Colaboración entre profesionales y padres de niños con discapacidad intelectual: Experiencias y expectativas de los padres

Con el fin de contribuir a precisar la noción de colaboración que actualmente se menciona con tanta frecuencia para designar las relaciones entre profesionales y padres de niños con discapacidad, en este artículo se presenta una investigación que aborda el punto de vista de los padres, tratando de recoger sus experiencias y sus deseos, identificando las dificultades que confrontan y los medios utilizados para superar o atenuar dichas dificultades. Dado que esta investigación aún está en curso, sólo se presentan los resultados obtenidos durante la fase exploratoria, es decir, el análisis de los testimonios escritos y publicados por los padres de familia

Midwives Understanding of Physical Activity Guidelines During Pregnancy

Objective to examine the current level of understanding held by midwives regarding the NICE physical activity guidelines in the UK, and to investigate the physical activity guidance given to women during pregnancy. Design an 11 question online survey comprising of a mixture of closed and open ended questions. Setting data reflects participants sampled across the United Kingdom. Participants fifty-nine midwives completed the online survey Measurements and findings an electronic survey was used to explore the midwives understanding of physical activity guidelines during pregnancy, and the advice they offered to women in their care. Qualitative content analysis was used to gain a more in-depth understanding of midwife knowledge. Two per cent of midwives correctly identified the physical activity guidelines, with 44 giving partially correct responses, 25 giving incorrect responses and 29 unsure of what the guidelines are. Despite the low level of correct responses, 59 of respondents reported they were confident or very confident in answering questions regarding physical activity. Only 4 of respondents reported having access to continual professional development (CPD) in the area of PA guidance. Key conclusions there appears to be a misplaced confidence amongst midwives in their knowledge of the NICE PA guidelines for pregnancy. Implications for practice as physical inactivity can be detrimental for the health of both mother and baby, there is a clear need for better dissemination of the current and future NICE physical activity guidelines in primary health care settings. The current study determined a substantial lack of CPD in the area of PA guidance, which may be a contributing factor to the lack of knowledge of the guidelines. As such, increasing CPD may in turn improve the accuracy of the advice given to pregnant women and consequently benefit the health of both mother and baby. © 2018 Elsevier Lt

The London exercise and pregnant smokers (LEAP) trial: A randomised controlled trial of physical activity for smoking cessation in pregnancy with an economic evaluation

Background: Smoking during pregnancy is the main preventable cause of poor birth outcomes. Improved methods are needed to help women to stop smoking during pregnancy. Pregnancy provides a compelling rationale for physical activity (PA) interventions as cessation medication is contraindicated or ineffective, and an effective PA intervention could be highly cost-effective.  Objective: To examine the effectiveness and cost-effectiveness of a PA intervention plus standard behavioural support for smoking cessation relative to behavioural support alone for achieving smoking cessation at the end of pregnancy.  Design: Multicentre, two-group, pragmatic randomised controlled trial and economic evaluation with follow-up at the end of pregnancy and 6 months postnatally. Randomisation was tratified by centre and a computer-generated sequence was used to allocate participants using a 1: 1 ratio. Setting: 13 hospitals offering antenatal care in the UK.  Participants: Women between 10 and 24 weeks’ gestation smoking five or more cigarettes a day before pregnancy and one or more during pregnancy.  Interventions: Participants were randomised to behavioural support for smoking cessation (control) or behavioural support plus a PA intervention consisting of supervised treadmill exercise plus PA consultations. Neither participants nor researchers were blinded to treatment allocation.  Main outcome measures: The primary outcome was self-reported, continuous smoking abstinence between a quit date and end of pregnancy, validated by expired carbon monoxide and/or salivary cotinine. Secondary outcomes were maternal weight, depression, birth outcomes, withdrawal symptoms and urges to smoke. The economic evaluation investigated the costs of the PA intervention compared with the control intervention.  Results: In total, 789 women were randomised (n = 394 PA, n = 395 control). Four were excluded post randomisation (two had been enrolled twice in sequential pregnancies and two were ineligible and randomised erroneously). The intention-to-treat analysis comprised 785 participants (n = 392 PA, n = 393 control). There was no significant difference in the rate of abstinence at the end of pregnancy between the PA group (7.7%) and the control group (6.4%) [odds ratio for PA group abstinence 1.21, 95% confidence interval (CI) 0.70 to 2.10]. For the PA group compared with the control group, there was a 33% (95% CI 14% to 56%), 28% (95% CI 7% to 52%) and 36% (95% CI 12% to 65%) significantly greater increase in self-reported minutes of moderate- and vigorous-intensity PA from baseline to 1 week, 4 weeks and 6 weeks respectively. Accelerometer data showed that there was no significant difference in PA levels between the groups. There were no significant differences between the groups for change in maternal weight, depression, withdrawal symptoms or urges to smoke. Adverse events and birth outcomes were similar between the groups except for there being significantly more caesarean births in the control group than in the PA group (28.7% vs. 21.3%; p < 0.023). The PA intervention was less costly than the control intervention by £35 per participant. This was mainly attributable to increased health-care usage in the control group. However, there was considerable statistical uncertainty around this estimate.  Conclusions: During pregnancy, offering an intervention combining supervised exercise and PA counselling does not add to the effectiveness of behavioural support for smoking cessation. Only 10% of participants had PA levels accessed by accelerometer and it is, therefore, unclear whether or not the lack of an effect on the primary outcome is the result of insufficient increases in PA. Research is needed to identify the smoking populations most suitable for PA interventions and methods for increasing PA adherence.  Trial registration: Current Controlled Trials ISRCTN48600346

Veranstaltungsbericht: Max Reger und das Klavier. Analyse – Interpretation – Performance

Veranstaltungsbericht über das vom 14. bis 16. September 2023 an der Hochschule der Künste Bern (HKB) durchgeführte und Max Reger als Pianisten und Klavierkomponisten gewidmete Symposium

L'hypotension artérielle essentielle : fréquence et symptomatologie

Ficha de fotocolecta de Procyon lotor (Linnaeus, 1758) en Bosque de Pino-Encino de Oaxac