Oral cancer knowledge in adults evaluated through a phone survey in the context of the SARS-CoV2 health emergency in Colombia

Background: in Colombia, oral cancer is the eighth most common type of cancer, with an estimated survival rate of 52%. Lack of knowledge about oral cancer and its risk factors is associated with late detection. Material and Methods: a descriptive cross-sectional study was carried out on 268 patients attending the School of Dentistry of the University of Antioquia clinics, to whom a validated 47-question questionnaire was applied by phone during the COVID-19 pandemic (2020 and 2021). Data were analyzed using the SPSS software. Results: the mean age was 58.9. 58.6% of the participants had heard of oral cancer, 42% acquire knowledge from the media, and 96.7% considered screening necessary. Most of the patients expressed not feeling worried (54.5%), fearful (59.7%), or anxious (56.3%) in the case of being submitted to an examination for early detection of oral cancer. A correlation between low socioeconomic status and educational level with less knowledge of oral cancer was found. The dimensions of experience and attitude towards screening were not associated with sociodemographic variables. Conclusions: There is little knowledge about oral cancer, especially in low socioeconomic and educational status, although this does not occur in the dimensions of attitude and experience toward screening. In contrast, patients participating in this study presented high knowledge about oral cancer risk. This population recognizes the situations most related to the development of cancer. This level of knowledge was similar for the demographic conditions except for people with no education, who presented less knowledge of the risks. The need for educational campaigns on oral cancer knowledge is reaffirmed, especially in socially disadvantaged groups, considering that there would be no barriers related to screening. (AU)

A pilot study to estimate the population size of endangered Galápagos marine iguanas using drones.

BACKGROUND: Large-scale species monitoring remains a significant conservation challenge. Given the ongoing biodiversity crisis, the need for reliable and efficient methods has never been greater. Drone-based techniques have much to offer in this regard: they allow access to otherwise unreachable areas and enable the rapid collection of non-invasive field data. Herein, we describe the development of a drone-based method for the estimation of population size in Galápagos marine iguanas, Amblyrhynchus cristatus. As a large-bodied lizard that occurs in open coastal terrain, this endemic species is an ideal candidate for drone surveys. Almost all Amblyrhynchus subspecies are Endangered or Critically Endangered according to the IUCN yet since several colonies are inaccessible by foot, ground- based methods are unable to address the critical need for better census data. In order to establish a drone-based approach to estimate population size of marine iguanas, we surveyed in January 2021 four colonies on three focal islands (San Cristobal, Santa Fe and Espanola) using three techniques: simple counts (the standard method currently used by conservation managers), capture mark-resight (CMR), and drone-based counts. The surveys were performed within a 4-day window under similar ambient conditions. We then compared the approaches in terms of feasibility, outcome and effort. RESULTS: The highest population-size estimates were obtained using CMR, and drone-based counts were on average 14% closer to CMR estimates-and 17-35% higher-than those obtained by simple counts. In terms of field-time, drone-surveys can be faster than simple counts, but image analyses were highly time consuming. CONCLUSION: Though CMR likely produces superior estimates, it cannot be performed in most cases due to lack of access and knowledge regarding colonies. Drone-based surveys outperformed ground-based simple counts in terms of outcome and this approach is therefore suitable for use across the range of the species. Moreover, the aerial approach is currently the only credible solution for accessing and surveying marine iguanas at highly remote colonies. The application of citizen science and other aids such as machine learning will alleviate the issue regarding time needed to analyze the images.

The floral repressors TEMPRANILLO1 and 2 modulate salt tolerance by regulating hormonal components and photo-protection in Arabidopsis.

Members of the plant specific RAV family of transcription factors regulate several developmental and physiological processes. In the model plant Arabidopsis thaliana, the RAV TEMPRANILLO 1 (TEM1) and TEM2 control important phase changes such as the juvenile to adult and the vegetative to reproductive transitions. Besides their known regulatory function in plant development, a transcriptomics analysis of transgenic plants overexpressing TEM1 also revealed overrepresentation of Gene Ontology (GO) categories related to abiotic stress responses. Therefore, to investigate the biological relevance of these TEM-dependent transcriptomic changes and elucidate whether TEMs contribute to the modulation of plant growth in response to salinity, we analyzed the behavior of TEM gain and loss of function mutants subjected to mild and high salt stresses at different development stages. With respect to increasing salinity, TEM overexpressing plants were hypersensitive whereas the tem1 tem2 double mutants were more tolerant. Precisely, tem1 tem2 mutants germinated and flowered faster than the wild-type plants under salt stress conditions. Also, tem1 tem2 plants showed a delay in salt-induced leaf senescence, possibly as a consequence of downregulation of jasmonic acid biosynthesis genes. Besides a shorter life cycle and delayed senescence, tem1 tem2 mutants appeared to be better suited to withstand oxidative stress as they accumulated higher levels of α-tocopherol (an important antioxidant metabolite) and displayed a slower degradation of photosynthetic pigments. Taken together, our studies suggest novel and crucial roles for TEM in adaptive growth as they modulate plant development in response to environmental changes such as increasing soil salinity.

Availability of Health Insurance Literacy Resources Fails to Meet Consumer Needs in Rural, Appalachian Communities: Implications for State Medicaid Waivers.

PURPOSE: With the impending changes to state Medicaid programs and other health reform policies, it is imperative to understand the factors at play in promoting consumer health insurance literacy and health system engagement. This study examines the availability of health system and community-based programs promoting health insurance literacy and supporting informed consumer health care decision making in rural communities in Kentucky. METHODS: Forty-six health systems, community-based providers, and outreach workers participated in 4 focus groups and 10 semistructured interviews. Descriptive and analytic coding techniques were used to identify 5 major themes and subthemes from interview and focus group transcripts. FINDINGS: Consumers were generally identified as having low health insurance literacy, especially in rural communities, serving as a barrier to accessing health care insurance and services. Participants identified their own lack of knowledge and understanding around health systems, resulting from lack of training and challenges with staying updated on constant changes in health systems and policies. Overall, consumer demand or need for health insurance literacy resources and programs far exceeded supply or availability. Constant changes in the status of Kentucky's Medicaid program and the proposed changes to eligibility, specifically work requirements and copays, have caused increased confusion among both providers and consumers. CONCLUSIONS: Findings indicate a pressing need for implementing programs that provide training, tools, and resources to outreach workers to help them better assist consumers with accessing and using health insurance, especially in low-income, rural areas. Health reform policies need to be responsive to the health insurance literacy needs and abilities of consumers.

Three new species of frogs of the genus Pristimantis (Anura, Strabomantidae) with a redefinition of the P. lacrimosus species group.

A new phylogeny for the Pristimantis lacrimosus species group is presented, its species content reviewed, and three new species described from the eastern slopes of the Ecuadorian Andes. Our phylogeny includes, for the first time, samples of P. aureolineatus, P. bromeliaceus, and P. lacrimosus. The morphology of hyperdistal subarticular tubercles is also assessed among 21 species of Pristimantis. The P. lacrimosus species group is composed of 36 species distributed in the Chocó, Guiana, and Amazon regions of tropical South America with a single species reaching Central America. Ancestral area reconstruction indicates that, despite its high diversity in the Amazon region, the P. lacrimosus group originated in the Pacific basin, Chocó region of Ecuador and Colombia. Pristimantis amaguanae sp. nov. is most closely related to P. bromeliaceus. It differs from P. bromeliaceus by being smaller, having transversal dark bands in the hindlimbs (absent or faint in P. bromeliaceus) and the absence of discoidal fold (present in P. bromeliaceus). Pristimantis nankints sp. nov. and P. romeroae sp. nov. are part of a clade of predominantly light-green frogs that includes P. acuminatus, P. enigmaticus, P. limoncochensis, and P. omeviridis. Pristimantis nankints sp. nov. and P. romeroae sp. nov. can be distinguished from all of them by the presence of a dark dorsolateral stripe that borders a light green band on a green background. Hyperdistal tubercles are present in all examined species of the P. lacrimosus species group and its sister clade. Species with hyperdistal tubercles are characterized by having relatively long terminal phalanges and narrow T-shaped expansion at the end of the terminal phalange. We discuss the phylogenetic distribution of these characters and their potential diagnostic significance.

Genes of the RAV Family Control Heading Date and Carpel Development in Rice.

In plants, correct formation of reproductive organs is critical for successful seedset and perpetuation of the species. Plants have evolved different molecular mechanisms to coordinate flower and seed development at the proper time of the year. Among the plant-specific RELATED TO ABI3 AND VP1 (RAV) family of transcription factors, only TEMPRANILLO1 (TEM1) and TEM2 have been shown to affect reproductive development in Arabidopsis (Arabidopsis thaliana). They negatively regulate the floral transition through direct repression of FLOWERING LOCUS T and GIBBERELLIN 3-OXIDASE1/2, encoding major components of the florigen. Here we identify RAV genes from rice (Oryza sativa), and unravel their regulatory roles in key steps of reproductive development. Our data strongly suggest that, like TEMs, OsRAV9/OsTEM1 has a conserved function as a repressor of photoperiodic flowering upstream of the floral activators OsMADS14 and Hd3a, through a mechanism reminiscent of that one underlying floral transition in temperate cereals. Furthermore, OsRAV11 and OsRAV12 may have acquired a new function in the differentiation of the carpel and the control of seed size, acting downstream of floral homeotic factors. Alternatively, this function may have been lost in Arabidopsis. Our data reveal conservation of RAV gene function in the regulation of flowering time in monocotyledonous and dicotyledonous plants, but also unveil roles in the development of rice gynoecium.

Analysis of ultraconserved elements supports African origins of narrow-mouthed frogs.

Narrow-mouthed frogs (Anura: Microhylidae) are globally distributed and molecular data suggest the rapid evolution of multiple subfamilies shortly after their origin. Despite recent progress, several subfamilial relationships remain unexplored using phylogenomic data. We analysed 1,796 nuclear ultraconserved elements, a total matrix of 400,664 nucleotides, from representatives of most microhylid subfamilies. Summary method species-tree and maximum likelihood analyses unambiguously supported Hoplophryninae as the earliest diverging microhylid and confirm Chaperininae as a junior synonym of Microhylinae. Given the emerging consensus that subfamilies from mainland Africa diverged early, microhylids have likely occupied the continent for more than 66 million years.

TEMPRANILLO is a direct repressor of the microRNA miR172.

In the age-dependent pathway, microRNA 156 (miR156) is essential for the correct timing of developmental transitions. miR156 negatively regulates several SPL genes, which promote the juvenile-to-adult and floral transitions in part through upregulation of miR172. The transcriptional repressors TEMPRANILLO1 (TEM1) and TEM2 delay flowering in Arabidopsis thaliana at least through direct repression of FLOWERING LOCUS T (FT) and gibberellin biosynthetic genes, and have also been reported to participate in the length of the juvenile phase. Levels of TEM mRNA and miR156 decrease gradually, allowing progression through developmental phases. Given these similarities, we hypothesized that TEMs and the miR156/SPL/miR172 module could act through a common genetic pathway. We analyzed the effect of TEMs on levels of miR156, SPL and miR172, tested binding of TEMs to these genes using chromatin immunoprecipitation and analyzed the genetic interaction between TEMs and miR172. We found that TEMs played a stronger role in the floral transition than in the juvenile-to-adult transition. TEM1 repressed MIR172A, MIR172B and MIR172C expressions and bound in vivo to at least MIR172C sequences. Genetic analyses indicated that TEMs affect the regulation of developmental timing through miR172.

A new treefrog from Cordillera del Cóndor with comments on the biogeographic affinity between Cordillera del Cóndor and the Guianan Tepuis (Anura, Hylidae, Hyloscirtus).

The Hyloscirtuslarinopygion group is a clade of 16 species of large hylids that inhabit cascading Andean streams. They have brown coloration that, in most species, contrasts with bright marks. Herein morphological and genetic evidence is used to describe a new species of the group from Cordillera del Cóndor, a sub-Andean mountain chain that has phytogeographic affinities with the Guianan Tepuis. The new species is characterized by dark-brown coloration with contrasting bright orange flecks and by the presence of an enlarged and curved prepollex protruding as a spine. The new species is closely related to H.tapichalaca and an undescribed species from the southern Andes of Ecuador. The genetic distance between H.hillisi sp. n. and its closest relative, H.tapichalaca, is 2.9% (gene 16S mtDNA). Our phylogeny and a review of recently published phylogenies show that amphibians from Cordillera del Cóndor have close relationships with either Andean or Amazonian species. Amphibians do not show the Condor-Guianan Tepuis biogeographic link that has been documented in plants.

[Suicide attempts and self inflicted harm: a one year follow up of risk behaviors among out of treatment cocaine users]. / Intentos de suicidio y heridas auto-inferidas: 12 meses de seguimiento de conductas de riesgo de consumidores de cocaína no consultantes de servicios de rehabilitación.

BACKGROUND: Cocaine users tend to have a higher frequency of risk behaviors. AIM: To compare risk behaviors of out -of -treatment Cocaine Base Paste (CBP) and Cocaine Hydrochloride (CH) users, by means of Privileged Access Interviewing in a one- year prospective study. MATERIAL AND METHODS: Twenty -eight interviewers were trained to recruit and administer a questionnaire on substance use patterns and related risk behaviors. Intentioned sampling was carried out in four municipalities of Santiago, Chile. Subjects who used CBP (group 1) or CH (group 2) at least once in the last month, with primary current use of CBP (group 1) or CH (group 2), and without treatment for substance abuse in the last six months were interviewed. Generalized Estimating Equations (GEE) were employed to compare risk behaviors during follow -up. RESULTS: Four hundred and two of 467 subjects (86.1%) were followed up for one year. CBP users (n = 204) reported greater frequency of self -inflicted injuries (Odds Ratio (OR): 1.97 [95% confidence intervals (CI): 1.07-3.66]) and suicide attempts (OR: 2.68 [95% CI: 1.19-6.01]) than CH users. CONCLUSIONS: CBP users had a greater frequency of self -inflicted injuries and suicide attempts, both life threatening risk behaviors, than CH users. This profile shows the high vulnerability of CBP users and should encourage further research and design of outreach interventions, particularly focused on this group.

Intentos de suicidio y heridas auto-inferidas: 12 meses de seguimiento de conductas de riesgo de consumidores de cocaína no consultantes de servicios de rehabilitación / Suicide attempts and self inflicted harm: a one year follow up of risk behaviors among out of treatment cocaine users

Background: Cocaine users tend to have a higher frequency of risk behaviors. Aim: To compare risk behaviors of out ­of ­treatment Cocaine Base Paste (CBP) and Cocaine Hydrochloride (CH) users, by means of Privileged Access Interviewing in a one­ year prospective study. Material and Methods: Twenty ­eight interviewers were trained to recruit and administer a questionnaire on substance use patterns and related risk behaviors. Intentioned sampling was carried out in four municipalities of Santiago, Chile. Subjects who used CBP (group 1) or CH (group 2) at least once in the last month, with primary current use of CBP (group 1) or CH (group 2), and without treatment for substance abuse in the last six months were interviewed. Generalized Estimating Equations (GEE) were employed to compare risk behaviors during follow ­up. Results: Four hundred and two of 467 subjects (86.1%) were followed up for one year. CBP users (n = 204) reported greater frequency of self ­inflicted injuries (Odds Ratio (OR): 1.97 [95% confidence intervals (CI): 1.07­3.66]) and suicide attempts (OR: 2.68 [95% CI: 1.19­6.01]) than CH users. Conclusions: CBP users had a greater frequency of self ­inflicted injuries and suicide attempts, both life threatening risk behaviors, than CH users. This profile shows the high vulnerability of CBP users and should encourage further research and design of outreach interventions, particularly focused on this group.

TEMPRANILLO Reveals the Mesophyll as Crucial for Epidermal Trichome Formation.

Plant trichomes are defensive specialized epidermal cells. In all accepted models, the epidermis is the layer involved in trichome formation, a process controlled by gibberellins (GAs) in Arabidopsis rosette leaves. Indeed, GA activates a genetic cascade in the epidermis for trichome initiation. Here we report that TEMPRANILLO (TEM) genes negatively control trichome initiation not only from the epidermis but also from the leaf layer underneath the epidermis, the mesophyll. Plants over-expressing or reducing TEM specifically in the mesophyll, display lower or higher trichome numbers, respectively. We surprisingly found that fluorescently labeled GA3 accumulates exclusively in the mesophyll of leaves, but not in the epidermis, and that TEM reduces its accumulation and the expression of several newly identified GA transporters. This strongly suggests that TEM plays an essential role, not only in GA biosynthesis, but also in regulating GA distribution in the mesophyll, which in turn directs epidermal trichome formation. Moreover, we show that TEM also acts as a link between GA and cytokinin signaling in the epidermis by negatively regulating downstream genes of both trichome formation pathways. Overall, these results call for a re-evaluation of the present theories of trichome formation as they reveal mesophyll essential during epidermal trichome initiation.

Flowering and trichome development share hormonal and transcription factor regulation.

Gibberellins (GAs) and cytokinins (CKs) are plant hormones that act either synergistically or antagonistically during the regulation of different developmental processes. In Arabidopsis thaliana, GAs and CKs overlap in the positive regulation of processes such as the transition from the vegetative to the reproductive phase and the development of epidermal adaxial trichomes. Despite the fact that both developmental processes originate in the rosette leaves, they occur separately in time and space. Here we review how, as genetic and molecular mechanisms are being unraveled, both processes might be closely related. Additionally, this shared genetic network is not only dependent on GA and CK hormone signaling but is also strictly controlled by specific clades of transcription factor families. Some key flowering genes also control other rosette leaf developmental processes such as adaxial trichome formation. Conversely, most of the trichome activator genes, which belong to the MYB, bHLH and C2H2 families, were found to positively control the floral transition. Furthermore, three MADS floral organ identity genes, which are able to convert leaves into floral structures, are also able to induce trichome proliferation in the flower. These data lead us to propose that the spatio-temporal regulation and integration of diverse signals control different developmental processes, such as floral induction and trichome formation, which are intimately connected through similar genetic pathways.

Changing Communities and Increases in the Prevalence of Depression: is there a Relationship? / Cambios en las comunidades y el aumento en la prevalencia de la depresión: ¿hay una relación?

The article analyses the impact of individualization processes on community-level determinants of health in postmodern societies, taking depression as an example. The analysis shows how the evolution of the broader social context towards forms of organization focused on the individual and on competition in a market economy implies the vanishing of traditional communities and there -fore of their health-supportive functions, thus endangering their ability to fulfill the needs of belonging, mutual support, and identity. The analysis also relates this evolution to cultural phenomena and to recent studies about culture -gene coevolution, implying that the effects of community decline are expected to be even greater in collectivist societies. Through its multidimensional conceptual analysis, this paper aims to contribute to further uncovering the interactions of psychological, psychosocial, and biological factors in mental health.

El artículo analiza el impacto que los procesos de individualización en las sociedades postmodernas tienen sobre los determinantes de salud de nivel comunitario, tomando como ejemplo la depresión. El análisis muestra cómo la evolución del contexto social más amplio hacia formas de organización enfocadas en el individuo y en la competencia de las economías de mercado, implican el desvanecimiento de las comunidades tradicionales y por lo tanto de sus funciones de apoyo a la salud. Es así que ponen en peligro su capacidad para satisfacer las necesidades de pertenencia, apoyo mutuo e identidad. El artículo también relaciona esta evolución con fenómenos culturales y con estudios recientes sobre la coevolución cultura-gen, implicando que los efectos de declinación de la comunidad deberían ser aún mayores en las sociedades colectivistas. A través de su análisis conceptual multidimensional, el artículo busca contribuir a profundizar sobre las interacciones de factores psicológicos, psicosociales y biológicos en salud mental.

El ahorro como estrategia de intervención social para la superación de la pobreza: estudio cualitativo sobre experiencias de ahorro de personas chilenas / Saving as a Social Intervention Strategy for Overcome Poverty: Qualitative Study about Saving Experiences of Chilean People

Vivir en situación de pobreza obliga a implementar estrategias de subsistencia, siendo un desafío generar recursos para cubrir gastos básicos, por lo que pensar en el ahorro resultaría algo ajeno. Este artículo analiza las experiencias de ahorro de un grupo de chilenos/as en situación de pobreza. Se realizó un estudio cualitativo con 70 personas en seis grupos focales. Inicialmente, señalan no ahorrar, pero emergen en sus discursos estrategias de ahorro e identifican facilitadores y obstaculizadores, produciéndose además un efecto de aprendizaje al compartir sus experiencias. Se concluye que sí es posible ahorrar y se reflexiona sobre la importancia de incluirlo en intervenciones sociales públicas y privadas que apuesten por la educación financiera como herramienta para la superación de la pobreza.

Living in poverty forces to implement subsistence strategies, being a challenge generate resources for covering basic expenses, so wanting to save would be something prohibited. This article analysis experiences about saving of Chilean people in poverty situation. A qualitative study which 70 people in 6 focus groups was conducted. Initially, participants didn't recognize that they save, but then it emerges from their speeches saving strategies, identifying facilitators and obstacles for saving. Collectively share these experiences produces an effect of learning about saving among the participants. We concluded that it is possible to save and we reflect about the importance of including this in public and private social interventions related to financial education as a tool for overcoming poverty.

Cambios y trayectorias de participación desde la experiencia de usuarios de programas de apoyo psicosocial / Changes and trajectories of participation from the experience of users of psychosocial support programs

Se presentan los resultados de un estudio cualitativo cuyo objetivo fue describir y analizar relacionalmente los cambios experimentados por personas participantes de dos emblemáticos programas sociales chilenos, el Programa Puente y el Programa Calle, ambos pertenecientes al Sistema de Protección Social. Para ello, se sostuvieron entrevistas en profundidad con 12 personas, las cuales fueron analizadas siguiendo los procedimientos de la Teoría Fundamentada. Se identificaron cambios a nivel personal (bienestar físico, valoración personal, enfrentamiento vital), económico (mayor capacidad económica, mejor administración del dinero, adquisición de bienes) y relacional (mejoramiento de relaciones familiares y sociales). Estos cambios interactuaron entre sí y variaron según el nivel de vulnerabilidad de las personas, definiendo distintas trayectorias de participación en los programas.

This paper presents the results of a qualitative study whose objective was to describe and make a relational analysis the changes experimented by participants of two emblematic Chilean social programs: Programa Puente and Programa Calle, both belonging to the Social Protection System. Twelve in-deep interviews were made, which were analyzed following the procedures of Grounded Theory. Changes on a personal level (physical well-being, personal value, vital showdown), economic (greater economic capacity, better money management, purchase goods) and relational (improving family and social relations) were identified. These changes interacted with each other and varied according to the level of vulnerability of people, defining different program participation paths.

SHORT VEGETATIVE PHASE Up-Regulates TEMPRANILLO2 Floral Repressor at Low Ambient Temperatures.

Plants integrate day length and ambient temperature to determine the optimal timing for developmental transitions. In Arabidopsis (Arabidopsis thaliana), the floral integrator FLOWERING LOCUS T (FT) and its closest homolog TWIN SISTER OF FT promote flowering in response to their activator CONSTANS under long-day inductive conditions. Low ambient temperature (16°C) delays flowering, even under inductive photoperiods, through repression of FT, revealing the importance of floral repressors acting at low temperatures. Previously, we have reported that the floral repressors TEMPRANILLO (TEM; TEM1 and TEM2) control flowering time through direct regulation of FT at 22°C. Here, we show that tem mutants are less sensitive than the wild type to changes in ambient growth temperature, indicating that TEM genes may play a role in floral repression at 16°C. Moreover, we have found that TEM2 directly represses the expression of FT and TWIN SISTER OF FT at 16°C. In addition, the floral repressor SHORT VEGETATIVE PHASE (SVP) directly regulates TEM2 but not TEM1 expression at 16°C. Flowering time analyses of svp tem mutants indicate that TEM may act in the same genetic pathway as SVP to repress flowering at 22°C but that SVP and TEM are partially independent at 16°C. Thus, TEM2 partially mediates the temperature-dependent function of SVP at low temperatures. Taken together, our results indicate that TEM genes are also able to repress flowering at low ambient temperatures under inductive long-day conditions.

Percepciones de pacientes y familiares sobre la comunicación con los profesionales de la salud / Patients and relatives’ perception regarding communication with healthcare professionals

Objetivo Comprender las fortalezas y dificultades de la comunicación entre los profesionales y las familias con un miembro con enfermedad crónica o discapacidad, desde la percepción de pacientes y familiares que asisten a servicios sanitarios. Métodos Es un estudio cualitativo interpretativo. El enfoque psicológico es el sistémico, desde una perspectiva socio construccionista. La muestra fue contactada en la clínica de la Universidad de La Sabana, Colombia En la primera fase se diseñaron las preguntas guía con base en las categorías deductivas. En la segunda fase se realizaron grupos focales, uno con por personas con enfermedad crónica o discapacidad y otros miembros de familias de personas en esta condición de salud. Posteriormente se aplicó una encuesta de resultados para triangulación y saturación de la información, incluyendo otros pacientes y familiares. Resultados Las personas ven como fortalezas el trabajo en equipo por parte de los profesionales, la disposición para la atención, la suficiencia en la información recibida y el uso de estrategias para enseñar procedimientos y aclarar dudas. Como dificultades comunicativas señalaron que el profesional haga presunciones pronosticas negativas o asuma actitudes de distancia o superioridad. Conclusiones En principio se muestra una actitud de aceptación con la comunicación establecida con los profesionales en familiares y pacientes; no obstante, al indagar más específicamente se explicitan los aspectos que pueden mejorar, donde la comunicación puede posibilitar una relación menos jerárquica y más colaborativa, dando espacio a los procesos emocionales.(AU)

Objective Understanding the strengths and difficulties regarding communication between healthcare workers and families and a family member suffering chronic illness or disability, from the perception of patients and families receiving healthcare services. Methods This was a qualitative, interpretative study. The psychological approach adopted was systemic, from a socio-constructionist perspective. The sample was drawn from people contacted at the Universidad de La Sabana’s clinic, Colombia. Question guidelines were based on deductive categories in the first phase; two focus groups were formed during the second phase by people suffering chronic diseases or disability and family members of people in such situation. A survey was then made using the results for data triangulation and saturation, including other patients and relatives. Results People saw professional teamwork, providing care, the sufficiency of the information received and the use of strategies for teaching procedures and answering questions as strengths. They pointed out communication difficulties, like healthcare workers making assumptions about negative prognostics and adopting superior attitudes, or lacking consistency and continuity, as well as high staff turnover. Conclusions Patients and relatives generally adopted an attitude of acceptance concerning the relationship established with healthcare workers; however, when probing more specifically, aspects to be improved were made more explicit, where communication may enable a less hierarchic and more collaborative relationship, providing a space for emotional processes.(AU)