A Serious Game for Cognitive Stimulation of Older People With Mild Cognitive Impairment: Design and Pilot Usability Study.

Background: Cognitive stimulation of older people helps prevent, and even treat, age-related diseases, such as mild cognitive impairment. Playing games reduces the probability of experiencing this pathology, which is related to the loss of the ability to carry out some instrumental activities of daily living. Objective: This work describes the design and development of a serious game for the cognitive stimulation of older people, with exercises related to the daily life task of shopping. A pilot study for its preliminary usability validation is also presented. Methods: The designed serious game includes 4 exercises consisting of shopping in a hypermarket, ordering products, making payments, and organizing the purchase, thus dealing with the most frequent cognitive problems of older people associated with episodic declarative memory, naming, calculation, and organization, respectively. Results: A total of 19 older people participated in the pilot study for the usability validation of the serious game. They indicated that they like the aesthetic and interesting topic of the game. They reported that it provides a high level of entertainment and could be useful in daily life for mental stimulation. The participants found the serious game to be intuitive, but the ease of use and readability of the instructions could be improved. Conclusions: This study suggests that the innovative serious game developed could be accepted by older people for their cognitive stimulation to prevent or treat mild cognitive impairment, although a long-term intervention study should be performed as future work. Its ecological validity design, with everyday tasks, adaptable levels of difficulty, and motivational mechanisms, is a differentiating factor compared to similar serious games.

Colonic Electrical Stimulation for Chronic Constipation: A Perspective Review.

Chronic constipation affects around 20% of the population and there is no efficient solution. This perspective review explores the potential of colonic electric stimulation (CES) using neural implants and methods of bioelectronic medicine as a therapeutic way to treat chronic constipation. The review covers the neurophysiology of colonic peristaltic function, the pathophysiology of chronic constipation, the technical aspects of CES, including stimulation parameters, electrode placement, and neuromodulation target selection, as well as a comprehensive analysis of various animal models highlighting their advantages and limitations in elucidating the mechanistic insights and translational relevance for CES. Finally, the main challenges and trends in CES are discussed.

The effect of varus rearfoot wedges on hallux dorsiflexion resistance.

BACKGROUND: The first metatarsophalangeal joint (MTPJ), which includes the first metatarsal and proximal phalanx, plays a crucial role in gait and impacts the windlass mechanism. Disruptions to this mechanism are implicated in various foot pathologies. Jack's Test serves as a valuable tool for clinicians to assess the functionality of the MTPJ. Varus rearfoot wedges (VRFWs) are a common treatment employed in the management of lower limb pathologies. The impact of VRFWs on the resistance of the first MTPJ during Jack´s Test is currently unknown. This study aimed to measure the influence of VRFWs on the resistance of the first MTPJ during Jack´s Test. The secondary objective was to validate a new measurement method using a digital force gauge. METHODS: Thirty participants (17 women and 13 men) were enrolled. A digital force gauge measured the weight-bearing force needed for Jack's Test, thereby evaluating the effects of VRFWs of different angulations. The Kolmogorov-Smirnov test confirmed that the data followed a normal distribution (p > 0.05). The nonparametric Friedman test (p < 0.001) showed that there were significant differences among all VRFWs, while the Wilcoxon test (p < 0.001) showed that there were differences between barefoot conditions and 3°, 5°, and 8° VRFWs. RESULTS: The use of 8° VRFWs yielded a statistically significant reduction in the passive dorsiflexion force of hallux during Jack's Test (12.51 N ± 4.12, p < 0.001). CONCLUSIONS: The use of VRFWs has been observed to reduce dorsiflexion resistance in the proximal phalanx of the first MTPJ during Jack's Test. Additionally, the digital force gauge was proven to be a valid tool for conducting Jack's Test, thus offering a reliable measurement method.

Influence of the time-task constraint on ocular metrics of semi-elite soccer players.

This study novelty aimed to investigate the influence of manipulating the available time to perform the training tasks on soccer players´ ocular metrics, following training. Specifically, pupillary response (pupil diameter) and saccadic features (latency, accuracy, velocity, and number) were measured with a portable eye tracker following training to reflect the mental load accumulated by players during the training sessions. Nine semi-elite soccer players performed two training sessions, based on large-sided games, on an artificial grass field. These two sessions were composed of the same tasks but varying the required time to complete the task goals (Session 1: No time limitations to perform the tasks; Session 2: Limited time to perform the tasks). The participants performed, before (pre-test) and after (post-test) each training session, a prosaccade task in a room near the playing field. Findings revealed a differentiated effect of the available time to complete the training tasks on ocular metrics because significant differences were found in all variables after training (p < .001 for pupil diameter; p < .01 for saccade accuracy and number of saccades; p < .05 for saccade velocity and latency). Ocular metrics could be a promising tool to evaluate mental load following practice because they were sensitive to the time-task constraint, providing researchers a valuable information for a better planning of the mental workload when designed training tasks.

The use of the eye-fixation-related potential to investigate visual perception in professional domains with high attentional demand: a literature review.

INTRODUCTION: Visual attention is a cognitive skill related to visual perception and neural activity, and also moderated by expertise, in time-constrained professional domains (e.g., aviation, driving, sport, surgery). However, the contribution of both perceptual and neural processes on performance has been studied separately in the literature. DEVELOPMENT: We defend an integration of visual and neural signals to offer a more complete picture of the visual attention displayed by professionals of different skill levels when performing free-viewing tasks. Specifically, we propose to zoom the analysis in data related to the quiet eye and P300 component jointly, as a novel signal processing approach to evaluate professionals' visual attention. CONCLUSION: This review highlights the advantages of using portable eye trackers and electroencephalogram systems altogether, as a promising technique for a better understanding of early cognitive components related to attentional processes. Altogether, the eye-fixation-related potentials method may provide a better understanding of the cognitive mechanisms employed by the participants in natural settings, revealing what visual information is of interest for participants and distinguishing the neural bases of visual attention between targets and non-targets whenever they perceive a stimulus during free viewing experiments.

Home-based exercise interventions delivered by technology in older adults: A scoping review of technological tools usage.

BACKGROUND: Despite technology-based systems being considered promising tools to stimulate and increase physical function at home, most older adults are unfamiliar with technology, which may pose some difficulties. Technology-related parameters, such as adherence, acceptance, and acceptability, are crucial to achieving higher efficacy levels of home-based exercise interventions delivered by technology. In this scoping review, we aimed to revise the use of home-based technological tools to improve physical function in the older population, focusing on the user's experience and perspective. Methods This scoping review was conducted following PRISMA guidelines. The search was conducted in April 2022 and updated in April 2023. A total of 45 studies were included in the review. Results Most studies (95.5%) met the technology usage levels defined by the research team or reported satisfactory technology usage levels. Positive health-related outcomes were reported in 80% of studies. Although the existence of guidelines to correctly define and use measures associated with technology use, including adherence, acceptance and acceptability, some terms are still being used interchangeably. Some concerns related to the lack of an international consensus regarding technology usage measures and the exclusion of older adults who did not own or have previous experience with technology in a large percentage of the included studies may have limited the results obtained. Conclusions Altogether, home-based exercise interventions delivered through technology were associated with positive health-related outcomes in older adults, and technology usage levels are considered satisfactory. Older adults are willing and able to use technology autonomously if adequate support is provided.

Clinical Validation Benchmark Dataset and Expert Performance Baseline for Colorectal Polyp Localization Methods.

Colorectal cancer is one of the leading death causes worldwide, but, fortunately, early detection highly increases survival rates, with the adenoma detection rate being one surrogate marker for colonoscopy quality. Artificial intelligence and deep learning methods have been applied with great success to improve polyp detection and localization and, therefore, the adenoma detection rate. In this regard, a comparison with clinical experts is required to prove the added value of the systems. Nevertheless, there is no standardized comparison in a laboratory setting before their clinical validation. The ClinExpPICCOLO comprises 65 unedited endoscopic images that represent the clinical setting. They include white light imaging and narrow band imaging, with one third of the images containing a lesion but, differently to another public datasets, the lesion does not appear well-centered in the image. Together with the dataset, an expert clinical performance baseline has been established with the performance of 146 gastroenterologists, who were required to locate the lesions in the selected images. Results shows statistically significant differences between experience groups. Expert gastroenterologists' accuracy was 77.74, while sensitivity and specificity were 86.47 and 74.33, respectively. These values can be established as minimum values for a DL method before performing a clinical trial in the hospital setting.

Understanding the Artemia Salina (Brine Shrimp) Test: Pharmacological Significance and Global Impact.

BACKGROUND: The microplate benchtop brine shrimp test (BST) has been widely used for screening and bio-guided isolation of many active compounds, including natural products. Although the interpretation given to the results appears dissimilar, our findings suggest a correlation between positive results with a specific mechanism of action. OBJECTIVE: This study aimed to evaluate drugs belonging to fifteen pharmacological categories having diverse mechanisms of action and carry out a bibliometric analysis of over 700 citations related to microwell BST. METHODS: Test compounds were evaluated in a serial dilution on the microwell BST using healthy nauplii of Artemia salina and after 24 hrs of exposition, the number of alive and dead nauplii was determined, and the LC50 was estimated. A metric study regarding the citations of the BST miniaturized method, sorted by type of documents cited, contributing country, and interpretation of results was conducted on 706 selected citations found in Google Scholar. RESULTS: Out of 206 drugs tested belonging to fifteen pharmacological categories, twenty-six showed LC50 values <100 µM, most of them belonging to the category of antineoplastic drugs; compounds with different therapeutical uses were found to be cytotoxic as well. A bibliometric analysis showed 706 documents citing the miniaturized BST; 78% of them belonged to academic laboratories from developing countries located on all continents, 63% interpreted their results as cytotoxic activity and 35% indicated general toxicity assessment. CONCLUSION: BST is a simple, affordable, benchtop assay, capable of detecting cytotoxic drugs with specific mechanisms of action, such as protein synthesis inhibition, antimitotic, DNA binding, topoisomerase I inhibitors, and caspases cascade interfering drugs. The microwell BST is a technique that is used worldwide for the bio-guided isolation of cytotoxic compounds from different sources.

Politico-Epistemic Tensions Regarding Personal Assistance and Care for People with Disabilities: An Integrative Literature Review.

BACKGROUND: Since the 1960s, the Independent Life Movement has demanded personal assistance as a right for people with disabilities to access autonomy. In turn, feminist movements have shown a special concern for the care and profile of the providers. Both postures have created tensions around the provision of personal assistance and care for people with disabilities. AIM: To know and analyze the scientific evidence regarding approaches to personal assistance and care for people with disabilities. METHODS: An Integrative Literature Review using five databases: Dialnet, Scielo, PubMed, Scopus, and Web of Science. The Boolean combinations were: "Personal assistance AND disability"; "Personal assistance AND care AND disability"; "Care AND disability" in English, and "Asistencia personal AND discapacidad"; "Asistencia personal AND cuidados AND discapacidad"; "Cuidados AND discapacidad" in Spanish. A total of 31 scientific articles were obtained. A content analysis was then, with five analysis dimensions emerging. RESULTS: The articles approached the positive aspects of personal assistance. Others established the need for more resources in order to not be an exclusive reality for developed countries. Profiles were made of racialized, young, migrant women as the identity behind (informal) care. From the perspective of a feminist disability care ethic, new forms of providing care are proposed, by changing the focus from individual and family responsibility, towards a social and collective focus. CONCLUSION: The evidence analyzed considers various dimensions of the epistemo-political tension between personal assistance and care. The meeting point between both perspectives is interdependence and autonomy; on the one side, for people with disabilities, and on the other, for the women profiled as the main caregivers.

Reivindicative occupational practices of activist with disabilities / Práticas ocupacionais reivindicativas de ativistas com deficiência

Abstract Introduction The occupational praxis of activists with disabilities in the Latin America has presented actions of revindication from historically marginalised territories. Objective To explore and describe strategies used by Chilean activist with disabilities. Method Qualitative design via three research techniques: a) 11 in-depth interviews; b) six group chat sessions; c) content analysis of eight social networks belonging to collectives of activists with disabilities in Chile. Results Activists indicate various occupations for revindication as subjects with rights. These trajectories are exemplified with the following dimensions: 1) Interpellate full social participation: demanding justice and citizenship; 2) Showing defective bodies: public mobilisations; 3) Occupying institutional space by placing: bodies in the system. Conclusion Dissident occupational practices intervene and transform the limited comprehension about what human vulnerability and fragility is capable of. This situation is mainly appreciated in the Global South.

Resumo Introdução A práxis ocupacional de ativistas com deficiência na América Latina tem apresentado ações de reivindicação de territórios historicamente marginalizados. Objetivo Explorar e descrever as estratégias utilizadas por ativistas chilenos com deficiência. Método Desenho qualitativo por meio de três técnicas de pesquisa: a) 11 entrevistas em profundidade; b) seis sessões de chat em grupo; c) análise de conteúdo de oito redes sociais pertencentes a coletivos de ativistas com deficiência no Chile. Resultados Os ativistas indicam diversas ocupações para reivindicação como sujeitos de direitos. Essas trajetórias são exemplificadas com as seguintes dimensões: 1) Interpelar a participação social plena: reivindicar justiça e cidadania; 2) Mostrar corpos defeituosos: mobilizações públicas; 3) Ocupar o espaço institucional colocando: os corpos no sistema. Conclusão Práticas ocupacionais dissidentes intervêm e transformam a compreensão limitada sobre do que é capaz a vulnerabilidade e fragilidade humana. Esta situação é apreciada principalmente no Sul Global.

Salvajes, indígenas, cojas, inválidas: Epistemologías anticapacitistas del Sur / Selvagem, indígena, coxo, inválido: epistemologias anticapacitistas do Sul / Wild, Indigenous, Lame, Invalid: Anti-Ableist Epistemologies of the South

Resumen El objetivo del manuscrito es presentar una primera aproximación a una propuesta epistemológica que reflexione y se ocupe de la construcción y legitimación de conocimientos generados desde corporeidades abyectas, anormales o tullidas geopolíticamente ubicadas al Sur. Pone especial atención al sistema sexo-género-capacidad en la organización social y epistemológica del saber. En ese devenir, identificamos una posicionalidad y riqueza desperdiciada para el análisis y transformación social regional como resultado de un ordenamiento moderno colonial. De ahí que esta propuesta se inscriba dentro del pensamiento crítico latinoamericano para reflexionar sobre esos lugares otros de enunciación abyecta.

Resumo O objetivo deste artigo é apresentar uma abordagem inicial de uma proposta epistemológica que reflita e lide com a construção e a legitimação do conhecimento gerado a partir de corporeidades abjetas, anormais ou inválidas, geopoliticamente localizadas no Sul. Dá atenção especial ao sistema de sexo-gênero-capacidade na organização social e epistemológica do saber. No processo, identificamos uma posição e uma riqueza desperdiçadas para a análise e transformação social regional como resultado de uma ordem colonial moderna. Por isso, esta proposta se inscreve no pensamento crítico latino-americano para refletir sobre esses outros lugares de enunciação abjeta.

Abstract The aim of the article was to present a first approach to an epistemological proposal that reflects on and deals with the construction and legitimation of knowledge generated from abject, abnormal, or crippled corporeities geopolitically located in the South. It pays special attention to the sex-gender-ability system in the social and epistemological organization of knowledge. In this development, we identify a positionality and wasted wealth for regional social analysis and transformation as a result of a modern colonial order. Hence, this proposal is inscribed within the Latin American critical thinking to reflect on those other places of abject enunciation.

Incorporación urgente de estudiantes de Enfermería durante la pandemia por COVID-19: análisis de competencias / Emergency incorporation of Nursing students during the COVID-19 pandemic: an analysis of competences

Objetivo: describir el nivel de competencia de los y las estudiantes del Grado en Enfermería contratadas como refuerzo en el Hospital Universitario Vall d’Hebron (Barcelona) durante la primera ola de la pandemia por COVID-19 y determinar su satis-facción con el entorno clínico. Método: estudio descriptivo transversal. Se incluyó a todas las personas contratadas (n= 39) entre febrero y mayo de 2020. Al mes de la incorporación se recogieron variables demográficas académicas, laborables y se midió el nivel de competencia (Cuestionario COM_VAT© de 21 ítems puntuados entre 1: ejecución insuficiente y 4 ejecución autónoma y correcta) y la satisfacción con el entorno clínico (cuestionario diseñado ad hoc de tres dimensiones -orientación, integración con el equipo y adaptación al entorno laboral- evaluadas con 15 ítems puntuados de 1 muy en desacuerdo a 5 muy de acuerdo). Se realizó estadística descriptiva y bivariante. Resultados: participaron las 39 personas. La puntuación global mediana de la evaluación competencial fue de 3,9 sobre 4 pun-tos [RIC 3,7-4]. La competencia de valorar, diagnosticar y abordar situaciones de salud cambiantes obtuvo 3,85 puntos [RIC 3,4-4]. La competencia de ayudar al paciente a cumplir el tratamiento y hacerlo partícipe de 4 [RIC 4-4] y la competencia de contribuir a garantizar la seguridad y el proceso asistencial de 3,8 [RIC 3,6 – 4]. La mediana de satisfacción con el entorno clínico fue de 69 sobre 75 [RIC 63-74] sin diferencias estadísticamente significativas en ella en función del resto de características. Conclusión: las personas participantes mostraron un nivel de competencia que representa una correcta ejecución, pero que puede requerir ayuda ocasional. Reportaron una alta satisfacción con el entorno clínico.(AU)

Objective: to describe the level of competence among Nursing Degree students hired as support at the Hospital Universitario Vall d’Hebron (Barcelona) during the first wave of the COVID-19 pandemic, and to determine their satisfaction with the clinical environment. Method: a descriptive cross-sectional study, including all persons hired (n= 39) between February and March 2020. Demographic, academic and occupational variables were collected at one month of their incorporation, and their level of competence was measured (COM_VAT© questionnaire with 21 items scored from 1: insufficient performance, to 4: autonomous and correct performance), as well as the satisfaction with their clinical environment (questionnaire designed ad hoc with three dimensions: orientation, integration with the team, and adaptation to the work environment, evaluated through 15 items scored from 1: high disagreement, to 5: high agreement). Descriptive and bivariate statistics was used. Results: all 39 persons were included. The overall median score of the evaluation of skills was 3.9 out of 4 scores [IQR 3.7-4]. The competence of assessing, diagnosing and addressing ever-changing health situations obtained a score of 3.85 [IQR 3.4-4]. The competence of helping patients to comply with treatment and getting them involved obtained a 4 [IQR 4-4], and the competence of contributing to guarantee safety and care process obtained 3.8 [IQR 3.6 – 4]. The median satisfaction with the clinical environment was 69 out of 75 [IQR 63-74] without statistically significant differences according to the other characteristics .Conclusion: the participants showed a level of competence ensuring correct performance, but that might require occasional help. They reported high satisfaction with the clinical environment.Keywords:care; coronavirus infections; volunteers; clinical competence; nursing students; job satisfaction; working conditions; cross-sectional studies.(AU)

Factor structure and measurement invariance of the psychosocial risk factors inventory of NOM-035-STPS-2018.

The primary objective of this study was to analyze the psychometric properties of the Inventory for the Identification and Analysis of Psychosocial Risk Factors (IIA-PRF) of Reference Guide III proposed in NOM-035-STPS-2018. A total of 2,149 workers in Baja California, Mexico's industrial and education-government sectors, were administered an online inventory version. Preliminary analyses were performed, as well as a Confirmatory Factor Analysis (CFA) based on two models proposed by the standard itself: an eight-factor model (8-FM) and a four-factor model (4-FM). Likewise, based on the results and with the recommendations of the specialists, a threefactor model (3-FM) was proposed. In addition, nested model sequencing methods were subsequently applied to validate the invariance between the origin of the activity. The dimensionality of 3-FM was found to have adequate fit values according to a-priori established criteria. It is concluded that the IIAPRF does not have the reliability and validity parameters necessary to support interpretations, uses and consequences based on the theoretical structure established by NOM-035-STPS-2018 and that, although the 3-FM presents better reliability and validity indices, it is not invariant in terms of the origin of the activity. Finally, we discuss the implications and recommend reviewing and adjusting the design of the IIAPRF items to extend the measurement of invariance to other groups of relevance for decision making in the improvement of the work environment.

Criteria for Teaching Performance in Psychology: Invariance According to Age, Sex, and Academic Stage of Peruvian Students.

The use of scales to assess the performance of professors from the students' standpoint is a generalized practice in higher education systems worldwide. The purpose of this study is to analyze the factorial structure and measure the invariance of the Scale of Teaching Performance of the Psychology Professor (EDDPsic) among groups according to gender, age, and academic stage. The sample of participants was composed of 316 Psychology students from the fourth and sixth semesters (basic cycles), and from the eighth and tenth semesters (disciplinary-professional cycles) of two renowned public universities in Lima, Peru. Two hundred and thirty-one participants were women (73%), and the mean age of students was 21.5 years old (SD = 2.37). The measurement invariance of the scale in the three study variables was underpinned by a multigroup confirmatory factor analysis (MGCFA) conducted using a five-factor model that showed the best fitness indices. It is concluded that significant differences in measuring teaching performance areas of the professor depend on the students' age difference and on their academic stage (to attend the disciplinary-professional cycles).

Lapnurse-A Blended Learning Course for Nursing Education in Minimally Invasive Surgery: Design and Experts' Preliminary Validation of Its Online Theoretical Module.

BACKGROUND: The implantation of Minimally Invasive Surgery (MIS) leads to the specialization of nurses in this surgical field. However, there is no standard curriculum of MIS Nursing in Europe. Spanish and Portuguese nurses are inexperienced and have poor training in MIS. For that, a blended learning course for nursing education in MIS (Lapnurse) has been developed. This work aims to detail the course design and to preliminary validate by experts its online theoretical module. METHODS: Lapnurse consists of an online module with nine theoretical lessons and a face-to-face module with three practical lessons. The e-learning environment created to provide the online module, with didactic contents based on surgical videos and innovative 3D designs, has been validated by two technicians (functionality) and four nurses with teaching experience in MIS (usability and content). RESULTS: The E-learning platform meets all technical requirements, provides whole and updated multimedia contents correctly applied for educational purposes, incorporates interactivity with 3D designs, and has an attractive, easy-to-use and intuitive design. CONCLUSIONS: The lack of knowledge in MIS of Spanish and Portuguese nurses could be addressed by the blended learning course created, Lapnurse, where the e-learning environment that provides theoretical training has obtained a positive validation.

Medical needs related to the endoscopic technology and colonoscopy for colorectal cancer diagnosis.

BACKGROUND: The high incidence and mortality rate of colorectal cancer require new technologies to improve its early diagnosis. This study aims at extracting the medical needs related to the endoscopic technology and the colonoscopy procedure currently used for colorectal cancer diagnosis, essential for designing these demanded technologies. METHODS: Semi-structured interviews and an online survey were used. RESULTS: Six endoscopists were interviewed and 103 were surveyed, obtaining the demanded needs that can be divided into: a) clinical needs, for better polyp detection and classification (especially flat polyps), location, size, margins and penetration depth; b) computer-aided diagnosis (CAD) system needs, for additional visual information supporting polyp characterization and diagnosis; and c) operational/physical needs, related to limitations of image quality, colon lighting, flexibility of the endoscope tip, and even poor bowel preparation. CONCLUSIONS: This study shows some undertaken initiatives to meet the detected medical needs and challenges to be solved. The great potential of advanced optical technologies suggests their use for a better polyp detection and classification since they provide additional functional and structural information than the currently used image enhancement technologies. The inspection of remaining tissue of diminutive polyps (< 5 mm) should be addressed to reduce recurrence rates. Few progresses have been made in estimating the infiltration depth. Detection and classification methods should be combined into one CAD system, providing visual aids over polyps for detection and displaying a Kudo-based diagnosis suggestion to assist the endoscopist on real-time decision making. Estimated size and location of polyps should also be provided. Endoscopes with 360° vision are still a challenge not met by the mechanical and optical systems developed to improve the colon inspection. Patients and healthcare providers should be trained to improve the patient's bowel preparation.

[Subverting medical vulneration: Dissident bodily itineraries of disability in Chile]. / Subvertir la vulneración médica: itinerarios corporales disidentes de la discapacidad en Chile.

Acknowledging dissident bodies of persons with disabilities is an act of continuous resistance, and as such our objective in this article is to analyze the vulnerability and bodily violation of disability activists in Chile. In order to do so, between September 2018 and February 2019 we conducted 11 in-depth interviews using the technique of bodily itineraries, as well as 6 discussion groups. Through qualitative thematic analysis, several categories emerged: the central category of "Bodily change or difference: experiences of medicalized fragility;" and three subcategories, "Bodily diagnosis: the institutional management of differences;" "Medical treatment: correcting bodily and social abnormality;" and "Rehabilitation: to function once again as a normative body." Activists' itineraries reveal the coaptation and bodily violation that they are subjected to by the biomedical apparatus, where they are systematically denied their human rights; however, despite attempts to discipline and control them, they create subversive strategies to validate their corporealities.

El reconocimiento de los cuerpos disidentes de la discapacidad ofrece una situación de continua resistencia, por lo que nuestro objetivo fue analizar la vulnerabilidad y vulneración corporal de las personas activistas de la discapacidad en Chile. Para eso, entre septiembre de 2017 y febrero de 2018, se realizaron once entrevistas en profundidad utilizando la técnica de los itinerarios corporales y seis conversatorios. A través del análisis temático cualitativo, surgió la categoría central "el cambio o diferencia corporal: experiencias de fragilidad medicalizada", y tres subcategorías: "diagnóstico corporal: la gestión institucional de las diferencias"; "tratamiento médico: corregir la anormalidad corporal y social"; y "rehabilitación: volver a funcionar como un cuerpo normativo". Los itinerarios de las personas activistas develan la coaptación y vulneración corporal a la que son sometidas al ingresar a los dispositivos biomédicos que niegan sistemáticamente sus derechos humanos. Sin embargo, a pesar de intentar disciplinar y controlar sus cuerpos, crean estrategias para subvertir y validar sus subjetividades.

Perspectivas feministas sobre (in)justicias ocupacionales de maternidades adolescentes / Perspectivas feministas sobre (in) justiças ocupacionais de maternidades para adolescentes / Feminist perspectives on occupational (in)justices of adolescent motherhood

Resumen Introducción La maternidad supone un importante desafío ocupacional para las mujeres, situación que se complejiza cuando son adolescentes. Objetivo Analizar las trayectorias de mujeres madres adolescentes desde la perspectiva de la Terapia Ocupacional Feminista. Método Estudio cualitativo que, a través de entrevistas en profundidad y un análisis temático, analizó seis experiencias de maternidades adolescentes en España. Resultados Emergieron tres categorías centrales de análisis que explican parte de las trayectorias ocupacionales. Destacamos dentro de éstas: la "Precarización ocupacional: una vulnerabilidad sexo-genérica", la cual da cuenta de las condicionantes previas que posibilitan la gestación adolescente; "Una ocupación familiar: maternidad (inter)dependiente", refleja la organización familiar de los cuidados y la crianza dando cuenta de la relevancia de las figuras femeninas que sostienen esta experiencia; y, finalmente, la categoría "El giro ocupacional: sus repercusiones psicosociales", que considera el impacto de la maternidad en las proyecciones, tanto a nivel educativo como en su inserción laboral. Conclusión Las trayectorias de las mujeres madres adolescentes reflejan un vaivén de emociones y complejidades en sus maternidades asociadas al periodo de vida en el cual la llevan a cabo. Por ello, la emergencia de una Terapia Ocupacional Feminista consciente de las inequidades de género permite interpelar la injusticia ocupacional que enfrentan las mujeres madres adolescentes por una vida más justa y digna.

Resumo Introdução: A maternidade é um importante desafio ocupacional para as mulheres, situação que se torna mais complexa na adolescência. Objetivo: Analisar as trajetórias de mães adolescentes na perspectiva da terapia ocupacional feminista. Método: Estudo qualitativo que, por meio de entrevistas em profundidade e análise temática, analisou seis experiências de maternidades para adolescentes na Espanha. Resultados: emergiram três categorias centrais de análise que explicam parte das trajetórias ocupacionais. Dentre elas, destacamos a "Precariedade ocupacional: uma vulnerabilidade gênero-sexo", que dá conta das condições anteriores que possibilitam a gravidez na adolescência. A categoria "Uma ocupação familiar: maternidade (inter) dependente" reflete a organização familiar do cuidado e da educação, dando conta da relevância das figuras femininas que sustentam essa experiência. Por fim, a categoria "O turno ocupacional: suas repercussões psicossociais", considera o impacto da maternidade nas projeções, tanto no nível educacional como na sua inserção laboral. Conclusão: As trajetórias de mães adolescentes refletem uma flutuação de emoções e complexidades em suas maternidades associadas ao período da vida em que a realizam. Por isso, o surgimento de uma terapia ocupacional feminista atenta às desigualdades de gênero nos permite desafiar as injustiças ocupacionais enfrentadas pelas mães adolescentes na luta por uma vida mais justa e digna.

Abstract Introduction Motherhood is an important occupational challenge for women, a situation that becomes more complex when they are adolescents. Objective To analyze the trajectories of adolescent mothers from the perspective of Feminist Occupational Therapy. Method Qualitative study that, through in-depth interviews and thematic analysis, analyzed six adolescent maternal experiences in Spain. Results Three central categories of analysis emerged that explain part of the occupational trajectories. We highlight within them, the "Occupational precariousness: a gender-sex vulnerability", which accounts for the previous conditions that make adolescent pregnancy possible. The category "A family occupation: (inter) dependent motherhood" reflects the family organization of care and upbringing, giving an account of the relevance of the female figures who support this experience. Finally, the category "The occupational shift: its psychosocial repercussions", considers the impact of motherhood in the projections, both at the educational level and in its labor insertion. Conclusion The trajectories of adolescent mothers reflect a fluctuation of emotions and complexities in their maternity wards associated with the period of life in which they carry it out. Therefore, the emergence of a Feminist Occupational Therapy aware of gender inequalities allows us to challenge the occupational injustice faced by adolescent mothers for a more just and dignified life.

Juventudes migrantes institucionalizadas: una mirada desde la Terapia Ocupacional del Sur / Juventude migrante institucionalizada: uma visão a partir da Terapia Ocupacional do Sul / Institutionalized migrant youth: a view from the Southern Occupational Therapy

Resumen Introducción El proceso migratorio implica una serie de desafíos ocupacionales, sociales y culturales, sin embargo, cuando este proceso se trata de jóvenes no acompañados que se institucionalizan, cambia radicalmente todo su desempeño e identidad ocupacional. Objetivo Analizar el impacto ocupacional de jóvenes no acompañados institucionalizados en un servicio de protección y emergencia en Cataluña, España. Método Estudio etnográfico que utilizó como técnica de recogida de información: las observaciones de campo, entrevistas semi estructuradas y conversaciones informales, las cuales fueron transcritas y codificadas a través de un proceso de análisis del contenido. Resultados Arrojaron tres grandes temas que explican el fenómeno a) El contexto precario del país de origen: la construcción del deseo migratorio, b) Racismo institucional: producción cultural de discriminación social y c) Privación ocupacional: como limitación para la autonomía y la inserción cultural. Conclusión Se evidencia la influencia de la institucionalización como un factor estructural que limita la elección y participación ocupacional de los jóvenes. Esta problemática se refugia en un imperativo jurídico de "protección" que termina reproduciendo un sistema de discriminación colonial, racial y asistencial que viola los derechos humanos de los jóvenes migrantes.

Resumo Introdução O processo de migração envolve uma série de desafios ocupacionais, sociais e culturais, porém, quando esse processo envolve jovens desacompanhados que se institucionalizam, muda radicalmente todo o seu desempenho e identidade ocupacional. Objetivo Analisar o impacto ocupacional de jovens desacompanhados institucionalizados em um serviço de proteção e emergência na Catalunha, Espanha. Método Estudo etnográfico que utilizou como técnica de coleta de informações: observações de campo, entrevistas semiestruturadas e conversas informais, as quais foram transcritas e codificadas por meio de um processo de análise de conteúdo. Resultados Três eixos temáticos foram escolhidos que explicam o fenômeno a) O contexto precário do país de origem: a construção do desejo migratório, b) Racismo institucional: produção cultural da discriminação social e c) Privação ocupacional: como limitação para autonomia e inserção cultural. Conclusão A influência da institucionalização é evidenciada como um fator estrutural que limita a escolha e a participação ocupacional dos jovens. Esse problema se refugia em um imperativo legal de "proteção" que acaba reproduzindo um sistema de discriminação colonial, racial e previdenciária que viola os direitos humanos dos jovens migrantes.

Abstract Introduction The migration process involves a series of occupational, social, and cultural challenges; however, when this process involves unaccompanied youth who become institutionalized, it radically changes their entire performance and occupational identity. Objective To analyze the occupational impact of unaccompanied youth institutionalized in a protection and emergency service in Catalonia, Spain. Method Ethnographic study that used as an information-gathering technique: field observations, semi-structured interviews, and informal conversations, which were transcribed and coded through a content analysis process. Results They brought up three main themes that explain the phenomenon a) The precarious context of the country of origin: the construction of the migratory desire, b) Institutional racism: cultural production of social discrimination and c) Occupational deprivation: as a limitation for autonomy and cultural insertion. Conclusion The influence of institutionalization is evidenced as a structural factor that limits the choice and occupational participation of young people. This problem takes refuge in a legal imperative of "protection" that ends up reproducing a system of colonial, racial, and welfare discrimination that violates the human rights of young migrants.