bluuebunny/crossref_metadata_2025 huggingface dataset:
Ценности и отношение к этнической культуре и традициям как предикторы субъективного благополучия русских и казахов
Authors: Shamionov Rail М. , Sultaniyazova Nassiya Zh.
Published: May 2018

Introduction. The article discusses the results of the study of the predictors of subjective well-being among representatives of two ethnic groups – Russians and Kazakhs from Russia and Kazakhstan. Values are the product of social creativity; they determine the type of adaptation, and also variations in the subjective well-being of the individual. This process occurs indirectly, through the correspondence of values and the realized activity. The main purpose of this study is to analyze values and attitudes to ethnic culture and traditions as predictors of subjective well-being.

Methods. These were the Satisfaction With Life Scale (E. Diener et al.) modified by D. A. Leont'ev and E. N. Osin; Subjective Happiness Scale (Lyubomirsky & Lepper) modified by D. A. Leont'ev and E. N. Osin; the Ruff Scales of Psychological Well-Being modified by L. V. Zhukovskaya and E. G. Troshikhina; the Schwartz Value Inventory; authors’ scales for revealing attitudes to ethnic culture and traditions. The study employed proportional sampling method; each sample comprised 75 persons (n = 300).

Results. The study revealed new data about subjective well-being in the conditions of isolation and integration of ethnic groups. Almost all of the investigated values were similar. The representatives of a titular nation had a higher level of the “Independence: thoughts” value; the minority groups had a significantly lower level of this value in both cases. Values and attitudes to ethnic culture and traditions were the strongest predictors of psychological well-being. More definite value determination of life satisfaction and happiness was inherent in the representatives of the titular ethnic groups.

Discussion. The paper considers the obtained results through the prism of ongoing changes in the two countries, characterizing two opposite tendencies – consolidation of titular ethnic groups and the adoption of multiculturalism.
Технология регулирования эмоциональных состояний учащегося
Authors: Popova Svetlana I.
Published: May 2018

Introduction. The technology of regulation is the process of indirect support of students’ favorable emotional states and also transformation of unfavorable ones. The article presents the author’s technology of regulation of emotional states. This is so-called meaningful ascending of students organized by the teacher. The paper brings forward the idea that the teacher contributes to students’ self-regulation of emotional states by changing the world image through the presentation of operational images.
Methods. The technology validation involved 810 teachers from three regions of the Russian Federation. The experimental part of the study relied on the activity-based approach and employed the following techniques: Recognition of Emotion Expressions and Emotional States (by A. Ya. Chebykin); Monitoring Map for the Dynamics of the Student’s Emotional States During Class (by A. Ts. Puni); The Reflexivity Level (A. V. Karpov); The Level of Pedagogical Regulation of a Schoolchild’s Emotional States (S. I. Popova); Method of Expert Evaluations of the Dynamics of Students’ Emotional States During Class (A. O. Prokhorov).
Results. The results of the study indicated a positive dynamics for all the parameters: (a) the degree of recognition and adequacy of interpreting emotional states; (b) the reflexivity level; (c) the level of pedagogical regulation of the student’s emotional states; (d) the dynamics of students’ emotional states during class.
Discussion. The obtained results suggest that the teacher seeks to recognize students emotional states and reveal his/her significant connections in the world around him/her. The study revealed the convergence of the images of students’ states and activities, teachers’ appeal to future events, focus on the development of students’ value relations on the basis of the dynamics of their emotional states.
Soybean Peroxidase‐Catalyzed Treatment of Azo Dyes with or without Fe° Pretreatment
Authors: Cordova Villegas Laura G. , Mazloum Samar , Taylor Keith E. , Biswas Nihar
Published: May 2018

Representative azo dyes (Acid Blue 113 [AB113] and Direct Black 38 [DB38]) were treated in a single step with soybean peroxidase (SBP) and hydrogen peroxide (H2O2), or in two steps, zero‐valent iron (Fe°) pretreatment followed SBP/H2O2. The purpose of this research was to compare both treatment processes and to determine which one was the optimal for degradation of each azo dye. For AB113, the preferred process was the single‐step process, 1.0 mM AB113 required 2.5 mM H2O2, 1.5 U/mL SBP at pH 4.0 for ≥ 95% color and dye removal and 30% total organic carbon (TOC) removal. For DB38, due to the products formed after Fe° reduction, which are enzyme substrates (aniline and benzidine; two of four products) a two‐step process was preferred, which allowed reduction in the required SBP and H2O2 concentrations by 5‐ and 2‐fold, respectively, compared to a single‐step treatment for ≥ 95% color, dye, and aniline/benzidine removal and 88% TOC removal.
Anaerobic‐Aerobic Combined System for the Biological Treatment of Azo Dye Solution using Residual Yeast
Authors: Bahia Marina , Passos Fabiana , Adarme Oscar F. H. , Aquino Sergio F. , Silva Silvana Q.
Published: May 2018

This study aimed to investigate the treatment efficiency of a synthetic dye solution in an anaerobic‐aerobic combined reactor system, using pretreated residual yeast as a nutrient source and redox mediator. The applicability of the residual yeast as a nutrient source was firstly evaluated in anaerobic batch tests. Subsequently, two continuous bench‐scale treatment settings were studied: (1) an Upflow Anaerobic Sludge Blanket (UASB) reactor followed by an activated sludge system and, (2) a UASB reactor followed by a shallow polishing pond. The two system configurations were fed with a synthetic azo dye solution of Yellow Gold Remazol (50 mg/L) and pretreated residual yeast (350 mg/L). According to the results, the UASB/shallow polishing pond‐combined reactor attained the best values of chemical oxygen demand (COD) (85%) and dye removal (23%).
Emotion Recognition Using Smart Watch Sensor Data: Mixed-Design Study
Authors: Quiroz Juan Carlos , Geangu Elena , Yong Min Hooi
Published: May 2018

Background

Research in psychology has shown that the way a person walks reflects that person’s current mood (or emotional state). Recent studies have used mobile phones to detect emotional states from movement data.

Objective

The objective of our study was to investigate the use of movement sensor data from a smart watch to infer an individual’s emotional state. We present our findings of a user study with 50 participants.

Methods

The experimental design is a mixed-design study: within-subjects (emotions: happy, sad, and neutral) and between-subjects (stimulus type: audiovisual “movie clips” and audio “music clips”). Each participant experienced both emotions in a single stimulus type. All participants walked 250 m while wearing a smart watch on one wrist and a heart rate monitor strap on the chest. They also had to answer a short questionnaire (20 items; Positive Affect and Negative Affect Schedule, PANAS) before and after experiencing each emotion. The data obtained from the heart rate monitor served as supplementary information to our data. We performed time series analysis on data from the smart watch and a t test on questionnaire items to measure the change in emotional state. Heart rate data was analyzed using one-way analysis of variance. We extracted features from the time series using sliding windows and used features to train and validate classifiers that determined an individual’s emotion.

Results

Overall, 50 young adults participated in our study; of them, 49 were included for the affective PANAS questionnaire and 44 for the feature extraction and building of personal models. Participants reported feeling less negative affect after watching sad videos or after listening to sad music, P<.006. For the task of emotion recognition using classifiers, our results showed that personal models outperformed personal baselines and achieved median accuracies higher than 78% for all conditions of the design study for binary classification of happiness versus sadness.

Conclusions

Our findings show that we are able to detect changes in the emotional state as well as in behavioral responses with data obtained from the smartwatch. Together with high accuracies achieved across all users for classification of happy versus sad emotional states, this is further evidence for the hypothesis that movement sensor data can be used for emotion recognition.
Clinical Adoption of mHealth Technology to Support Pediatric Cystic Fibrosis Care in Sweden: Qualitative Case Study (Preprint)
Authors: Longacre Meghan , Grande Stuart , Hager Andreas , Montan Meera , Bergquist Rikard Palmer , Martensson Maria , Kotzbauer Greg
Published: May 2018

BACKGROUND

Mobile health (mHealth) technologies have potential to improve self-management and care co-ordination of pediatric chronic diseases requiring complex care, such as cystic fibrosis (CF). Barriers to implementation include the lack of support and infrastructure to use mHealth in the clinical microsystem. Coproducing mHealth technology with patients, clinicians, and designers may increase the likelihood of successful integration into the clinical setting.

OBJECTIVE

This study explored the development, adoption, and integration of a new, co-produced mHealth platform (Genia) for the management of pediatric CF in Sweden.

METHODS

A retrospective, qualitative case study approach was used. The case was defined as the process of introducing and using Genia at the Pediatric Cystic Fibrosis Center at Skåne University Hospital in Lund, Sweden. Data sources included interviews, presentations, meeting notes, and other archival documents created between 2014 and 2017. To be included, data sources must have described or reflected upon the Genia adoption process. Iterative content analysis of data source materials was conducted by 2 qualitatively trained researchers to derive themes characterizing the mHealth clinical adoption process.

RESULTS

In total, 4 core themes characterized successful clinical integration of Genia in Lund: cultural readiness to use mHealth; use of weekly huddles to foster momentum and rapid iteration; engagement in incremental “Genia Talk” to motivate patient adoption; and co-design approach toward pediatric chronic care.

CONCLUSIONS

Principles of quality improvement, relational co-ordination, user-centered design, and coproduction can facilitate the integration of mHealth technology into clinical care systems for pediatric CF care.
How Confidence in Prior Attitudes, Social Tag Popularity, and Source Credibility Shape Confirmation Bias Toward Antidepressants and Psychotherapy in a Representative German Sample: Randomized Controlled Web-Based Study (Preprint)
Authors: Schweiger Stefan , Cress Ulrike
Published: May 2018

BACKGROUND

In health-related, Web-based information search, people should select information in line with expert (vs nonexpert) information, independent of their prior attitudes and consequent confirmation bias.

OBJECTIVE

This study aimed to investigate confirmation bias in mental health–related information search, particularly (1) if high confidence worsens confirmation bias, (2) if social tags eliminate the influence of prior attitudes, and (3) if people successfully distinguish high and low source credibility.

METHODS

In total, 520 participants of a representative sample of the German Web-based population were recruited via a panel company. Among them, 48.1% (250/520) participants completed the fully automated study. Participants provided prior attitudes about antidepressants and psychotherapy. We manipulated (1) confidence in prior attitudes when participants searched for blog posts about the treatment of depression, (2) tag popularity —either psychotherapy or antidepressant tags were more popular, and (3) source credibility with banners indicating high or low expertise of the tagging community. We measured tag and blog post selection, and treatment efficacy ratings after navigation.

RESULTS

Tag popularity predicted the proportion of selected antidepressant tags (beta=.44, SE 0.11; P<.001) and blog posts (beta=.46, SE 0.11; P<.001). When confidence was low (−1 SD), participants selected more blog posts consistent with prior attitudes (beta=−.26, SE 0.05; P<.001). Moreover, when confidence was low (−1 SD) and source credibility was high (+1 SD), the efficacy ratings of attitude-consistent treatments increased (beta=.34, SE 0.13; P=.01).

CONCLUSIONS

We found correlational support for defense motivation account underlying confirmation bias in the mental health–related search context. That is, participants tended to select information that supported their prior attitudes, which is not in line with the current scientific evidence. Implications for presenting persuasive Web-based information are also discussed.

CLINICALTRIAL

ClinicalTrials.gov NCT03899168; https://clinicaltrials.gov/ct2/show/NCT03899168 (Archived by WebCite at http://www.webcitation.org/77Nyot3Do)
Development and Implementation of a Person-Centered, Technology-Enhanced Care Model For Managing Chronic Conditions: Cohort Study (Preprint)
Authors: Petersen Curtis L , Weeks William B , Norin Olof , Weinstein James N
Published: May 2018

BACKGROUND

Caring for individuals with chronic conditions is labor intensive, requiring ongoing appointments, treatments, and support. The growing number of individuals with chronic conditions makes this support model unsustainably burdensome on health care systems globally. Mobile health technologies are increasingly being used throughout health care to facilitate communication, track disease, and provide educational support to patients. Such technologies show promise, yet they are not being used to their full extent within US health care systems.

OBJECTIVE

The purpose of this study was to examine the use of staff and costs of a remote monitoring care model in persons with and without a chronic condition.

METHODS

At Dartmouth-Hitchcock Health, 2894 employees volunteered to monitor their health, transmit data for analysis, and communicate digitally with a care team. Volunteers received Bluetooth-connected consumer-grade devices that were paired to a mobile phone app that facilitated digital communication with nursing and health behavior change staff. Health data were collected and automatically analyzed, and behavioral support communications were generated based on those analyses. Care support staff were automatically alerted according to purpose-developed algorithms. In a subgroup of participants and matched controls, we used difference-in-difference techniques to examine changes in per capita expenditures.

RESULTS

Participants averaged 41 years of age; 72.70% (2104/2894) were female and 12.99% (376/2894) had at least one chronic condition. On average each month, participants submitted 23 vital sign measurements, engaged in 1.96 conversations, and received 0.25 automated messages. Persons with chronic conditions accounted for 39.74% (8587/21,607) of all staff conversations, with higher per capita conversation rates for all shifts compared to those without chronic conditions (P<.001). Additionally, persons with chronic conditions engaged nursing staff more than those without chronic conditions (1.40 and 0.19 per capita conversations, respectively, P<.001). When compared to the same period in the prior year, per capita health care expenditures for persons with chronic conditions dropped by 15% (P=.06) more than did those for matched controls.

CONCLUSIONS

The technology-based chronic condition management care model was frequently used and demonstrated potential for cost savings among participants with chronic conditions. While further studies are necessary, this model appears to be a promising solution to efficiently provide patients with personalized care, when and where they need it.
Identification of Primary Medication Concerns Regarding Thyroid Hormone Replacement Therapy From Online Patient Medication Reviews: Text Mining of Social Network Data (Preprint)
Authors: Park So Hyun , Hong Song Hee
Published: May 2018

BACKGROUND

Patients with hypothyroidism report poor health-related quality of life despite having undergone thyroid hormone replacement therapy (THRT). Understanding patient concerns regarding levothyroxine can help improve the treatment outcomes of THRT.

OBJECTIVE

This study aimed to (1) identify the distinctive themes in patient concerns regarding THRT, (2) determine whether patients have unique primary medication concerns specific to their demographics, and (3) determine the predictability of primary medication concerns on patient treatment satisfaction.

METHODS

We collected patient reviews from WebMD in the United States (1037 reviews about generic levothyroxine and 1075 reviews about the brand version) posted between September 1, 2007, and January 30, 2017. We used natural language processing to identify the themes of medication concerns. Multiple regression analyses were conducted in order to examine the predictability of the primary medication concerns on patient treatment satisfaction.

RESULTS

Natural language processing of the patient reviews of levothyroxine posted on a social networking site produced 6 distinctive themes of patient medication concerns related to levothyroxine treatment: how to take the drug, treatment initiation, dose adjustment, symptoms of pain, generic substitutability, and appearance. Patients had different primary medication concerns unique to their gender, age, and treatment duration. Furthermore, treatment satisfaction on levothyroxine depended on what primary medication concerns the patient had.

CONCLUSIONS

Natural language processing of text content available on social media could identify different themes of patient medication concerns that can be validated in future studies to inform the design of tailored medication counseling for improved patient treatment satisfaction.
An Evaluation of the Effectiveness of the Modalities Used to Deliver Electronic Health Interventions for Chronic Pain: Systematic Review With Network Meta-Analysis (Preprint)
Authors: Slattery Brian W , Haugh Stephanie , O'Connor Laura , Francis Kady , Dwyer Christopher P , O'Higgins Siobhán , Egan Jonathan , McGuire Brian E
Published: May 2018

BACKGROUND

Electronic health (eHealth) is the use of information and communication technology in the context of health care and health research. Recently, there has been a rise in the number of eHealth modalities and the frequency with which they are used to deliver technology-assisted self-management interventions for people living with chronic pain. However, there has been little or no research directly comparing these eHealth modalities.

OBJECTIVE

The aim of this systematic review with a network meta-analysis (NMA) is to compare the effectiveness of eHealth modalities in the context of chronic pain.

METHODS

Randomized controlled trials (N>20 per arm) that investigated interventions for adults with chronic pain, delivered via an eHealth modality, were included. Included studies were categorized into their primary node of delivery. Data were extracted on the primary outcome, pain interference, and secondary outcomes, pain severity, psychological distress, and health-related quality of life. Pairwise meta-analyses were undertaken where possible, and an NMA was conducted to generate indirect comparisons and rankings of modalities for reducing pain interference.

RESULTS

The search returned 18,470 studies with 18,349 being excluded (duplicates=2310; title and abstract=16,039). Of the remaining papers, 30 studies with 5394 randomized participants were included in the review. Rankings tentatively indicated that modern eHealth modalities are the most effective, with a 43% chance that mobile apps delivered the most effective interventions, followed by a 34% chance that interventions delivered via virtual reality were the most effective.

CONCLUSIONS

This systematic review with an NMA generated comparisons between eHealth modalities previously not compared to determine which delivered the most effective interventions for the reduction of pain interference in chronic pain patients. There are limitations with this review, in particular, the underrepresented nature of some eHealth modalities included in the analysis. However, in the event that the review is regularly updated, a clear ranking of eHealth modalities for the reduction of pain interference will emerge.
Uptake and Utilization of the Management of Anticoagulation in the Periprocedural Period App: Longitudinal Analysis (Preprint)
Authors: Spyropoulos Alex C , Myrka Anne , Triller Darren M , Ragan Stephen , York Collin , King Jaz-Michael , Lee Ti-Kuang
Published: May 2018

BACKGROUND

Anticoagulants are major contributors to preventable adverse drug events, and their optimal management in the periprocedural period is particularly challenging. Traditional methods of disseminating clinical guidelines and tools cannot keep pace with the rapid expansion of available therapeutic agents, approved indications for use, and published medical evidence, so a mobile app, Management of Anticoagulation in the Periprocedural Period (MAPPP), was developed and disseminated to provide clinicians with guidance that reflects the most current medical evidence.

OBJECTIVE

The objective of this study was to assess the global, national, and state-level acquisition of a mobile app since its initial release and characterize individual episodes of use based on drug selection, procedural bleeding risk, and patient thromboembolic risk.

METHODS

Data were extracted from a mobile app usage tracker (Google Analytics) to characterize new users and completed episodes temporally (by calendar quarter) and geographically (globally, nationally, and in the targeted US state of New York) for the period between April 1, 2016 and September 30, 2017.

RESULTS

The app was acquired by 2866 new users in the measurement period, and the users completed nearly 10,000 individual episodes of use. Acquisition and utilization spanned 51 countries globally, predominantly in the United States and particularly in New York State. Warfarin and rivaroxaban were the most frequently selected drugs, and completed episodes most frequently included the selection of high bleeding risk (4888/9963, 49.06%) and high thromboembolic risk categories (4500/9963, 45.17%).

CONCLUSIONS

The MAPPP app is a successful means of disseminating current guidance on periprocedural anticoagulant use, as indicated by broad global uptake and upward trends in utilization. Limitations in access to provider and patient-specific data preclude objective evaluation of the clinical impact of the app. An ongoing study incorporating app logic into electronic health record systems at participant health systems will provide a more definitive evaluation of the clinical impact of the app logic.
Digital Weight Loss Intervention for Parents of Children Being Treated for Obesity: A Prospective Cohort Feasibility Trial (Preprint)
Authors: Kay Melissa C , Burroughs Jasmine , Askew Sandy , Bennett Gary G , Armstrong Sarah , Steinberg Dori M
Published: May 2018

BACKGROUND

The prevalence of childhood obesity continues to increase, and clinic-based treatment options have failed to demonstrate effectiveness. One of the strongest predictors of child weight is parent weight. Parental treatment for weight loss may indirectly reduce obesity in the child. We have previously demonstrated the effectiveness among adults of a fully automated, evidence-based digital weight loss intervention (Track). However, it is unknown if it is feasible to deliver such a treatment directly to parents with obesity who bring their child with obesity to a weight management clinic for treatment.

OBJECTIVE

The objective of our study was to evaluate the feasibility of and engagement with a digital weight loss intervention among parents of children receiving treatment for obesity.

METHODS

We conducted a 6-month pre-post feasibility trial among parents or guardians and their children aged 4-16 years presenting for tertiary care obesity treatment. Along with the standard family-based treatment protocol, parents received a 6-month digital weight loss intervention, which included weekly monitoring of personalized behavior change goals via mobile technologies. We examined levels of engagement by tracking completed weeks of self-monitoring and feasibility by assessing change in weight.

RESULTS

Participants (N=48) were on average 39 years old, mostly female (35/42, 82% ), non-Hispanic Black individuals (21/41, 51%) with obesity (36/48, 75%). Over a quarter had a yearly household income of <US $25,000, and about a third had the equivalent of a high school education. Children were on average 10 years old and had a body mass index of 29.8 kg/m2. The median percentage of weeks participants tracked their behaviors was 77% (18.5/24 total weeks; interquartile range [IQR] 6.3 to 100). The median number of attempts via phone or text message (short message service) required to complete one tracking week was 3.3 (IQR 2.6 to 4.9). Nearly half (23/48, 48%) had high levels of engagement, completing 80% (19/24) or more weeks of tracking. Of the 26 participants with weight measurements reported at 6 months, of which 81% (21/26) were self-reported, there was a median 2.44 kg (IQR −6.5 to 1.0) decrease in weight.

CONCLUSIONS

It is feasible to deliver an evidence-based digital weight loss intervention to parents or guardians whose children are enrolled in a weight management program. Given the feasibility of this approach, future studies should investigate the effectiveness of digital weight loss interventions for parents on child weight and health outcomes.
Efecto de una intervención educativa multidisciplinaria sobre la calidad de vida en pacientes hipertensos
Authors: Guzmán Pantoja Jaime E. , Valadez Toscano Francisco J. , Cabrera Pivaral Carlos E. , Campollo Rivas Octavio , Gutiérrez Román Elsa A. , Barrera Parraga Jaime , Sandoval Magaña Mónica A.
Published: May 2018

<span style="font-size: 10pt; color: #231f20; font-family: Garamond-Bold; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond-Bold; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;">Objetivo: comparar el efecto de una intervención educativa multidisciplinaria versus manejo convencional en la calidad de vida, índice de masa corporal y presión arterial de pacientes hipertensos. Diseño: experimental de intervención educativa. Métodos: de marzo a octubre de 2005 se realizó una intervención educativa multidisciplinaria en una unidad de primer nivel de atención; participaron especialistas en Medicina Familiar, nutriólogos, trabajadoras sociales y un especialista en Salud Mental. El grupo experimental recibió la intervención que consistió en cinco sesiones durante tres meses; se evaluó la calidad de vida, índice de masa corporal y presión arterial, se utilizó la prueba de t para determinar las diferencias entre los grupos, p ≤ 0.05 fue significativa. Resultados: se asignaron aleatoriamente 25 pacientes al grupo experimental y 25 al grupo control. En la evaluación inter-grupal el grupo experimental presentó mejoría global de 10 puntos en la calidad de vida (p=0.001), la disminución promedio en la presión arterial fue de 10 mmHg en la media, (p=0.001), el índice de masa corporal sólo disminuyó en el grupo experimental en 1 kg/mt2 (p=0.001). Conclusión: la participación multidisciplinaria tiene un mayor impacto en la calidad de vida y el control de la presión arterial.
Neuropatía diabética
Authors: Gómez Clavelina Francisco J.
Published: May 2018

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XXII Congreso Nacional de Medicina Familiar y III Congreso Estatal de Medicina Familiar
Authors: Ponce Rosas Efrén R.
Published: May 2018

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Geriatría
Authors: Gutiérrez Robledo Luis Miguel , D'Hyver de las Deses Carlos
Published: May 2018

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La experiencia de Sobramfa médicos familiares como profesores de seis facultades de medicina en São Paulo, Brasil
Authors: González Blasco Pablo , Roncoletta Adriana F.T. , Janaudis Marco Aurélio , Moreto Graziela , Levites Marcelo R. , De Benedetto María Auxiliadora C. , García Deborah S.O. , Pinheiro Thais Raquel , Mônaco Cauê F.
Published: May 2018

Resumen

Las experiencias de Sobramfa en la actividad docente universitaria conducen a una conclusión: lo más importante es incorporarse a la enseñanza, y enfocarse en los alumnos para brindarles ayuda. Tener la flexibilidad para adaptarse a multitud de posibilidades docentes y saber decantar los valores que se viven en la medicina familiar. Lo que realmente importa, y el alumno lo valora, es enseñar con dedicación y entusiasmo.

 
Propuesta para actualizar las políticas de atención integral a la salud en personas mayores de 65 años de edad en México
Authors: García-Pedroza Felipe de Jesús , De la Fuente-Rocha Javier , Irigoyen-Coria Arnulfo , Peñaloza-López Yolanda Rebeca
Published: May 2018

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Identifique el caso
Authors: Chacón-Pizano Wendy Lea , Mejía-Rodríguez Oliva , Antonio-Valdiviezo Aquiles
Published: May 2018

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Frecuencia de factores de riesgo para cáncer de mama en una unidad de atención primaria
Authors: Guerra-Castañón Carlos Daniel , Ávalos-de la Tejera Maricarmen , González-Pérez Brian , Salas-Flores Ricardo , Sosa-López María Lucero
Published: May 2018

Objetivo:
determinar la frecuencia de los factores de riesgo para cáncer de mama en pacientes en una clínica de medicina familiar. Material y métodos: se realizó un estudio transversal, descriptivo y retrospectivo de revisión de casos con diagnóstico de cáncer de mama en sus diferentes etapas clínicas entre enero de 2006 y diciembre de 2010. Las variables a estudiar fueron: edad al momento del diagnóstico, índice de masa corporal (imc), antecedentes heredofamiliares, ginecoobstétricos, Diabetes mellitus, alcoholismo, tabaquismo y prescripción de hormonas exógenas. Resultados: de la revisión de expedientes se identificaron 122 pacientes con diagnóstico de cáncer de mama. El promedio de edad fue de 54.57 + 12 años y los casos se dividieron por grupos de edad, siendo el más frecuente, con 24 casos (31.6%), el de 40-49. El antecedente de Diabetes mellitus tipo 2 previo al diagnóstico de cáncer de mama se encontró en 23 pacientes (30.3%) y el uso de hormonales en 37 (48.7%). El promedio de edad de la menopausia fue de 39.38 + 17.92 años. Asimismo, 57 pacientes (75%) tuvieron lactancia, 21 (27.6%) se clasificaron con sobrepeso, 45 (59.2%) con obesidad y 10 (13.2%) presentaron imc normal. Conclusiones: los factores de riesgo presentados en este estudio son de vital importancia para identificar población femenina de alto riesgo en medicina familiar.
Frecuencia de “riesgo elevado de desarrollar diabetes” en pacientes de una clínica de medicina familiar
Authors: Ortiz-Contreras Evelia , Baillet-Esquivel Laura E. , Ponce-Rosas Efrén R. , Sánchez-Escobar Laura E. , Santiago-Baena Guadalupe , Landgrave-Ibáñez Silvia
Published: May 2018

Objetivo: identificar la frecuencia de prediabetes en pacientes de 20 a 64 años en la consulta externa de una clínica de medicina familiar de la ciudad de México. Método: Estudio: descriptivo, transversal, prospectivo. Población: muestra no aleatoria y no representativa (123 pacientes). Instrumento: 35 variables distribuidas en cuatro secciones: ficha de identificación, parámetros de laboratorio, datos clínicos y un cuestionario validado por la American Diabetes Association (ada). Mediciones: una medición de glucosa en sangre venosa e interrogatorio directo a los pacientes que aceptaron participar. Resultados: se encontró una frecuencia de prediabetes de 43.9%; 65.2% de los pacientes presentó índice de masa corporal (imc) >30 (n=30). Se encontraron diferencias estadísticamente significativas en los pacientes con hipertensión arterial y prediabetes comparados con aquellos sin hipertensión pero con riesgo elevado de desarrollar diabetes (redd), χ2 de Pearson de 13.422, p=0.001. Más de 70% de los pacientes no llevaba una alimentación balanceada ni realizaban ejercicio físico. Conclusiones: el médico familiar debería detectar oportunamente la existencia de redd a fin de prevenir o retrasar la Diabetes mellitus tipo 2 lo cual aumentaría en los pacientes tanto la esperanza como la calidad de vida.
Prevalencia de disfonías funcionales en docentes argentinos
Authors: Agostini-Zampieron Marcela , Barlatey-Frontera Consuelo , Barlatey-Frontera María Florencia , Arca-Fabre Adriana
Published: May 2018

Objetivos: determinar la frecuencia de patología vocal en docentes de escuelas en la ciudad de Esperanza, establecer diferencias según edad y sexo, identificar factores de riesgo asociados al uso profesional de la voz y describir las patologías ocasionadas por el uso vocal como herramienta laboral. Material y métodos: estudio observacional, descriptivo, de corte transversal, con base en datos obtenidos por medio de encuestas a profesionales docentes, pertenecientes a doce escuelas primarias y secundarias situadas en la ciudad de Esperanza, provincia de Santa Fe, entre febrero y mayo de 2012. Resultados: de los 238 docentes estudiados, se encontró una prevalencia de patología vocal de 16.8%, sin hallar diferencias estadísticamente significativas según edad y sexo. Los principales trastornos vocales referidos fueron las disfonías funcionales (55%) y los nódulos (22.5%). Los factores de riesgo identificados con valores altos fueron: ambiente de trabajo ruidoso, seco y frío; exposición a polvo de gis; enfermedades de las vías respiratorias y consumo de medicamentos prescritos. Una prevalencia que osciló entre 21.4 y 68.9% del total de docentes señaló síntomas de alteración vocal. Conclusión: la prevalencia de patología vocal en docentes de la ciudad de Esperanza fue menor a la esperada, en comparación con la literatura científica revisada. Sin embargo, se observó que un gran número de docentes refería presencia de síntomas de afección vocal. La promoción y prevención de estas patologías asociadas a la voz no se cumplen debido a la falta de capacitación a los docentes para un correcto uso de su voz.
Embarazo en adolescentes problema de salud pública y prioridad para el médico familiar
Authors: Rosales-Silva José Gerardo , Irigoyen-Coria Arnulfo
Published: May 2018

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Características sociodemográficas de adolescentes embarazadas menores de 16 años de una unidad de medicina familiar en San Luis Potosí, México
Authors: Rosales-Silva José Gerardo , Lemoine-Loredo Sofía , Rodríguez-Pérez Carlos Vicente , Andrade-Rodríguez Héctor de Jesús
Published: May 2018

identificar las características sociodemográficas de adolescentes embarazadas menores de 16 años de la unidad de medicina familiar no. 45 del Instituto Mexicano del Seguro Social (imss), Delegación San Luis Potosí, México. Material y métodos: estudio descriptivo y transversal. Muestra: no probabilística por conveniencia. Se efectuó entre el 2 de enero y el 30 de noviembre de 2011. Se incluyeron 41 adolescentes embarazadas menores de 16 años, las cuales participaron de forma voluntaria; en todos los casos se solicitó la autorización correspondiente. El instrumento de recolección de datos incluyó: ficha de identificación, antecedentes sociofamiliares, antecedentes relacionados con el embarazo actual y antecedentes patológicos, con un total de 28 ítems. Resultados: se entrevistó a 41 adolescentes, 34 de entre 15 y 16 años y siete de entre 13 y 14 años. Un total de 33 adolescentes pertenecía a familias nucleares y ocho a familias monoparentales; 28 adolescentes estaban integradas a familias modernas y 13 a familias tradicionales; 38 pertenecían a hogares con estrato socioeconómico bajo y tres con estrato medio bajo. Conclusiones: los médicos de los tres niveles de atención deberían estar más comprometidos con la difusión de la educación sexual para los adolescentes y con ser fuente eficaz de información anticonceptiva. Se deberían replantear las estrategias que se llevan a cabo en la prevención tanto primaria como secundaria del embarazo en adolescentes.
Clinimetría geriátrica propuesta de un instrumento integral en medicina familiar
Authors: Yépez-Ramírez Daniel , Jacinto-Becerra Brenda Fátima , Méndez-Bravo Erendida Guadalupe , Muñoz-López Diana Elena , Osornio-Mendoza Esmeralda Patricia , Soria-Navarro María del Carmen
Published: May 2018

determinar la confiabilidad y validez de un instrumento clinimétrico integral aplicable a la población geriátrica en medicina familiar. Material y métodos: estudio descriptivo, transversal, prospectivo, en 110 pacientes mayores de 65 años de la unidad de medicina familiar no. 56 de León, Guanajuato, México. Se aplicó el instrumento “valoración geriátrica integral” estructurado con base en dimensiones de la evaluación geriátrica normada. Para el análisis se utilizó estadística descriptiva mediante spss 14.0. Resultados: se construyó un instrumento con 15 reactivos seleccionados mediante correlación de Pearson tomando en cuenta sus pesos factoriales. Se obtuvo un alfa de Cronbach por varianza de 0.813 y por suma correlacional de 0.816. El instrumento fue aplicado en siete minutos en promedio y mostró que 83.6% de la muestra (n=92 χ2 42.6 p<0.05) presentó un estado de salud integral óptimo. Discusión: se diseñó un instrumento confiable y válido para el tamizaje del paciente geriátrico; los pacientes de más de 65 años presentaron condiciones integrales de salud óptimas.
Valoración gerontogeriátrica integral comparación diagnóstica entre el módulo gerontológico y la consulta externa
Authors: González-Domínguez Ricardo , Castillo-Feliciano Luz María , González-Pedraza Avilés Alberto
Published: May 2018

Objetivo: comparar la valoración gerontogeriátrica integral (vgi) contra la asistencia médica tradicional. Material y métodos: estudio retrospectivo, comparativo, observacional y analítico. Muestreo probabilístico de 300 expedientes clínicos de pacientes que tenían 60 o más años de edad y eran atendidos en el módulo gerontológico (grupo 1). Muestreo no probabilístico de 400 expedientes de pacientes de consultorios de medicina familiar (grupo 2). Se utilizó una cédula de recolección diseñada ex profeso. Todas las variables fueron categorizadas como presencia o ausencia diagnóstica e incluyeron las referentes a las cuatro áreas: biológica, psicológica, social y funcional. Análisis estadístico: χ2 de homogeneidad, nivel de significancia de 0.05. Programa estadístico spss 15. Resultados: se presentaron diferencias con significancia estadística entre los dos grupos en prácticamente todas las diagnósticas de las cuatro áreas. Al realizar el análisis en función de los grupos etarios, en el de los muy viejos y centenarios prácticamente no existieron diferencias entre diagnósticas. Conclusiones: las diferencias en los porcentajes diagnósticos hacen necesario realizar la vgi en el primer nivel de atención médica, toda vez que es el sitio donde se concentra el mayor número de población de adultos mayores y que son atendidos en forma inicial.
Perfil del varón que elige vasectomía sin bisturí en un centro de salud de la ciudad de México: 15 años de experiencia
Authors: Flores-Huitrón Patricia , Jiménez-Hernández Judith del Carmen , Madrigal-de León Hilda Gabriela , Ponce-Rosas Efrén Raúl , Landgrave-Ibáñez Silvia , Baillet-Esquivel Laura Eugenia
Published: May 2018

Objetivo: identificar el perfil sociodemográfico del varón que elige vasectomía sin bisturí (vsb). Material y métodos: estudio descriptivo, transversal de cohorte retrospectiva. Se estudiaron 1 023 expedientes clínicos de los pacientes que fueron vasectomizados entre 1993 y 2007 en el centro de salud “Dr. José Castro Villagrana” de la ciudad de México. Variables sociales, demográficas, clínicas y quirúrgicas. Se efectuó una medición al momento de elaborar la historia clínica. Se utilizó una lista de cotejo aplicada a las historias clínicas. Resultados: el perfil sociodemográfico fue: edad promedio de 33.5 años±7.1, número de hijos vivos de dos a tres, edad promedio del hijo menor de 3.2 años, 81.5% de los hombres tuvo entre 25 y 42 años de edad, promedio de años de unión conyugal de 8.9±5.1, casados 82.5% o en unión libre 15.2%. Nivel de escolaridad de secundaria completa hasta posgrado en 77.2% de los casos. La paridad satisfecha junto con el nivel de escolaridad de secundaria completa, bachillerato o nivel técnico fue el motivo y condición asociados más importantes para decidir realizarse la vasectomía, χ2=29.59, p<0.0009. Conclusiones: el perfil determinado en el presente estudio puede ser útil para tomar decisiones y elaborar estrategias de mercadotecnia social en salud; de este modo, se podrá orientar mejor a los candidatos a la vsb y se realizará más eficazmente la difusión de este método de planificación familiar.
Funciones de un Comité de Evaluación Curricular una propuesta aplicable a la medicina familiar
Authors: Ponce de León-Castañeda María Eugenia , Petra-Micu Ileana , Ramírez-López Norma L. , Varela-Ruiz Margarita , Cortés-Gutiérrez María Teresa
Published: May 2018

Un Comité de Evaluación Curricular (cec) tiene como propósito verificar si un plan de estudios (incluyendo planes de estudios de diversas especialidades como la Medicina Familiar) cumple con lo programado y da respuesta a las necesidades detectadas; de esta manera se orienta la toma de decisiones y la realización de acciones que conduzcan a mejorar los planes y programas.
Factores familiares que favorecen el apego al tratamiento en casos de tuberculosis pulmonar
Authors: Martínez-Hernández Yaneth Odalis , Guzmán-López Felipe , Flores-Pulido Juan José , Vázquez-Martínez Víctor Hugo
Published: May 2018

Objetivo: identificar los factores familiares que favorecen el apego al tratamiento de la tuberculosis pulmonar (tbp). Material y métodos: estudio observacional, descriptivo, transversal, prospectivo, realizado en la unidad de medicina familiar (umf) no. 33 de Reynosa, Tamaulipas. México. Se incluyó al total de pacientes con diagnóstico de tbp de primera vez seleccionados mediante censo nominal. Resultados: se identificó a 57 pacientes con tbp. Fue determinada una prevalencia de 0.02%, con predominio del sexo masculino (56%). La edad mínima fue de 18 años y la máxima de 83, con una media de 39±12 años, moda de 26 y mediana de 50.5; 85% de los pacientes inició con un tratamiento acortado estrictamente supervisado (taes), 66.6% logró la curación al final del tratamiento, 19.2% continuó en retratamiento y 12% abandonó el tratamiento; 92.2% refirió afectación en su vida personal después del diagnóstico de tbp. De los pacientes con abandono al tratamiento, 75% presentaba algún grado de disfunción familiar. Conclusiones: la prevalencia de tbp en la umf fue de 0.02%, cifra notoriamente inferior a la media nacional, que es de 15 por cada 100 000 habitantes. Se observaron niveles más altos de disfunción familiar y rechazo social en los pacientes con abandono al tratamiento que en aquellos con diagnóstico de curación, quienes presentaron mayor funcionalidad familiar.
Causas de los errores clínicos percepción de los residentes de medicina familiar de Murcia, España
Authors: Saura-Llamas José , Sebastián-Delgado María Elena , Martínez-Garre Nieves , Martínez-Pastor Antonio , Leal-Hernández Mariano
Published: May 2018

Objetivo: analizar las causas específicas de los errores clínicos percibidos por los residentes de cinco promociones de Medicina Familiar y Comunitaria (mfyc) de Murcia, España. Material y métodos: estudio descriptivo, analítico y transversal sobre errores médicos recogidos mediante encuesta, realizada en los centros de salud de dos Unidades Docentes de mfyc, con los residentes de las promociones 2007-2011, 2008-2012, 2009-2013, 2010-2014 y 2011-2015. A través de una pregunta abierta se indagó sobre el último error médico que habían identificado y reconocido, como un ejercicio práctico al inicio de cinco ediciones de la actividad formativa del Programa teórico-práctico sobre seguridad del paciente. La pregunta fue distribuida en mano, la respuesta anónima, confidencial, voluntaria y manuscrita. Los datos se analizaron utilizando la clasificación de incidentes por causas del Estudio regional de incidentes derivados de la atención (erida). Resultados: asistieron a los cinco cursos 169 del total de residentes (174), y respondieron la encuesta 165 (tasa de respuesta del 97.6%); el 94.6% reconoció haber cometido errores. De los que respondieron, 132 describían el último error cometido (80%). Los errores se agruparon según sus causas fundamentales relacionados con: el diagnóstico: 58 (37.4% de los errores); el tratamiento: 52 (33.5%);  los cuidados: 21 (13.5%); la comunicación asistencial: 15 (9.6%); la gestión y el sistema de información: 9 (5.8%). Los errores en el diagnóstico, el tratamiento y los cuidados representaron 84% del total. Se analizaron y detallaron todas las causas específicas de los errores. Conclusiones: la gran mayoría de los residentes poseen una actitud constructiva y autocrítica, y son conscientes de haber cometido errores, cuyas causas identificadas, en orden de importancia, están relacionadas con el diagnóstico, el tratamiento y los cuidados. Esta información puede ser útil para adecuar y mejorar la formación de los residentes, considerando las causas de sus errores como necesidades formativas identificadas.
Nivel de empatía en médicos del servicio de urgencias de un hospital público de la ciudad de México
Authors: Loyola-Durán Liliana , Landgrave-Ibáñez Silvia , Ponce-Rosas Efrén R. , González-Pedraza Avilés Alberto
Published: May 2018

Objetivo: identificar el nivel de empatía en la relación médico-paciente de los médicos internos, residentes y adscritos a un servicio de urgencias de un hospital público. Métodos: estudio observacional, descriptivo y transversal; realizado entre septiembre y octubre de 2014. Muestreo no probabilístico por conveniencia en la población total de médicos adscritos al servicio de urgencias. Bajo consentimiento informado, se aplicó el instrumento validado y adaptado al español, escala de empatía de Jefferson en su versión Student a médicos adscritos al servicio de urgencias de un hospital público de la Secretaría de Salud del Distrito Federal. Para el análisis estadístico inferencial se utilizó la prueba no paramétrica de Kruskal-Wallis y U de Mann-Whitney; el nivel de significancia fue de α=0.05 para ambas; se empleó el programa estadístico spss v. 18. Resultados: de acuerdo con la escala de Jefferson, 17 de 51 médicos incluidos en el estudio, no fueron empáticos (33.3%), 10 lo fueron medianamente (19.6%) y 24 fueron empáticos (47.1%). Conclusiones: cerca de la mitad de los 51 médicos entrevistados presentó empatía en la relación médico-paciente.
Funcionalidad familiar en pacientes con anorexia nerviosa y bulimia
Authors: Sainos-López Daniella Guillermina , Sánchez-Morales María Teresa , Vázquez-Cruz Eduardo , Gutiérrez-Gabriel Itzel
Published: May 2018

La anorexia nerviosa y la bulimia son problemas de salud que se manifiestan como trastornos del comportamiento alimentario, que si no se atienden oportunamente pueden llegar a comprometer la vida de los pacientes. La sospecha de trastornos de la alimentación entre adolescentes está relacionada con la percepción de disfunción familiar. La prevención y el tratamiento de los trastornos de la alimentación pueden ser más eficaces si se realiza un abordaje familiar durante la adolescencia; momento en el que se presenta una gran oportunidad de intervención pero al mismo tiempo un formidable compromiso para los médicos familiares.