Indicador de Medición en Psicología online en América Latina en tiempos de pandemia

Introduction: In the areas of technology and virtualization from provide online services in pandemic times there is a possibility psychology online acquiring services thinking that web sites are confidence for users and good quality. This paper proposes a number of indicators to websites evaluation that provide online services psychology in Latin American. Methodology: Whith experimental methodology were tracked 144 websites online services psychology assessing objectives variables with the purpose of factor analysis to the indicators building. Results: According the proposed indicators Brazil

Estrategias de intervención y posvención del comportamiento suicida

This second book, framed in the research on suicidal behavior, contains strategies of intervention and postvention, both at the level of prevention and in the face of the occurrence of an event. It is the reflective result of a work, carried out for 4 years, funded by the Catholic University Luis Amigó, and carried out in eight localities of Antioquia in face-to-face and in some countries of the region in a virtual way; where technical advice and support has been provided in order to strengthen the institutional competences of these localities with regard to suicide; the book, presents this process of action research. We hope that its content will be useful for any person or institution interested in knowing how to deal with and contain this human problem.PublishedEste segundo libro enmarcado en la investigación sobre el comportamiento suicida, contiene estrategias de intervención y de posvención, tanto a nivel de la prevención como ante la ocurrencia de un evento. Es el resultado reflexivo de un trabajo, ejecutado durante 4 años, financiado por la Universidad Católica Luis Amigó, y llevado a cabo en ocho localidades de Antioquia de forma presencial y en algunos países de la región de manera virtual; en donde se ha prestado asesoría y acompañamiento técnico con el propósito de fortalecer las competencias institucionales de estas localidades en lo referente al suicidio; el libro, presenta este proceso de investigación acción. Esperamos que su contenido, sea de utilidad para toda persona o institución interesados en saber cómo afrontar y contener esta problemática humana

Trastornos de personalidad asociados a trastorno obsesivo compulsivo

Ubicación en Biblioteca USB Medellín (San Benito): CD-3196t .--Grupo de Investigación en Estudios Clínicos y Sociales en Psicología .--Línea de Investigación: Perfiles Cognitivos y Psicopatología.--Área: clínica y de la salud.-- Tema: Trastornos de personalidad asociados a trastorno obsesivo compulsivoLa asociación de los trastornos de la personalidad y el trastorno obsesivo compulsivo se ha estudiado de forma más sistemática desde el establecimiento de un eje independiente para la enfermedad desde el DSM-III (American Psychiatric Association, 1987). Estudios recientes han demostrado que la mayoría de las personas con trastorno obsesivo compulsivo cumplen los criterios para al menos un tipo de comorbilidad con trastornos de personalidad (sin hacer énfasis propiamente dicho en las creencias que hacen parte del perfil cognitivos de dichos trastornos), por lo general de la agrupación ansiosa, aunque la mayoría con diagnóstico de tipo mixto, puede hacer referencia a posibles asociaciones con otros trastornos de personalidad pertenecientes a agrupaciones depresivas (AuBuchon & Malatesta, 1994). Con base en la revisión presentada sobre los antecedentes, hasta el momento las investigaciones no han sido lo suficientemente claras a la hora de especificar a qué tipo de relación se refieren arrojando así resultados contradictorios, además de esto, la mayoría de las investigaciones referenciadas, encuentran una asociación entre trastornos de personalidad y el trastorno obsesivo compulsivo, aunque sin especificar tal relación. Por otro lado, los estudios no refieren relación entre creencias de trastornos del eje I y creencias de trastornos del eje II, puntualmente, trastornos de la personalidad, junto con la magnitud de dicha relación, lo cual motiva a plantearse como pregunta de investigación ¿existe relación entre las creencias de los trastornos de la personalidad y el trastorno obsesivo compulsivo? A la vez que vale la pena continuar esta línea de investigación controlando diferentes aspectos tales como el tipo de instrumentos (cuestionarios y entrevistas), los grupos de comparación (casos y controles) y el número de participantes que pueden servir de base para la aplicación de instrumentos

El suicidio. Una mirada integral e integradora

El contenido de esta publicación resulta de una investigación acerca de la prevención del comportamiento suicida, liderada por la Universidad Católica Luis Amigó (sede Medellín, Colombia) e implementada en cinco localidades del departamento de Antioquia con el objetivo de acompañar desde la asesoría y asistencia técnica a los municipios participantes mediante el trabajo interactivo con la institucionalidad de cada localidad. La investigación y el texto mismo tienen la pretensión de visibilizar esta compleja problemática como un asunto de todos y todas, en aras de posicionarla como una cuestión de interés público

Pneumonia treated in the internal medicine department: Focus on healthcare-associated pneumonia

Patients with pneumonia treated in the internal medicine department (IMD) are often at risk of healthcare-associated pneumonia (HCAP). The importance of HCAP is controversial. We invited physicians from 72 IMDs to report on all patients with pneumonia hospitalized in their department during 2weeks (one each in January and June 2010) to compare HCAP with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). We analysed 1002 episodes of pneumonia: 58.9% were CAP, 30.6% were HCAP and 10.4% were HAP. A comparison between CAP, HCAP and HAP showed that HCAP patients were older (77, 83 and 80.5years; p<0.001), had poorer functional status (Barthel 100, 30 and 65; p<0.001) and had more risk factors for aspiration pneumonia (18, 50 and 34%; p<0.001). The frequency of testing to establish an aetiological diagnosis was lower among HCAP patients (87, 72 and 79; p<0.001), as was adherence to the therapeutic recommendations of guidelines (70, 23 and 56%; p<0.001). In-hospital mortality increased progressively between CAP, HCAP and HAP (8, 19 and 27%; p<0.001). Streptococcus pneumoniae was the main pathogen in CAP and HCAP. Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) caused 17 and 12.3% of HCAP. In patients with a confirmed aetiological diagnosis, the independent risk factors for pneumonia due do difficult-to-treat microorganisms (Enterobacteriaceae, P. aeruginosa or MRSA) were HCAP, chronic obstructive pulmonary diseases and higher Port Severity Index. Our data confirm the importance of maintaining high awareness of HCAP among patients treated in IMDs, because of the different aetiologies, therapy requirements and prognosis of this population. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old

Liraglutide and Renal Outcomes in Type 2 Diabetes.

BACKGROUND: In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown. METHODS: We report the prespecified secondary renal outcomes of that randomized, controlled trial in which patients were assigned to receive liraglutide or placebo. The secondary renal outcome was a composite of new-onset persistent macroalbuminuria, persistent doubling of the serum creatinine level, end-stage renal disease, or death due to renal disease. The risk of renal outcomes was determined with the use of time-to-event analyses with an intention-to-treat approach. Changes in the estimated glomerular filtration rate and albuminuria were also analyzed. RESULTS: A total of 9340 patients underwent randomization, and the median follow-up of the patients was 3.84 years. The renal outcome occurred in fewer participants in the liraglutide group than in the placebo group (268 of 4668 patients vs. 337 of 4672; hazard ratio, 0.78; 95% confidence interval [CI], 0.67 to 0.92; P=0.003). This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P=0.004). The rates of renal adverse events were similar in the liraglutide group and the placebo group (15.1 events and 16.5 events per 1000 patient-years), including the rate of acute kidney injury (7.1 and 6.2 events per 1000 patient-years, respectively). CONCLUSIONS: This prespecified secondary analysis shows that, when added to usual care, liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo. (Funded by Novo Nordisk and the National Institutes of Health; LEADER ClinicalTrials.gov number, NCT01179048 .)