Asunto(s)

RESUMEN

The balloon-assisted tracking technique can be useful in short venous occlusions that conventional venoplasty fails. This technique could be feasible and with an expected low complication rate.

Asunto(s)

RESUMEN

This work presents a study on the homogeneity and thermal stability of Al0.7Sc0.3N films sputtered from Al-Sc segmented targets. The films are sputtered on Si substrates to assess their structural properties and on SiO2/Mo-based stacked acoustic mirrors to derive their piezoelectric activity from the frequency response of acoustic resonators. Post-deposition annealing at temperatures up to 700 °C in a vacuum are carried out to test the stability of the Al0.7Sc0.3N films and their suitability to operate at high temperatures. Despite the relatively constant radial composition of the films revealed from RBS measurements, a severe inhomogeneity in the piezoelectric activity is observed across the wafer, with significantly poorer activity in the central zone. RBS combined with NRA analysis shows that the zones of lower piezoelectric activity are likely to show higher surface oxygen adsorption, which is attributed to higher ion bombardment during the deposition process, leading to films with poorer crystalline structures. AFM analysis reveals that the worsening of the material properties in the central area is also accompanied by an increased roughness. XRD analysis also supports this hypothesis, even suggesting the possibility of a ScN non-piezoelectric phase coexisting with the AlScN piezoelectric phase. Thermal treatments do not result in great improvements in terms of piezoelectric activity and crystalline structure.

RESUMEN

Cerebral nocardia infections is a rare entity, which has been mainly reported in immunosuppressed patients. Currently, there are no clinical guidelines for first-line treatment. Our case refers to an older immunocompetent adult, with encephalopathy and left hemiparesis, associated with lesions compatible with multiple brain abscess and suggestive of infectious etiology. He initially received treatment for tuberculosis, bacterial abscess, and toxoplasmosis, without a favorable clinical response. An empirical treatment for nocardiosis started, by using meropenem and trimethoprim / sulfamethoxazole, and clinical and imaging improvement was achieved. The occurrence of adverse events forces the temporary use of alternative medications. We highlight some criteria for including nocardiosis in the differential diagnosis in cases of multiple brain abscess and mention laboratory diagnostic methods and drugs to initiate empirical treatment.

La nocardiosis cerebral es una entidad rara que ha sido reportada principalmente en inmunosuprimidos, y en la actualidad no se dispone de guías clínicas que recomienden un tratamiento de primera línea. Presentamos el caso de un adulto mayor, inmunocompetente, con cuadro de encefalopatía y hemiparesia izquierda, asociado a lesiones compatibles con absceso cerebral múltiple y sugerente de etiología infecciosa. Recibió, inicialmente, tratamiento para la tuberculosis, absceso bacteriano y toxoplasmosis, sin respuesta clínica favorable. Se inició un tratamiento empírico para la nocardiosis con meropenem y trimetoprim/sulfametoxazol, y se logró mejoría clínica e imagenológica. La ocurrencia de eventos adversos obliga el uso temporal de medicamentos alternativos. Se resaltan algunos criterios a considerar para incluir la nocardiosis en el diagnóstico diferencial en los casos de absceso cerebral múltiple y se mencionan los métodos diagnósticos de laboratorio y los fármacos para iniciar un tratamiento empírico.

Asunto(s)

RESUMEN

This article presents the idea of articulating the concepts of individualism and gregariousness as two elements in tension in the psychological configuration of human beings, and the historical variations in self-configurations. The essay explores the genesis and evolution of the archetypes of the self developed in the different historical contexts throughout the history of humanity. This analysis connects with the functional and contextual perspective facilitating an inclusive vision of the behavioral repertoires that are articulated through the concepts of individualism, gregariousness, and the self. The main characteristics of the two groups of self-configurations emerged throughout the history of the human being are described: archetypes of gregarious selves, and archetypes of individualistic selves. Differentiating three individualistic archetypes such as romantic self, modernist self, and postmodernist self (AU)

Asunto(s)

RESUMEN

RESUMEN La nocardiosis cerebral es una entidad rara que ha sido reportada principalmente en inmunosuprimidos, y en la actualidad no se dispone de guías clínicas que recomienden un tratamiento de primera línea. Presentamos el caso de un adulto mayor, inmunocompetente, con cuadro de encefalopatía y hemiparesia izquierda, asociado a lesiones compatibles con absceso cerebral múltiple y sugerente de etiología infecciosa. Recibió, inicialmente, tratamiento para la tuberculosis, absceso bacteriano y toxoplasmosis, sin respuesta clínica favorable. Se inició un tratamiento empírico para la nocardiosis con meropenem y trimetoprim/sulfametoxazol, y se logró mejoría clínica e imagenológica. La ocurrencia de eventos adversos obliga el uso temporal de medicamentos alternativos. Se resaltan algunos criterios a considerar para incluir la nocardiosis en el diagnóstico diferencial en los casos de absceso cerebral múltiple y se mencionan los métodos diagnósticos de laboratorio y los fármacos para iniciar un tratamiento empírico.

ABSTRACT Cerebral nocardia infections is a rare entity, which has been mainly reported in immunosuppressed patients. Currently, there are no clinical guidelines for first-line treatment. Our case refers to an older immunocompetent adult, with encephalopathy and left hemiparesis, associated with lesions compatible with multiple brain abscess and suggestive of infectious etiology. He initially received treatment for tuberculosis, bacterial abscess, and toxoplasmosis, without a favorable clinical response. An empirical treatment for nocardiosis started, by using meropenem and trimethoprim / sulfamethoxazole, and clinical and imaging improvement was achieved. The occurrence of adverse events forces the temporary use of alternative medications. We highlight some criteria for including nocardiosis in the differential diagnosis in cases of multiple brain abscess and mention laboratory diagnostic methods and drugs to initiate empirical treatment.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

No disponible

Unfiltered coffee consumption has been associated to the increase in serum cholesterol levels. The aim of this population study was to verify if the change in the type of coffee consumed from unfiltered to filtered produces effects on the serum cholesterol levels of the participants. The sample was formed of 30 volunteers (9 men) with no health problems (age range= 18-47; average= 28.2; SD= 8.8). The study was structured according to an A-B-A reversible design with simultaneous replications between subjects. During the Baseline and Reversion phases (A), participants consumed unfiltered coffee in their usual way, while in the Intervention Phase (B) they consumed only filtered coffee. Participants were divided into two subgroups according to their serum level of cholesterol LDL at Baseline Phase (resulting in a subgroup formed by 16 participants with LDL <115 mg/dL, and a subgroup formed by 14 participants with LDL ≥115 mg/dL). Results indicated that 90% of participants showed decrease in their serum cholesterol LDL level at the end of the Intervention Phase contingent to coffee change with an increase in their serum cholesterol LDL level at the end of the Reversion Phase when they returned to consuming unfiltered coffee. Also a change in serum cholesterol HDL level was shown by 93% of participants, with an increase in serum cholesterol HDL level contingent on the change to filtered coffee and a decrease when they return to consume unfiltered coffee. The implications of these findings and the limitations of the study are discussed

Asunto(s)

RESUMEN

No disponible

This paper proposes a functional interpretation of psychopathic behavior as an alternative to formal attempts to explain this rare, complex and, dangerous pattern of behaviors. First of all, the contextual-functional approach is briefly summarized. In second place, four well-known historical cases of psychopathy are briefly described and analyzed. According to a functional approach, the key issues are the contingencies occurring in the personal histories of such individuals as well as the derived transformation of functions that established such rare and dangerous pattern of behavior regulation. A brief analysis is made of the cognitive and emotional characteristics traditionally predicated as exclusive of psychopathy (as lack of empathy, emotional responsiveness, impulsivity, the need of power, etcetera) that sets the stage for an interpretative analysis about the conditions that might be involved in the emergence and expansion of the behaviors typically categorized with the psychopathic label. This analysis focuses on the personal history and describes the confluence of conditions that form thoughts/beliefs about oneself and the others, that establishes as dominant reinforcers obtaining immediate pleasure and escaping aversive funtions as well as feeling unlimited power upon others. This analysis might indicate that the exceptionality of psychopathy migth lie on the occurrence of very extreme specific and unusual conditions and the non-occurrence of those conditions that might prevent the building of repertoires as those described in psychopathy. Therefore, the functional-contextual interpretation characterizes psychopaths persons not as having specific differences in their brains or having difficulties for the formation of adaptive cognitive functioning and behavior regulation, to give account for their psychopatic behavior

Asunto(s)

RESUMEN

The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome). Cognitive behavioral therapy (CBT) is the best studied treatment and seems to be the most promising therapeutic approach. However, some studies have challenged the effectiveness of this therapy for irritable bowel syndrome. One study concluded that cognitive behavioral therapy is no more effective than attention placebo control condition and another study showed that the beneficial effects wane after six months of follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome (AU)

No disponible

Asunto(s)

RESUMEN

The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome). Cognitive behavioral therapy (CBT) is the best studied treatment and seems to be the most promising therapeutic approach. However, some studies have challenged the effectiveness of this therapy for irritable bowel syndrome. One study concluded that cognitive behavioral therapy is no more effective than placebo attention control condition and another study showed that the beneficial effects wane after six months of follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome.

Asunto(s)

RESUMEN

Letter to the editor.

Se pretende realizar con el presente estudio, un análisis exploratorio de variables que puedan ayudar a explicar el éxito o fracaso en cesación tabáquica mediante autoabandono. El presente estudio obtuvo el informe favorable de la Comisión de Bioética de la Universidad de Almería, cuyo número de referencia es UALBIO2011/025. Los participantes del estudio se consiguieron mediante anuncios en prensa y radio y centros de salud, se les realizó una entrevista dirigida al registro de distintas variables relacionadas con el consumo de tabaco, edad de inicio, edad de abandono, años de uso del tabaco, número de cigarrillos al día y dependencia nicotínica.

Asunto(s)

RESUMEN

No disponible

Smoking Self-quitting is the most commonly used tool for smokers who wish to quit smoking. The aim of this study is to analyze the relationship between habits related to smoking and some personal regulation variables and succesful self-quitting from smoking. 137 participants who had attempted to quit smoking on their own (99 remained abstinent and 38 still smoking) provided information on their smoking history, quit attempts, nicotine dependence, self-control and psychological flexibility. Differences between succesful quiters and smokers who failed in cessation found that age at wich cessation begins (p= .01), and psychological flexibility (p= .001) were related with succesful quiting. In addittion, a logistic regresion model to estimate the influence of all variables on success in quitting showed that flexibility was related to successful self-quiting (p <.05). These results show evidence that psychological flexibility is associated to successful self-quitting, and suggest that this variable could facilitate success in attempts to stop smoking without professional help. Limitations and implications of this study for smoking treatment are discussed (AU)

Asunto(s)

RESUMEN

No disponible

Asunto(s)

RESUMEN

No disponible

The prevalence of smoking in the general population remains high in spite of the extended acknowledgement of the well-documented health consequences of smoking and potential benefits of quitting. Only a minority of smokers who attempt to quit seeks professional treatment, yet most of the research on smoking cessation focuses on such form of quitting. Research on self-quitting is scarce, although most smokers who successfully quit, do so on their own. Recently, research has evidenced that psychological flexibility, a core concept in Acceptance and Commitment Therapy, is an important variable in predicting successful behavioral change in many clinically relevant areas. The goal of this study was to analyze the relationship between psychological flexibility and successful self-quitting from smoking. 277 participants who had attempted to quit on their own (217 successfully abstinent and 60 still smoking) provided information on their smoking history, quit attempts, nicotine dependence, and demographics, and were assessed with the Acceptance and Action Questionnaire-II. Abstinence status was measured through self-reports of continuous abstinence and confirmed by concentrations of expired carbon monoxide below 8 ppm. Results show a statistically significant difference (t= -8,775; p <.01) for the AAQ-II scores of successful (M= 18.39, SD= 7.76) and unsuccessful self-quitters (M= 27.17; SD= 6.88). Only 26% participants with high level of psychological inflexibility quitted successfully, compared to 94% participants with low levels of psychological inflexibility. These results show clear evidence that psychological flexibility is associated to successful self-quitting, and suggest that this variable could facilitate success in attempts to stop smoking without professional help. Implications and limitations of this study are discussed (AU)

Asunto(s)

RESUMEN

BACKGROUND: Many studies have explored personal values in nursing, but none has assessed whether the predictions made by the theory of intergenerational value change are true for the different generations of nursing professionals and students. This theory predicts a shift in those personal values held by younger generations towards ones focussed on self-expression. RESEARCH QUESTION: The purpose of the study was to identify intergenerational differences in personal values among nursing professionals and nursing students and to determine whether generational value profiles fit the predictions made by the theory. RESEARCH DESIGN: An exploratory comparative design with a cross-sectional survey method was used. PARTICIPANTS AND RESEARCH CONTEXT: Participants were recruited from four public hospitals and 10 Primary Care Centres in medium-size cities in Spain. A sample of 589 nurses and 2295 nursing students participated in the study. An open survey method was used to collect data that were classified grouping reported values into categories following a method of value lexicon construction and analysed by contingency tables with Pearson's χ (2) and standardized residuals. ETHICAL CONSIDERATIONS: Approval to conduct the study was obtained from the Deans of the nursing schools and the Directors of Nursing of the institutions. Anonymity was guaranteed, participation was voluntary and participants were informed of the purpose of the study. FINDINGS: The results can be synthesized in two age-related trends in the reporting of values among three groups of participants. First, among younger nurses and students, some nursing core values (e.g. ethical and professional) decreased in importance, while other values centred on social relationships and personal well-being increased. DISCUSSION AND CONCLUSION: This study shows intergenerational change in personal values among both nursing students and young nursing professionals. Findings suggest the need to pay more attention to value training and professional socialization during the schooling period.

Asunto(s)

RESUMEN

A longitudinal study was conducted to assess the presence of beliefs about symptoms related to hypertension and the time since diagnosis in which they appear. A randomly selected sample of hypertensive patients (67% women, mean age 53.27 years and range 20-65) was divided into four groups according to the time from diagnosis. All patients (N = 171) were interviewed at the beginning (initial assessment) and 12 months later (final assessment) and the patients (n = 75) who did not report beliefs about symptoms at the initial assessment were interviewed in a follow-up schedule. The results showed that 56% of patients reported beliefs about symptoms at the initial assessment, and this percentage increased to 77% at the final assessment (p < .001) finding significant differences between the two groups with a more recent diagnosis and the two groups of long-standing patients. Longitudinal analysis of the group with the recent diagnosis showed that the critical period for the emergence of beliefs was the first year from diagnosis. This period could be decisive in order to prevent them. Healthcare professionals should pay attention to the emergence of these beliefs, as they could negatively affect treatment adherence (AU)

Se realizó un estudio para evaluar creencias sobre síntomas relacionados con la hipertensión y el tiempo transcurrido desde el diagnóstico. Una muestra elegida al azar de pacientes con hipertensión (media de edad 53,27 años, rango 20-65; 67% mujeres) se dividió en cuatro grupos de acuerdo al tiempo transcurrido desde el diagnóstico. Se entrevistó a todos los pacientes (N = 171) al comienzo del estudio (evaluación inicial) y 12 meses después (evaluación final). A los pacientes que no informaron creencias en síntomas (n = 75) se les entrevistó cada tres meses de acuerdo a un programa de seguimiento. Los resultados indicaron que en la evaluación inicial el 56% de los pacientes informó creencias en síntomas, elevándose al 77% en la evaluación final (p < .001), y diferencias significativas entre los grupos con menor y mayor tiempo desde el diagnóstico. El análisis longitudinal del grupo de pacientes de reciente diagnóstico mostró que el primer año es el período crítico para la emergencia de creencias en síntomas, información que resulta clave para planear la prevención. Los profesionales de la salud deberían prestar atención a la emergencia de creencias en síntomas dado que pueden afectar negativamente a la adherencia al tratamiento (AU)

Asunto(s)

RESUMEN

OBJETIVO: Comprobar la eficacia de un programa para la mejora de la adherencia en pacientes hipertensos de reciente diagnóstico. DISEÑO: Estudio cuasi-experimental. Emplazamiento: Cuatro Centros de Atención Primaria de la provincia de Almería. PARTICIPANTES: Ciento veinte sujetos entre 18 y 65 años que habían sido diagnosticados como hipertensos en un periodo inferior a 12 meses. MEDICIONES PRINCIPALES: Los participantes fueron divididos en tres grupos: grupo de intervención A que recibió una instrucción educativa, grupo de intervención B que recibió la instrucción educativa y un procedimiento de feedback; y grupo control C que recibió el tratamiento habitual. La adherencia se determinó en función del estilo de vida (patrones de alimentación, actividad física, tabaco, alcohol) y tratamiento farmacológico. RESULTADOS: En el caso de la alimentación y actividad física, tras la intervención se observaron diferencias significativas entre los grupos de actuación (p < 0,05), encontrando mejores niveles de adherencia en los sujetos del grupo B con respecto a estas variables. También se observaron mejores patrones de adherencia al tratamiento farmacológico en dichos pacientes. No se hallaron resultados significativos con respecto al alcohol y tabaco. CONCLUSIONES: En la población de estudio, los pacientes que recibieron la instrucción educativa y feedback tuvieron mejores niveles de adherencia que aquellos que solo recibieron la instrucción o el tratamiento habitual

OBJECTIVE: To test the effectiveness of a program to improve treatment adherence in new onset hypertensive PATIENTS: DESIGN: This is a quasi-experimental study. LOCATION: Four health centers in Almeria. PARTICIPANTS: A total of 120 subjects between 18 and 65 years, diagnosed with hypertension within the previous 12 months. MAIN MEASUREMENTS: The participants were divided into three groups: intervention group A, which received educational instruction, intervention group B, educational instruction and feedback process, and the control group C, received usual care. Adherence was determined by lifestyle (diet, physical activity, smoking, alcohol) and drug treatment. RESULTS: As regards diet and physical activity, there were significant differences between performance groups after intervention (p < 0,05), with better adherence levels being found in group B subjects for these variables. Better adherence to pharmacological treatment was also observed in these PATIENTS: No significant results were found regarding alcohol and smoking. CONCLUSIONS: In the study population, patients undergoing educational instruction and feedback had better adherence levels than those who received only instruction or usual treatment

Asunto(s)