En la actualidad el número de estudiantes con diversidad funcional que ha ingresado al sistema educativo colombiano es amplio, así pues, el punto neurálgico de esta revolución educativa es transformar paradigmas desde una perspectiva práctica. Aunado a esto, el docente juega un papel fundamental en la inclusión. Esta investigación se orientó a identificar los retos y realidades del docente en contextos escolares colombianos. En este sentido, se planteó partir de una metodología de corte cuantitativo con un diseño no experimental de alcance descriptivo. Destacando que, una escuela para todos no es una utopía, es un espacio de los educandos y para los educandos donde convergen libremente una gama de particularidades y habilidades propias de una escuela humana e igualitaria.

El objetivo de la investigación fue evaluar la relación entre los niveles de estrés, la valencia y la predictibilidad de sucesos vitales en relación con el índice de ansiedad y depresión de estudiantes de una universidad privada en el nororiente de Colombia. Se trabajó bajo una metodología cuantitativa, con diseño transversal de tipo no experimental y alcance descriptivo-correlacional. La muestra fue de carácter no probabilístico a conveniencia constituida por un 33.7% (n = 186) de hombres y 66.3% (n = 366) de mujeres, con una edad promedio de 18.9 años. Las variables del estudio se evaluaron con: el Inventario de Depresión de Beck II, el Inventario de Ansiedad de Beck y el Cuestionario de Sucesos Vitales. Se encontraron correlaciones estadísticamente significativas entre los niveles de ansiedad y depresión con la valencia negativa y la predictibilidad del suceso. Estos resultados apoyan la teoría de indefensión-desesperanza y discrepan de evidencia científica existente sobre esta temática.

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in the world. Prevalence is estimated at around 100 million patients worldwide. There is evidence that antiplatelet agents and antihypertensive medication reduce the risk of new vascular events in this population, but treatment adherence is very low. Objective: We developed an intervention based on behavioral modification techniques delivered via mobile short message services (SMS) to increase the adherence to pharmacologic treatment on patients with prior history of ASCVD. Methods: We conducted a randomized controlled clinical trial for patients with a prior diagnosis of cardiovascular event such as acute myocardial infarction, unstable angina, cerebrovascular disease or peripheral artery disease in one centre in Colombia. Patients randomized to the intervention arm were assigned to receive SMS daily for the first 4 weeks, five SMS on week 5: three SMS per week from week 6, and one SMS from 8th week until 52nd week. Patients in the control arm received a monthly SMS reminding them of the next study appointment, requesting information about changes in phone number, thanking them for participating in the study and reminding them of the importance of the study. Primary endpoint was change in Low Density Lipoprotein-Cholesterol (LDL-C) and the secondary endpoints were change in thromboxane B2 levels, heart rate, systolic and diastolic blood pressure. Medication adherence was measured with the Medication Adherence Report Scale (MARS 5), mortality and new cardiac hospitalization were assessed at one year end point. A logistic regression analysis and bivariate testing was performed. Results: Nine hundred and thirty patients were randomized, 805 (87%) completed follow up, and were analyzed for the primary endpoint. There was no difference between arms in change of LDL-C at 12 months (P=.41). or for any of the secondary outcomes. No adverse events were reported. Conclusions: In our study we did not find evidence that a behavior modification intervention delivered by SMS improved LDL-C, blood pressure levels or adherence at 12 months. More research is needed to evaluate whether different SMS strategies including personalized messages and with different timing are effective; future studies should include mixed methods to understand better why, for whom and in which context (e.g. health system, social environment) SMS interventions work (or not) to improve adherence in patients with ASCVD. Clinical Trial: Clinicaltrial.gov Abstract Background Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in the world. Prevalence is estimated at around 100 million patients worldwide. There is evidence that antiplatelet agents and antihypertensive medication reduce the risk of new vascular events in this population, but treatment adherence is very low. An intervention was developed based on behavioral modification techniques delivered via mobile short message services (SMS) to increase the adherence to pharmacologic treatment on patients with prior history of ASCVD. Objective The main aim was to evaluate the efficacy and safety of an intervention with SMS messages delivered by mobile phones to improve adherence to cardiovascular medications in patients with ASCVD. Nine hundred and thirty patients were randomized, 805 (87%) completed follow-up, and were analyzed for the primary endpoint. There was no evidence that the intervention changed the primary outcome LDL ( P = .41) , or any of the secondary outcomes evaluated (all p-value > .05). There was no evidence that the intervention was associated with adverse events. improved LDL-C, blood

Introduccion: El abordaje psicologico del dolor osteomuscular (OM) asociado a enfermedades reumaticas ha producido una respetable cantidad de bibliografia referida a los efectos que tiene sobre el comportamiento emocional y social de los pacientes. No solo muchos problemas de dolor cronico OM tienen su origen primario en factores psicosociales, sino que estos influyen decisivamente en su evolucion, ya sea positiva o negativamente. Estudiar este tema en ancianos incrementa su importancia pues esta poblacion es la que mas sufre problemas de dolor OM y paradojicamente, no reciben un tratamiento de calidad pues en muchas culturas se consideran que son “normales” en el envejecimiento. Objetivo: Presentar una actualizacion sobre el estado del arte de la investigacion en el tema, con enfasis en los aportes iberoamericanos. Metodo: Revision narrativa de publicaciones del 2000 al 2018 en revistas, libros y actas de congresos disponibles en texto completo. Resultados: Se discuten las principales lineas de investigacion, sus resultados fundamentales y los principales problemas y retos. Conclusion: La investigacion sobre el tema es incipiente e insuficiente, con predominio de las publicaciones en ingles y de autores norteamericanos. Se establecen algunas recomendaciones.

This study evaluated the medium-term performance of some of the most widely used methods of cleaning stone: dry brushing or washing with water or with an ethanol-water (1:1) mixture, benzalkonium chloride or commercial products based on quaternary ammonium salts with biocidal properties (Biotin R®, Biotin T®, Preventol RI80®, and New Des 50®). The ability of the different methods to remove an algal biofilm formed on a granite-built historical monument was compared. The biofilm has been shown to affect the appearance, but not the integrity, of the building material. In the cleaning trials, the presence and vitality of the organisms colonizing the substrate were determined, immediately after treatment and after one, three, six and twelve months, by colour spectrophotometry and chlorophyll-a fluorescence (ChlaF) analysis. The quantity and physiological state of the biofilm-forming phototrophs in the test areas were also determined one year after the treatments. Although recolonization of the test areas was barely noticeable after all of the treatments, Preventol RI80® proved to be the most effective, followed by benzalkonium chloride and the ethanol-water (1:1) mixture, which yielded similar results. New Des 50® caused clearly visible colour changes on the granite wall, and the biocidal efficacy was poor. Biotin R® performed better than Biotin T®, which yielded similar results to New Des 50® regarding recolonization. Considering the overall results and the potential toxicity of the products tested, cleaning with water is recommended if and when required.

OBJECTIVE:To study the impact of the spontaneous use of Internet on breast cancer patients and on their relationship with health professionals.METHODS:A mixed methodology was used. Two questionnaires were designed through three focus groups, and then administered to 186 patients and 59 professionals in order to assess: (1) patients' use of Internet for health-related information and (2) the impact of this information on patients' psychological outcomes and on their relationship with professionals.RESULTS:Patients spent more time looking for illness-related information after diagnosis, using interactive communities more than static information websites. Patients and professionals disagreed about the use of Internet in terms of the knowledge it provides, and its psychological impact. The main barrier reported by patients regarding the sharing of online information with their professionals was the belief that it would damage their relationship.CONCLUSIONS:Both professionals and patients have a protectionist conception of the therapeutic relationship. This attitude tends to dismiss the positive impact that the use of Internet and the new communication tools may have in cancer patients. New resources should provide an "Internet Prescription" and modes of interaction to facilitate a more open digital communication.

Introducción: A pesar de que los tratamientos psico-oncológicos han demostrado su efectividad en disminuir el malestar emocional y mejorar la calidad de vida de las personas con cáncer, aún existen numerosas barreras que limitan su acceso. La transformación a online de esta atención se plantea como una solución para aumentar la cobertura del servicio y mejorar su coste-utilidad. Objetivo: Crear un ecosistema digital de salud para reducir el impacto del cáncer, aumentando el bienestar y la calidad de vida del ciudadano con cáncer. Método: Programa dirigido a pacientes diagnosticadas de cáncer de mama en fase de supervivencia aguda. Es un programa de atención escalonada dividido en 4 niveles de intervención jerarquizados por complejidad: Nivel 1, cribado y monitorización psicosocial; Nivel 2, Campus: psicoeducación y educación sanitaria; Nivel 3, soporte psicosocial comunitario; y Nivel 4, tratamiento psicoterapéutico grupal. Resultados: En 2019, 259 mujeres fueron incluidas en el programa (39,91% de los nuevos casos de cáncer de mama en los centros participantes). Solo el 3,47% (n = 9) requirió atención clínica especializada (Nivel 4). Conclusión: El programa Iconnecta’t adopta un modelo integrado de atención psicosocial en cáncer que se adecúa a las necesidades específicas de los supervivientes. Da solución a algunas de las barreras de la atención sanitaria tradicional, democratizando el acceso a los servicios mediante el uso de tecnologías de uso común en la mayoría de ciudadanos. En un futuro próximo se prevé la implementación progresiva a otras neoplasias, junto con un ensayo clínico controlado y aleatorizado que evaluará su eficacia.

Objective: To identify the different characteristics of musculoskeletal pain and the perception of social support in a sample of older adults in the city of Bucaramanga. Method: A quantitative, descriptive methodological approach was used, with a convenience sample of 120 older adults from the department of Santander, Bucaramanga, Colombia. Results: It was found that the sample was composed of women, in 73.3%, most of whom were between 65 and 75 years old. Regarding the characteristics of the condition, 78% do not know their diagnosis. A description of pain as being sharp, cruel and annoying predominates. Regarding social support, it can be observed that the sample presents high levels in the following categories: affective support (78%), instrumental support (76%), social interaction (73%) and informational support (72%). Conclusion: Different descriptors are evidenced for pain experiences, as well as a high perceived social support. It is suggested to perform correlational analyses to identify if the social support mediates pain experience as referred to in various investigations.

AbstractBackgroundCardiovascular medication for secondary prevention has been shown to be effective. However, cardiovascular patients have poor medication adherence, the consequences of which include premature death, recurrence risk, hospitalization, and high financial cost for the healthcare system. Behavioral interventions based on text messaging technology are a promising strategy to improving adherence in medications. In low-middle income settings there is no high-quality evidence of a behavioral program delivered by SMS; hence we describe the development, message content, and the program design of the intervention for improving adherence to cardiovascular medication.MethodsWe used the model reported by Abroms and colleagues’ for developing and evaluating text messages-based interventions. This model describes a process in which the intervention created is based on theory and evidence, the target audience is involved to ensure the intervention is engaging and useful, and there is a focus on implementation from the outset.ResultsOur main result was the design of the program, which consisted of a twelve-month structured intervention based on Transtheoretical Model of Behavior Change. We wrote and validated clusters of texts messages targeting each stage of the model. Each message went through an examination process including the evaluation of former cardiovascular patients, experts and the team research personnel. Another important result was an understanding of patients’ perceptions of their experience of cardiovascular disease, barriers to accessing healthcare in Colombia and the use of mobile technology for health.ConclusionsAn SMS intervention has the potential to be an acceptable and effective way of improving adherence to medication in patients with cardiovascular disease. This paper describes the development and content of one such intervention.

Aim Radiation oncology services in Spain are undergoing a process of technical modernization, but—in a context of increasing demand by an ageing population—it is unclear whether there are enough radiation oncologists to staff the newly equipped units. This study aims to assess the number of specialists working in radiation oncology services in Spain relative to current and future needs. Materials and methods In the second half of 2017, the Commission on Infrastructures of the Spanish Society for Radiation Oncology (SEOR) sent a questionnaire on radiation oncology staff to the heads of all 122 public ( n = 76, 62%) and private ( n = 46, 38%) radiation oncology services in Spain. Data collected were the number of professionals, their position, and their year of birth for specialists and residents in each service. In the descriptive analysis, for continuous variables we calculated means, standard deviations and ranges for each Spanish region and work post. For qualitative variables, we constructed frequency tables. All analyses were performed with R statistical software, version 3.5.1. Results The survey response rate was 100% among service heads across all 122 centers. The total number of radiation oncologists working in these centers is 721, or 15.4 per million population, with considerable variations between regions. Given the national recommendations to have 20 radiation oncologists per million population, there is currently a deficit of 204 specialists. If the 163 upcoming retirements are also taken into account, there will be 367 fewer radiation oncologists than required to meet the 25% increase in indications for radiotherapy projected for 2025. Conclusions The classic model for calculating staff needs based on the number of treatments is outdated, and recommendations should be revised to reflect the current reality. A new model should integrate the most complex technological advances and emerging plans in radiotherapy, without neglecting the other activities carried out in radiation oncology services that are not directly linked to patient care.

INTRODUCTION:Anti-platelet therapy, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta-blockers and statins are cost-effective in patients with atherosclerotic cardiovascular diseases (ASCVD) for reducing the risk of ASCVD events. Unfortunately, there is abundant evidence that adherence to these cardiovascular medications is far from ideal. A recent Cochrane review showed a potential beneficial effect of Short Message Service (SMS) interventions on adherence to medication in ASCVD patients. METHODS AND ANALYSIS:The txt2heart study is a pragmatic randomised single-blind controlled trial. The objective is to evaluate the efficacy and safety of an intervention with SMS messages delivered by mobile phones to improve adherence to cardiovascular medications in patients with ASCVD. The intervention consists of behavioural techniques delivered via SMS. The primary outcome is change in blood serum low-density lipoprotein cholesterol levels as an indicator of adherence to statins. Secondary outcomes will include systolic blood pressure as an indicator of adherence to blood-lowering therapies and heart rate as an indicator of adherence to beta-blockers, urine levels of 11-dehydrothromboxane B2, self-reported adherence to cardiovascular medications and rates of cardiovascular death or hospitalisation due to cardiovascular disease. ETHICS AND DISSEMINATION:The study will be performed in compliance with the protocol, regulatory requirements, Good Clinical Practice and ethical principles of the Declaration of Helsinki. The Ethics Committee of Fundación Cardiovascular de Colombia evaluated and approved the trial. The txt2heart Colombia trial aims to provide robust evidence to evaluate whether SMS messages delivered through mobile telephones change the behaviour of Colombian patients who have suffered a cardiovascular event. Trial results will be presented to the local health authorities, and if the intervention is effective and safe, we hope this strategy will be implemented quickly because of its low cost and wide-reaching impact on the population. TRIAL REGISTRATION NUMBER:NCT03098186.

Aims There is currently no consensus on the effect of treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), on the prognosis of patients with heart failure and preserved ejection fraction (HFpEF). Therefore, we have analysed the relationship of commencing treatment with ACEIs or ARBs and the prognosis of patients with incident HFpEF. Methods Retrospective study over 15 years on 3864 patients with HFpEF (GAMIC cohort). Main outcomes were mortality (all-cause and cardiovascular) and hospitalisations for HF. The independent relationship between CT-RASIs and the prognosis, stratifying patients for cardiovascular comorbidity after propensity score-matching was analysed. Results During a median follow-up of 7.94 years, 2960 died (76.6%) and 3138 were hospitalised (81.2%). Therapy with RASIs was associated with a lower mortality, all-cause (RR [95% CI] for ACEIs: 0.76 [0.66-0.86], and RR for ARBs: 0.88 [0.80-0.96]; P < 0.001 in both cases), and cardiovascular (RR for ACEIs: 0.72 [0.66-0.78], and RR for ARBs: 0.87 [0.80-0.94]; P < 0.001), a lower hospitalisation rate (RR for ACEIs: 0.82 [0.74-0.90], and RR for ARBs: 0.90 [0.82-0.98]; P < 0.001), and a lower 30-day readmission rate (RR for ACEIs: 0.66 [0.60-0.73], and RR for ARBs: 0.86 [0.75-0.97]; P < 0.001), after adjustment for the propensity to take RASIs or other medications, comorbidities and other potential confounders. Results on the effect of ARBs are compromised by the small number of patients. Analyses of recurrent hospitalisations gave larger treatment benefits than time-to-first-event analyses. Conclusion In this propensity-matched study, commencing treatment with ACEIs is associated with an improved prognosis of patients newly diagnosed with incident HFpEF.

The main objective of this research was the design, construction and validation of a scale to measure the psychosocial factors and the organic symptomatology in the workplace. The study was non-experimental and crosssectional. It included a sample of 363 participants from three private companies and one from the government sector in Puerto Rico. The scale was submitted to a panel of ten expert judges in order to determine its content validity and, subsequently, it was administered to the sample. The construct validity of the scale was made by an analysis of factors, which determined the suitability of the dimensions and reagents. The development of the scale for measuring the psychosocial factors and their effect on the symptoms proves to be a useful tool as an early intervention strategy.

Se presenta un estudio con metodología mixta predominantemente cuantitativa, el cual tuvo como propósito identificar la forma en que actuarían los gerentes en situaciones hipotéticas relacionadas con el soborno, coerción, engaño, robo, discriminación y transparencia. La muestra estuvo compuesta por 281 gerentes de los sectores público y privado de Puerto Rico, Colombia y Costa Rica. Para recolectar la información, se usó la versión en español del Cuestionario Sobre Situaciones Éticas de Fritzsche y Oz (2007). Se realizaron análisis estadísticos descriptivos, pruebas t para muestras independientes, Anova de una dirección y análisis de contenido en el que se agruparon las respuestas cualitativas por categorías. Se identificó que, en la mayoría de los casos, los gerentes encuestados tomarían una decisión ética ante un escenario éticamente ambiguo. Así mismo, se encontraron diferencias estadísticamente significativas entre los gerentes de los sectores público y privado de algunos de los países estudiados en determinadas situaciones éticas. En términos generales, se observaron tendencias éticas ligeramente más fuertes entre los gerentes del sector público que entre los del sector privado. Por otro lado, no se encontraron diferencias estadísticamente significativas en las tendencias éticas de los gerentes que formaron parte de la investigación, por razón de su país donde trabajaban: Puerto Rico, Costa Rica o Colombia. Finalmente, los resultados cualitativos revelaron que el razonamiento axiológico, fue el tipo de razonamiento más utilizado por los gerentes de la muestra, al enfrentar un dilema o situación éticamente ambigua.

Planning for radiation oncology requires reliable estimates of both demand for radiotherapy and availability of technological resources. This study compares radiotherapy resources in the 17 regions of the decentralised Spanish National Health System (SNHS).

Nowadays we are faced with a society immersed in globalization and native technology, causing a great challenge in the university teaching staff. The gamification, as teaching-learning didactic methodology, gathers the characteristics that allow to motivate and achieve an active and significant learning. The objective of this work is to show the experience of the nursing career, which combines the learning based on games and the use of digital applications.

En la actualidad la prevalencia de dolor en el adulto mayor constituye un problema de salud pública. Esta condición del doliente, en ocasiones tiende agravarse con el tiempo, limitan las actividades diarias del individuo y generan un impacto psicológico, social, familiar y laboral. El objetivo de este artículo es describir el nivel dependencia funcional y apoyo social percibido en el adulto mayor con dolor. Metodológicamente se concibe como una investigación transversal descriptiva con muestreo no probabilístico por conveniencia con una muestra de 200 adultos mayores de Bucaramanga. Se aplicó el instrumento de apoyo social percibido, la prueba Barthel y el cuestionario Mcguill. Como resultado se obtuvo que hay una mayor prevalencia de mujeres, casadas, en edades entre los 65 y 75 años, pertenecientes a estratos 3, con nivel de escolaridad sin finalización de básica primaria. Los participantes describen su dolor en mayor medida como brusco 58,5 %, cruel 71,5 % y molesto 61,0 %. La mayoría tiene altos niveles de apoyo social y el 86,5 % son totalmente independientes.

In recent years, major advances in our understanding of the molecular biology of lung cancer, together with significant improvements in radiotherapy technologies, have revolutionized the treatment of non-small cell lung cancer (NSCLC). This has led to the development of new therapies that target molecular mutations specific to each tumor type, acting on the cell surface antigens or intracellular signaling pathways, or directly affecting cell survival. At the same time, ablative dose radiotherapy can be delivered safely in the context of metastatic disease. In this article, the GOECP/SEOR (Oncological Group for Study of Lung Cancer/Spanish Society of Radiation Oncology) reviews the role of new targeted therapies used in combination with radiotherapy in patients with locally advanced (stage III) NSCLC and in patients with advanced, metastatic (stage IV) NSCLC.

Currently, the prevalence of pain in the elderly constitutes a public health problem, since these disorders tend to worse over time, limiting the daily activities of the individual and generating a psychological, social, family and work impact. Objective: Describing the functional dependence level and the perceived social support in the elderly with pain. Methodology: transversal descriptive research with non-probability convenience sampling, with a sample of 200 older adults from bucaramanga. the instrument of perceived social support, the Barthel test and the McGill questionnaire were applied. The results indicate higher prevalence of 69% women, married, with ages between 65 and 75 years, belonging to social strata 3, with a level of education without the elementary school complete. that participants describe their pain as abrupt 58.5%, 71.5% cruelly, 61.0% Most have high levels of social and 86.5% is totally independent.

Assessing the demand for radiotherapy in Spain based on existing evidence to estimate the human resources and equipment needed so that every person in Spain has access to high-quality radiotherapy when they need it.