Autonomía y centralismo:: la configuración del Estado y la Nación chilena (1823-1830).

The power vacuum existing after the napoleonic invasion in the Iberian Peninsula activated the proliferation of many self-government scattered through the Spanish monarchy substituting the sovereignty of the captive monarch. A mosaic of political bodies that performed a significant role during the first moments of the monarchical crisis, the following shaping of the Independence movement and later on during the configuration of the emerging American States. Chile - even though it was ahead his neighbour countries regarding strengthening a stable State - did not avoid the movements towards autonomy that found their highest extent during the period of “Anarchy”, intermission within two dictatorships characterised by the confrontation between Santiago – old headquarters of the colonial administration – and the provinces for management of the building of the State. In this article it is intended to synthesise that period based in the most recent research on the topic.El vacío de poder generado por la invasión napoleónica en la Península Ibérica activó el estallido de múltiples soberanías en toda la Monarquía hispánica en sustitución de la soberanía del monarca cautivo. Un mosaico de cuerpos políticos que desempeñaron un papel trascendental en los primeros momentos de la crisis monárquica, en la posterior configuración del movimiento independentista y, más adelante, en la organización de los incipientes Estados americanos. Chile, si bien aventajó a sus vecinos a la hora de consolidar un Estado estable, no escapó a las tendencias autonomistas, las que hallaron su máxima expresión en el periodo de la «Anarquía», intervalo entre dos dictaduras caracterizado por el enfrentamiento             entre Santiago, antigua sede de la administración colonial y las provincias por la conducción en la construcción del Estado. En este artículo se pretende realizar una síntesis sobre dicho periodo basándonos en algunas de las más recientes investigaciones sobre el tema

Efectos de la motivación extrínseca sobre el rendimiento de saltos contínuos "CMJ" hasta la fatiga en sujetos sanos de 20 a 30 años

Tesis (Kinesiólogo)La motivación es considerada una herramienta importante en todo ámbito de la vida para la ejecución de diferentes actividades como el logro de metas a conseguir, ya sea en el ámbito laboral, desarrollo profesional, vida personal, social, entre otros. Tanto la motivación intrínseca y extrínseca son necesarias para cumplir algún propósito en particular. Es por aquello que el propósito de esta investigación fue evaluar el efecto de la motivación extrínseca sobre el rendimiento de saltos continuos (CMJ), la altura y tiempo de ejecución hasta la fatiga en sujetos sanos de 20 a 30 años. Se realizó un estudio de tipo comparativo, enfoque cuantitativo, alcance explicativo y diseño cuasi experimental. Se estudiaron a 42 sujetos sanos, físicamente activos entre 23,1 ± 3,1 de edad quienes fueron sometidos a dos evaluaciones bajo las condiciones de sin motivación extrínseca y con motivación extrínseca. Se realizó esta prueba mediante un salto llamado contra movimiento “CMJ” según protocolo de Bosco, el cual debieron realizar saltos continuos hasta la fatiga sobre una plataforma de salto DMJUMP, se realizaron mediciones pre y post intervención de las siguientes variables de percepción de esfuerzo (Escala de Borg), lactato en sangre, altura y tiempo de ejecución

Clinical implications of head trauma in frontotemporal dementia and primary progressive aphasia

BackgroundTraumatic brain injury (TBI) and repetitive head impacts (RHI) have been linked to increased risk for multiple types of neurodegenerative disease, higher dementia risk, and earlier age of dementia symptom onset, suggesting transdiagnostic implications for later-life brain health. Frontotemporal dementia (FTD) and primary progressive aphasia (PPA) represent a spectrum of clinical phenotypes that are neuropathologically diverse. FTD/PPA diagnoses bring unique challenges due to complex cognitive and behavioral symptoms that disproportionately present as an early-onset dementia (before age 65). We performed a detailed characterization of lifetime head trauma exposure in individuals with FTD and PPA compared to healthy controls to examine frequency of lifetime TBI and RHI and associated clinical implications.MethodsWe studied 132 FTD/PPA (age 68.9 ± 8.1, 65% male) and 132 sex-matched healthy controls (HC; age 73.4 ± 7.6). We compared rates of prior TBI and RHI (contact/collision sports) between FTD/PPA and HC (chi-square, logistic regression, analysis of variance). Within FTD/PPA, we evaluated associations with age of symptom onset (analysis of variance). Within behavioral variant FTD, we evaluated associations with cognitive function and neuropsychiatric symptoms (linear regression controlling for age, sex, and years of education).ResultsYears of participation were greater in FTD/PPA than HC for any contact/collision sport (8.5 ± 6.7yrs vs. 5.3 ± 4.5yrs, p = .008) and for American football (6.2yrs ± 4.3yrs vs. 3.1 ± 2.4yrs; p = .003). Within FTD/PPA, there were dose-dependent associations with earlier age of symptom onset for TBI (0 TBI: 62.1 ± 8.1, 1 TBI: 59.9 ± 6.9, 2 + TBI: 57.3 ± 8.4; p = .03) and years of American football (0yrs: 62.2 ± 8.7, 1-4yrs: 59.7 ± 7.0, 5 + yrs: 55.9 ± 6.3; p = .009). Within bvFTD, those who played American football had worse memory (z-score: -2.4 ± 1.2 vs. -1.4 ± 1.6, p = .02, d = 1.1).ConclusionsLifetime head trauma may represent a preventable environmental risk factor for FTD/PPA. Dose-dependent exposure to TBI or RHI influences FTD/PPA symptom onset and memory function in bvFTD. Clinico-pathological studies are needed to better understand the neuropathological correlates linking RHI or TBI to FTD/PPA onset and symptoms

The professionalism disconnect: Do entering residents identify yet participate in unprofessional behaviors?

Background Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior. Methods Duke University Hospital and Vidant Medical Center/East Carolina University surveyed entering PGY1 residents. Residents were queried on two issues: their perception of the professionalism of 46 specific behaviors related to training and patient care; and their own participation in those specified behaviors. The study reports data analyses for gender and institution based upon survey results in 2009 and 2010. The study received approval by the Institutional Review Boards of both institutions. Results 76% (375) of 495 PGY1 residents surveyed in 2009 and 2010 responded. A majority of responders rated all 46 specified behaviors as unprofessional, and a majority had either observed or participated in each behavior. For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional. Men were more likely than women to have participated in behaviors. There were several significant differences in both the perceptions of specified behaviors and in self-reported observation of and/or involvement in those behaviors between institutions. Respondents indicated the most important professionalism issues relevant to medical practice include: respect for colleagues/patients, relationships with pharmaceutical companies, balancing home/work life, and admitting mistakes. They reported that professionalism can best be assessed by peers, patients, observation of non-medical work and timeliness/detail of paperwork. Conclusion Defining professionalism in measurable terms is a challenge yet critical in order for it to be taught and assessed. Recognition of the differences by gender and institution should allow for tailored teaching and assessment of professionalism so that it is most meaningful. A shared understanding of what constitutes professional behavior is an important first step

The concept of mental toughness: Tests of dimensionality, nomological network and traitness

Mental toughness has received increased scholarly attention in recent years, yet conceptual issues related to its (a) dimensionality, (b) nomological network, and (c) traitness remain unresolved. The series of studies reported in this article were designed to examine these three substantive issues across several achievement contexts, including sport, education, military, and the workplace. Five studies were conducted to examine these research aims—Study 1: N = 30; Study 2: calibration sample (n = 418), tertiary students (n = 500), athletes (n = 427), and employees (n = 550); Study 3: N = 497 employees; Study 4: N = 203 tertiary students; Study 5: N = 115 army candidates. Collectively, the results of these studies revealed that mental toughness may be best conceptualized as a unidimensional rather than a multidimensional concept; plays an important role in performance, goal progress, and thriving despite stress; and can vary and have enduring properties across situations and time. This series of studies provides a foundation for further basic and applied research of mental toughness across various achievement contexts

The Use of Sideline Video Review to Facilitate Management Decisions Following Head Trauma in Super Rugby

Background Sideline video review has been increasingly used to evaluate risk of concussive injury during match play of a number of collision sports, with the view to reducing the incidence of match play concussion injuries. The purpose of this study was to evaluate the effectiveness of sideline video review for identifying and evaluating head impact events in Rugby Union. Methods All Australian teams’ 2015 Super Rugby season matches were studied. Meaningful head impact events (HIEs) were identified, comprising events identified and acted upon during matches and events identified through a post-season retrospective review. Video footage of each HIE was coded by two experienced independent sports medicine clinicians to evaluate management decisions made by match-day (MDD) and team doctors (TD). HIE incidences for matches with and without sideline video were compared, and the agreement between game-day video interpretation and the independent clinician opinion calculated. Results Seventy HIEs were identified in 83 matches (47 identified during matches and 23 identified post-season), equating to 42.5 HIEs per 1000 player match hours. When video review was available, an unnoticed HIE occurred once every 4.3 matches, compared to once every 2.3 matches when the sideline video review was unavailable. Of the 47 identified in-match HIEs evaluated by TD and MDD during the season, 18 resulted in an immediate and permanent removal, 28 resulted in temporary removal for an off-field assessment, and one resulted in the player continuing the game. Game-day head injury assessment process video decisions agreed with the independent clinician view in 72% of cases, κ = 0.49 (95% CI 0.38–0.59, weak agreement). Conclusions These findings suggest that access to sideline video review is an important supplementary component to identify potential concussions; however, there is a critical need for improved systems and processes to reduce the likelihood of missing an incident

Relationship Between the King-Devick Test and Commonly Used Concussion Tests at Baseline

Context: Comprehensive assessments are recommended to evaluate sport-related concussion (SRC). The degree to which the King-Devick (KD) test adds novel information to an SRC evaluation is unknown. Objective: To describe relationships at baseline among the KD and other SRC assessments and explore whether the KD provides unique information to a multimodal baseline concussion assessment. Design: Cross-sectional study. Setting: Five National Collegiate Athletic Association institutions participating in the Concussion Assessment, Research and Education (CARE) Consortium. Patients or other participants: National Collegiate Athletic Association student-athletes (N = 2258, age = 20 ± 1.5 years, 53.0% male, 68.9% white) in 11 men's and 13 women's sports. Main outcome measure(s): Participants completed baseline assessments on the KD and (1) the Symptom Inventory of the Sport Concussion Assessment Tool-3rd edition, (2) the Brief Symptom Inventory-18, (3) the Balance Error Scoring System, (4) the Standardized Assessment of Concussion (SAC), (5) the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test battery, and (6) the Vestibular/Ocular Motor Screening tool during their first year in CARE. Correlation coefficients between the KD and the 6 other concussion assessments in isolation were determined. Assessments with ρ magnitude >0.1 were included in a multivariate linear regression analysis to evaluate their relative association with the KD. Results: Scores for SAC concentration, ImPACT visual motor speed, and ImPACT reaction time were correlated with the KD (ρ = -0.216, -0.276, and 0.164, respectively) and were thus included in the regression model, which explained 16.8% of the variance in baseline KD time (P < .001, Cohen f2 = 0.20). Better SAC concentration score (β = -.174, P < .001), ImPACT visual motor speed (β = -.205, P < .001), and ImPACT reaction time (β = .056, P = .020) were associated with faster baseline KD performance, but the effect sizes were small. Conclusions: Better performance on cognitive measures involving concentration, visual motor speed, and reaction time was weakly associated with better baseline KD performance. Symptoms, psychological distress, balance, and vestibular-oculomotor provocation were unrelated to KD performance at baseline. The findings indicate limited overlap at baseline among the CARE SRC assessments and the KD

Participation in environmental enhancement and conservation activities for health and well-being in adults: a review of quantitative and qualitative evidence

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