Tacit engagement using tablet-mediated learning for social good.

We discuss the effectiveness of mediated communication (internet communication via a computer tablet) and tacit engagement in a Project on mental health. The project is aimed at improving the wellbeing of adult women living with chronic mental disorders in long-term psychiatric internment. The computer tablets act as "portals" to provide access and conatct with the outside world for patients who have poor (if any) external social support. This support includes a patient-centred psycho-social care, and accompanying clinical and pharmaceutical treatment. Both patients and their relatives accepted the benefits of internet mediation, for very different reasons. For the patient, this is a flash of contact with humanity, and for the relatives the internet communication this proved to be an alternative to the need for physical proximity. As some patients had no relatives or friends to communicate (even remotely) with the outside world, and because there is a school next door to the clinic, we visualized that the communication between these two communities could provide both a therapeutic and poetic act of learning and compassion. The electronic portal could serve as a virtual bridge between two forbidden domains. Although awareness of students of the nearby school was raised about mental health, the use of internet mediation devoid of physical proximity made the students suspicious of the goal of the mediation. From the patient's side, however, each contact was an instance of joy. Several issues were raised from this exercise.

Surgical recommendations for the extraction of erupted maxillary third molars: landmarks emerging from a clinical study.

OBJECTIVE: This study evaluated the efficacy of an anatomicalradiologic- surgical protocol for the extraction of erupted maxillary third molars (EMTMs). METHODS AND MATERIALS: 166 EMTMs were extracted according to two different extraction techniques. Group 1 (G1, 97 teeth) was treated with the proposed protocol: multiple roots with forceps DG 117/DG 118; single roots with DG 250; tapered roots with DG 270; curved roots with Apexo 303 elevator. Group 2 (G2, 69 teeth) was treated with straight elevator and forceps DG 250 or DG 270. Extraction time and total number of complications (TNCs) were the main outcomes; TNCs were also divided in complications during the extraction (CDEs) and complications after the extraction (CAEs) as secondary outcomes. RESULTS: Differences between G1 and G2 were detected for extraction time (146.8 vs 225.6 seconds; P < .05) and for complications (G1, 13.4% vs G2, 47.8%; P < .001). Multivariate analysis showed that extraction time and smoking habit were independent risk factors for TNCs (P < .001); furthermore, "not applying the proposed extraction protocol" increases almost 7 times (6.86; 95% CI, 1.41-33.32; P < .02) the possible onset of CAEs. CONCLUSION: The proposed protocol can be helpful for the general dental practitioner in planning the extraction of EMTMs, shortening the extraction time, and diminishing the complications, especially those occurring after the extraction.

Implementing Hospital Self-Management Policy in Chile: Health Professionals' Perceptions / Implementando la política de autogestión hospitalaria en Chile: percepciones de profesionales de la salud / Implementando a política de autogestão hospitalar no Chile: percepções de profissionais da saúde

Context of the problem: Hospitals have been considered a main component for health systems success. Objective: To describe perceptions from hospital staff regarding the implementation of the hospital self-management policy in two highly complex facilities in Chile. Justification: A successful policy implementation demands aligned health professionals regarding policy changes. Methods: Descriptive and exploratory qualitative study based on semi-structured interviews for health professionals from two hospitals in southern Chile. A convenience sample of nineteen health professionals was selected for interviewing. The interviews' analysis was thought as the content analysis technique in its conventional approach. Results: For health professionals, a hospital's self-management policy is conceptualized from financial autonomy. Human resources for health and organizational capabilities still remain as weaknesses of the implementation process. Conclusions: Overcoming gaps between design and implementation processes are crucial for success in hospital reform implementation.

Contexto del problema: los hospitales son considerados claves para el éxito de los sistemas de salud. Objetivo: describir las percepciones de profesionales de la salud sobre la implementación de la política de autogestión en red en dos hospitales de alta complejidad en Chile. Justificación: una implementación exitosa demanda profesionales alineados con los cambios. Métodos: estudio cualitativo descriptivo y exploratorio basado en entrevistas semiestructuradas a profesionales de la salud de dos hospitales complejos del sur de Chile. Se seleccionó una muestra por conveniencia de diecinueve profesionales. Los datos se analizaron mediante análisis de contenido en su aproximación convencional. Resultados: para los profesionales, la política es conceptualizada desde la autonomía financiera. Como debilidad de la implementación persiste la ausencia de capacidades organizacionales y competencias de los recursos humanos en salud. Conclusiones: superar las brechas entre el diseño y la implementación es crucial para avanzar en la implementación de reformas a los hospitales.

Contexto do problema: os hospitais sao considerados chave para o sucesso dos sistemas de saúde. Objetivo: descrever as percepções de profissionais da saúde sobre a implementação da política de autogestão em rede em dois hospitais de alta complexidade no Chile. Justificação: uma implementacao exitosa demanda profissionais alinhados com as mudancas. Métodos: estudo qualitativo descritivo e exploratorio baseado em entrevistas semiestruturadas a profissionais da saúde de dois hospitais complexos do sul de Chile. Uma amostra por conveniencia de dezenove profissionais foi selecionada. Os dados analisaram-se mediante análise de conteúdo em sua aproximacao convencional. Resultados: para os profissionais, a política é concebida a partir da autonomia financeira. Como fraqueza da implementacao persiste a ausencia de capacidades organizacionais e competencias dos recursos humanos em saúde. Conclusoes: superar a fenda entre concepcao e implementacao é crucial para o progresso na implementacao de reformas aos hospitais.

[Hospital self-management policy in Chile: perceptions of decision-makers]. / Política de autogestión hospitalaria en Chile: percepciones de los tomadores de decisiones.

OBJECTIVE: To learn the perceptions of decision-makers concerning the imple-men-t-ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. METHODS: A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. RESULTS: The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. CONCLUSIONS: Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

Política de autogestión hospitalaria en Chile: percepciones de los tomadores de decisiones / Hospital self-management policy in Chile: perceptions of decision-makers

OBJETIVO: Conocer las percepciones de los tomadores de decisiones respecto de la etapa de implementación de la política de autogestión hospitalaria en dos hospitales de alta complejidad del sur de Chile. MÉTODOS: Se realizó un estudio cualitativo descriptivo y exploratorio basado en entrevistas semiestructuradas en profundidad a tomadores de decisiones de los hospitales Regional de la ciudad de Valdivia y San José de la ciudad de Osorno, durante el período de agosto de 2010 a diciembre de 2011. Se seleccionó una muestra por conveniencia de 26 tomadores de decisiones. Las 26 entrevistas fueron grabadas y transcritas en forma literal. El análisis de la información se hizo utilizando la técnica de análisis de contenido, en su aproximación inductiva. RESULTADOS: Para los entrevistados, la conceptualización de la autogestión está determinada por la autonomía para la toma de decisiones respecto de la asignación de recursos y el financiamiento de la provisión de servicios de salud en las instituciones hospitalarias. También manifestaron que para mejorar la etapa de implementación se deben incluir políticas de recursos humanos y de financiamiento de la función de provisión de servicios de salud. A las debilidades, por su parte, las relacionaron con la ausencia de capacidades organizacionales y competencias gerenciales de los equipos de salud para la implementación de los cambios. CONCLUSIONES: La política de autogestión hospitalaria es conceptualizada desde la autonomía financiera, y su implementación está determinada por las brechas de capacidad que persisten en el diseño de la política.

OBJECTIVE: To learn the perceptions of decision-makers concerning the imple­men­t­ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. METHODS: A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. RESULTS: The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. CONCLUSIONS: Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

Drenaje percutáneo de colecciónsubhepática post colecistectomía / Percutaneous drainage of subhepatic collection post cholecystectomy

Las colecciones abdominales postquirúrgicas en las colecistectomíasafortunadamente son poco frecuentes, y muchasveces carentes de significación clínica. Un porcentaje bajo adquierenun volumen suficiente para dar síntomas y que requieranun tratamiento de drenaje. Actualmente el método de elecciónpara tratar una colección intraabdominal es la vía percutánea deforma mínima invasiva. Se presenta el caso de una paciente postoperada con una colección postquirúrgica con resolución pordrenaje percutáneo guiado bajo pantalla ecográfica

Autoestima profesional: competencia mediadoraen el marco de la evaluación docente / Professional self-esteem: measuring competence in teaching evaluation

En este artículo describimos la relación de la evaluación docente y la autoestimaprofesional de los profesores y profesoras evaluados de la ciudad de Valdivia (Chile). Tomamos comoreferente conceptual la Evaluación de Programas de Stake y Autoestima Profesional de Miranda enrelación con los aportes teóricos y metodológicos de la psicología social. Registramos y analizamosautoreportes de un grupo de profesores y profesoras pertenecientes a establecimientos educativos decarácter público. Entre los hallazgos encontramos el carácter predictor de la autoestima profesionalen relación con el resultado de la evaluación del desempeño docente, lo cual tiene implicancias en lagestión de los procesos de formación permanente de los profesores y profesoras del país.Palabras clave: autoestima, autoestima en profesores y profesoras, autoestima profesional

[Gender perspective in health care teaching: a pending task]. / Perspectiva de género en la formación de profesionales de la salud: Una tarea pendiente.

BACKGROUND: Gender must be considered in the design and implementation of health policies to safeguard equity and accomplish sanitary objectives. AIM: To identify gender perspective in the curricula of five health care careers in the Universidad Austral de Chile. To identify the situation of women in the teaching profile of such curricula. MATERIAL AND METHODS: An exploratory and descriptive study with a critical reading of the structure of the programs of 217 courses. Revision of official academic registries. RESULTS: Gender is usually not included in the curricula of health care careers. The generic language conceals female academics and students. There was a scarce inclusion of cross sectional issues such as collaborative work, interpersonal and democratic relationship, equity and critical analysis. There were no differences in academic achievements between female and male students. The contractual profile of female academics reproduces the gender inequity of the work market. CONCLUSIONS: The inclusion of gender is a pending task in the training of health care professionals.

Perspectiva de género en la formación de profesionales de la salud: Una tarea pendiente / Gender perspective in health care teaching: A pending task

Background: Gender must be considered in the design and implementation of health policies to safeguard equity and accomplish sanitary objectives. Aim: To identify gender perspective in the curricula of five health care careers in the Universidad Austral de Chile. To identify the situation of women in the teaching profile of such curricula. Material and methods: An exploratory and descriptive study with a critical reading of the structure of the programs of 217 courses. Revision of official academic registries. Results: Gender is usually not included in the curricula of health care careers. The generic language conceals female academics and students. There was a scarce inclusion of cross sectional issues such as collaborative work, interpersonal and democratic relationship, equity and critical analysis. There were no differences in academic achievements between female and male students. The contractual profile of female academics reproduces the gender inequity ofthe work market. Conclusions: The inclusion of gender is a pending task in the training of health care professionals).

Estimación de pérdida de suelo y patrón de deposición de sedimentos en el embalse La Cañada / sss

La regulacion de las aguas del río de Comarapa por medio de la construcción de la presa La Cañada permitio formar un embalse con el objetivo de incrementar la disponibilidad de agua para riego en los valles cruceños de la provincia Manuel Maria caballero del departamento de Santa Cruz. El trabajo comprende la determinacion de áreas de riesgo por erosión y la cuantificación de la périda de suelo en la cuenca Comarapa utilizando el modelo Djorovic, utilizando como insumos mapas temáticos de propiedad del PNC generados por el centro de Levantamientos Aeroespaciales y Aplicaciones SIG para el Manejo de los Recursos Naturales y resgistros pluviométricos, aforados líquidos y sólidos y características del embalse obtenido de PRICRUZ, asi como otros mapas de propiedad de GFA a partir del mapa de erosión, se plantean medidas de mitigación en la cuenca para frenar los procesos erosivos existentes...

Optimización de tiempos de semáforos en intersecciones aisladas con el software oscady

El objetivo de esta actividad es de aumentar el rendimiento y la seguridad de las calles, especialmente en intersecciones aisladas, sin modificar sustancialmente su estructura, por medio de la utilización del software OSCADY.Ademas de poder realizar la correspodiente validación de dicho programa, con la realidad de las intersecciones en estudio de nuestra ciudad.Objetivo específico es la ordenación y la regulación a través de un ordenador, para poder limitar la capacidad de circulación en una intersección, con la ayuda del software OSCADY.Conseguir en cada intersección que el reparto del tiempo sea él más adecuado a cada situación de tráfico...