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Empathy is a complex cognitive and affective process that allows humans to experience concern for others, comprehend their emotions, and eventually help them. In addition to studies with healthy subjects and various neuropsychiatric populations, a few reports have examined this domain focusing on mental health workers, whose daily work requires the development of a saliently empathic character. Building on this research line, the present population-based study aimed to (a) assess different dimensions of empathy for pain in mental health workers relative to general-physicians and non-medical workers; and (b) evaluate their relationship with relevant factors, such as moral profile, age, gender, years of experience, and workplace type. Relative to both control groups, mental health workers exhibited higher empathic concern and discomfort for others' suffering, and they favored harsher punishment to harmful actions. Furthermore, this was the only group in which empathy variability was explained by moral judgments, years of experience, and workplace type. Taken together, these results indicate that empathy is continuously at stake in mental health care scenarios, as it can be affected by contextual factors and social contingencies. More generally, they highlight the importance of studying this domain in populations characterized by extreme empathic demands. Fil: Santamaria Garcia, Hernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: García, Adolfo Martín. Instituto de Neurología Cognitiva. Laboratorio de Psicología Experimental y Neurociencia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad Nacional de Cuyo. Facultad de Educación Elemental y Especial; Argentina Fil: Flichtentrei, Daniel. Intramed; Argentina Fil: Prats, Lucía María. Intramed; Argentina. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; Argentina Fil: Mastandueno, Ricardo. Intramed; Argentina Fil: Sigman, Mariano. Universidad Torcuato di Tella; Argentina Fil: Matallana, Diana. Pontificia Universidad Javeriana; Colombia Fil: Cetkovich Bakmas, Marcelo Gustavo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Ibanez Barassi, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina

Research on sex differences in empathy has revealed mixed findings. Whereas experimental and neuropsychological measures show no consistent sex effect, self-report data consistently indicates greater empathy in women. However, available results mainly come from separate populations with relatively small samples, which may inflate effect sizes and hinder comparability between both empirical corpora. To elucidate the issue, we conducted two large-scale studies. First, we examined whether sex differences emerge in a large population-based sample (n = 10,802) when empathy is measured with an experimental empathy-for-pain paradigm. Moreover, we investigated the relationship between empathy and moral judgment. In the second study, a subsample (n = 334) completed a self-report empathy questionnaire. Results showed some sex differences in the experimental paradigm, but with minuscule effect sizes. Conversely, women did portray themselves as more empathic through self-reports. In addition, utilitarian responses to moral dilemmas were less frequent in women, although these differences also had small effect sizes. These findings suggest that sex differences in empathy are highly driven by the assessment measure. In particular, self-reports may induce biases leading individuals to assume gender-role stereotypes. Awareness of the role of measurement instruments in this field may hone our understanding of the links between empathy, sex differences, and gender roles. Fil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad de los Andes; Colombia Fil: Flichtentrei, Daniel. IntraMed; Argentina Fil: Prats, María. IntraMed; Argentina Fil: Mastandueno, Ricardo. IntraMed; Argentina Fil: García, Adolfo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad Nacional de Cuyo. Facultad de Educación Elemental y Especial; Argentina Fil: Cetkovich, Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Ibáñez Barassi, Agustín Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad Adolfo Ibañez; Chile. Australian Research Council ; Australia

It is estimated that 60% of all people living with dementia today reside in low and middle-income countries, like those in Latin America, and this proportion is expected to increase (WHO, 2015). In some of these countries, providing an accurate diagnosis of dementia and achieving effective care remainsasaseriousissue.Inourregion,thedivision of public and private health systems often determines the quality and promptness of diagnoses (Nitrini et al., 2009) and the subject level of care. This study is a descriptive and cross-sectional study aimed at investigating physicians? knowledge related to dementia in Latin America. Participants were medical doctors recruited by a banner ad on the home page of the IntraMed web site (the largest online Spanish speaking medical community) that invited them to voluntarily access an online questionnaire regarding dementia care. All statistical analyses were conducted using the IBM-SPSS 19.0 package. The survey was answered by 5119 physicians (representing 15.4% of the subjects exposed to the banner), whose mean age was 46 years (SD 12.45). The subjects were grouped in three different categories: specialists (neurologists, psychiatrists, and geriatricians), generalists (general practitioners, family physicians, and internal medicine specialists), and others. 33 Fil: Richly, Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Instituto de Neurología Cognitiva. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Fundación Favaloro. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt; Argentina Fil: Lopez, Pablo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Instituto de Neurología Cognitiva. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Fundación Favaloro. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Prats, Maria. IntraMed; Argentina Fil: Mastadueno, Ricardo. IntraMed; Argentina Fil: Bustin, Julián. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Instituto de Neurología Cognitiva. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Fundación Favaloro. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Gonzalez, Macarena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Instituto de Neurología Cognitiva. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Fundación Favaloro. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt; Argentina Fil: Flichtentrei, Daniel. IntraMed; Argentina Fil: Manes, Facundo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Instituto de Neurología Cognitiva. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Fundación Favaloro. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt; Argentina Fil: Oneill, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Instituto de Neurología Cognitiva. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt | Fundación Favaloro. Instituto de Neurociencia Cognitiva y Traslacional. Fundación Ineco Rosario Sede del Incyt; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina

Diagnosis of behavioral variant frontotemporal dementia (bvFTD) can be especially challenging during the early stages for several reasons, including the fact that (a) behavioral disturbances in bvFTD can mimic the symptomatic profile of psychiatric disorders; (b) neuropsychological performance may be relatively spared; and (c) changes in structural neuroimaging may go undetected. Most frequently, bvFTD is not included as part of medical or residency training outside the field of cognitive neurology. The present study aimed at examining bvFTD-related practices concerning academic and professional training, diagnosis, and treatment across Latin America. We surveyed the academic and professional aspects of clinical practice related to bvFTD of 596 physicians from different fields throughout the continent. We discuss several aspects concerning Latin American physicians' training on dementia and bvFTD, the way in which they approach the differential diagnosis of bvFTD, and their most frequent strategies for the treatment of this condition. We conclude that information about bvFTD deserves more attention in both undergraduate and postgraduate medical education in Latin America, and that understanding clinical practices related to FTD can help design more efficient training programs for physicians in this and other world regions.

Burnout syndrome is related to cultural and individual factors. The aim of this study was to compare the frequency of burnout and the scores for its three components with the perceptions and the demographic and professional characteristics of the workers. Methods: Burnout syndrome was studied in 11,530 Hispanic Americans and Spanish healthcare professionals (51% male, mean age 41.7 years). The Maslach Burnout Inventory and a previously drawn up questionnaire were administered online from the Intramed website from December 2006 to September 2007. Associations were tested using multiple logistic regression. Results: The frequency of burnout in professionals resident in Spain was 14.9%, in Argentina 14.4%, and in Uruguay 7.9% whereas professionals in Mexico, Ecuador, Peru, Columbia, Uruguay, Guatemala and El Salvador presented frequencies of burnout of between 2.5% and 5.9%. By professions, doctors had a prevalence of burnout of 12.1%, nurses 7.2%, and dentists, psychologists and nutritionists of

Background: The question of whether or not to allow family to be present during resuscitation is relevant to everyday professional health care assistance, but it remains largely unexplored in the medical literature. Objectives: We conducted an online survey with the aim of increasing our knowledge and understanding of this issue. Methods: This is a cross-sectional, multicenter, descriptive, national, and international study using a webbased, voluntary survey. The survey was designed and distributed through a medical website in Spanish, targeting physicians who frequently deal with critical patients. Results: A total of 1,286 Argentine physicians and 1,848 physicians from other countries responded to this voluntary survey. Of Argentine respondents, 15.8% (203) treat only children, 68.2% (877) treat adults, and 16% (206) treat patients of any age. The survey found that 23% (296) of Argentine and 20% of other respondents favor the presence of family members during cardiopulmonary resuscitation (p = 0.03). This practice was more common among physicians treating pediatric and neonatal patients than among those who treat adults. The most commonly reported reason (21.8%) for avoiding the presence of relatives was concerns that physicians, communications, and medical practices might be misunderstood or misinterpreted. Conclusions: Avoiding relatives’ presence while performing cardiopulmonary resuscitation is the most frequent choice made by the surveyed physicians who treat critical Argentine patients. The main causes for discouraging family presence during cardiopulmonary resuscitation or other critical procedures include the following: risk of misinterpretation of the physician’s actions and/or words; risk of a relative’s decompensation; uncertainty about possible reactions; and interpretation of the relative’s presence as negative. Highlights Relatives’ presence during CPR has been recommended. Around only 20% of the Spanish-speaking physicians offer for the family to be present during CPR. Pediatricians and neonatologists offer family presence more often than physicians taking care of adult patients do.

Determine the frequency of assaults on health workers and characterize aspects that deepen understanding and development of prevention strategies.A voluntary and confidential electronic survey was conducted through the IntraMed website, a social network of health professionals. Frequency of verbal and physical assaults was analyzed along with their association with demographic variables, occupation, career, specialty, potential consequences, perception of insecurity in the workplace, and proposals to reduce them.A total of 19 967 surveys were analyzed, of which 13 323 (66.7%) described assaults. Assaults were physical in 11.3% of cases, and 73.4% occurred in public institutions, mainly in emergency areas. Delay in care and lack of resources were the most frequent triggers. Alcohol or drug intoxication was reported in 13.8% of aggressors, altered mental status from another cause or psychiatric illness in 13.9%, and no detected impairment of mental faculties in 63%. Of professionals attacked, 16.9% reported sequelae, 7.9% of which were physical, and 28% were temporarily unable to work. Insecurity in the workplace was described by 46.6% of respondents, who suggested various measures to reduce it, chief among them, community educationVerbal and physical violence toward health workers was frequent, resulting in work-related, mental, and even physical sequelae. This study contributes information that could be used to develop strategies aimed at prevention and control of assaults.

espanolPara ejercer apropiadamente a lo largo de su vida profesional, los medicos han de involucrarse en alguna forma de educacion continua. La educacion medica continua no se limita a la educacion formal desarrollada mediante tal o cual metodo educativo, sino que comprende experiencias de muy diversa indole, formales e informales, tales como los encuentros con colegas, el autoaprendizaje y la educacion a distancia. El proposito de esta publicacion es presentar los resultados obtenidos al explorar las estrategias y recursos mas frecuentemente utilizados por los profesionales medicos para mantenerse actualizados. Se implemento una encuesta electronica de cinco preguntas cerradas con varias opciones de respuesta. Las preguntas indagaban sobre: lugar de trabajo, frecuencia con la que experimenta ‘necesidad’ de actualizar sus conocimientos, modalidades y recursos utilizados. Se obtuvieron 9.851 respuestas. Las modalidades mas frecuentemente mencionadas fueron asistencia a cursos presenciales, a congresos y seminarios, y participacion en actividades hospitalarias. Las revistas publicadas por sociedades cientificas y las guias clinicas son las fuentes de informacion senaladas con mayor frecuencia. Los recursos disponibles en Internet fueron mencionados por menos del 20% de los profesionales que respondieron. Se encontraron algunas diferencias entre las modalidades y recursos que utilizan los medicos que trabajan solo en su consulta y los que atienden en un hospital. EnglishTo properly exercise throughout his professional life, doctors have to engage in some form of continuing education. Continuing medical education is not limited to formal education, includes very diverse experiences, formal and informal such as meetings with colleagues, self-learning and distance education. The purpose of this paper is to present the results to explore strategies and resources used by medical professionals to keep up to date. Implemented an electronic survey of 5 questions with several response options; explored questions about: workplace, frequency experiences ‘need’ to update their medical knowledge, methods and resources used more frequently. 9.851 answers were obtained. The most frequently mentioned modalities were assistance to courses, conferences and seminars and participating in activities in the hospital. Journals published by scientific societies and clinical guidelines are information sources referred to most frequently. The resources available on the internet were mentioned by less than 20% of the professionals who responded. There are some differences between the methods and resources used by doctors who work only in their offices and those who attend at hospital.

AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication. METHODS: This was a descriptive, cross sectional study that surveyed Latin-American physicians to evaluate differences between groups divided in three main sections. The first section included demographic and professional data. The second section asked about the available medical resources: weighing scales, sphygmomanometer and measuring tape. Finally, the third section aimed at looking into the attitudes towards cardiovascular prevention. The latter was also divided into two subsections. In the first one, the questions were about weight, blood pressure and waist perimeter. In the second subsection the questions asked about the proportion of patients: (1) that suffered from overweight and/or obesity; (2) whose lipids and glycemia were controlled by the physician; (3) that were questioned by, and received information from the physician about smoking; and (4) that received recommendations from the physician to engage in regular physical activity. The participants were physicians, users of the medical website Intramed. The visitors were recruited by a banner that invited them to voluntarily access an online self-reported structured questionnaire with multiple options. RESULTS: We surveyed 1185 general physicians and 792 psychiatrists. Regarding basic medical resources, a significantly higher proportion of general physicians claimed to have weighing scales (χ2 = 404.9; P < 0.001), sphygmomanometers (χ2 = 419.3; P < 0.001), and measuring tapes (χ2 = 336.5; P < 0.001). While general physicians measured overweight and metabolic indexes in the general population in a higher proportion than in patients treated with antipsychotics (Z = -11.91; P < 0.001), psychiatrists claimed to measure them in patients medicated with antipsychotics in a higher proportion than in the general population (Z = -3.26; P < 0.001). Also general physicians tended to evaluate smoking habits in the general population more than psychiatrists (Z = -7.02; P < 0.001), but psychiatrists evaluated smoking habits in patients medicated with antipsychotics more than general physicians did (Z = -2.25; P = 0.024). General physicians showed a significantly higher tendency to control blood pressure (χ2 = 334.987; P < 0.001), weight (χ2 = 435.636; P < 0.001) and waist perimeter (χ2 = 96.52; P < 0.001) themselves and they did so in all patients. General physicians suggested physical activity to all patients more frequently (Z = -2.23; P = 0.026), but psychiatrists recommended physical activity to patients medicated with antipsychotics more frequently (Z = -7.53; P < 0.001). CONCLUSION: Psychiatrists usually check vascular risk factors in their patients, especially in those taking antipsychotics. General practitioners check them routinely without paying special attention to this population.

The medical record is a key component in the modern health systems, a fundamental basis of higher functionalities that guaranties quality care and the possibility of improved clinical management. The dissemination of information systems for the electronic medical record (EMR) has a growing acceptance and use in developed countries. This type of recognition however has not been widespread in Latin America. Realizing this we conducted a web survey to users of a Latin American medical portal to assess their perception of the EMRs usefulness. Among the results we found that over 90% of respondents were in favor of its use, with values that exceed 80% in the analysis of the utilities by categories. More in-depth studies are needed to determine the reasons for the lack of dissemination and implementation of EMR in our region.

Burnout syndrome is related to cultural and individual factors. The aim of this study was to compare the frequency of burnout and the scores for its three components with the perceptions and the demographic and professional characteristics of the workers.Burnout syndrome was studied in 11,530 Hispanic Americans and Spanish healthcare professionals (51% male, mean age 41.7 years). The Maslach Burnout Inventory and a previously drawn up questionnaire were administered online from the Intramed website from December 2006 to September 2007. Associations were tested using multiple logistic regression.The frequency of burnout in professionals resident in Spain was 14.9%, in Argentina 14.4%, and in Uruguay 7.9% whereas professionals in Mexico, Ecuador, Peru, Columbia, Uruguay, Guatemala and El Salvador presented frequencies of burnout of between 2.5% and 5.9%. By professions, doctors had a prevalence of burnout of 12.1%, nurses 7.2%, and dentists, psychologists and nutritionists of6%. Amongst doctors, burnout predominated amongst doctors working in emergency departments (17%) and internal medicine departments (15.5%) whereas anaesthetists and dermatologists had the lowest prevalence (5% and 5.3%, respectively). Older age (OR=0.96), having children (OR=0.93), the perception of feeling valued (OR=0.53), optimism (OR=0.80), job satisfaction (OR=0.80), and satisfaction with salary (OR=0.91) are variables which protect against burnout.The expression of burnout varies among nations and professions. Age (older age), having children, the perception of feeling valued, optimism, job satisfaction and satisfaction with salary are protective variables of burnout.

a b s t r a c t Objectives: Identify the frequency and intensity of the perception of adverse professional consequences and their association with burnout syndrome and occupational variables. Methods: Cross-sectional sample of 11,530 healthcare professionals resident in Spain and Latin America. The association of negative work-related consequences on burnout, as measured by the MBI and work- related variables was analysed by multiple logistic regression. Results: The emotional exhaustion was the first variable associated with absenteeism, with intention of giving up profession, personal deterioration, and family deterioration. Depersonalization was most associated with the perception of having made mistakes. Conclusions: The findings indicate a considerable prevalence of adverse work-related consequences. © 2014 The Authors. Published by Elsevier GmbH. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

OBJETIVO: Determinar la frecuencia de agresiones al personal sanitario en una red social de profesionales de la salud y caracterizar aspectos que profundicen su comprensión y el desarrollo de estrategias de prevención. MÉTODOS: Se realizó una encuesta electrónica voluntaria y confidencial a través del sitio web IntraMed. Se analizó la frecuencia de agresiones verbales y físicas y su asociación con variables demográficas, ocupación, carrera, especialidad, eventuales consecuencias, percepción de inseguridad en el lugar de trabajo y propuestas para reducirla. RESULTADOS: Se analizaron 19 967 encuestas. En 13 323 (66,7%), se refirieron agresiones. El 11,3% de las agresiones fueron físicas. El 73,4% ocurrieron en instituciones públicas, principalmente en áreas de emergencia. Los desencadenantes más frecuentes fueron la demora en la atención y la carencia de recursos. Se informó, en los agresores, intoxicación por alcohol o drogas en 13,8%, estado mental alterado por otra causa o enfermedad psiquiátrica en 13,9%, y en 63% no se detectó alteración de las facultades mentales. En 16,9% de los casos se informaron secuelas en los profesionales agredidos, en 7,9% secuelas físicas y en 28% de los lesionados suspensión temporaria de la actividad laboral. En 46,6% se refirió inseguridad en el lugar de trabajo y se sugirieron diversas medidas para reducirla, entre las que se destacó la educación comunitaria. CONCLUSIONES: La violencia verbal o física hacia el personal de la salud resultó frecuente, con la consecuencia de secuelas laborales, psíquicas e incluso físicas. La información aportada por este estudio podría utilizarse para desarrollar estrategias orientadas a su prevención y control.