National University of Colombia program. Materials and methods: Descriptive cross-sectional study, with application of the Survey on patient safety in health services (version for Colombia, adapted and in electronic format), to three occupational therapists who were linked during the years 2013 to 2015 in a site teaching assistant of the National University of Colombia. Consultation of reports and statistics of the service corresponding to the period of analysis. Results: Among the findings of the survey highlight underreporting of events, even though there is no punitive perception regarding their report; open communication is perceived, but improving feedback facing the errors; rotation and shortage of personnel; there is institutional support for the topic; and organizational learning and continuous improvement of the service are evaluated as positive. Conclusions: Overall, professionals value good the patient's safety environment in the service analyzed, but have to work on the key aspects that showed weaknesses in the analyzed categories, where is apparent lack of event registration and the consequent weakness in establishing corrective measures. In addition, it is important to capitalize on these experiences and processes on quality management and patient safety, articulating with the training and teaching activities that are also carried out there.

Experiencias de terapia ocupacional para la paz: aportes desde las regiones colombianas / Peace experiences in occupational therapy: contributions from Colombian regions

RESUMEN Objetivos Identificar y caracterizar las experiencias profesionales de terapia ocupacional en las regiones de Colombia, relacionadas con la superación del conflicto armado. Métodos Estudio descriptivo transversal, con la aplicación de una encuesta sobre experiencias profesionales en el conflicto armado colombiano, versión digital, en el aplicativo Typeform, respondida por 34 terapeutas ocupacionales. La muestra diligenció el respectivo consentimiento informado para participar en el estudio. Resultados El balance general de las experiencias reportadas se concentran en la región andina; cubren 18 departamentos del país; un porcentaje representativo se desarrolla con comunidades indígenas; la intervención se ha dirigido especialmente a adultos y a la atención de víctimas y personas con discapacidad; el mayor énfasis ha sido comunitario; el terapeuta se ha vinculado principalmente como ejecutor y docente universitario; preocupan los problemas de presencia de actores armados ilegales y la realidad de una problemática desbordante; y como logros se resaltan el impacto de la intervención y los aprendizajes profesionales y personales capitalizados. Conclusiones El enfoque territorial demanda mayor presencia en las regiones y sensibilidad cultural. Fortalecer el trabajo con la población que estuvo vinculada a los grupos armados ilegales, con procesos de resignificación ocupacional que permitan avanzar en la reincorporación económica y social esperada.(AU)

ABSTRACT Objective To identify and characterize professional experiences in occupational therapy in different regions of Colombia regarding the overcoming of the armed conflict. Methods Cross-sectional, descriptive study in which the digital version of the Survey on professional experiences in the Colombian armed conflict was applied using Type-form. 34 occupational therapists responded the survey. The sample filled the corresponding informed consent to participate in the study. Results The overall balance shows that experiences are mostly concentrated in the Andean region and cover 18 departments of the country, while a representative percentage are observed in works with indigenous communities. Intervention has targeted mainly adults and victims and people with disabilities, although greatest emphasis is on communities. Therapists are involved mainly as executors and university professors. Finally, there is concern about the presence of illegal armed actors and the reality of an overwhelming problem. Achievements include the impact of the intervention and the capitalized professional and personal learning. Conclusions A territorial approach requires greater presence in the regions and cultural sensitivity. Strengthening the work carried out with the population that was linked to illegal armed groups through occupational resignification processes allow to make progress in the expected economic and social reincorporation.(AU)

Seguridad del paciente en las prácticas formativas de un programa de pregrado en terapia ocupacional / Patient safety in the training practices of an undergraduate program in occupational therapy

RESUMEN Objetivo Identificar condiciones y experiencias sobre la seguridad del paciente en prácticas académicas de terapia ocupacional de la Universidad Nacional de Colombia. Métodos Estudio descriptivo transversal, con una muestra integrada por 29 estudiantes de práctica académica del programa Terapia Ocupacional. Diseño y aplicación de una encuesta sobre atención segura de usuarios (versión electrónica), sometida a revisión de expertos para validar su contenido. Previamente, cada estudiante dio su consentimiento para la realización de la encuesta. Resultados Las caídas de los pacientes son las que se escapan más frecuentemente del reporte o registro en el sitio de práctica (47,1 % de los estudiantes nunca las reporta). A pesar de esto, es el evento que mayor registro presenta con respecto a otros reportes (41,1 %). En menor proporción los estudiantes siempre dejan reporte de los incidentes relacionados con documentación y registro, y con equipos y dispositivos de atención (21,5 % y 28,6 %, respectivamente). En estas dos últimas categorías son más numerosos los estudiantes que sólo algunas veces reportan lo ocurrido (46,4 % en ambos casos). Discusión Es necesario avanzar en la indagación sobre las causas y consecuencias de los eventos que afectan la seguridad del paciente en las prácticas de los estudiantes, y en la disposición de medidas de mejora que sean eficientes junto con el impacto que tienen al implementarse. Se requieren esfuerzos para transformar la posible percepción punitiva que pueda estar recayendo sobre el seguimiento de las medidas para la seguridad del paciente. Todo lo anterior podría estar explicando parte del considerable subregistro de incidentes que documenta la literatura y que coincide con los hallazgos de este estudio.(AU)

ABSTRACT Objective To identify conditions and experiences about the patient safety in the academic practices of the Occupational therapy program of the Universidad Nacional de Colombia. Methods Descriptive cross-sectional study, with a sample composed of 29 students of academic practices of the program Occupational Therapy. A survey about safe customer assistance (electronic version) was designed and applied. The survey was rigorously validated and reviewed by experts. Each student gave consent to carry out the survey. Results The patients' falls are the ones that most frequently escape from the report or register on the practice area (47.1 % never report them). Despite that, falls are the most reported issue among other events (41.1 %). To a lesser extent, students always report incidents related to documentation and registration; equipment and health care devices (21.5 % and 28.6 %, respectively). In these two categories it is more prevalent to find several students who often report what actually happen (46.4 % in both cases). Discussion It is necessary to advance in the investigation of the causes and co sequences of events that affect the patient's safety in student practices, also in the provision of improvement measures that are efficient along with impact they have when implemented. Efforts are needed to transform the potential punitive perception that may be on the follow-up of measures track for patient safety. All the foregoing may be explaining part of the considerable under-reporting of incidents documented in the literature, in turn, going along with the findings of this study.(AU)

[Peace experiences in occupational therapy: contributions from Colombian regions]. / Experiencias de terapia ocupacional para la paz: aportes desde las regiones colombianas.

OBJECTIVE: To identify and characterize professional experiences in occupational therapy in different regions of Colombia regarding the overcoming of the armed conflict. METHODS: Cross-sectional, descriptive study in which the digital version of the Survey on professional experiences in the Colombian armed conflict was applied using Type-form. 34 occupational therapists responded the survey. The sample filled the corresponding informed consent to participate in the study. RESULTS: The overall balance shows that experiences are mostly concentrated in the Andean region and cover 18 departments of the country, while a representative percentage are observed in works with indigenous communities. Intervention has targeted mainly adults and victims and people with disabilities, although greatest emphasis is on communities. Therapists are involved mainly as executors and university professors. Finally, there is concern about the presence of illegal armed actors and the reality of an overwhelming problem. Achievements include the impact of the intervention and the capitalized professional and personal learning. CONCLUSIONS: A territorial approach requires greater presence in the regions and cultural sensitivity. Strengthening the work carried out with the population that was linked to illegal armed groups through occupational resignification processes allow to make progress in the expected economic and social reincorporation.

OBJETIVOS: Identificar y caracterizar las experiencias profesionales de terapia ocupacional en las regiones de Colombia, relacionadas con la superación del conflicto armado. MÉTODOS: Estudio descriptivo transversal, con la aplicación de una encuesta sobre experiencias profesionales en el conflicto armado colombiano, versión digital, en el aplicativo Typeform, respondida por 34 terapeutas ocupacionales. La muestra diligenció el respectivo consentimiento informado para participar en el estudio. RESULTADOS: El balance general de las experiencias reportadas se concentran en la región andina; cubren 18 departamentos del país; un porcentaje representativo se desarrolla con comunidades indígenas; la intervención se ha dirigido especialmente a adultos y a la atención de víctimas y personas con discapacidad; el mayor énfasis ha sido comunitario; el terapeuta se ha vinculado principalmente como ejecutor y docente universitario; preocupan los problemas de presencia de actores armados ilegales y la realidad de una problemática desbordante; y como logros se resaltan el impacto de la intervención y los aprendizajes profesionales y personales capitalizados. CONCLUSIONES: El enfoque territorial demanda mayor presencia en las regiones y sensibilidad cultural. Fortalecer el trabajo con la población que estuvo vinculada a los grupos armados ilegales, con procesos de resignificación ocupacional que permitan avanzar en la reincorporación económica y social esperada.

[Virtual objects for self-regulated learning of occupational therapy students]. / Objetos virtuales para el aprendizaje autorregulado de estudiantes de terapia ocupacional.

OBJECTIVE: To identify the relationship between the characteristics of students, their learning environment, their occupation, and the virtual objects for self-regulated learning. In addition, to establish connections with participant's observation. Important aspects for the training of health professionals. METHODS: A qualitative study was applied to students who participated in the Education and Occupational Therapy subject. Two tools were used: virtual Objects Questionnaire for the educational field learning and Participant Observation. The first instrument was piloted and reviewed by experts. RESULTS: The study reported similar demographic data and background of similar education in relation to: origin, access to the computer and exclusivity to study; as well as the development of secondary education studies in Bogotá and in private institutions. In the learning environments, there is a tendency to show that they agree with the program of the subject in fulfillment of explicit objectives chosen for the study in 75 % and implicit in 60 %. With regards to the occupation, it was found that the virtual object allowed to deepen on the subject that the students developed and put into practice previous knowledge on communication technologies. The Participant Observation tool found particularities in the elements of motivation, efficacy and self-regulated learning. CONCLUSIONS: The implementation of the Virtual Learning Objects favor the students' motivation, self-regulated learning and their appropriation of concepts and knowledge related to the subject; therefore, it is proposed as a learning strategy.

OBJETIVOS: Identificar las relaciones entre las características de los estudiantes, su ambiente de aprendizaje, su ocupación, y los objetos virtuales para el aprendizaje autorregulado a través de la observación participante. Aspectos importantes para la formación de profesionales de la salud. MÉTODOS: Estudio cualitativo aplicado a estudiantes que participaron en la asignatura Educación y Terapia Ocupacional. Se emplearon dos herramientas: Cuestionario Objetos Virtuales para el aprendizaje en el campo educativo y Observación participante. Al primer instrumento se le realizó pilotaje y revisión por experto. RESULTADOS: El estudio dio cuenta de datos demográficos y antecedentes de educación media similares, con relación a: procedencia, acceso al computador y exclusividad para estudiar; así como desarrollo de estudios de educación media en Bogotá y en instituciones privadas. En los ambientes de aprendizaje hay una tendencia a evidenciar que están de acuerdo con el programa de la asignatura: en cumplimiento de objetivos explícitos escogidos para el estudio en un 75 % e implícitos en un 60 %. En la ocupación, se encontró que el objeto virtual permitió profundizar sobre el tema que desarrollaron los estudiantes y poner en práctica conocimientos previos sobre tecnologías de la información y la comunicación. La observación participante arrojó particularidades en los elementos motivación, eficacia y aprendizaje autorregulado. CONCLUSIONES: La implementación de los Objetos Virtuales de Aprendizaje favorece en los estudiantes la motivación, el aprendizaje autorregulado y la apropiación de conceptos y conocimientos relacionados con la asignatura; por lo que se propone como estrategia de aprendizaje.

[Patient safety in the training practices of an undergraduate program in Occupational Therapy]. / Seguridad del paciente en las prácticas formativas de un programa de pregrado en Terapia Ocupacional.

OBJECTIVE: To identify conditions and experiences about the patient safety in the academic practices of the Occupational therapy program of the Universidad Nacional de Colombia. METHODS: Descriptive cross-sectional study, with a sample composed of 29 students of academic practices of the program Occupational Therapy. A survey about safe customer assistance (electronic version) was designed and applied. The survey was rigorously validated and reviewed by experts. Each student gave consent to carry out the survey. RESULTS: The patients' falls are the ones that most frequently escape from the report or register on the practice area (47.1 % never report them). Despite that, falls are the most reported issue among other events (41.1 %). To a lesser extent, students always report incidents related to documentation and registration; equipment and health care devices (21.5 % and 28.6 %, respectively). In these two categories it is more prevalent to find several students who often report what actually happen (46.4 % in both cases). DISCUSSION: It is necessary to advance in the investigation of the causes and co sequences of events that affect the patient's safety in student practices, also in the provision of improvement measures that are efficient along with impact they have when implemented. Efforts are needed to transform the potential punitive perception that may be on the follow-up of measures track for patient safety. All the foregoing may be explaining part of the considerable under-reporting of incidents documented in the literature, in turn, going along with the findings of this study.

OBJETIVO: Identificar condiciones y experiencias sobre la seguridad del paciente en prácticas académicas de terapia ocupacional de la Universidad Nacional de Colombia. MÉTODOS: Estudio descriptivo transversal, con una muestra integrada por 29 estudiantes de práctica académica del programa Terapia Ocupacional. Diseño y aplicación de una encuesta sobre atención segura de usuarios (versión electrónica), sometida a revisión de expertos para validar su contenido. Previamente, cada estudiante dio su consentimiento para la realización de la encuesta. RESULTADOS: Las caídas de los pacientes son las que se escapan más frecuentemente del reporte o registro en el sitio de práctica (47,1 % de los estudiantes nunca las reporta). A pesar de esto, es el evento que mayor registro presenta con respecto a otros reportes (41,1 %). En menor proporción los estudiantes siempre dejan reporte de los incidentes relacionados con documentación y registro, y con equipos y dispositivos de atención (21,5 % y 28,6 %, respectivamente). En estas dos últimas categorías son más numerosos los estudiantes que sólo algunas veces reportan lo ocurrido (46,4 % en ambos casos). DISCUSIÓN: Es necesario avanzar en la indagación sobre las causas y consecuencias de los eventos que afectan la seguridad del paciente en las prácticas de los estudiantes, y en la disposición de medidas de mejora que sean eficientes junto con el impacto que tienen al implementarse. Se requieren esfuerzos para transformar la posible percepción punitiva que pueda estar recayendo sobre el seguimiento de las medidas para la seguridad del paciente.Todo lo anterior podría estar explicando parte del considerable subregistro de incidentes que documenta la literatura y que coincide con los hallazgos de este estudio.

Terapia ocupacional en la normatividad colombiana relacionada con conflicto armado / Occupational therapy in Colombian law related to armed conflict

Resumen Introducción. La literatura especializada señala la importancia del terapeuta ocupacional en conflictos violentos al reportar múltiples reflexiones y experiencias; sin embargo, son ausentes los trabajos que en Colombia profundicen en los alcances y posibilidades profesionales según la legislación vigente. Objetivo. Analizar disposiciones del marco legal colombiano relacionadas con conflicto armado para identificar contenidos afines a la terapia ocupacional. Materiales y métodos. Investigación documental acerca de la normatividad colombiana sobre conflicto armado para su respectivo análisis. Resultados. Las disposiciones revisadas no mencionan la terapia ocupacional. Las normas, según áreas de ejercicio, se distribuyen así: bienestar social 21.8%, psicosocial 21.8%, sociolaboral 20.6%, biosocial 20.6% y educación 14%; estas, en su mayoría, cubren a víctimas del conflicto y se interesan en el desplazamiento forzado. Se destacan la mirada diferencial para protección de la población infantil y los procedimientos como atención directa, actividades grupales e intervención con familias. Conclusiones. Se evidencia una necesidad de impulso gremial al reconocimiento social de las posibilidades de la terapia ocupacional en ámbitos distintos al clínico. La falta de claridad por parte de la sociedad y el desconocimiento de legisladores sobre los alcances profesionales de los terapeutas ocupacionales pueden ser causa de la no mención en las disposiciones analizadas. Como retos gremiales queda participar en escenarios de formulación de políticas públicas, divulgar experiencias profesionales en conflictos violentos y fomentar programas dirigidos a actores armados.

Abstract Introduction: Specialized literature points the importance of occupational therapists during violent conflicts when reporting thoughts and experiences; however, works that explore the scope and career possibilities of occupational therapists in the light of current legislation are scarce. Objective: To analyze provisions in the Colombian legal framework related to armed conflict to identify content related to occupational therapy. Materials and methods: Documentary research on Colombian law regarding armed conflict. Results: The provisions consulted during this research do not mention occupational therapy. Regulations, according to practice areas, are distributed as follows: social welfare 21.8%, psychosocial welfare 21.8%, social and occupational welfare 20.6%, biosocial welfare 20.6% and education 14%, which mostly cover victims of the conflict and are interested in forced displacement. Differential perspectives regarding children protection and procedures such as direct care, group activities and intervention with families stand out. Conclusions: Occupational therapy should be promoted by professionals in settings different from the clinical context. The lack of clarity in the population and the ignorance of legislators regarding the scope of professional occupational therapists can be one of the causes of the omission of occupational therapy in the analyzed provisions. Challenges include the participation in scenarios involved in public policies, the dissemination of professional experiences in violent conflicts and the promotion of programs aimed at armed groups.

Caracterización y condiciones de los cuidadores de personas con discapacidad severa en Bogotá / Characterization and conditions of caregivers to people with severe disabilities in Bogotá

Objetivo Describir las características socioeconómicas, funciones asumidas y morbilidad sentida de un grupo de cuidadores de personas con discapacidad severa en Bogotá. Materiales y Métodos Estudio descriptivo transversal, con una muestra de 2 557 cuidadores de personas con discapacidad severa en 19 localidades de Bogotá, seleccionados bajo criterios de saturación de la información. El instrumento Caracterización de la persona en condición de discapacidad severa-capítulo cuidadores, se diseñó, fue sometido a validez de contenido a partir de la revisión de expertos y posteriormente se efectuó prueba piloto. La versión validada y ajustada se aplicó a la muestra en el marco de visitas domiciliarias interdisciplinarias. Con cada participante se formalizó un consentimiento informado y se ha asegurado confidencialidad en los datos suministrados. Resultados El estudio detectó la influencia de variables de género en el quehacer del cuidador, así como precariedad económica, fragilidad en redes de apoyo, autopercepción de alteraciones en la salud, elevada dedicación en tiempo a actividades de cuidado informal y multiplicidad de funciones a cargo. Conclusiones Las condiciones de bienestar y salud de los cuidadores de personas con discapacidad severa evidencian alteraciones que urgen respuestas, no sólo desde el actuar profesional a la luz del reconocimiento cultural y fortalecimiento de dicha labor, sino también desde el ámbito de la acción pública.(AU)

Objective Describe socioeconomic characteristics, functions assumed, and perceived morbidity of a group of caregivers to people with severe disabilities in Bogotá. Materials and Methods Descriptive transversal study with a sample of 2 557 caregivers to people with severe disabilities in 19 locations in Bogota, selected under saturation of information criteria. The instrument, Characterization of Severely Disabled Individuals- Caregiver Chapter, was designed and subjected to content validity based on expert review. The pilot test was carried out subsequently. The validated and adjusted version was applied to the sample in the context of interdisciplinary home visits. Each participant signed an informed consent form and the complete confidentiality of the data supplied has been assured. Results The study found the influence of gender variables on the work of caregivers as well as economic insecurity, fragility of support networks, self-rated health disorders, high dedication in time to informal care activities, and the multiplicity of functions performed. Conclusions The wellness and health conditions of caregivers to people with severe disabilities show alterations that urge responses, not only in professional duties in the light of cultural recognition and the strengthening of this work, but also from the field of public action.(AU)

[Characterization and conditions of caregivers to people with severe disabilities in Bogotá]. / Caracterización y condiciones de los cuidadores de personas con discapacidad severa en Bogotá.

Objective Describe socioeconomic characteristics, functions assumed, and perceived morbidity of a group of caregivers to people with severe disabilities in Bogotá. Materials and Methods Descriptive transversal study with a sample of 2 557 caregivers to people with severe disabilities in 19 locations in Bogota, selected under saturation of information criteria. The instrument, Characterization of Severely Disabled Individuals- Caregiver Chapter, was designed and subjected to content validity based on expert review. The pilot test was carried out subsequently. The validated and adjusted version was applied to the sample in the context of interdisciplinary home visits. Each participant signed an informed consent form and the complete confidentiality of the data supplied has been assured. Results The study found the influence of gender variables on the work of caregivers as well as economic insecurity, fragility of support networks, self-rated health disorders, high dedication in time to informal care activities, and the multiplicity of functions performed. Conclusions The wellness and health conditions of caregivers to people with severe disabilities show alterations that urge responses, not only in professional duties in the light of cultural recognition and the strengthening of this work, but also from the field of public action.

Participación de terapia ocupacional en contextos de conflicto armado y postconflicto / The role of occupational therapy in contexts of armed conflict and the post-conflict

Objetivos Identificar experiencias profesionales de terapia ocupacional en contextos nacional e internacional de conflicto armado y postconflicto. Métodos Revisión sistemática cualitativa de literatura 2005-2014, según cinco categorías analíticas: experiencias profesionales; problemáticas; poblaciones; referentes teóricos; y procedimientos. Resultados Se recuperaron 78 trabajos. Contexto nacional: los modelos más empleados son ocupación humana y desempeño ocupacional realizante; la problemática más tratada es desplazamiento forzado. Contexto internacional: 19 países documentan experiencias; los modelos canadiense y rehabilitación basada en comunidad se emplean en mayor número; las principales problemáticas tratadas son desplazamiento forzado, condición de refugiados y atención a integrantes de la fuerza pública. En ambos contextos se destacan procedimientos como las actividades artísticas e intervenciones en bienestar social e inclusión sociolaboral. Conclusiones Los trabajos de grado son la principal fuente de experiencias nacionales, aunque pocos están publicados; son escasos los trabajos con población victimaria (desmovilizados, desvinculados); cobra relevancia el sector rural como escenario típico del conflicto armado y contexto expulsor; se han introducido frecuentes categorías conceptuales y prácticas al quehacer, desde la perspectiva de la terapia ocupacional crítica, que afianzan el papel profesional en fenómenos de exclusión social y violencias, como agente de transformación que acude a la dimensión sociopolítica de la ocupación humana. Estos hallazgos plantean retos gremiales y académicos para publicar, abordar poblaciones no sólo en condición de víctimas, incursionar en la formación y ejercicio en contextos rurales y reconocer el papel profesional como agente que trasciende más allá de la dimensión salubrista de la ocupación humana.(AU)

Objective To identify professional experiences of Occupational Therapy in Colombian and international contexts of armed conflict and post-conflict. Methods A qualitative systematic review of the literature between 2005-2014 in five analytical categories: professional experiences, problem situations, populations, theoretical frameworks, and procedures. Results 78 papers were retrieved. Colombian context: the models most used are human occupation and occupational performance; the most frequent problem is forced displacement. International context: 19 countries documented experiences; the Canadian model and the community-based rehabilitation model are most used; the main problem situations are forced displacement, refugee status, and attention to members of the armed forces. Both contexts highlight procedures such as artistic activities and interventions related to social welfare and social-inclusion. Conclusions Graduate these are the main source of Colombian experiences, though few are published; there are a few studies about victim population (demobilized). The rural sector as a typical scenario of armed conflict and a context of displacement have been seen as relevant. Frequent conceptual categories and practices have been introduced from the critical perspective of Occupational Therapy which reinforce the role of the professional in phenomena of social exclusion and violence, as a transformational agent that addresses the socio-political dimension of human occupation. These findings posit challenges for professionals and academics to publish, to work with populations (victims or not), to approach training and practice in rural contexts, and to recognize the role of the professional as an agent that transcends the public health dimension of human occupation.(AU)

[The role of occupational therapy in contexts of armed conflict and the post-conflict]. / Participación de terapia ocupacional en contextos de conflicto armado y postconflicto.

Objective To identify professional experiences of Occupational Therapy in Colombian and international contexts of armed conflict and post-conflict. Methods A qualitative systematic review of the literature between 2005-2014 in five analytical categories: professional experiences, problem situations, populations, theoretical frameworks, and procedures. Results 78 papers were retrieved. Colombian context: the models most used are human occupation and occupational performance; the most frequent problem is forced displacement. International context: 19 countries documented experiences; the Canadian model and the community-based rehabilitation model are most used; the main problem situations are forced displacement, refugee status, and attention to members of the armed forces. Both contexts highlight procedures such as artistic activities and interventions related to social welfare and social-inclusion. Conclusions Graduate these are the main source of Colombian experiences, though few are published; there are a few studies about victim population (demobilized). The rural sector as a typical scenario of armed conflict and a context of displacement have been seen as relevant. Frequent conceptual categories and practices have been introduced from the critical perspective of Occupational Therapy which reinforce the role of the professional in phenomena of social exclusion and violence, as a transformational agent that addresses the socio-political dimension of human occupation. These findings posit challenges for professionals and academics to publish, to work with populations (victims or not), to approach training and practice in rural contexts, and to recognize the role of the professional as an agent that transcends the public health dimension of human occupation.

Modification of the technique for subclavian-vein catheterization.

INTRODUCTION: In invasive monitoring, subclavian-vein puncture is a routine procedure indicated for central vein cathe-terization. It is indicated in patients according to hospital stay, including the administration of drugs and the treatment of chronic and cardiac disease. The techniques described to date include infraclavicular percutaneous puncture; others place catheters using angiographic methods, and the use of magnetic resonance imaging and ultrasound has also been reported. Studies have been done in cadavers to get a better understanding of the procedure since the relationship between vascular elements and surrounding tissues are obtained. The usual technique is with the patient in Trendelenburg position, with the arm in adduction, the placement of an interscapular roll, and the head turned away from the puncture site. OBJECTIVE: The aim of this study was to demonstrate less frequent technical failures and complications using a modification of the usual technique. We propose catheterization of the right subclavian vein with the patient in decubitus, without an interescapular roll, with the arm in abduction and using the distal third of the clavicle and the suprasternal notch as anatomical references. RESULTS: Two technical puncture failures and three complications occurred in a total of 42 patients with a statistically significant difference (p = 0.0410) in frequency (11.9%) from that reported with the traditional technique (21.8%). CONCLUSIONS: Greater efficacy with the technique modified by the authors was confirmed. Anatomical cadaver dissections showed a greater space between the right subclavian vein and the clavicle.