Assistentes Virtuais Inteligentes e saúde mental: debates regulatórios no Brasil / Intelligent Virtual Assistants and mental health: regulatory debates in Brazil / Asistentes Virtuales Inteligentes y salud mental: debates regulatorios en Brasil

A inserção dos Assistentes Virtuais Inteligentes na vida cotidiana representa um marco na história da comunicação entre humanos e máquinas. Devido às suas características interativas, estes estão sendo cada vez mais apropriados e desenvolvidos para fins de cuidado, especialmente no âmbito da saúde mental. Este artigo visa compreender se e como o debate regulatório brasileiro oferece instrumentos para lidar com os desafios e as preocupações desses sistemas de Inteligência Artificial em relação à saúde mental. A partir de uma análise documental, mapeamos exemplos de aplicação dos Assistentes Virtuais Inteligentes em saúde mental, a fim de identificar riscos a direitos dos usuários e avaliar, na legislação brasileira vigente e em discussão, se há proteção suficiente para lidar com eles. Por meio de uma abordagem crítica, salientamos a insuficiência da legislação brasileira atual e a necessidade de ampliação do debate sobre como equilibrar possíveis riscos e benefícios dessas tecnologias.

The integration of Intelligent Virtual Assistants into everyday life marks a milestone in the history of human-machine communication. Due to their interactive characteristics, they are increasingly being appropriated and developed for caregiving purposes, especially in the field of mental health. This article aims to understand whether and how the Brazilian regulatory debate provides tools to address the challenges and concerns of these Artificial Intelligence systems concerning mental health. Through a document analysis, we map examples of Intelligent Virtual Assistants's applications to mental health to identify risks to users' rights and evaluate whether the current and the proposed Brazilian legislation offer sufficient protection to address these risks. Through a critical approach, we highlight the inadequacy of current Brazilian legislation and the need to expand the debate on how to balance the potential risks and benefits of these technologies.

La inserción de los Asistentes Virtuales Inteligentes en la vida cotidiana representa un hito en la historia de la comunicación entre humanos y máquinas. Debido a sus características interactivas, cada vez son más apropiados y desarrollados para fines de cuidado. Este artículo tiene como objetivo comprender si y cómo el debate regulatorio brasileño ofrece instrumentos para abordar los desafíos y preocupaciones de estos sistemas de Inteligencia Artificial en relación con la salud mental. A partir de un análisis documental, mapeamos ejemplos de la aplicación de los Asistentes Virtuales Inteligentes a la salud mental, con el fin de identificar riesgos para los derechos de los usuarios y evaluar, en la legislación brasileña vigente y en discusión, si hay protección suficiente para abordarlos. Destacamos la insuficiencia de la legislación brasileña actual y la necesidad de ampliar el debate sobre cómo equilibrar los posibles riesgos y beneficios de estas tecnologías.

Exposure to Smartphones and Tablets, Physical Activity and Sleep in Children From 5 to 10 Years Old: A Systematic Review and Meta-Analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis to verify the association between smartphone/tablet exposure and physical activity and sleep in children from 5 to 10 years old. Data Source: This study followed the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and included studies that met eligibility criteria based on the "PECO" strategy: participants (children from 5 to 10 years old), exposure (smartphone and tablet use), and outcome (physical activity and sleep). STUDY INCLUSION AND EXCLUSION CRITERIA: The inclusion criteria were observational studies published in indexed scientific journals and written in Portuguese, English, and Spanish that verified the association of exposure to smartphones/tablets with physical activity and sleep in children aged 5 to 10 years of both sexes. Studies were considered eligible only if they met the previous criteria. Data Extraction: The search was conducted in January 2023 on databases from electronic journals without the restriction of the period. To meta-analyze were extracted and grouped using models of fixed and random effects, the coefficients Odds Ratio (OR), Beta (ß), Standard Error (SE), and Confidence Intervals of 95% (95%CI). Data Synthesis: 2396 potentially relevant papers were identified, and 17 met the inclusion criteria. RESULTS: It can be verified that there was an inverse association between smartphones with physical activity and sleep. Studies indicate that for every additional hour of smartphone and tablet use, sleep can be expected to decrease by an average of 11 minutes (ß = - 0.11; 95%CI = -0.13; -0.09). Children using smartphones and tablets were 1.79 times (OR = 1.79; 95%CI = 1.72-1.86) more likely to have shorter sleep duration and 1.53 times (OR = 1.53; 95%CI = 1.41-1.65) more likely to have worse sleep quality. Children with shorter smartphone and tablet usage were 1.19 times more likely to be active (OR = 1.19; 95% CI = 1.03-1.37). CONCLUSION: Children of 5 to 10 years who are more often exposed to smartphones and tablets are prone to have worse quality and quantity of sleep, as well as less practice of physical activity. Health promotion actions can be encouraged based on the results, aiming to reduce the use time of these devices and improve children's health and quality of life.

Adaptação transcultural do Mobile Proficiency Questionnaire (Questionário de Proficiência em Dispositivos Móveis) e validade de conteúdo para o português brasileiro / Cross-cultural adaptation of the Mobile Device Proficiency Questionnaire and content validity for Brazilian Portuguese

Resumo Objetivo Apresentar o processo de adaptação transcultural do Mobile Device Proficiency Questionnaire na população idosa brasileira e sua validade de conteúdo. Método Trata-se de um estudo de validação. Foram realizadas a tradução, retrotradução, análise do comitê de especialistas e pré-teste com 32 pessoas idosas para avaliar a equivalência semântica e cultural. Resultados A versão brasileira do instrumento manteve as categorias da versão original, avaliando de tarefas básicas a avançadas, divididas em oito subescalas avaliativas: funções básicas, comunicação, armazenamento de dados e arquivos, internet, calendário, entretenimento, privacidade e soluções de problemas e gerenciamento de software. Nesses domínios são investigadas a facilidade de uso e a experiência com as funções do dispositivo móvel. Conclusão A adaptação transcultural mostrou que o instrumento avaliativo é uma ferramenta útil e com alto potencial para a avaliação da proficiência de pessoas idosas no uso de dispositivos móveis. O instrumento permite estabelecer um panorama das competências digitais na população idosa, além de favorecer no processo de programação dos serviços de inclusão digital.

Abstract Objective To present the process of cross-cultural adaptation of the Mobile Device Proficiency Questionnaire in the Brazilian older population and its content validity. Method This is a validation study. Translation, back-translation, analysis by an expert committee, and also a pre-test with 32 older adults were conducted to assess semantic and cultural equivalence. Results The Brazilian version of the instrument maintained the categories of the original version, evaluating tasks ranging from basic to advanced, divided into eight evaluative subscales: basic functions, communication, data and file storage, internet usage, calendar, entertainment, privacy, and problem-solving and software management. Within these domains, the ease of use and experience with mobile device functions are examined. Conclusion The cross-cultural adaptation demonstrated that the evaluative instrument is a useful tool with high potential for assessing the proficiency of older adults in using mobile devices. The instrument enables the establishment of a panorama of digital competencies in the older population, facilitating the planning of digital inclusion services.

Prácticas de cuidado al recién nacido y su relación con el uso de dispositivos móviles en mujeres en puerperio inmediato / Newborn care practices and their relationship with the use of mobile devices in women in the immediate postpartum period / Práticas de cuidados ao recém-nascido e sua relação com a utilização de dispositivos móveis entre mulheres no período pós-parto imediato

Objetivo: Conocer las prácticas de cuidado al recién nacido y su relación con el uso de dispositivos móviles en mujeres en puerperio inmediato en un hospital de segundo nivel de complejidad. Método: Se trata de un estudio de enfoque cualitativo, descriptivo y exploratorio, con muestreo teórico y saturación de los datos. Se contó con la participación de 9 personas vinculadas al área de ginecología del hospital, a quienes se les aplicó una entrevista semiestructurada. Los datos fueron analizados mediante el programa Atlas T.I. Resultados: Se obtuvieron 43 códigos y 6 categorías centrales que incluyen: Conductas de riesgo en la salud del recién nacido, afectaciones en la lactancia y alimentación, dificultades emocionales, psicológicas en el vínculo madre e hijo y en los cuidados básicos al neonato, afectaciones en el estado físico, emocional y psicológico de la madre.

Objective: To learn about newborn care practices and their relationship with the use of mobile devices in women in immediate postpartum period in a second level hospital. Method: This is a qualitative, descriptive and exploratory study, with theoretical sampling and data saturation. Nine people linked to the gynecology area of the hospital participated in a semi-structured interview. The data were analyzed using the Atlas T.I. program. Results: 43 codes and 6 central categories were obtained, including: Newborn health risk behaviors, effects on breastfeeding and feeding, emotional and psychological difficulties in the mother-child bond and in the basic care of the newborn, effects on the physical, emotional and psychological state of the mother.

Objetivo: Conhecer as práticas de cuidado ao recém-nascido e sua relação com o uso de dispositivos móveis em mulheres no pós-parto imediato em um hospital de segundo grau. Método: Trata-se de um estudo qualitativo, descritivo e exploratório, com amostragem teórica e saturação de dados. Nove pessoas vinculadas à área de ginecologia do hospital participaram de uma entrevista semiestruturada. Os dados foram analisados com recurso ao programa Atlas T.I. Resultados: Obtiveram-se 43 códigos e 6 categorias centrais, incluindo: Comportamentos de risco na saúde do recém-nascido, efeitos na amamentação e alimentação, dificuldades emocionais e psicológicas no vínculo mãe-filho e nos cuidados básicos ao recém-nascido e efeitos no estado físico, emocional e psicológico da mãe.

Use of hand-held ultrasound to perform E-FAST by general surgery residents in a trauma reference center: First experience in the Colombian Caribbean region / Uso de ecografía portátil para realizar E-FAST por residentes de cirugía general en un centro de referencia en trauma: primera experiencia en la región del Caribe colombiano

Introduction. Extended focused assessment with sonography for trauma (E-FAST) can be performed with minimal training and achieve ideal results. It allows easy transport and use in austere environments such as the Colombian Caribbean, where many centers do not have 24-hour radiology services. The objective of this study was to determine the performance of the use of E-FAST in the evaluation of trauma by second-year general surgery residents in the emergency department. Methods. Retrospective observational study that evaluated the diagnostic performance of E-FAST with Butterfly IQ, in patients with thoracoabdominal trauma, who attended a referral center in the Colombian Caribbean between November 2021 and July 2022. Sensitivity, specificity, and positive and negative predictive values were evaluated, compared with intraoperative findings or conventional imaging. Results. A total of 46 patients were included, with a mean age of 31.2 ± 13.8 years, 87.4% (n=39) were male. The main mechanism of trauma was penetrating (n=32; 69.5%). It was found that 80.4% (n=37) of the patients had a positive E-FAST result, and of these, 97% (n=35) had a positive intraoperative finding. Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 75%, 94.6%, and 66.6%, respectively. The positive likelihood ratio was 3.68, while the negative likelihood ratio was 0.10. Conclusion. General surgery residents have the competence to perform accurate E-FAST scans. The hand-held ultrasound device is an effective diagnostic tool for trauma and acute care surgery patients.

Introducción. La evaluación enfocada extendida con ecografía en trauma (E-FAST, extended focused assessment with sonography for trauma) puede realizarse con entrenamiento mínimo y lograr resultados ideales. Su fácil transporte permite usarla en entornos austeros, como el Caribe colombiano, donde muchos centros no disponen de servicio radiológico las 24 horas. El objetivo de este estudio fue determinar el rendimiento del uso de E-FAST por residentes de cirugía general de segundo año en la evaluación del paciente con trauma en urgencias. Métodos. Estudio observacional retrospectivo que evaluó el rendimiento diagnóstico de E-FAST con Butterfly IQ, en pacientes con trauma toracoabdominal que acudieron a un centro de referencia del Caribe colombiano, entre noviembre de 2021 y julio de 2022. Se evaluaron sensibilidad, especificidad, valores predictivos positivo y negativo, comparando la descripción de la ecografía con los hallazgos intraoperatorios o imagenología convencional. Resultados. Se incluyeron un total de 46 pacientes, con una media de edad de 31,2 ± 13,8 años, siendo el 87,4 % (n=39) hombres. El principal mecanismo de trauma fue penetrante (n=32; 69,5 %). Se encontró que el 80,4 % (n=37) de los pacientes tuvo resultado E-FAST positivo, y que, de estos, el 97 % (n=35) tuvo un hallazgo positivo intraoperatorio. Se calculó una sensibilidad de 92,1 %, especificidad de 75 %, valor predictivo positivo de 94,6 % y negativo de 66,6 %; la razón de verosimilitud positiva fue de 3,68 y la negativa de 0,10. Conclusión. Los residentes de cirugía general están capacitados para realizar exploraciones E-FAST precisas. El ecógrafo portátil es una herramienta de diagnóstico eficaz para pacientes traumatizados.

Aplicaciones para dispositivos móviles de uso estomatológico / Mobile Device Applications to be Used in the Dentistry Field

Introducción: El uso de tecnologías móviles para apoyar el logro de los objetivos de salud tiene el potencial de influir y transformar la provisión de servicios mundialmente. Objetivo: Reflexionar sobre la utilidad de las aplicaciones para dispositivos móviles en las ramas estomatológicas. Comentarios principales: Las aplicaciones para dispositivos móviles tienen muchas ventajas: son constantemente accesibles, se pueden ajustar a las necesidades del usuario, pueden proporcionar comentarios personalizados, son más anónimas que el contacto cara a cara, pueden enviar recordatorios, y tienen un amplio alcance y características interactivas. Consideraciones globales: La utilidad de las aplicaciones para dispositivos móviles en las ramas estomatológicas es innegable. Esta variante tecnológica se ha impuesto como un arma valiosa dentro de los servicios de salud móvil en áreas como la promoción y la prevención de salud, la información a pacientes, la comunicación entre profesionales y el diagnóstico de entidades patológicas. Es una necesidad la búsqueda de la calidad en las que se creen y que se incorporen a la práctica de la profesión para potencializar los beneficios que ofrecen(AU)

Introduction: Using mobile technologies to support the achievement of health goals is very much likely to influence and transform service provision globally. Objective: To reflect on the usefulness of mobile device applications in the branches of dentistry. Key remarks: Mobile device applications have many advantages: they are accessible at any time, they can be adjusted to the user's needs, they provide personalized feedback, they are more anonymous than face-to-face contact, they can send reminders; in addition, they have a wide reach and interactive features. Global considerations: The usefulness of mobile device applications in the branches of dentistry is undeniable. This technological variant has established itself as a valuable weapon within mobile health services in areas such as health promotion and prevention, patient information, communication between professionals, and diagnosis of pathological entities. It is necessary to search for quality, creating and incorporating mobile device applications into the professional practice, in order to maximize the benefits that they offer(AU)

Development of a Mobile Application with Health Guidelines for TB Patients Care.

Health guidelines inform recommendations for different clinical practices or public health policies. They are a simple way to organize and retrieve relevant information that can impact patient care. Although these documents are easy to use, most are not user-friendly because they are difficult to access. Our work aims to present the developing approach for a decision-making tool based on health guidelines to assist health professionals in caring for patients with tuberculosis. This tool is being developed for use on mobile devices and as a web-based system, which will transform a passive and declarative health guideline document into an interactive tool that will provide data, information, and knowledge. User tests with functional prototypes developed for the Android platform show that this application has the potential to be applied in TB healthcare facilities in the future.

Exposición a pantallas de niñas, niños y adolescentes: recomendaciones, límites y controversias en el marco del distanciamiento social obligatorio: un estudio cualitativo / Child and Teenage Screen Exposure: Recommendations, Limits,and Controversies in the Context of Enforced Social Distancing: a Qualitative Study

Introducción: la utilización de pantallas durante la niñez y la preocupación por su potencial daño aumentaron en los últimos años. La recomendación de no superar dos horas diarias de uso resultó controvertida durante la pandemia por COVID-19. El objetivo principal de esta investigación fue explorar las opiniones y actitudes de los profesionales con respecto al uso de pantallas y comprender cómo se modificaron durante dicha pandemia. Materiales y métodos: estudio exploratorio con enfoque cualitativo y estrategia de teoría fundamentada, realizado entre 2020 y 2021.Participaron 23 profesionales (pediatras y generalistas) en cuatro grupos focales. Se realizaron lecturas del material desgrabado para interpretación del contenido. El análisis incluyó la generación de códigos que fueron agrupados en cinco ejes temáticos. Resultados: los ejes resultantes fueron: 1) temática de las pantallas en la consulta ambulatoria de niños sanos, 2) percepción sobre daños, 3) percepción sobre beneficios, 4) pantallas en épocas de ASPO (Aislamiento Social Preventivo y Obligatorio) y 5) pensamientos y acciones contradictorios sobre el uso de pantallas. Discusión: a la hora de recomendar sobre exposición a pantallas, en nuestros entrevistados predominó la intuición personal por sobre la evidencia científica disponible. Reconocieron que el contexto de ASPO visibilizó algunos beneficios asociados a la conectividad que brindan estos dispositivos. Conclusión: nuestros resultados muestran que la percepción sobre las pantallas se está volviendo cada vez más neutral en términos del balance entre sus riesgos y beneficios, conduciendo a que los profesionales sean más flexibles en sus recomendaciones al respecto. (AU)

Introduction: screen use during childhood and potential harm concerns have increased in recent years. Advice not to allow more than two hours of screen use per day was contested during the COVID-19 pandemic. The primary purpose of this research was to probe the opinions and attitudes of professionals regarding the use of screens and to understand how these changed during the pandemic. Materials and methods: this exploratory study, with a qualitative approach and theory-based strategy, was made between 2020 and 2021, and involved the participation of 23 professionals (pediatricians and general practitioners) in four focus groups. The recorded material was analyzed for content interpretation. The analysis included generating codes that were grouped into five thematic areas. Results: the resulting axes were: 1) the issue of screens in the outpatient practice of healthy children; 2) perception of harm; 3) perception of benefits; 4) screens in times of Preventive and Compulsory Social Isolation (ASPO, for its acronym in Spanish); and 5) contradictory thoughts and actions on the use of screens. Discussion: when making recommendations regarding screen exposure, the interviewees' intuition predominated over available scientific evidence. They recognized that the ASPO context highlighted some of the benefits associated with the connectivity provided by these devices. Conclusion: our results show that awareness of screen displays is becoming increasingly neutral concerning the trade-off between their risks and benefits, prompting practitioners to become more flexible in their recommendations. (AU)

Dependence on the use of technologies and daytime sleepiness in adolescent students

INTRODUCTION: Over the past 50 years, there has been a decline in average sleep duration and quality, with adverse consequences for overall health. Growing evidence from countries around the world shows the negative impact of using internet access technologies on sleep due to the short wavelength enriched light emitted by these electronic devices. OBJECTIVE: To analyze the exposure to modern technologies/internet and its relationship with the state of daytime sleepiness in teenage high school students. METHODS: a survey was conducted in six public schools located in the northeast of Brazil. The sample consisted of 1,130 students (mean age 16.6 years ± 1.1). The data collection instrument used was an objective criterion. The characteristic analytical study and quantitative interpretation. Quantitative variables were expressed as mean and standard deviation. For association analyses, the chi-square test or Student's t-test was used. It was considered significant p<0.05. RESULTS: We found that 7% and 31.6% of the participants reported a state of sleepiness during and after classes, respectively. 59.3% report using the internet excessively, 39.9% have a feeling of dependence, 32.6% report sleep deprivation due to excessive internet use, and 26.7% are unsuccessful in trying to reduce the use of cell phones. CONCLUSION: The relationships between the variables in this study will allow us, the younger students use internet access equipment, the more they are exposed to the risk of sleep impairment.

The influence of whole-body vibration, media, and artificial lighting on eye-movement during reading / A influência da vibração de corpo inteiro, da mídia e da iluminação artificial no movimento dos olhos durante tarefas de leitura

ABSTRACT Objective: To evaluate if participants, subjected to whole-body vibration, two different types of media (paper versus tablet) and two lighting environments (fluorescent versus LED), present a difference in eye-movement parameters during reading tasks. Methods: Fourteen adults silently read two different texts in each one of the eight randomized testing conditions (whole-body vibration versus media versus lighting), resulting in 16 different texts read per individual. Whole-body vibration was applied in the vertical direction, 5Hz and 0.8 m/s2 root-mean-square amplitude, a condition similar to those experienced by forklift truck drivers. Participants were in a sitting position with a backrest. An eye-tracker evaluated the eye-movements during the reading task. Results: Whole-body vibration significantly reduced the number of ocular fixations, and cross-correlation; and increased the reading efficiency, fixation duration, directional attack, and binocular anomalies. Neither the type of media nor the lighting environment interfered significantly with the eye-movements, both in situations with and without vibration. Conclusion: The results indicate that whole-body vibration interfered in the eye-movements during the reading task. This may impose a difficulty to process the visual information and to synchronously coordinate the binocular movements under vibration environments.

RESUMO Objetivo: Avaliar se participantes submetidos à vibração de corpo inteiro, a dois tipos diferentes de mídia (papel versus tablet) e a dois ambientes de iluminação (fluorescente versus LED) apresentam diferença nos parâmetros de movimento dos olhos durante tarefas de leitura. Métodos: Quatorze adultos leram silenciosamente dois textos diferentes em cada uma das oito condições de teste (vibração de corpo inteiro versus mídia versus iluminação), de forma aleatória, resultando em 16 textos diferentes lidos por indivíduo. A vibração de corpo inteiro foi aplicada no sentido vertical, com amplitude de 5Hz e 0,8m/s² da raiz do valor quadrático médio, em condição semelhante às vivenciadas pelos motoristas de empilhadeiras. Os participantes permaneceram em postura sentada com encosto. Um rastreador ocular avaliou os movimentos oculares durante a leitura. Resultados: A vibração de corpo inteiro reduziu significativamente o número de fixações oculares e a correlação cruzada entre os olhos e aumentou a eficiência de leitura, duração da fixação, ataque direcional e anomalias binoculares. Nem o tipo de mídia nem as condições de ambientes de iluminação interferiram significativamente nos movimentos oculares, tanto em situações com ou sem vibração. Conclusão: Os resultados indicam que a Vibração de Corpo Inteiro pode interferir nos movimentos oculares durante a leitura. Isso pode impor uma dificuldade no processamento da informação visual e na coordenação síncrona dos movimentos binoculares em ambientes de vibração.

Dependencia a los dispositivos móviles: revisión sistemática en Latinoamérica y Cuba durante la última década / Dependence on mobile devices: systematic review in Latin America and Cuba during the last decade

Introducción: la adicción a los dispositivos móviles se caracteriza por la dependencia patológica hacia estos, puede llegar a ocasionar ansiedad, estrés, baja competencia social y dificultades en la concentración. Resulta de suma importancia la revisión teórica de los principales resultados sobre el tema como punto de partida para la elaboración de estrategias de desarrollo. Objetivo: realizar una revisión sistemática de las principales investigaciones relacionadas con la adicción a los dispositivos móviles en Latinoamérica y particularmente, en Cuba. Métodos: se realizó una revisión sistemática para analizar los principales resultados en Latinoamérica y Cuba, se consideraron artículos originales publicados entre 2012 y 2022. Fueron utilizadas las pautas de revisiones sistemáticas PRISMA. Tras la identificación de los estudios en las bases de datos consultadas se realizó la lectura del título, resumen y contenido para determinar su relación con los objetivos del estudio. Desarrollo: se constató que existen pocos estudios en materia de adicciones a los dispositivos móviles en el contexto latinoamericano y cubano; las investigaciones muestran el impacto negativo sobre la salud mental de quienes padecen esta adicción, se destaca su influencia negativa en estudiantes universitarios, así como la validación de instrumentos que permitirán profundizar en esta temática. Conclusiones: se destaca la calidad de los estudios y la validez de los resultados científicos y se sugiere emplearlos como base para el desarrollo de proyectos de carácter terapéutico.

Background: addiction to mobile devices is characterized by pathological dependence on them, it can cause anxiety, stress, low social competence, and difficulties in concentration. The theoretical review of the main results on the subject is extremely important as a starting point for the elaboration of development strategies. Objective: to carry out a systematic review of the main investigations related to addiction to mobile devices in Latin America and particularly, in Cuba. Methods: a systematic review was carried out to echnol the main results in Latin America and Cuba, original articles published from 2012 to 2022 were considered. PRISMA systematic review guidelines were used. After identifying the studies in the consulted databases, the title, abstract and content were read to determine their relationship with the objectives of the study. Development: it was found that there are few studies on addictions to mobile devices in the Latin American and Cuban context; Research shows the negative impact on the mental health of those who suffer from this addiction, its negative influence on university students stands out, as well as the validation of instruments that will allow us to delve into this subject. Conclusions: the quality of the studies and the validity of the scientific results stand out and it is suggested to use them as a basis for the development of projects of a therapeutic nature.

Eficacia de la terapia de estimulación cognitiva asistida por tecnología en pacientes con demencia / Efficacy of technology-assisted cognitive stimulation therapy in patients with dementia

De la mano del envejecimiento poblacional, la demencia o trastorno neurocognitivo mayor afecta a una cantidad cada vez mayor de personas, lo que implica un alto costo para los servicios de salud. Las guías de práctica clínica recomiendan ofrecer terapias de estimulación cognitiva a las personas afectadas y cada vez es más común el empleo de herramientas tecnológicas que permiten su aplicación a gran escala a pesar de la incertidumbre acerca de su beneficio.En este artículo revisamos la evidencia más actualizada sobre la eficacia de las herramientas computarizadas para el entrenamiento cognitivo de pacientes con demencia. Encontramos algunos estudios que sugieren que podría haber una posible mejora cognitiva en los pacientes con demencia y en la calidad de vida de sus cuidadores. Sin embargo, la mayoría de los estudios no fueron de buena calidad metodológica, fueron realizados con un número limitado de pacientes, en periodos poco prolongados, y los desenlaces fueron evaluados a través de múltiples pruebas de difícil interpretación. (AU)

With the increasing population aging, dementia or major neurocognitive disorder affects a growing number of people,incurring a substantial burden on healthcare services. Clinical practice guidelines recommend providing cognitive stimulation therapies to affected individuals, and the use of technological tools for implementing therapies on a large scale is increasingly common despite the uncertainty about their benefits.In this article, we reviewed the most up-to-date evidence on the effectiveness of computerized tools for cognitive training in patients with dementia. We found some studies that suggest that there could be a possible cognitive improvement in patients with dementia and in the quality of life of their caregivers. However, most studies were not of good methodological quality, were carried out with a limited number of patients, in short periods of time, and the outcomes were evaluated through multiple tests that were difficult to interpret. (AU)

A new periocular dataset collected by mobile devices in unconstrained scenarios.

Recently, ocular biometrics in unconstrained environments using images obtained at visible wavelength have gained the researchers' attention, especially with images captured by mobile devices. Periocular recognition has been demonstrated to be an alternative when the iris trait is not available due to occlusions or low image resolution. However, the periocular trait does not have the high uniqueness presented in the iris trait. Thus, the use of datasets containing many subjects is essential to assess biometric systems' capacity to extract discriminating information from the periocular region. Also, to address the within-class variability caused by lighting and attributes in the periocular region, it is of paramount importance to use datasets with images of the same subject captured in distinct sessions. As the datasets available in the literature do not present all these factors, in this work, we present a new periocular dataset containing samples from 1122 subjects, acquired in 3 sessions by 196 different mobile devices. The images were captured under unconstrained environments with just a single instruction to the participants: to place their eyes on a region of interest. We also performed an extensive benchmark with several Convolutional Neural Network (CNN) architectures and models that have been employed in state-of-the-art approaches based on Multi-class Classification, Multi-task Learning, Pairwise Filters Network, and Siamese Network. The results achieved in the closed- and open-world protocol, considering the identification and verification tasks, show that this area still needs research and development.

Uso y abuso de dispositivos móviles y su rol en el desarrollo de trastornos del sueño en adolescentes / Use and abuse of mobile devices and their role in the development of sleep disorders in adolescents

Las tecnologías de información y comunicación suponen un avance para la sociedad. Hoy en día, los dispositivos móviles proveen servicios convenientes para la cotidianidad, facilitando la comunicación, el ocio y las relaciones interpersonales, sin embargo, se describe que su uso excesivo influye en la aparición de síntomas como ansiedad, comportamientos adictivos y alteraciones del sueño. De todos los usuarios de estas tecnologías, los adolescentes son un grupo especialmente afectado, debido al fácil acceso a estas desde edades muy tempranas y la consecuente integración a su vida diaria. Por lo que se pretende determinar el papel del uso de dispositivos móviles en el desarrollo de trastornos del sueño en adolescentes. Pese a sus efectos deletéreos, se ha observado que el uso de estas tecnologías puede ocasionar sensación de bienestar y apoyo social en algunos usuarios, particularmente cuando promueve la interacción con sus pares. El uso excesivo de las tecnologías, en especial horas antes de dormir, se relaciona con un patrón de sueño anómalo, se ha identificado que los trastornos del sueño más prevalentes en los usuarios son el insomnio y la somnolencia diurna excesiva

Information and communication technologies represent an advance for society. Nowadays, mobile devices provide convenient services for everyday life, facilitating communication, leisure and interpersonal relationships, however, it is described that their excessive use influences the appearance of symptoms such as anxiety, addictive behaviors and sleep disturbances. Of all the users of these technologies, adolescents are a particularly affected group, due to the easy access to them from a very early age and the consequent integration into their daily lives. Therefore, it is intended to determine the role of the use of mobile devices in the development of sleep disorders in adolescents. Despite their deleterious effects, it has been observed that the use of these technologies can cause a feeling of well-being and social support in some users, particularly when it promotes interaction with their peers. The excessive use of technologies, especially hours before bed, is related to an abnormal sleep pattern, it has been identified that the most prevalent sleep disorders in users are insomnia and excessive daytime sleepiness

Digital asthenopia: blue-blocking lenses and + 0,40D additional power in the near zone, for eye strain, accommodation and convergence functions / Astenopia digital: avaliação de lentes com filtro de luz azul e poder adicional de +0,40D na zona de perto, para fadiga visual e nas funções de convergência e acomodação

ABSTRACT Purpose Evaluate blue-violet light filter and additional power of +0.40 D in the near zone ophthalmic lenses, on convergence, accommodative functions, and symptoms of digital asthenopia (DA). Methods Randomized study in cross-over design conducted on 49 volunteers (age, 29 ± 5.5 years; male: female, 18:31). Each subject wore test (+0.40 D in the near zone) and control lenses (regular single vision) for 4 weeks in randomized order. Both lenses had a selective blue-violet light filter. A baseline measurement was taken with the subjects' current updated glasses. Accommodation amplitude (AA) and near point of convergence (NPC) were measured binocularly with the RAF ruler. DA was evaluated by a questionnaire. Results No significant difference (p=.52) was found for AA comparing baseline (11.50±1.88 D), test (11.61± 1.62 D), and control SV lenses (11.88±1.50 D). No significant difference was found for NPC (p=.94), between baseline (6.50 ± 2.89cm), test (6.71± 3.49) and control SV lenses (6.82± 3.50 cm). No significant difference was found comparing test and control SV lenses in symptoms of DA (p=0.20). Conclusions The +0.40 D lenses have no negative impact on convergence or loss of accommodation power. The +0.40 D and control SV lenses had a similar impact on attenuating symptoms of DA.

RESUMO Objetivo Avaliar os efeitos do uso de lentes oftálmicas com filtro seletivo de luz azul-violeta, sem e com poder adicional de + 0,4D na zona de perto nas funções de acomodação e convergência e para sintomas de astenopia digital (AD). Métodos Ensaio clínico controlado, randomizado e mascarado, com 49 voluntários (idade, 29 ± 5,5 anos; masculino: feminino, 18: 31). Cada participante usou lentes de teste (+0,40 D na zona de perto) e controle (visão simples), por 4 semanas de forma randomizada. Ambas as lentes tinham filtro seletivo de luz azul-violeta. A medição inicial (baseline) foi feita com os óculos atualizados de cada participante. A amplitude de acomodação (AA) e o ponto de convergência próximo (PPC) foram medidos binocularmente com a régua RAF. A AD foi avaliada por um questionário. Resultados Não houve diferença estatisticamente significante (p=0,52) para as medidas de AA comparando as lentes baseline (11,50±1,88 D), teste (11,61±1,62 D) e controle VS (11,88±1,50 D). Nenhuma diferença significativa foi encontrada para a medida do PPC (p=0,94), entre as lentes baseline (6,50 ± 2,89cm), teste (6,71±3,49) e controle VS (6,82±3,50 cm). Nenhuma diferença significativa foi encontrada comparando lentes teste de VS e controle nos sintomas de AD (p=0,20). Conclusões As lentes com +0,40 D não têm impacto negativo na convergência ou na perda de acomodação. As lentes +0,40 D e controle VS, tiveram impacto semelhante na redução dos sintomas de AD.

Development and usability of a photograph-based smartphone app for ocular surface tumor screening / Desenvolvimento e usabilidade de um aplicativo para smartphones baseado em fotografias para rastreio de tumores de superfície ocular

ABSTRACT Objective: To develop and examine the usability of a mobile application aimed at improving knowledge about ocular surface tumors among medical students, general practitioners and ophthalmologists. Methods: A cross-sectional quantitative study was carried out by a multidisciplinary team and developed in three stages: administration of a specific questionnaire to medical students, assessing the demand for the application, creation and development of the application in collaboration with the Technological Innovation Laboratory of Centro Universitário Christus and usability assessment. General practitioners and ophthalmologists were selected to answer the System Usability Scale questionnaire. Data were exported into the Statistical Package for the Social Sciences, version 20.0 Windows, for quantitative analysis. Results: The OncoEye application was developed for the iOS and the Android platforms and included four main menus: Glossary, Patients, Referrals and Queries. Most students (89.9%) considered the development of the application important for wider access to information about the topic. Most students (39.9%) were able to recognize ocular lesions and 26.1% could distinguish between benign and malignant conditions. System Usability Scale questionnaire responses revealed good usability, with an average score of 92.65. Users (100%) described the application as user-friendly and well- integrated. Conclusion: An innovative application for ocular surface tumors was created and developed. The application achieved good levels of acceptance and was described as user-friendly by users.

RESUMO Objetivo: Desenvolver e avaliar a usabilidade de um aplicativo para dispositivos móveis que aprimore o conhecimento de estudantes de medicina e de médicos sobre tumores da superfície ocular. Métodos: Foi realizado estudo transversal e quantitativo por uma equipe multiprofissional, consistindo em três etapas: realização de um questionário específico com estudantes de medicina, avaliando a necessidade de elaboração do aplicativo; criação e desenvolvimento do aplicativo pelo Laboratório de Inovação Tecnológica do Centro Universitário Christus e avaliação de usabilidade. Médicos generalistas e oftalmologistas foram selecionados para responder ao questionário System Usability Scale. Os dados foram exportados para o programa Statistical Package for the Social Sciences, versão 20.0, para Windows para análise quantitativa. Resultados: O aplicativo OncoEye foi desenvolvido com quatro menus principais: Glossário, Pacientes, Encaminhamento e Perguntas. Dentre os estudantes, 89,9% consideraram o desenvolvimento do aplicativo importante para orientação sobre o tema, 39,9% souberam reconhecer lesão ocular, e 26,1% puderam diferenciar lesão ocular maligna ou benigna. As respostas dos usuários à ferramenta System Usability Scale demonstraram boa usabilidade, com pontuação média de 92,65 (87,74 a 97,55). Todos os usuários consideraram o aplicativo de fácil manuseio e bem integrado. Conclusão: Um aplicativo inovador para tumores da superfície ocular foi criado e desenvolvido, apresentando boa aceitação e fácil manuseio pelos usuários.

An Architecture for Collaborative Terrain Sketching with Mobile Devices.

3D terrains used in digital animations and videogames are typically created by several collaborators with a single-user application, which constrains them to update the shared terrain from their PCs, using a turn-taking strategy. Moreover, collaborators have to visualize the terrain through 2D views, confusing novice users when conceiving its shape in 3D. In this article, we describe an architecture for collaborative applications, which allow co-located users to sketch a terrain using their mobile devices concurrently. Two interaction modes are supplied: the standard one and an augmented reality-based mode, which helps collaborators understand the 3D terrain shape. Using the painting with brushesparadigm, users can modify the terrain while visualizing its shape evolution through the camera of their devices. Work coordination is promoted by enriching the 3D space with each collaborator's avatar, which provides awareness information about identity, location, and current action. We implemented a collaborative application from this architecture that was tested by groups of users, who assessed its hedonic and pragmatic qualities in both interaction modes and compared them with the qualities of a similar Web terrain editor. The results showed that the augmented reality mode of our prototype was considered more attractive and usable by the participants.

Sistema de gestión TO-BE: garantizar el derecho a la salud de pacientes con ITS en Perú / TO-BE management system: guaranteeing the right to health of patients with STIs in Peru

Se realizó una investigación de campo para conocer la gestión de los procesos de solicitud y admisión de citas médicas, considerando la estigmatización y discriminación de las personas ITS, con el fin de garantizar el derecho a la salud de estos pacientes en Perú. Se ejecutó la sistematización de la información sobre los procesos y mecanismos de exigibilidad, bajo los lineamientos y manuales de los cuatro procesos estratégicos del MINSA contemplados para el otorgamiento de citas médicas, siguiendo los lineamientos de Gob.Pe, Adicionalmente, mediante verificación de los procesos se construyeron la matriz entidad-relación de la gestión por procesos del SSP, y el flujograma del proceso de solicitud y otorgamiento de citas AS-ISS. Se consideraron aspectos tecnológicos-médicos-legales con la participación de 201 pacientes independientemente del motivo o patología a consultar, identificando incidentes en la eficiencia del proceso misional. Por último, se implementó el flujograma de procesos de reserva de citas médicas a través de la aplicación ejecutable para smartphones, tabletas y otros dispositivos móviles (APP) TO-BE la cual conlleva a 10 pasos desde el registro de usuario hasta la emisión de comprobante de otorgamiento de cita médica. Se analizaron las preferencias de los usuarios sobre las causas superables en el proceso misional, mediante una encuesta estructura a 170 usuarios de SSP(AU)

A field investigation was carried out to learn about the management of the processes of request and admission of medical appointments, considering the stigmatization and discrimination of STI people, in order to guarantee the right to health of these patients in Peru. The systematization of the information on the processes and mechanisms of enforceability was carried out, under the guidelines and manuals of the four strategic processes of the MINSA contemplated for the granting of medical appointments, following the guidelines of Gov. Pe, Additionally, through verification of the processes The entity-relationship matrix of the management by processes of the SSP, and the flowchart of the process of request and granting of appointments AS-ISS were constructed. Technological-medical-legal aspects were considered with the participation of 201 patients regardless of the reason or pathology to be consulted, identifying incidents in the efficiency of the missionary process. Finally, the flowchart of medical appointment reservation processes was implemented through the executable application for smartphones, tablets and other mobile devices (APP) TO-BE, which entails 10 steps from user registration to issuance of voucher of granting a medical appointment. Users' preferences regarding causes that can be overcome in the missionary process were analyzed through a structured survey of 170 SSP users(AU)

Análise dos sintomas osteomioarticulares pelo uso de tecnologias portáteis em docentes de uma instituição privada / Analysis of musculoskeletal symptoms by the use of portable technologies in teachers of a private institution

As tecnologias portáteis cada vez mais estão sendo utilizadas e tornaram-se necessárias para o dia a dia da população de maneira geral, entretanto, o uso em excesso, más posturas durante o uso, padrão inadequado ergonômico, potencializado pelo sedentarismo, estresse, expõem seus usuários a riscos de desenvolver processos agudos e crônicos de dor e possíveis lesões osteomioarticulares. Objetivo: Analisar a prevalência dos sintomas osteomioarticulares pelo uso de tecnologias portáteis em docentes de uma instituição privada. Materiais e métodos: Trata-se de um estudo descritivo e observacional transversal, de caráter quantitativo, composta por uma amostra de 68 docentes do centro de ciências biológicas e da saúde na Universidade da Amazônia. As variáveis encontradas foram mensuradas e tabuladas visando eliminar erros utilizando o software microsoft excel, assim como, foram feitas análises descritas dos dados através do software bioestat. Resultados: Como resultados, foi constatado que docentes de uma instituição privada apresentam em grande maioria sintomas osteomioarticulares pelo uso de tecnologias portáteis, principalmente para a região cervical (49% dos participantes), seguido da região lombar (46% dos participantes) obtendo valores significantes para esses e demais achados(p<0,05). Conclusão: Os resultados deste estudo apresentam importância sobre vários segmentos, principalmente para os docentes, pois fornece fundamentais informações e descrições acerca do uso de tecnologias portáteis e possíveis repercussões no sistema osteomioarticular. (AU)

Portable technologies are increasingly being used and have become necessary for the daily life of the population in general, however, overuse, bad postures during use, inadequate ergonomic pattern, enhanced by sedentary lifestyle, stress, expose their users at risk of developing acute and chronic pain processes and possible musculoskeletal injuries. Objective: To analyze the prevalence of musculoskeletal symptoms through the use of portable technologies in teachers of a private institution. Materials and methods: It is a descriptive and observational cross-sectional study, of quantitative character, composed of a sample of 68 professors from the center of biological sciences and health at the University of the Amazon. The variables found were measured and tabulated in order to eliminate errors using the microsoft excel software, as well as described analyzes of the data using the bioestat software. Results: As a result, it was found that professors at a private institution mostly present musculoskeletal symptoms due to the use of portable technologies, mainly for the cervical region (49% of the participants), followed by the lumbar region (46% of the participants) obtaining significant values for these and other findings (p <0.05). Conclusion: The results of this study are important in several segments, mainly for teachers, as it provides fundamental information and descriptions about the use of portable technologies and possible repercussions on the osteomioarticular system. (AU)