Assessment of posttraumatic stress disorder among women after childbirth using the City Birth Trauma Scale in Spain

OBJECTIVE: Postpartum posttraumatic stress disorder (PP-PTSD) affects 3.1-6.3% of women after childbirth. The City Birth Trauma Scale (City-BiTS) is a questionnaire designed to evaluate and diagnose this disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria, including the following groups of symptoms characteristic of posttraumatic stress: reexperiencing, avoidance, negative cognitions and mood, and hyperarousal. The aim of the present study was to evaluate the psychometric properties of the Spanish-language version of this questionnaire (City-BiTS-S), based on a community sample of Spanish women. METHOD: A total of 207 mothers, recruited at three health centers in southern Spain, completed the City-BiTS-S questionnaire and provided sociodemographic and obstetric data. RESULTS: Exploratory factor analysis of the data replicated the two-factor structure reported in previous studies that explained 47.9% of the variance: Factor 1 of general symptoms and Factor 2 of birth-related symptoms. Both City-BiTS-S (Cronbach's alpha = .90) and the two factors (Cronbach's alpha for Factor 1 = 0.89; Cronbach's alpha for Factor 2 = 0.82) presented high internal consistency. Rasch analysis confirmed the unidimensionality of the two factors as valid subscales of the PP-PTSD. Results suggested reducing response options, reviewing Item 8, and rewording Item 3 in the Spanish version. CONCLUSIONS: The City-BiTS-S presents appropriate psychometric properties to measure symptoms of PP-PTSD. Nevertheless, further research is recommended to confirm its validity in a clinical population and in different medical approaches to the birth process

Physical literacy in older adults: a scoping review protocol

Population aging is a prominent phenomenon worldwide. The increase in physical inactivity and co-morbid diseases poses a major challenge to current community health policies. Physical activity guidelines recommended for older people have not been met by this population group. For this reason, a new model, physical literacy, is being innovated and has gained global attention and has emerged as an effective and innovative active aging strategy to improve physical activity participation of this vulnerable group. However, the evidence on physical literacy in the older adult so far is brief and diffuse. Therefore, the aim was to conduct a scoping review protocol to identify and map physical literacy in older people. This scoping review protocol was based on the Joanna Briggs Institute Method. The search will be performed on Embase, IBSS ProQuest, Medline OVID, PsycINFO Ebsco, PubMed, ScienceDirect, Scopus, SPORTDiscus, Social Services Abstracts ProQuest, Sociological Abstracts ProQuest, Web of Science ISI, Wiley Online Library, Cochrane Library, and ERIC Ebsco databases. All types of studies published since 2001 in English, Spanish, and Portuguese examining physical literacy over the lifespan of older adults were included. Two independent reviewers will organize and select studies according to the objectives and questions of the scoping review. The selected publications will be organized and summarized using a checklist proposed by the PRISMA-ScR. Qualitative data analysis (thematic analysis) will be performed to identify meanings and patterns to answer the research question. The final scoping review will present the main evidence available, key concepts/definitions, research conducted, and knowledge gaps related to physical literacy in older adults, leading to strategies to improve the community health of this population, as well as health literacy

Investment in the long-tail of biodiversity data: from local research to global knowledge

In business, the "long-tail economy" refers to a market strategy where the gravity center shifts from a few high-demand products to many, varied products focused on small niches. Commercialization of individually low-demand products can be profitable as long as their production cost is low and, all taken together, they aggregate into a big chunk of the market. Similarly, in the "business" of biodiversity data acquisition, we can find several mainstream products that produce zillions of bits of information every year and account for most of the budget allocated to increase our primary data-based knowledge about Earth's biological diversity. These products play a crucial role in biodiversity research. However, along with these large global projects, there is a constellation of small-scale institutions that work locally, but whose contribution to our understanding of natural processes should not be dismissed. These information datasets can be collectively referred to as the "long-tail biodiversity data"

Mesoscopic effects in an agent-based bargaining model in regular lattices

The effect of spatial structure has been proved very relevant in repeated games. In this work we propose an agent based model where a fixed finite population of tagged agents play iteratively the Nash demand game in a regular lattice. The model extends the multiagent bargaining model by Axtell, Epstein and Young [1] modifying the assumption of global interaction. Each agent is endowed with a memory and plays the best reply against the opponent’s most frequent demand. We focus our analysis on the transient dynamics of the system, studying by computer simulation the set of states in which the system spends a considerable fraction of the time. The results show that all the possible persistent regimes in the global interaction model can also be observed in this spatial version. We also find that the mesoscopic properties of the interaction networks that the spatial distribution induces in the model have a significant impact on the diffusion of strategies, and can lead to new persistent regimes different from those found in previous research. In particular, community structure in the intratype interaction networks may cause that communities reach different persistent regimes as a consequence of the hindering diffusion effect of fluctuating agents at their borders.Spanish Ministry of Science and Innovation, references TIN2008-06464-C03-02 and CSD2010-00034 (CONSOLIDER-INGENIO 2010), and by the Junta de Castilla y Leon, references VA006A009, BU034A08 and GREX251-200

Rationale and methods of the multicenter randomised trial of a heart failure management programme among geriatric patients (HF-Geriatrics)

<p>Abstract</p> <p>Background</p> <p>Disease management programmes (DMPs) have been shown to reduce hospital readmissions and mortality in adults with heart failure (HF), but their effectiveness in elderly patients or in those with major comorbidity is unknown. The Multicenter Randomised Trial of a Heart Failure Management Programme among Geriatric Patients (HF-Geriatrics) assesses the effectiveness of a DMP in elderly patients with HF and major comorbidity.</p> <p>Methods/Design</p> <p>Clinical trial in 700 patients aged ≥ 75 years admitted with a primary diagnosis of HF in the acute care unit of eight geriatric services in Spain. Each patient should meet at least one of the following comorbidty criteria: Charlson index ≥ 3, dependence in ≥ 2 activities of daily living, treatment with ≥ 5 drugs, active treatment for ≥ 3 diseases, recent emergency hospitalization, severe visual or hearing loss, cognitive impairment, Parkinson's disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), anaemia, or constitutional syndrome. Half of the patients will be randomly assigned to a 1-year DMP led by a case manager and the other half to usual care. The DMP consists of an educational programme for patients and caregivers on the management of HF, COPD (knowledge of the disease, smoking cessation, immunizations, use of inhaled medication, recognition of exacerbations), diabetes (knowledge of the disease, symptoms of hyperglycaemia and hypoglycaemia, self-adjustment of insulin, foot care) and depression (knowledge of the disease, diagnosis and treatment). It also includes close monitoring of the symptoms of decompensation and optimisation of treatment compliance. The main outcome variables are quality of life, hospital readmissions, and overall mortality during a 12-month follow-up.</p> <p>Discussion</p> <p>The physiological changes, lower life expectancy, comorbidity and low health literacy associated with aging may influence the effectiveness of DMPs in HF. The HF-Geriatrics study will provide direct evidence on the effect of a DMP in elderly patients with HF and high comorbidty, and will reduce the need to extrapolate the results of clinical trials in adults to elderly patients.</p> <p>Trial registration</p> <p>(ClinicalTrials.gov number, <a href="http://www.clinicaltrials.gov/ct2/show/NCT01076465">NCT01076465</a>).</p

Imperio vs. multitud : el problema de la biopolítica y la formación

Esta obra recoge y actualiza el debate contemporáneo de la biopolítica a partir de Imperio de Michael Hardt y Antoni Negri. Se presentan diversas contribuciones que articulan, desde una mirada crítica, el despliegue de la biopolítica respecto de la formación. La multitud constituye uno de los horizontes que atraviesa el debate dado. Se caracteriza cómo la reciente concepción de la biopolítica se ancla en la tradición filosífica que se desprende desde Ockham y Scoto, hasta llegar a la discusión contemporánea sobre la individuación, y cómo el despliegue de las variantes de la biopolítica va posibilitando la configuración de subjetividad(es) en el imperio. En estos escenarios deviene la producción no sólo de mercancías materiales, sino, también, de bienes inmateriales. Las sociedades producen subjetividades que el imperio quiere dominar, por lo que cobra relevancia, entonces, el tema de la resistencia y la pregunta por un proyecto de formación que posibilite el despliegue de la persona