Programas, intervenciones y redes de apoyo a los cuidadores informales en salud. Necesidad de convergencia entre los programas formales y el apoyo informal

Hacerse cargo del cuidado de un familiar dependiente puede afectar negativamente a la salud del cuidador/a en su vida afectiva y laboral. Las repercusiones del cuidado informal preocupan a las diferentes administraciones y también a los profesionales sanitarios, quienes se proponen ofrecer el soporte más adecuado a los cuidadores familiares, para que puedan seguir desempeñando las actividades derivadas del cuidado y a su vez minimicen el cansancio y la carga que supone cuidar. Desde hace una década se ha venido acrecentando el interés por planificar y desarrollar programas de soporte, desde la iniciativa pública y privada, dirigidos a cuidadores familiares. Los contenidos de estos programas son de diversa índole, y ofrecen asesoramiento e información, apoyo emocional, ayuda económica o descargas temporales del cuidado de las personas dependientes. La literatura científica revisada coincide en la importancia y la necesidad de coordinación y complementariedad que debe darse entre las redes informales y formales en el soporte a los cuidadores de las personas dependientes.

La formación de habilidades terapéuticas en el psicólogo general sanitario: una propuesta basada en el aprendizaje experiencial

La adquisición de Habilidades Terapéuticas (HHTT) es esencial en la formaciónde los psicólogos clínicos y de otros profesionales de la salud (Bados y García,2011; Cunico, Sartori, Marongnolli y Meneghini, 2012). Consideramos que unabuena manera de adquirir y potenciar habilidades clínicas es a través de lapráctica dirigida en situaciones reales de aspectos personalmente significativos;es decir, lo que podríamos denominar “APRENDIZAJE EXPERIENCIAL”.Así, en lugar de practicar la Escucha activa o la Empatía con alguien que“simula” ser un paciente con depresión o que ha experimentado una experienciatraumática, pensamos que es mejor trabajar con las propias experiencias vitales.Es decir, realizando ejercicios dirigidos a mejorar la capacidad para escucharactivamente o entender a personas significativas (padres, hermanos, parejas,amigos, etc.) con las que se tienen dificultades reales de relación.En el ámbito universitario son escasas las experiencias didácticas de éste tipo(Saldaña, Bados, García-Grau, Balaguer y Fusté, 2009), por lo que apenas existen estudios que evalúen su eficacia.

Més de tres segles d"història: les exploracions florístiques al Cadí-Moixeró i muntanyes veïnes.

El 2003 es va publicar el catàleg de plantes vasculars del Parc del Cadí-Moixeró i les serres veïnes; poc després un de nosaltres en va presentar una síntesi en el número 3 d"aquesta revista. Al·ludíem aleshores a l"important bagatge tant d"exploracions científiques com de dades sobre la flora del territori existents en el moment de redactar el catàleg; de fet, gairebé tots els botànics catalans, i molts de francesos i d"espanyols, hi han passat en algun moment i han contribuït al coneixement de la seva flora.

Differential effects of two virtual reality interventions: distraction versus pain control

There is evidence that virtual reality (VR) pain distraction is effective at improving pain-related outcomes. However, more research is needed to investigate VR environments with other pain-related goals. The main aim of this study was to compare the differential effects of two VR environments on a set of pain-related and cognitive variables during a cold pressor experiment. One of these environments aimed to distract attention away from pain (VRD), whereas the other was designed to enhance pain control (VRC). Participants were 77 psychology students, who were randomly assigned to one of the following three conditions during the cold pressor experiment: (a) VRD, (b) VRC, or (c) Non-VR (control condition). Data were collected regarding both pain-related variables (intensity, tolerance, threshold, time perception, and pain sensitivity range) and cognitive variables (self-efficacy and catastrophizing). Results showed that in comparison with the control condition, the VRC intervention significantly increased pain tolerance, the pain sensitivity range, and the degree of time underestimation. It also increased self-efficacy in tolerating pain and led to a reduction in reported helplessness. The VRD intervention significantly increased the pain threshold and pain tolerance in comparison with the control condition, but it did not affect any of the cognitive variables. Overall, the intervention designed to enhance control seems to have a greater effect on the cognitive variables assessed. Although these results need to be replicated in further studies, the findings suggest that the VRC intervention has considerable potential in terms of increasing self-efficacy and modifying the negative thoughts that commonly accompany pain problems.

Some pneumococcal serotypes are more frequently associated with relapses of acute exacerbations in COPD patients

Objectives: To analyze the role of the capsular type in pneumococci causing relapse and reinfection episodes of acute exacerbation in COPD patients. Methods: A total of 79 patients with 116 recurrent episodes of acute exacerbations caused by S. pneumoniae were included into this study (1995–2010). A relapse episode was considered when two consecutive episodes were caused by the same strain (identical serotype and genotype); otherwise it was considered reinfection. Antimicrobial susceptibility testing (microdilution), serotyping (PCR, Quellung) and molecular typing (PFGE/MLST) were performed. Results: Among 116 recurrent episodes, 81 (69.8%) were reinfections, caused by the acquisition of a new pneumococcus,and 35 (30.2%) were relapses, caused by a pre-existing strain. Four serotypes (9V, 19F, 15A and 11A) caused the majority (60.0%) of relapses. When serotypes causing relapses and reinfection were compared, only two serotypes were associatedwith relapses: 9V (OR 8.0; 95% CI, 1.34–85.59) and 19F (OR 16.1; 95% CI, 1.84–767.20). Pneumococci isolated from relapses were more resistant to antimicrobials than those isolated from the reinfection episodes: penicillin (74.3% vs. 34.6%, p,0.001), ciprofloxacin (25.7% vs. 9.9%, p,0.027), levofloxacin (22.9% vs. 7.4%, p = 0.029), and co-trimoxazole (54.3% vs. 25.9%, p,0.001). Conclusions: Although the acquisition of a new S. pneumoniae strain was the most frequent cause of recurrences, a third ofthe recurrent episodes were caused by a pre-existing strain. These relapse episodes were mainly caused by serotypes 9V and 19F, suggesting an important role for capsular type