Somatisation in primary care: experiences of primary care physicians involved in a training program and in a randomised controlled trial

Background: A new intervention aimed at managing patients with medically unexplained symptoms (MUS) based on a specific set of communication techniques was developed, and tested in a cluster randomised clinical trial. Due to the modest results obtained and in order to improve our intervention we need to know the GPs' attitudes towards patients with MUS, their experience, expectations and the utility of the communication techniques we proposed and the feasibility of implementing them. Physicians who took part in 2 different training programs and in a randomised controlled trial (RCT) for patients with MUS were questioned to ascertain the reasons for the doctors' participation in the trial and the attitudes, experiences and expectations of GPs about the intervention. Methods: A qualitative study based on four focus groups with GPs who took part in a RCT. A content analysis was carried out. Results: Following the RCT patients are perceived as true suffering persons, and the relationship with them has improved in GPs of both groups. GPs mostly valued the fact that it is highly structured, that it made possible a more comfortable relationship and that it could be applied to a broad spectrum of patients with psychosocial problems. Nevertheless, all participants consider that change in patients is necessary; GPs in the intervention group remarked that that is extremely difficult to achieve. Conclusion: GPs positively evaluate the communication techniques and the interventions that help in understanding patient suffering, and express the enormous difficulties in handling change in patients. These findings provide information on the direction in which efforts for improving intervention should be directed.

Effects of 12 weeks muscle hipetrophy training program in a young male athlete: stydy case

PURPOSE: The main goals of the present study were: 1) to review some recommendations about how to increase lean body mass; 2) to analyse whether following scientific sources of current recommendations, visible changes can be shown or not in a participant (body composition, strength and blood analyses). METHODS: One male athlete completed 12 weeks of resistance training program and following a diet protocol. Some test were determined such as, strength 6RM, blood analyses, skindfold measurements, body perimeters and impedance test. Body composition measurements were taken 3 times during the program (before-T1, after 6 weeks of intervention period-T2 and at the end of the program-T3). On the other hand, strength tests and blood analyses were performed twice (before and after the program). RESULTS: Strength was increased in general; blood analyses showed that Creatine kinase was increased a 104% and Triglycerides level was decreased a 22.5%; in the impedance test, body mass (1.6%), lean body mass (3.5%) and Body mass index (1.7%) were increased, whereas fat mass was decreased (15.5%); relaxed and contracted biceps perimeters were also increased. CONCLUSION: A muscle hypertrophy training program mixed with an appropriate diet during 12 weeks leads to interesting adaptations related to increase in body weight, lean body mass, biceps perimeters, strength and creatine kinase levels, and a decrease in fat mass.

A short training program improves the accuracy of portion-size estimates in future dietitians

[EN] The objective of this study was to determine whether a short training program, using real foods, would decreased their portion-size estimation errors after training. 90 student volunteers (20.18±0.44 y old) of the University of the Basque Country (Spain) were trained in observational techniques and tested in food-weight estimation during and after a 3-hour training period. The program included 57 commonly consumed foods that represent a variety of forms (125 different shapes). Estimates of food weight were compared with actual weights. Effectiveness of training was determined by examining change in the absolute percentage error for all observers and over all foods over time. Data were analyzed using SPSS vs. 13.0. The portion-size errors decreased after training for most of the foods. Additionally, the accuracy of their estimates clearly varies by food group and forms. Amorphous was the food type estimated least accurately both before and after training. Our findings suggest that future dietitians can be trained to estimate quantities by direct observation across a wide range of foods. However this training may have been too brief for participants to fully assimilate the application.

Integrated treatment of first episode psychosis with online training (e-learning): study protocol for a randomised controlled trial

Background: The integrated treatment of first episode psychosis has been shown to improve functionality and negative symptoms in previous studies. In this paper, we describe a study of integrated treatment (individual psychoeducation complementary to pharmacotherapy) versus treatment as usual, comparing results at baseline with those at 6-month re-assessment (at the end of the study) for these patients, and online training of professionals to provide this complementary treatment, with the following objectives: 1) to compare the efficacy of individual psychoeducation as add-on treatment versus treatment as usual in improving psychotic and mood symptoms; 2) to compare adherence to medication, functioning, insight, social response, quality of life, and brain-derived neurotrophic factor, between both groups; and 3) to analyse the efficacy of online training of psychotherapists. Methods/design: This is a single-blind randomised clinical trial including patients with first episode psychosis from hospitals across Spain, randomly assigned to either a control group with pharmacotherapy and regular sessions with their psychiatrist (treatment as usual) or an intervention group with integrated care including treatment as usual plus a psychoeducational intervention (14 sessions). Training for professionals involved at each participating centre was provided by the coordinating centre (University Hospital of Alava) through video conferences. Patients are evaluated with an extensive battery of tests assessing clinical and sociodemographic characteristics (Positive and Negative Syndrome Scale, State-Trait Anxiety Inventory, Liebowitz Social Anxiety Scale, Hamilton Rating Scale for Depression, Scale to Assess Unawareness of Mental Disorders, Strauss and Carpenter Prognostic Scale, Global Assessment of Functioning Scale, Morisky Green Adherence Scale, Functioning Assessment Short Test, World Health Organization Quality of Life instrument WHOQOL-BREF (an abbreviated version of the WHOQOL-100), and EuroQoL questionnaire), and brain-derived neurotrophic factor levels are measured in peripheral blood at baseline and at 6 months. The statistical analysis, including bivariate analysis, linear and logistic regression models, will be performed using SPSS. Discussion: This is an innovative study that includes the assessment of an integrated intervention for patients with first episode psychosis provided by professionals who are trained online, potentially making it possible to offer the intervention to more patients.

Assessment of faculty training program for the use of e-learning platforms: analysis of current use

5th International Conference on Education and New Learning Technologies (Barcelona, Spain. 1-3 July, 2013)

Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients

Fibromyalgia is a disabling syndrome. Results obtained with different therapies are very limited to date.The goal of this study was to verify whether the application of a mindfulnessbased training program was effective in modifying anger, anxiety, and depression levels in a group of women diagnosed with fibromyalgia. This study is an experimental trial that employed a waiting list control group. Measures were taken at three different times: pretest, posttest, and follow-up. The statistical analyses revealed a significant reduction of anger (trait) levels, internal expression of anger, state anxiety, and depression in the experimental group as compared to the control group, as well as a significant increase in internal control of anger. It can be concluded that the mindfulness-based treatment was effective after 7 weeks. These results were maintained 3 months after the end of the intervention.

Lanbide heziketako irakasleen prestakuntza konpetentziak garatzeko metodologietan: Ikaskuntza Agertoki Berriak esperientziaren azterketa

[EU]XX. mendearen azken bi hamarkadetatik hona jendartean gertatu diren aldaketek, Lanbide Heziketaren (lan merkatura bideratzeko langileen prestakuntza oinarri duen heziketaren epe gisara ulertuta) planteamendua birpentsatu beharra ekarri dute. Dinamikoa eta aldakorra den jendarte honetan, Lanbide Heziketari bere hezkuntza jardueraren gaineko gogoeta egin beharra suertatu zaio, eta baita zer eta nola irakatsi lanbidea garatzea helburu duten ikasleei bezalako galderei erantzuna eman ere. Ingurumari honetan konpetentzia kontzeptua eta haren inguruko esperientziak eta metodoak garatu dira hala nazioartean nola Euskal Herrian. Master Bukaerako lan honetan Lanbide Heziketan aurrera eraman den irakasleen etengabeko prestakuntza programa baten azterketa egin dugu. Horretarako, berrikuntza eta kalitatea sustatzeko zeregina duen Tknika zentroak zuzendu eta gidatutako Ikaskuntza Agertoki Berriak prestakuntza programan parte hartu duen Tolosaldeko Lanbide Institutua aukeratu dugu, kasu azterketaren ikuspegia erabiliz. Azken xedea, laburki, irakasleei konpetentzietan oinarritutako ikaskuntza aukera didaktikoak eskaini eta haiei buruzko gogoeta egitea da, gero praktikara eraman ditzaten. Gure ikerlanaren helburua, berriz, programa horren asmoak praktikan nola ebazten eta gauzatzen diren ikustea da, prozesuan engaiatuta dauden pertsonen bizipenetatik abiatuta. Hurbilketa kualitatibo eta interpretatibo honetatik lau irakasle elkarrizketatu ditugu eta haien igurikapen, kezka eta bestelakoak jasotzen saiatu gara. Ondorio nagusienak, honakoak: (i) konpetentzien bidezko irakaskuntza-ikaskuntzaren potentziala oso nabarmena dela ikusten dutela elkarrizketatuek, (ii) gogo eta motibazio handia dutela, (iii), ikastetxean, euren egunerokoan, zailtasun eta oztopo andana topatzen dutela, (iv) zailtasunak kasu batzuetan metodologia berari dagozkion arren beste askotan ikasleak eurek ez dutela aldaketarako borondate handirik atzematen da.