La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos de Antioquía y Putumayo

A partir del estudio de los diferentes casos suministrados en el diplomado de profundización acompañamiento psicosocial en escenarios de violencia, cuyo propósito radica en hacer un análisis a profundidad, como psicólogos en formación, de los impactos psicosociales que ha generado en la población el conflicto armado en Colombia y que además permite abordarlos desde un modelo sistémico integrando al individuo, la familia y la comunidad. Este abordaje permite reconocer no solo las huellas negativas que deja la violencia en el individuo como el trauma, la fragmentación de las familias, las afectaciones en el bienestar y la salud mental, sino que también lleva a comprobar que el ser humano tiene la capacidad de reinventarse a través de la transformación de realidades, de la capacidad de resiliencia y de empoderamiento como actores sociales y políticos, que luchan por continuar contando historias y creando memorias de sobrevivencia que los convierte en vencedores de la guerra. Esta investigación inicia con una reflexión sobre el relato de Alfredo quien a través de la narrativa describe los acontecimientos que ha enfrentado en su condición de desplazado, pero llama la atención su forma de afrontar las situaciones adversas, la prontitud de continuar ayudando a su comunidad y la manera en que ha utilizado sus fortalezas y herramientas para abordar el sufrimiento e iniciar con el diseño de un nuevo proyecto de vida. Por su parte, el caso de Peñas Coloradas permite realizar un análisis contextual, a través del reconocimiento de los emergentes psicosociales que necesitan ser intervenidos, los derechos que como pobladores les han sido negados a través de los años, la necesidad de políticas públicas que incluyan y reconozcan a la población como víctimas que requieren un acompañamiento, una reparación integral y el aporte de elementos que les permita transformar el dolor en esperanza, así mismo, se encuentra en este caso el planteamiento de preguntas mediante las cuales el psicólogo en formación busca conectar con la historia de las personas, crear sucesos alternativos cargadas de aprendizajes, de propósitos, autoconocimiento y de valoración de recursos que les lleve a reconocer y resaltar los logros que han alcanzado.Based on the study of the different cases provided in the diploma course on psychosocial accompaniment in scenarios of violence, the purpose of which is to make an in-depth analysis, as psychologists in training, of the psychosocial impacts that the armed conflict in Colombia has generated in the population and that also allows to approach them from a systemic model integrating the individual, the family and the community. This approach allows recognizing not only the negative traces left by violence on the individual, such as trauma, fragmentation of families, affectations in well-being and mental health, but also proves that human beings have the capacity to reinvent themselves through the transformation of realities, the capacity for resilience and empowerment as social and political actors, who struggle to continue telling stories and creating memories of survival that turn them into victors of the war. This research begins with a reflection on the story of Alfredo who, through his narrative, describes the events he has faced as a displaced person, but his way of facing adverse situations, his readiness to continue helping his community and the way in which he has used his strengths and tools to address the suffering and begin to design a new life project are striking. For its part, the case of Peñas Coloradas allows for a contextual analysis, through the recognition of the psychosocial emergencies that need to be intervened, the rights that have been denied to them as inhabitants over the years, the need for public policies that include and recognize the population as victims who require accompaniment, Likewise, in this case, the psychologist in training seeks to connect with the history of the people, to create alternative events loaded with learning, purposes, self-knowledge and valuation of resources that lead them to recognize and highlight the achievements they have reached

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Full developmental potential of mammalian preimplantation embryos is maintained after imaging using a spinning-disk confocal microscope

Fluorescent live imaging of cells and embryos at subcellular resolution poses significant challenges for biologists due to morbidity and mortality ensuing from phototoxicity. Here we report the use of a spinning-disk confocal microscope to image mouse and bovine preimplantation embryos without impairing their developmental potential. We also present data indicating that this imaging technique does not affect the functionality of subcellular components as assessed by reactive oxygen species (ROS) production, caspase activity, and DNA integrity. Spinning-disk confocal microscopy was also useful in determining cell number and allocation in transgenic bovine blastocysts. We conclude that this imaging method is suitable for monitoring preimplantation embryos

MAPC Transplantation Confers a More Durable Benefit Than AC133(+) Cell Transplantation in Severe Hind Limb Ischemia

There is a need for comparative studies to determine which cell types are better candidates to remedy ischemia. Here, we compared human AC133(+) cells and multipotent adult progenitor cells (hMAPC) in a mouse model reminiscent of critical limb ischemia. hMAPC or hAC133(+) cell transplantation induced a significant improvement in tissue perfusion (measured by microPET) 15 days posttransplantation compared to controls. This improvement persisted for 30 days in hMAPC-treated but not in hAC133(+)-injected animals. While transplantation of hAC133(+) cells promoted capillary growth, hMAPC transplantation also induced collateral expansion, decreased muscle necrosis/fibrosis, and improved muscle regeneration. Incorporation of differentiated MC 133(+) or hMAPC progeny into new vessels was limited; however, a paracrine angio/arteriogenic effect was demonstrated in animals treated with hMAPC. Accordingly, hMAPC-conditioned, but not hAC133(+)-conditioned, media stimulated vascular cell proliferation and prevented myoblast, endothelial, and smooth muscle cell apoptosis in vitro. Our study suggests that although hAC133(+) cell and hMAPC transplantation both contribute to vascular regeneration in ischemic limbs, hMAPC exert a more robust effect through trophic mechanisms, which translated into collateral and muscle fiber regeneration. This, in turn, conferred tissue protection and regeneration with longer term functional improvement.status: publishe

Non-valvular atrial fibrillation in patients on peritoneal dialysis, prevalence, treatment and professionals involved

Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillars for the prevention of thromboembolic events. However, there are no randomized clinical trials on the risk-benefit profile of oral anticoagulation in patients with chronic kidney disease stage 5 on peritoneal dialysis and there is little evidence in the literature in this population.The objective of our study was to know the prevalence, treatment and professionals involved in the management of atrial fibrillation in peritoneal dialysis patients. For this purpose, we performed a descriptive analysis through a survey sent to different peritoneal dialysis units in Spain. A total of 1,403 patients on peritoneal dialysis were included in the study, of whom 186 (13.2%) had non-valvular atrial fibrillation. In addition, the assessment of the scores of thromboembolic and bleeding risks for the indication of oral anticoagulation was mainly carried out by the cardiologist (60% of the units), as well as its prescription (cardiologist 47% or in consensus with the nephrologist 43%).In summary, patients on peritoneal dialysis have a remarkable prevalence of non-valvular atrial fibrillation. Patients frequently receive oral anticoagulation with vitamin K antagonists, as well as direct oral anticoagulants. The data obtained regarding the scores used for the assessment of thromboembolic and bleeding risk, treatment and involvement by Nephrology indicates that there is a need for training and involvement of the nephrologist in this pathology. Resumen: La fibrilación auricular es la arritmia crónica más frecuente en pacientes con enfermedad renal crónica. La anticoagulación oral con antagonistas de la vitamina K y actualmente los anticoagulantes orales de acción directa han sido y son el pilar fundamental para la prevención de eventos tromboembólicos. Sin embargo, no existen ensayos clínicos aleatorizados de su perfil riesgo-beneficio en pacientes con enfermedad renal crónica estadio 5 en diálisis peritoneal y son pocas evidencias en la literatura en esta población. El objetivo del estudio fue conocer la prevalencia, tratamiento y profesionales implicados en el manejo de la fibrilación auricular en diálisis peritoneal en nuestro entorno mediante el análisis descriptivo de una encuesta enviada a diferentes unidades de diálisis peritoneal de España. Se incluyeron en el estudio 1403 pacientes en programa de diálisis peritoneal, de los cuales 186 (13,2%) presentaban fibrilación auricular no valvular. Además, observamos que la valoración de los scores para el inicio del tratamiento anticoagulante la realizaba mayoritariamente el cardiólogo (60% de los centros), así como la prescripción de anticoagulación (cardiólogo 47% o conjuntamente con nefrólogo 43%).En conclusión, los pacientes en diálisis peritoneal presentan una notable prevalencia de fibrilación auricular no valvular. Reciben frecuentemente anticoagulación oral con antagonistas de la vitamina K, así como con anticoagulantes orales de acción directa. Los datos obtenidos respecto a las escalas utilizadas para la valoración de riesgo tromboembólico y de sangrado, tratamiento e implicación por parte de Nefrología indica que existe una necesidad de formación e implicación del nefrólogo en esta patología