Low intensity vs. self-guided internet-delivered psychotherapy for major depression: a multicenter, controlled, randomized study.

BACKGROUND Major depression will become the second most important cause of disability in 2020. Computerized cognitive-behaviour therapy could be an efficacious and cost-effective option for its treatment. No studies on cost-effectiveness of low intensity vs self-guided psychotherapy has been carried out. The aim of this study is to assess the efficacy of low intensity vs self-guided psychotherapy for major depression in the Spanish health system. METHODS The study is made up of 3 phases: 1.- Development of a computerized cognitive-behaviour therapy for depression tailored to Spanish health system. 2.- Multicenter controlled, randomized study: A sample (N=450 patients) with mild/moderate depression recruited in primary care. They should have internet availability at home, not receive any previous psychological treatment, and not suffer from any other severe somatic or psychological disorder. They will be allocated to one of 3 treatments: a) Low intensity Internet-delivered psychotherapy + improved treatment as usual (ITAU) by GP, b) Self-guided Internet-delivered psychotherapy + ITAU or c) ITAU. Patients will be diagnosed with MINI psychiatric interview. Main outcome variable will be Beck Depression Inventory. It will be also administered EuroQol 5D (quality of life) and Client Service Receipt Inventory (consume of health and social services). Patients will be assessed at baseline, 3 and 12 months. An intention to treat and a per protocol analysis will be performed. DISCUSSION The comparisons between low intensity and self-guided are infrequent, and also a comparative economic evaluation between them and compared with usual treatment in primary. The strength of the study is that it is a multicenter, randomized, controlled trial of low intensity and self-guided Internet-delivered psychotherapy for depression in primary care, being the treatment completely integrated in primary care setting. TRIAL REGISTRATION Clinical Trials NCT01611818.

Effect of treatment with cyclophosphamide in low doses upon the onset of delayed type hypersensitivity in mice chronically infected with Trypanosoma cruzi: involvement of heart interstitial dendritic cells

Acute infection with Trypanosoma cruzi results in intense myocarditis, which progresses to a chronic, asymptomatic indeterminate form. The evolution toward this chronic cardiac form occurs in approximately 30% of all cases of T. cruzi infection. Suppression of delayed type hypersensitivity (DTH) has been proposed as a potential explanation of the indeterminate form. We investigated the effect of cyclophosphamide (CYCL) treatment on the regulatory mechanism of DTH and the participation of heart interstitial dendritic cells (IDCs) in this process using BALB/c mice chronically infected with T. cruzi. One group was treated with CYCL (20 mg/kg body weight) for one month. A DTH skin test was performed by intradermal injection of T. cruzi antigen (3 mg/mL) in the hind-footpad and measured the skin thickness after 24 h, 48 h and 72 h. The skin test revealed increased thickness in antigen-injected footpads, which was more evident in the mice treated with CYCL than in those mice that did not receive treatment. The thickened regions were characterised by perivascular infiltrates and areas of necrosis. Intense lesions of the myocardium were present in three/16 cases and included large areas of necrosis. Morphometric evaluation of lymphocytes showed a predominance of TCD8 cells. Heart IDCs were immunolabelled with specific antibodies (CD11b and CD11c) and T. cruzi antigens were detected using a specific anti-T. cruzi antibody. Identification of T. cruzi antigens, sequestered in these cells using specific anti-T. cruzi antibodies was done, showing a significant increase in the number of these cells in treated mice. These results indicate that IDCs participate in the regulatory mechanisms of DTH response to T. cruzi infection.

Off-axis low coherence interferometry contouring

In this article we present a method to achieve tri-dimensional contouring of macroscopic objects. A modified reference wave speckle interferometer is used in conjunction with a source of reduced coherence. The depth signal is given by the envelope of the interference signal, directly determined by the coherence length of the source. Fringes are detected in the interferogram obtained by a single shot and are detected by means of adequate filtering. With the approach based on off-axis configuration, a contour line can be extracted from a single acquisition, thus allowing to use the system in harsh environment. (C) 2009 Elsevier B.V. All rights reserved.

El sector hotelero en China : el fenómeno "low cost" en la nueva clase urbana

Aquest treball es justifica per la complementarietat que, d'una banda ofereix el potencial i volum d'un mercat en plena efervescència com és l'àmbit urbà de la Xina, on el seu incipient maduresa, com a conseqüència de l'efecte d'arrossegament que la inversió estrangera - intensa i innovadora - ha provocat, facilitant l'aparició d'una demanda d'un nivell superior, no primària, com les activitats emmarcades en el lleure i el turisme. D'altra banda, per una proposta de negoci dins d'un sector amb grans expectatives de desenvolupament com és el turístic i, finalment, també per l'opció d'un consum basat en el factor preu, amb unes característiques socioeconòmiques determinades de demanda, i en què la societat urbana de la Xina ja comença a veure's reflectida. Més enllà del paper tradicional de la Xina com a procés avantatjós dins de la cadena productiva o com a mercat d'outputs de volum, es dibuixa una nova classe mitjana urbana, inserint-se de ple i en molt poc temps en les dinàmiques de consum global, recolzada en les noves tecnologies - on el procés productiu low cost basa gran part del seu desenvolupament -.