A Mindfulness-Based Program Improves Health in Caregivers of People with Autism Spectrum Disroder: a pilot study

Mindfulness-based interventions have demonstrated to be effective in reducing stress and health complaints in clinical populations. However, to our knowledge, biological health markers have not been used in studies of the effectiveness of mindfulness programs in caregivers of people with autism spectrum disorders (ASDs). This study aimed to assess the effects of a mindfulness intervention on mood disturbances and health complaints in this population compared with non-caregivers. The design of the study was quasiexperimental, with repeated measures. Self-reported health, cortisol awakening response (CAR), and afternoon cortisol levels before and after a mindfulness session were assessed at the beginning, middle, and end of the intervention. There was a significant reduction in mood disturbances and afternoon cortisol levels during the sessions in all participants, with the reductions being more pronounced in caregivers. Moreover, all participants showed fewer depressive and somatic symptoms at the end of the program, with an improvement in their self-perceived general health. Nevertheless, the CAR levels had not changed significantly after the program. Overall, these results indicate that mindfulness group therapy could be effective for reducing health complaints and reinforce the validity of these programs for caregivers

Negative affect, perceived health, and endocrine and immunological levels in caregivers of offspring with schizophrenia.

Negative affect (NA) and chronic stress are separately associated with health imbalances, and the interaction between the two aspects remains unclear. Care of relatives with long-term pathologies could be a likely model in the study of this issue, as caregivers frequently report chronic stress and health complaints. The aim of this study is examine the role of NA on psychophysiological stress-induced response and health in schizophrenia caregivers. Method: Forty-one caregivers were distributed into two groups accordingly to their scores in NA. Thirteen non-caregivers were included as a control group. Participants were exposed to a repeated acute psychosocial stress while salivary cortisol, immunoglobulin A (IgA), and skin conductance level (SCL) were measured before, during, and after stress. Mood, state-anxiety, care conditions and perceived general health were also assessed. Results: Caregivers with higher NA reported negative perceptions, worse health, and greater decreases in cortisol and IgA response than caregivers with low NA and than non-caregivers. Conclusions: NA could reduce the capability to develop adaptive psychophysiological stress responses. From a preventive view, the evaluation of NA could be useful to detect and assist high-risk individuals in potentially chronically stressed population

Psychophysiological responses to acute stress in two groups of healthy women differing in fitness

This study examined how the degree of fitness affects several psychophysiological responses to stress in elite sportswomen and physically active women. Trait anxiety and mood were evaluated, and salivary testosterone (Tsal) and cortisol (Csal) concentrations determined before and after a maximal ergometry. Afterwards, subjects carried out the Stroop task, where heart rate (HR) and skin conductance level (SCL) were continuously recorded. At baseline, elite sportswomen had worse mood, and lower cardiovascular basal measures and testosterone:cortisol ratio. In the Stroop task, they showed higher SCL reactivity and worse recovery with respect to the baseline values than physically active women. There was a positive relationship between Tsal and HR as well as between negative mood and SCL, and a negative one between negative mood and HR. In women, the degree of fitness moderates he electrodermal responses to acute stress, a specific pattern of relationship among different psychophysiological variables being found

Internal attribution of outcome moderates the cortisol response to a cooperative task in women

Las observaciones etológicas actuales indican que las conductas cooperativas desempeñan un papel adaptativo. En humanos, las situaciones competitivas han sido mayoritariamente investigadas en varones, aunque en escasas ocasiones se ha estudiado la cooperación. Se pretende analizar la respuesta psicológica y del cortisol a una situación cooperativa, en comparación con una competitiva en el laboratorio en mujeres. Se establecieron cuatro grupos en función de la tarea y su resultado: cooperación positiva, cooperación negativa, competición con victoria y competición con derrota. La cooperación produce efectos diferentes en cortisol que la competición, pero no en las variables psicológicas, aunque estos efectos únicamente se producen cuando se considera el resultado y su atribución. Solo las participantes que cooperaron y fueron evaluadas positivamente y las que compitieron y perdieron mostraron descensos signifi cativos de cortisol. La atribución interna se asocia a niveles de cortisol más estables, sugiriendo un efecto modulador de la controlabilidad en la vivencia de la situación. Estos resultados podrían hacerse extensibles a situaciones en las que la negociación, la mediación y las estrategias cooperativas son relevantes para la toma de decisiones y/o resolución de conflictos

La valoración del resultado modula la respuesta del cortisol a una tarea cooperativa en mujeres

Las observaciones etológicas actuales indican que las conductas cooperativas desempeñan un papel adaptativo. En humanos, las situaciones competitivas han sido mayoritariamente investigadas en varones, aunque en escasas ocasiones se ha estudiado la cooperación. Se pretende analizar la respuesta psicológica y del cortisol a una situación cooperativa, en comparación con una competitiva en el laboratorio en mujeres. Se establecieron cuatro grupos en función de la tarea y su resultado: cooperación positiva, cooperación negativa, competición con victoria y competición con derrota. La cooperación produce efectos diferentes en cortisol que la competición, pero no en las variables psicológicas, aunque estos efectos únicamente se producen cuando se considera el resultado y su atribución. Solo las participantes que cooperaron y fueron evaluadas positivamente y las que compitieron y perdieron mostraron descensos significativos de cortisol. La atribución interna se asocia a niveles de cortisol más estables, sugiriendo un efecto modulador de la controlabilidad en la vivencia de la situación. Estos resultados podrían hacerse extensibles a situaciones en las que la negociación, la mediación y las estrategias cooperativas son relevantes para la toma de decisiones y/o resolución de conflictos

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Second GHEP-ISFG exercise for DVI: “DNA-led” victims’ identification in a simulated air crash

The Spanish and Portuguese-Speaking Working Group of the International Society for Forensic Genetics (GHEP-ISFG) has organized a second collaborative exercise on a simulated case of Disaster Victim Identification (DVI), with the participation of eighteen laboratories. The exercise focused on the analysis of a simulated plane crash case of medium-size resulting in 66 victims with varying degrees of fragmentation of the bodies (with commingled remains). As an additional difficulty, this second exercise included 21 related victims belonging to 6 families among the 66 missings to be identified. A total number of 228 post-mortem samples were represented with aSTR and mtDNA profiles, with a proportion of partial aSTR profiles simulating charred remains. To perform the exercise, participants were provided with aSTR and mtDNA data of 51 reference pedigrees —some of which deficient—including 128 donors for identification purposes. The exercise consisted firstly in the comparison of the post-mortem genetic profiles in order to re-associate fragmented remains to the same individual and secondly in the identification of the re-associated remains by comparing aSTR and mtDNA profiles with reference pedigrees using pre-established thresholds to report a positive identification. Regarding the results of the post-mortem samples re-associations, only a small number of discrepancies among participants were detected, all of which were from just a few labs. However, in the identification process by kinship analysis with family references, there were more discrepancies in comparison to the correct results. The identification results of single victims yielded fewer problems than the identification of multiple related victims within the same family groups. Several reasons for the discrepant results were detected: a) the identity/non-identity hypotheses were sometimes wrongly expressed in the likelihood ratio calculations, b) some laboratories failed to use all family references to report the DNA match, c) In families with several related victims, some laboratories firstly identified some victims and then unnecessarily used their genetic information to identify the remaining victims within the family, d) some laboratories did not correctly use “prior odds” values for the Bayesian treatment of the episode for both post-mortem/post-mortem re-associations as well as the ante-mortem/post-mortem comparisons to evaluate the probability of identity. For some of the above reasons, certain laboratories failed to identify some victims. This simulated “DNA-led” identification exercise may help forensic genetic laboratories to gain experience and expertize for DVI or MPI in using genetic data and comparing their own results with the ones in this collaborative exercise.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Peer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Pasados y presente. Estudios para el profesor Ricardo García Cárcel

Ricardo García Cárcel (Requena, 1948) estudió Historia en Valencia bajo el magisterio de Joan Reglà, con quien formó parte del primer profesorado de historia moderna en la Universidad Autónoma de Barcelona. En esta universidad, desde hace prácticamente cincuenta años, ha desarrollado una extraordinaria labor docente y de investigación marcada por un sagaz instinto histórico, que le ha convertido en pionero de casi todo lo que ha estudiado: las Germanías, la historia de la Cataluña moderna, la Inquisición, las culturas del Siglo de Oro, la Leyenda Negra, Felipe II, Felipe V, Austrias y Borbones, la guerra de la Independencia, la historia cultural, los mitos de la historia de España... Muy pocos tienen su capacidad para reflexionar, ordenar, analizar, conceptualizar y proponer una visión amplia y llena de matices sobre el pasado y las interpretaciones historiográficas. A su laboriosidad inimitable se añade una dedicación sin límites en el asesoramiento de alumnos e investigadores e impulsando revistas, dosieres, seminarios o publicaciones colectivas. Una mínima correspondencia a su generosidad lo constituye este volumen a manera de ineludible agradecimiento

XVI International Congress of Control Electronics and Telecommunications: "Techno-scientific considerations for a post-pandemic world intensive in knowledge, innovation and sustainable local development"

Este título, sugestivo por los impactos durante la situación de la Covid 19 en el mundo, y que en Colombia lastimosamente han sido muy críticos, permiten asumir la obligada superación de tensiones sociales, políticas, y económicas; pero sobre todo científicas y tecnológicas. Inicialmente, esto supone la existencia de una capacidad de la sociedad colombiana por recuperar su estado inicial después de que haya cesado la perturbación a la que fue sometida por la catastrófica pandemia, y superar ese anterior estado de cosas ya que se encontraban -y aún se encuentran- muchos problemas locales mal resueltos, medianamente resueltos, y muchos sin resolver: es decir, habrá que rediseñar y fortalecer una probada resiliencia social existente - producto del prolongado conflicto social colombiano superado parcialmente por un proceso de paz exitoso - desde la tecnociencia local; como lo indicaba Markus Brunnermeier - economista alemán y catedrático de economía de la Universidad de Princeton- en su libro The Resilient Society…La cuestión no es preveerlo todo sino poder reaccionar…aprender a recuperarse rápido.This title, suggestive of the impacts during the Covid 19 situation in the world, and which have unfortunately been very critical in Colombia, allows us to assume the obligatory overcoming of social, political, and economic tensions; but above all scientific and technological. Initially, this supposes the existence of a capacity of Colombian society to recover its initial state after the disturbance to which it was subjected by the catastrophic pandemic has ceased, and to overcome that previous state of affairs since it was found -and still is find - many local problems poorly resolved, moderately resolved, and many unresolved: that is, an existing social resilience test will have to be redesigned and strengthened - product of the prolonged Colombian social conflict partially overcome by a successful peace process - from local technoscience; As Markus Brunnermeier - German economist and professor of economics at Princeton University - indicates in his book The Resilient Society...The question is not to foresee everything but to be able to react...learn to recover quickly.Bogot