Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

2000 Seat Belt Usage Survey, September 13, 2001

The good news is that safety belt usage on municipal road systems (city streets) increased 1.07 percent. This is encouraging since more than 45 percent of all motor vehicle crashes occur on city streets, and usage on the municipal road system has consistently been the lowest of the road systems studied. In communities where usage is good, enforcement and public education must be maintained in order to improve usage further; in communities where usage is still low, enforcement and public education must both be increased. Usage on the primary system (U.S. or state highways) rose 1.01 percent from the previous year. This is also welcome news because almost half of all fatalities (49 percent) occur on the primary road system. There was a decline in interstate belt use (-1.45 percent). Despite this decrease interstate usage is still traditionally the highest of all roadway categories presumably because the longer trips, higher travel speeds and large number of vehicles cause drivers to assume there is greater risk.

2005 Seat Belt Usage Survey, June 12, 2006

During the spring and summer of 2005, two surveys were taken of motor vehicle drivers’ and passengers’ seat belt usage. These surveys are before and after parts of the “Click it or Ticket” education and enforcement campaign. The whole project starts with a pre-campaign survey followed by the four-week public information, education and enforcement campaign. Finally, the postcampaign survey is taken to test the effectiveness of the education and enforcement campaign. In the pre-campaign survey of seat belt usage, the usage/non-usage of 15,444 front seat occupants of cars, vans, SUVs and pickups were observed at 100 locations. In the post-campaign survey of seat belt usage, 15,731 observations were made of front seat occupants of cars, vans, SUVs and pickups. The day of the week and time of day the observations took place were selected for each site using a random number generation computer program.

2006 Seat Belt Usage Survey, April 28, 2011

Surveys were taken of motor vehicle drivers’ and passengers’ seat belt usage. These surveys are before and after parts of the “Click it or Ticket” education and enforcement campaign. The whole project starts with a pre-campaign survey followed by the four-week public information, education and enforcement campaign. Finally, the postcampaign survey is taken to test the effectiveness of the education and enforcement campaign.

2007 Seat Belt Usage Survey, April 28, 2011

Surveys were taken of motor vehicle drivers’ and passengers’ seat belt usage. These surveys are before and after parts of the “Click it or Ticket” education and enforcement campaign. The whole project starts with a pre-campaign survey followed by the four-week public information, education and enforcement campaign. Finally, the postcampaign survey is taken to test the effectiveness of the education and enforcement campaign.

2008 Seat Belt Usage Survey, April 28, 2011

Surveys were taken of motor vehicle drivers’ and passengers’ seat belt usage. These surveys are before and after parts of the “Click it or Ticket” education and enforcement campaign. The whole project starts with a pre-campaign survey followed by the four-week public information, education and enforcement campaign. Finally, the postcampaign survey is taken to test the effectiveness of the education and enforcement campaign.

2010 Seat Belt Usage Survey, April 28, 2011

Surveys were taken of motor vehicle drivers’ and passengers’ seat belt usage. These surveys are before and after parts of the “Click it or Ticket” education and enforcement campaign. The whole project starts with a pre-campaign survey followed by the four-week public information, education and enforcement campaign. Finally, the postcampaign survey is taken to test the effectiveness of the education and enforcement campaign.

2009 Seat Belt Usage Survey, April 28, 2011

Surveys were taken of motor vehicle drivers’ and passengers’ seat belt usage. These surveys are before and after parts of the “Click it or Ticket” education and enforcement campaign. The whole project starts with a pre-campaign survey followed by the four-week public information, education and enforcement campaign. Finally, the postcampaign survey is taken to test the effectiveness of the education and enforcement campaign.

2011 Seat Belt Usage Survey, July 20, 2011

Surveys were taken of motor vehicle drivers’ and passengers’ seat belt usage. These surveys are before and after parts of the “Click it or Ticket” education and enforcement campaign. The whole project starts with a pre-campaign survey followed by the four-week public information, education and enforcement campaign. Finally, the postcampaign survey is taken to test the effectiveness of the education and enforcement campaign.

Older Adult Injury Risk Assessment in the Driving and Occupational Environments

Thesis (Ph.D.)--University of Washington, 2016-08

Traumatic abdominal wall hernia. Case report

Despite the high incidence of abdominal traumas, traumatic abdominal wall hernias (TAWHs) remain rare probably because of elasticity of the abdominal wall. The TAWH is due to blunt abdominal trauma with disruption of the abdominal wall muscles and fascia with intact overlying skin. TAWH can be classified into high energy injures (generally motor vehicle accidents) and low energy injures (impact on a small blunt object). Common example of the latter type is a fall onto a bicycle handlebar. The mechanism of the trauma includes sudden increase of intra-abdominal pressure and extensive shear forces applied to the abdominal wall. The diagnosis of TAWH is difficult in the Emergency Room because during the primary diagnostic process most attention is directed toward the detection of internal injures and TAWH can be missed. In this article we report a case of TAWH caused by a work accident (an heavy steel tube fallen onto the abdominal wall of the patient from a height of five meters) with delayed diagnosis.

Delayed presentation of blunt duodenal injuries in children. Case report and review of literature

Background. Duodenal injuries are rare in children and classically present following a fall over the handle bar. Retroperitoneal location of the duodenum may lead to delay in diagnosis, and missed injuries are associated with increased morbidity and mortality. Case report. A 5-year-old child was admitted to the National Trauma Center, in Tirana (Albania), 28 hours after a Motor Vehicle Crash (MVC), complaining of mild abdominal pain. He was febrile (39°C) and had a white blood cells count of 18,000 mm3. On physical exam he had mild tenderness. Plain abdominal X-rays and Focused Abdominal Sonography for Trauma (FAST) were negative for free air or free fluid. The CT scan of the abdomen demonstrated free air and fluid in the retroperitoneal space. At laparatomy, a perforation of the second portion of the duodenum was found. A single layer suture repair of the duodenum with wide drainage was performed. The patient was discharged from the hospital tolerating oral feeding 8 days later. Conclusion. Duodenal injuries in children are rare. Most duodenal hematomas are managed non-operatively. This is a case of MCV with delayed presentation that was treated surgically for perforation successfully.

Factores asociados al desplazamiento activo en bicicleta al colegio en el Distrito Bogotá, Colombia. Estudio FUPRECOL

Introducción: El transporte activo (TA) puede ser una oportunidad para incrementar los niveles de actividad física diarios de los niños y adolescentes, además de destacarse como una estrategia práctica, accesible y sostenible a largo plazo. Objetivos: El objetivo del presente estudio es doble: Analizar los patrones de desplazamiento activo en bicicleta al y desde el centro educativo, y b) Identificar los factores asociados al uso de la bicicleta como TA; en una muestra de niños y jóvenes pertenecientes a escuelas oficiales de Bogotá, Colombia. Material y métodos: Se trata de un sub-análisis del estudio FUPRECOL en 8060 niños y adolescentes entre los 9-17 años de edad). El modo de desplazamiento del escolar fue determinado a través de la pregunta: “¿Durante los últimos 7 días, usaste bicicleta para ir al colegio/escuela y volver a la casa?. Dicha respuesta se categorizó en activos “Si” (si se desplazan en bicicleta) y pasivos “No” (si se desplazan en vehículo motorizado). Se midieron parámetros antropométricos de peso, talla y perímetro de cintura. El máximo nivel de estudios alcanzados por la madre/padre (no reporta, primaria o secundaria/técnico o tecnólogo/universitario o postgrado) y la composición del hogar (vive con padre/vive con madre/con ambos padres/con abuelos/otros familiares) se auto-reportó por los padres. Las relaciones entre el TA y los factores anteriormente descritos se analizaron mediante regresión logística binaria. Resultados: El 21,9% del total de la muestra reporta usar la bicicleta como medio de transporte y el 7,9% acumula más de 120 minutos al día. Se observó una mayor probabilidad de usar la bicicleta como medio de desplazamiento activo a la escuela en los varones, en los jóvenes entre 9 y 12 años, y en aquellos cuyo padre/madre reportaron mayor grado académico, es decir, “universitario/postgrado”. 3 Conclusión: Los hallazgos del presente estudio sugieren que es necesario promover el TA desde la niñez, poniendo mayor énfasis en el paso a la adolescencia y en las jóvenes, para así aumentar los niveles diarios de AF de estos.

FAST-E en Pacientes con Trauma Abdominal Cerrado Estable, en un Departamento de Urgencias en Colombia

El impacto que ha generado el trauma en Colombia a lo largo de la historia, nos ha obligado a mejorar y adaptar diferentes tipos de sistemas de atención en trauma, basados en los lineamientos internacionales, los cuales buscan evitar el significativo aumento en las tasas de mortalidad y discapacidad que se obtienen de este, especialmente en los servicios de Emergencias en los cuales se reciben el 100% de estos pacientes con traumatismo múltiple o politraumatismo. Dentro de este grupo de pacientes hay un subgrupo que son las pacientes con trauma de abdomen que cursan con estabilidad hemodinámica y además son clasificados de bajo riesgo, ya sea por índices de trauma o por otros métodos como la medición sérica de lactato, los cuales tienen un papel poco despreciable al momento de ver mortalidad y discapacidad por trauma, ya sea penetrante o cerrado; en este trabajo específicamente nos centramos en las personas que consultan al servicio de Emergencias con trauma cerrado de abdomen los cuales son considerados de bajo riesgo, siendo este subgrupo de pacientes uno de los más difíciles de abordar y enfocar al momento de la valoración inicial, ya que se debe tener la seguridad de que no hay lesiones que comprometen la vida y por consiguiente estos pacientes puedan ser dados de alta.

La construcción de sentido (‘sensemaking’) de un entorno estratégico turbulento por parte de los altos directivos: un estudio en una multinacional automotriz

Este artículo presenta los resultados de una investigación realizada al interior de dos contextos. Por un lado, el teórico, en el marco de uno de los discursos más relevantes en los campos de la estrategia organizacional, de la managerial and organizational cognition (MOC) y, en general, de los estudios organizacionales (organization studies): la construcción de sentido (sensemaking). Por el otro, el empírico, en una de las grandes compañías multinacionales del sector automotriz con presencia global. Esta corporación enfrenta una permanente tensión entre lo que dicta la casa matriz, en relación con el cumplimiento de metas y estándares específicos, considerando el mundo entero, y los retos que, teniendo en cuenta lo regional y lo local, experimentan los altos directivos encargados de hacer prosperar la empresa en estos lugares. La aproximación implementada fue cualitativa. Esto en atención a la naturaleza de la problemática abordada y la tradición del campo. Los resultados permiten ampliar el actual nivel de comprensión acerca de los procesos de sensemaking de los altos directivos al enfrentar un entorno estratégico turbulento.