Efectividad de la intervención psicosocial en pacientes con enfermedad avanzada y final de vida

Objetivos: Demostrar la efectividad de la intervención psicosocial en la atención integral a personas con enfermedades avanzadas. Método: Se ha evaluado la presencia y evolución de parámetros psicológicos y espirituales de 8.964 pacientes, visitados por 117 profesionales de 29 equipos en un estudio de diseño cuasi-experimental, prospectivo, multcéntrico de un solo grupo pre-test post-test. Resultados: Los resultados muestran mejoras significativas en parámetros como ansiedad (RL 657,64; p<0,001), malestar emociona (RL 757,44; p<0,001), sentido de la vida (RL 248,30; p<0,001) y sentimientos de paz y perdón (RL 190,94; p<0,001). Conclusiones: El efecto positivo de la intervención psicosocial en la reducción de los parámetros psicológicos y espirituales evaluados sugiere que esta es eficaz en el contexto de la atención a personas con enfermedades avanzadas.

La influència de les dinàmiques de grup en la millora de la cohesió de grup i l’estabilitat emocional dels infants

En aquest estudi qualitatiu s’investiga la influència de les dinàmiques de grup en la millora de la cohesió de grup i l’estabilitat emocional dels infants. La mostra està constituïda per 24 infants, d’edats compreses entre els 5 i 6 anys, i per una mestra de 58 anys. Es realitza una intervenció educativa, basada en quatre dinàmiques de grup diferents, per tal d’avaluar la seva incidència en relació a la cohesió de grup i l’estabilitat emocional dels infants. Els instruments utilitzats són de naturalesa qualitativa, concretament, l’entrevista i l’observació, que s’apliquen pre i post intervenció per tal d’identificar possibles canvis. En els resultats, no es poden observar grans canvis a nivell de cohesió de grup ni d’estabilitat emocional dels infants, però sí, una actitud positiva i de motivació en relació a l’aplicació de dinàmiques de grup. La curta durada de la intervenció educativa ha estat la principal limitació d’aquesta investigació, fet pel qual no s’han pogut extreure uns resultats significatius. És per això que a les conclusions es mostren un seguit d’aspectes a tenir en compte en futurs estudis.

El desarrollo de competencias para la promoción de la resiliencia: buenas prácticas y procesos formativos en educación social

La aplicación de la resiliencia a la intervención social y educativa la ha convertido en un concepto aglutinador de muchos otros previamente investigados y presentes en la praxis profesional. La resiliencia aporta una mirada integradora que hace de ella una excelente metáfora del bienestar o la calidad de vida que los profesionales sociales contribuyen a desarrollar en los ámbitos en los que intervienen. En este artículo revisamos algunas buenas prácticas destacadas por educadores y educadoras sociales para la promoción de los factores protectores y exploramos, mediante la autopercepción de los estudiantes, en qué medida la formación universitaria capacita a los futuros profesionales para desarrollar actuaciones constructoras de resiliencia.

Cysteine cathepsin proteases: regulators of cancer progression and therapeutic response.

Cysteine cathepsin protease activity is frequently dysregulated in the context of neoplastic transformation. Increased activity and aberrant localization of proteases within the tumour microenvironment have a potent role in driving cancer progression, proliferation, invasion and metastasis. Recent studies have also uncovered functions for cathepsins in the suppression of the response to therapeutic intervention in various malignancies. However, cathepsins can be either tumour promoting or tumour suppressive depending on the context, which emphasizes the importance of rigorous in vivo analyses to ascertain function. Here, we review the basic research and clinical findings that underlie the roles of cathepsins in cancer, and provide a roadmap for the rational integration of cathepsin-targeting agents into clinical treatment.

To return or to discard? Randomised trial on gastric residual volume management

Background: The control of gastric residual volume (GRV) is a common nursing intervention in intensive care; however the literature shows a wide variation in clinical practice regarding the management of GRV, potentially affecting patients" clinical outcomes. The aim of this study is to determine the effect of returning or discarding GRV, on gastric emptying delays and feeding, electrolyte and comfort outcomes in critically ill patients. Method: A randomised, prospective, clinical trial design was used to study 125 critically ill patients, assigned to the return or the discard group. Main outcome measure was delayed gastric emptying. Feeding outcomes were determined measuring intolerance indicators, feeding delays and feeding potential complications. Fluid and electrolyte measures included serum potassium, glycaemia control and fluid balance. Discomfort was identified by significant changes in vital signs. Results: Patients in both groups presented similar mean GRV with no significant differences found (p=0.111), but participants in the intervention arm showed a lower incidence and severity of delayed gastric emptying episodes (p=0.001). No significant differences were found for the rest of outcome measurements, except for hyperglycaemia. Conclusions: The results of this study support the recommendation to reintroduce gastric content aspirated to improve GRV management without increasing the risk for potential complications.

Sugar-and artificially sweetened beverages and intrahepatic fat : a randomized controlled trial.

OBJECTIVE: To test the hypothesis that substituting artificially sweetened beverages (ASB) for sugar-sweetened beverages (SSB) decreases intrahepatocellular lipid concentrations (IHCL) in overweight subjects with high SSB consumption. METHODS: About 31 healthy subjects with BMI greater than 25 kg/m(2) and a daily consumption of at least 660 ml SSB were randomized to a 12-week intervention in which they replaced SSBs with ASBs. Their IHCL (magnetic resonance spectroscopy), visceral adipose tissue volume (VAT; magnetic resonance imaging), food intake (2-day food records), and fasting blood concentrations of metabolic markers were measured after a 4-week run-in period and after a 12-week period with ASB or control (CTRL). RESULTS: About 27 subjects completed the study. IHCL was reduced to 74% of the initial values with ASB (N = 14; P < 0.05) but did not change with CTRL. The decrease in IHCL attained with ASB was more important in subjects with IHCL greater than 60 mmol/l than in subjects with low IHCL. ALT decreased significantly with SSB only in subjects with IHCL greater than 60 mmol/l. There was otherwise no significant effect of ASB on body weight, VAT, or metabolic markers. CONCLUSIONS: In subjects with overweight or obesity and a high SSB intake, replacing SSB with ASB decreased intrahepatic fat over a 12-week period.

La música i la multiculturalitat a l'aula. Com la pràctica de les diferents expressions musicals dels infants a l'aula pot ajudar al coneixement mutu en el grup- classe

Actualment, vivim en una societat on hi conviuen diferents cultures i la música és un llenguatge que s’utilitza en totes elles. Aquest treball tractarà el tema de la música i la multiculturalitat a l’aula per investigar si és possible, a partir de la música dels diferents països d’origen dels infants, conèixer-se millor i conèixer millor als companys. Com a mestres hem de tenir en compte totes les cultures de la nostra aula per tal d’ajudar als infants a respectar i valorar cada una d’elles. En aquesta investigació trobarem quina ha estat la metodologia d’estudi, quina ha estat la intervenció a l’aula i quins són els resultats que hem obtingut.

The learning about imaging diagnosis technology

Objective To investigate the learning about management of the technology (efficient use, acquisition and maintenance of imaging diagnosis equipment) in the radiology residency program of Escola Paulista de Medicina - Universidade Federal de São Paulo, with a view to improving the education of radiologists. Materials and Methods Exploratory research where residents, faculty staff and tutors of the program were quantitative and qualitatively approached with Likert scale questionnaires (46), and deepening with recorded interviews (18) and categorization based upon meaning units (thematic analysis). Results Among the participants, 66% agreed that they had the opportunity of learning about the use of radiological equipment; for 61% the program should include knowledge on the importance of acquiring equipment; and 72% emphasized the lack of learning about equipment management and maintenance. Conclusion As the major moment in the education of specialists, the medical residency program provides residents with a favorable environment to the learning of the skills required to the future of their professional practice, but with limited emphasis on the management of the technology: efficient use, acquisition and mainly maintenance of equipment, still poorly explored. Both the investigated program and the medical residency in radiology should incorporate, whenever possible, the commitment with the training in supplementary skills related to equipment management, developing the competence of the future radiologists.

Campesinos, Estado y mercado. La conflictividad forestal en el Noroeste de España, León (1870­ ¿1936)

Peer-reviewed

Sorcin links pancreatic β cell lipotoxicity to ER Ca2+ stores.

NlmCategory="UNASSIGNED">Preserving β cell function during the development of obesity and insulin resistance would limit the worldwide epidemic of type 2 diabetes (T2DM). Endoplasmic reticulum (ER) calcium (Ca(2+)) depletion induced by saturated free fatty acids and cytokines causes β cell ER stress and apoptosis, but the molecular mechanisms behind these phenomena are still poorly understood. Here, we demonstrate that palmitate-induced sorcin (SRI) down-regulation, and subsequent increases in glucose-6-phosphatase catalytic subunit-2 (G6PC2) levels contribute to lipotoxicity. SRI is a calcium sensor protein involved in maintaining ER Ca(2+) by inhibiting ryanodine receptor activity and playing a role in terminating Ca(2+)-induced Ca(2+) release. G6PC2, a GWAS gene associated with fasting blood glucose, is a negative regulator of glucose-stimulated insulin secretion (GSIS). High fat feeding in mice and chronic exposure of human islets to palmitate decreases endogenous SRI expression while levels of G6PC2 mRNA increase. Sorcin null mice are glucose intolerant, with markedly impaired GSIS and increased expression of G6pc2. Under high fat diet, mice overexpressing SRI in the β cell display improved glucose tolerance, fasting blood glucose and GSIS, whereas G6PC2 levels are decreased and cytosolic and ER Ca(2+) are increased in transgenic islets. SRI may thus provide a target for intervention in T2DM.

Evaluation of Implementation of BSc IT Curriculum at Tumaini University

In Tanzania computer knowledge is vital to supplement the pace fast growing economic and development activities, which demands high and reliable level of expertise in com- puting field. In 2006, a research carried out at Tumaini University with purpose to design and implement a contextualized curriculum that can supplement for such needs hence facilitate development in Tanzanian context. A contextualized curriculum took advantage of six principles namely curriculum contex- tualization, projects, practical, interdisciplinary orientation, international recognition and continuous research for the program’s formative and development. Implementation of the curriculum followed the CATI (Contextualize, Apply, Transfer, and Import) model with emphasis on students to identify societal expectations at the early stage in learning process, in which case the graduates will potentially cater for societal expertise needs on ICT. This study adopts an emergent exploratory cross-section research design, while employ- ing a qualitative approach. This study was conducted at Tumaini University in Iringa where by purposeful sampling was used to obtain participants such as students, teach- ers, administrators and employers who participated in several focus group discussions, in-depth interviews and participant observation. The study reveals that six principles are satisfactorily met,despite of bottlenecks such as incompatibility in pedagogical thinking and technology availability for e-learning, learning attitudes, insufficient experts with actual skills and experience,in academic field among the others. The study recommends that iterative longitudinal study should be car- ried out to design for proper intervention in response to these problems which will help in improving and stabilize the curriculum.

Hacia la alfabetización numérica en Educación Infantil: algunos avances en Chile y España

This article reviews the main contemporary international references on numerical knowledge acquisition in the kindergarten stage. Secondly it analyzes the instructions curricular in two countries-one Spanish-speaking Latin America (Chile) and one European (Spain) - to determine the extent to assume international benchmarks while comparing the curricula of both countries. Finally, it presents a proposal for intervention in the classroom that the combination of different learning contexts and processes to investigate mathematical teaching practices and most effective in promoting and numeracy of children from the earliest ages

Afrontamiento de situaciones de hostilidad y desempeño de la función directiva. Planteamientos y reflexiones a raíz de una actividad de formación permanente de directivos de centros educativos de titularidad pública

The intervention in the organized conflicts and, particularly, the confrontation of hostile situations (based on the emotional alteration, the strain, the verbal aggressiveness, etc) is one of the aspects that worry the principals of the educative centres and, therefore, a main attention must be given to the initial and permanent training to have managing duties. Throughout the text we take some aspects into account in the development of these managing skills:a) we set the distinctive features; b) we answer to the dilemma about the existence of improvement possibilities; c) we state the need to star from the motivation and the active participation of the principals in their own personal development and, finally, d) we contribute with the design of a training activity to develop skills to confront hostile situations, addressed to the principals of primary and secondary schools, that was done in Girona, in November 2005

The grammar of psychosis

This thesis is concerned with the philosophical grammar of certain psychiatric concepts, which play a central role in delineating the field of psychiatric work. The concepts studied are ‘psychosis’, ‘delusion’, ‘person’, ‘understanding’ and ‘incomprehensibility’. The purpose of this conceptual analysis is to provide a more perspicuous view of the logic of these concepts, how psychiatric work is constituted in relation to them, and what this tells us about the relationships between the conceptual and the empirical in psychiatric concepts. The method used in the thesis is indebted primarily to Ludwig Wittgenstein’s conception of philosophy, where we are urged to look at language uses in relation to practices in order to obtain a clearer overview of practices of interest; this will enable us to resolve the conceptual problems related to these practices. This questioning takes as its starting point the concept of psychosis, a central psychiatric concept during the twentieth century. The conceptual analysis of ‘psychosis’ shows that the concept is logically dependent on the concepts of ‘understanding’ and ‘person’. Following the lead found in this analysis, the logic of person-concepts in psychiatric discourse is analysed by a detailed textual analysis of a psychiatric journal article. The main finding is the ambiguous uses of ‘person’, enabling a specifically psychiatric form of concern in human affairs. The grammar of ‘understanding’ is then tackled from the opposite end, by exploring the logic of the concept of ‘incomprehensibility’. First, by studying the DSM-IV definition of delusion it is shown that its ambiguities boil down to the question of whether psychiatric practice is better accounted for in terms of the grammar of ‘incorrectness’ or ‘incomprehensibility’. Second, the grammar of ‘incomprehensibility’ is further focused on by introducing the distinction between positive and negative conceptions of ‘incomprehensibility’. The main finding is that this distinction has wide-ranging implications for our understanding of psychiatric concepts. Finally, some of the findings gained in these studies are ‘put into practice’ in studying the more practical question of the conceptual and ethical problems associated with the concept of ‘prodromal symptom of schizophrenia’ and the agenda of early detection and intervention in schizophrenia more generally.

La hipnosis en el tratamiento del dolor crónico

For a long time, hypnosis has been associated with knowledge areas of little apparent scientific validity. Fourtanely, in recent years, hypnosis has proved to be a useful technique for intervention in the health area. The area where mor estudies have been conducted and with greater success is on treatment of chronic pain. However, some obstacles must yet be overcome: the limited use of hypnosis in the public health services in Spain, and the resources assigned by universities for researchand professional trainingon these techniques are scarce. This paper aims to briefly review the current state of hypnosis in the treatment of chronic pain, and advocates for its integration within a multidisciplinary treatment of chronic pain.