Resultados de una intervención para la prevención de la depresión en cuidadores a través de multiconferencia telefónica

Traballo Fin de Máster en Psicoloxía Xeral Sanitaria. Curso 2016-2017El objetivo principal de este trabajo fue aplicar y evaluar los resultados de un programa breve (5 sesiones), grupal, en formato telefónico, dirigido a cuidadores informales con síntomas depresivos elevados. Previamente se realizó una revisión sistemática y un meta-análisis sobre la eficacia de intervenciones psicológicas administradas por teléfono para los trastornos depresivos. En el meta-análisis se halló un tamaño del efecto pequeño (d = -.39, IC 95% [-0.45,-0.32], p < .001). En relación al programa, se halló una reducción significativa de sintomatología depresiva (p < 0.001) y del riesgo de desarrollar depresión (p < 0.001) tras la intervención y en los seguimientos a 1 y 3 meses. La incidencia total de nuevos casos de depresión fue de 6.5%. La adherencia y satisfacción fueron muy elevadas. Los resultados alientan a la realización de una evaluación adicional del programa utilizando un ensayo clínico controlado aleatorizadoO obxectivo principal deste traballo foi aplicar e avaliar os resultado dun programa breve (5 sesións), grupal, en formato telefónico, dirixido a coidadores informais con síntomas depresivos elevados. Previamente realizouse unha revisión sistemática e unha meta-análise sobre a eficacia de intervencións psicolóxicas administradas por teléfono para os trastornos depresivos. Na meta-análise achouse un tamaño do efecto pequeno (d = -.39, IC 95% [-0.45,-0.32], p < .001). En relación ao programa, achouse unha redución significativa da sintomatoloxía depresiva (p < 0.001) e do risco de desenrolar depresión (p < 0.001) tras a intervención e nos seguimentos a 1 e 3 meses. A incidencia total de novos casos de depresión foi de 6.5%. A adherencia e a satisfacción foron moi elevadas. Os resultados alentan á realización dunha avaliación adicional do programa utilizando un ensaio clínico controlado aleatorizadoThe main objective of this work was to implement and evaluate the results of a brief program (5 sessions), in group, by telephone format, aimed at informal caregivers with elevated depressive symptoms. Previously it was conducted a systematic review and meta-analysis on the effectiveness of psychological interventions delivered by telephone for depressive disorders. In the meta-analysis, it was found a small effect size (d = -.39, 95% CI [ -0.45 , -0.32 ] , p < .001 ). In relation to the program, it was found a significant reduction in depressive symptoms (p < 0.001) and the risk of developing depression (p < 0.001) after intervention and follow-ups at 1 and 3 months. The total incidence of new cases of depression was 6.5%. The adherence and satisfaction were very high. The results encourage the performance of further evaluation of the program using a randomized controlled clinical trialEsta investigación ha sido financiada por el Ministerio de Economía y Competitividad a través del Proyecto PSI2012-37396. Agradecemos también la colaboración de la Secretaría Xeral de Política Social, Unidade Técnica de Coordinación de Dependencia, Consellería de Traballo e Benestar (Xunta de Galicia) a través del Convenio con dicha institució

Análisis de los componentes de una intervención cognitivo conductual administrada a través de conferencia telefónica para la prevención de la depresión en cuidadores no profesionales: un ensayo controlado aleatorizado con un seguimiento a 36 meses

El principal objetivo de esta tesis fue evaluar la eficacia de una intervención cognitivo conductual, y otra solo con el componente de activación conductual, administradas a través de multiconferencia telefónica para la prevención indicada de la depresión en cuidadores no profesionales. Los resultados de los estudios incluidos avalaron la viabilidad del programa administrado mediante multiconferencia telefónica, la pertinencia de la activación conductual para la prevención indicada de la depresión en los cuidadores, y la eficacia a corto y a largo plazo de las dos intervenciones administradas mediante multiconferencia telefónica para la prevención indicada de la depresión en cuidadores no profesionales

Cuestionario de Personalidad de Eysenck Revisado-Abreviado para cuidadores informales

The objective of this study was to analyze the psychometric properties of the Spanish version of the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) in informal caregivers. Trained, independent evaluators administered the EPQR-A and evaluated informal caregivers’ depressive symptoms, automatic negative thoughts, self-efficacy, and pleasant social contacts, and clinical experts assessed major depressive episode in 592 caregivers (87.2% women, mean age 55.4 years). Women scored significantly higher on Neuroticism than men (p < .001). Subscale internal consistencies were .77 for Neuroticism, .75 for Extraversion, .47 for Sincerity; and .24 for Psychoticism. These four factors accounted for 38.1% of total variance. However, a three-factor model (excluding Psychoticism) better fit the data. Neuroticism was significantly, inversely correlated with both self-efficacy (r = -.35) and pleasant social contacts (r = -.22), and positively correlated with both depressive symptoms (r = .59) and negative thoughts (r = .53). Extraversion was significantly, inversely correlated with both depressive symptoms (r = -.22) and negative thoughts (r = -.22), and positively correlated with both selfefficacy (r = .36) and pleasant social contacts (r = .16). A cutoff score of 4 on Neuroticism suitably discriminated between depressed and non-depressed informal caregivers (sensitivity = 68.1%, specificity = 79.9%The objective of this study was to analyze the psychometric properties of the Spanish version of the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) in informal caregivers. Trained, independent evaluators administered the EPQR-A and evaluated informal caregivers’ depressive symptoms, automatic negative thoughts, self-efficacy, and pleasant social contacts, and clinical experts assessed major depressive episode in 592 caregivers (87.2% women, mean age 55.4 years). Women scored significantly higher on Neuroticism than men (p < .001). Subscale internal consistencies were .77 for Neuroticism, .75 for Extraversion, .47 for Sincerity; and .24 for Psychoticism. These four factors accounted for 38.1% of total variance. However, a three-factor model (excluding Psychoticism) better fit the data. Neuroticism was significantly, inversely correlated with both self-efficacy (r = -.35) and pleasant social contacts (r = -.22), and positively correlated with both depressive symptoms (r = .59) and negative thoughts (r = .53). Extraversion was significantly, inversely correlated with both depressive symptoms (r = -.22) and negative thoughts (r = -.22), and positively correlated with both selfefficacy (r = .36) and pleasant social contacts (r = .16). A cutoff score of 4 on Neuroticism suitably discriminated between depressed and non-depressed informal caregivers (sensitivity = 68.1%, specificity = 79.9%This work was supported by the Ministry of Economy and Competitiveness of Spain [grant number 2012-PN162 (PSI2012-37396)]S

Long-Term Effects of a Cognitive Behavioral Conference Call Intervention on Depression in Non-Professional Caregivers

Recent evidence supports the efficacy of conference call cognitive–behavioral interventions in preventing depression in caregivers at post-intervention, but we do not know whether the results are sustained long term. The main objective of this study was to evaluate the long-term efficacy of a cognitive–behavioral intervention administered by telephone conference call in preventing depression in caregivers with elevated depressive symptoms, comparing all components of the intervention versus only the behavioral ones. A randomized controlled trial was conducted using a dismantling strategy. At total of 219 caregivers were randomly assigned to a cognitive–behavioral conference call intervention (CBCC; n = 69), a behavioral-activation conference call intervention (BACC; n = 70), or a usual care control group (CG, n = 80). Information was collected on depressive symptoms and depression at pre-intervention and at 1, 3, 6, 12, and 36 months post-intervention. At 36 months, there was a reduction in depressive symptoms (p < 0.001) and a lower incidence of major depressive episodes in both the CBCC and BACC groups compared to CG (8.7%, 8.6%, and 33.7%, respectively). The results show that a conference call intervention was effective in the long term to prevent depression in caregivers and that the behavioral-activation component was comparable to the complete cognitive–behavioral protocolThis research was funded by the Spanish Ministry of Economy and Competitiveness under grant number 2012-PN162S

Cognitive-behavioral intervention via interactive multimedia online video game for active aging: study protocol for a randomized controlled trial

Background Due to the progressive aging of the population, programs to promote active aging have been recommended. However, older adults have difficulty accessing them. Interventions administered through online video games may increase their accessibility, and complementing these with a smartphone app will likely increase adherence and allow for ongoing professional monitoring. The objective of this study is to evaluate the efficacy of a cognitive-behavioral intervention for active aging administered through an online interactive multimedia video game that includes a smartphone app companion. The secondary objectives are to analyze the moderators and mediators of the change in the outcome variables and to evaluate the adherence to the intervention. Methods/design A randomized controlled clinical trial will be conducted. Adults 45 years and older will be randomly assigned to a cognitive-behavioral intervention administered through an online multimedia video game that includes a smartphone app companion or to a control group that will receive online information on active aging (274 participants per group). The intervention will be administered in eight weekly 45-min modules. An investigator-blinded evaluation will be conducted using online self-administered tests at baseline, post-intervention, and 6- and 12-month follow-ups. The primary outcome will be mental health status as evaluated using the 36-item Short-Form Health Survey (SF-36) at post-intervention. Secondary outcomes will be emotional well-being, depressive symptoms, reinforcement, negative thoughts, self-reported memory, cognitive task performance, sleep hygiene behaviors, physical activity, eating habits, body mass index, social support, dropout, treatment adherence, and satisfaction with the intervention. Discussion If the results are favorable, this study would involve the development of the first evidence-based active aging promotion intervention based on a video game that includes a smartphone app companion, providing evidence on its efficacy, accessibility, and clinical utility.The development of this protocol was funded by grant EXP - 00091195/ ITC20161137 from Center for Industrial Technological Development of Spain and the European Regional Development Fund, and grant 2018-PU054 from Department of Culture, Education and University RegulationS

Analysis of the Components of a Cognitive-Behavioral Intervention for the prevention of Depression Administered via Conference Call to Nonprofessional Caregivers: A Randomized Controlled Trial

Effective and accessible interventions for indicated prevention of depression are necessary and lacking, especially for informal caregivers. Although telephone-based interventions could increase the accessibility for caregivers, randomized controlled trials are scarce, with no examination of prevention to date. Moreover, the efficacy of specific therapeutic components in preventive cognitive-behavioral programs is unknown. The main objective of this study was to evaluate the efficacy of a telephone-administered psychological preventive intervention in informal caregivers with high depressive symptoms. A total of 219 caregivers were randomized to a cognitive-behavioral conference call intervention (CBCC, n = 69), a behavioral-activation conference call intervention (BACC, n = 70), or a usual care control group (CG, n = 80). Both interventions consisted of five 90-minute group sessions. At the post-intervention, incidence of depression was lower in CBCC and BACC compared to CG (1.5% and 1.4% vs. 8.8%). Relative risk was 0.17 for the CBCC and 0.16 for the BACC, and the number-needed-to-treat was 14 in both groups. Depressive symptoms were significantly lower in BACC and BACC groups compared to CG (d = 1.16 and 1.29), with no significant differences between CBCC and BACC groups. The conference call intervention was effective in preventing depression and the behavioral-activation component (BACC) was comparable to the CBCC interventionThis research was funded by the Spanish Ministry of Economy and Competitiveness under grant number 2012-PN162S

Accurate Identification of ALK Positive Lung Carcinoma Patients: Novel FDA-Cleared Automated Fluorescence In Situ Hybridization Scanning System and Ultrasensitive Immunohistochemistry

Background: Based on the excellent results of the clinical trials with ALK-inhibitors, the importance of accurately identifying ALK positive lung cancer has never been greater. However, there are increasing number of recent publications addressing discordances between FISH and IHC. The controversy is further fuelled by the different regulatory approvals. This situation prompted us to investigate two ALK IHC antibodies (using a novel ultrasensitive detection-amplification kit) and an automated ALK FISH scanning system (FDA-cleared) in a series of non-small cell lung cancer tumor samples. Methods: Forty-seven ALK FISH-positive and 56 ALK FISH-negative NSCLC samples were studied. All specimens were screened for ALK expression by two IHC antibodies (clone 5A4 from Novocastra and clone D5F3 from Ventana) and for ALK rearrangement by FISH (Vysis ALK FISH break-apart kit), which was automatically captured and scored by using Bioview's automated scanning system. Results: All positive cases with the IHC antibodies were FISH-positive. There was only one IHC-negative case with both antibodies which showed a FISH-positive result. The overall sensitivity and specificity of the IHC in comparison with FISH were 98% and 100%, respectively. Conclusions: The specificity of these ultrasensitive IHC assays may obviate the need for FISH confirmation in positive IHC cases. However, the likelihood of false negative IHC results strengthens the case for FISH testing, at least in some situation

Assessment of a New ROS1 Immunohistochemistry Clone (SP384) for the Identification of ROS1 Rearrangements in Patients with Non–Small Cell Lung Carcinoma: the ROSING Study

Introduction: The ROS1 gene rearrangement has become an important biomarker in NSCLC. The College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology testing guidelines support the use of ROS1 immunohistochemistry (IHC) as a screening test, followed by confirmation with fluorescence in situ hybridization (FISH) or a molecular test in all positive results. We have evaluated a novel anti-ROS1 IHC antibody (SP384) in a large multicenter series to obtain real-world data. Methods: A total of 43 ROS1 FISH-positive and 193 ROS1 FISH-negative NSCLC samples were studied. All specimens were screened by using two antibodies (clone D4D6 from Cell Signaling Technology and clone SP384 from Ventana Medical Systems), and the different interpretation criteria were compared with break-apart FISH (Vysis). FISH-positive samples were also analyzed with next-generation sequencing (Oncomine Dx Target Test Panel, Thermo Fisher Scientific). Results: An H-score of 150 or higher or the presence of at least 70% of tumor cells with an intensity of staining of 2+ or higher by the SP384 clone was the optimal cutoff value (both with 93% sensitivity and 100% specificity). The D4D6 clone showed similar results, with an H-score of at least 100 (91% sensitivity and 100% specificity). ROS1 expression in normal lung was more frequent with use of the SP384 clone (p < 0.0001). The ezrin gene (EZR)-ROS1 variant was associated with membranous staining and an isolated green signal FISH pattern (p = 0.001 and p = 0.017, respectively). Conclusions: The new SP384 ROS1 IHC clone showed excellent sensitivity without compromising specificity, so it is another excellent analytical option for the proposed testing algorithm

Updated guidelines for predictive biomarker testing in advanced non-small-cell lung cancer: a national consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

Data de publicació electrònica: 09-10-2019In 2011 the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP) started a joint project to establish guidelines on biomarker testing in patients with advanced non-small-cell lung cancer (NSCLC) based on current evidence. As this field is constantly evolving, these guidelines have been updated, previously in 2012 and 2015 and now in 2019. Current evidence suggests that the mandatory tests to conduct in all patients with advanced NSCLC are for EGFR and BRAF mutations, ALK and ROS1 rearrangements and PD-L1 expression. The growing need to study other emerging biomarkers has promoted the routine use of massive sequencing (next-generation sequencing, NGS). The coordination of every professional involved and the prioritisation of the most suitable tests and technologies for each case remains a challenge

Polarization‐Sensitive and Broadband Photodetection Based on a Mixed‐Dimensionality TiS3/Si p–n Junction

The capability to detect the polarization state of light is crucial in many day‐life applications and scientific disciplines. Novel anisotropic 2D materials such as TiS3 combine polarization sensitivity, given by the in‐plane optical anisotropy, with excellent electrical properties. Here, the fabrication of a monolithic polarization‐sensitive broadband photodetector based on a mixed‐dimensionality TiS3/Si p–n junction is demonstrated. The fabricated devices show broadband responsivity up to 1050 nm, a strong sensitivity to linearly polarized illumination with difference between the two orthogonal polarization states up to 350%, and a good detectivity and fast response time. The discussed devices can be used as building blocks to fabricate more complex polarization‐sensitive systems such as polarimeters.The authors acknowledge funding from the EU Graphene Flagship (Grant Graphene Core2 785219) and from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement no. 755655, ERC‐StG 2017 project 2D‐TOPSENSE). R.F. acknowledges support from the Netherlands Organisation for Scientific Research (NWO) through the research program Rubicon with project number 680‐50‐1515. D.P.d.L. acknowledges support from the MINECO (program FIS2015‐67367‐C2‐1‐P). Y.N. acknowledges the grant from the China Scholarship Council (File No. 201506120102). W.C.J. acknowledges the Program for the Top Young and Middle‐aged Innovative Talents of Harbin Institute of Technology. MIRE group acknowledges financial support from MINECO‐FEDER (MAT2015‐65203‐R).Peer reviewe