Reconstrucción narrativa de una experiencia de hospitalización. Narrative Reconstruction of a Hospitalization Experience

Al integrar la perspectiva más reciente de la Psicología de la salud con la Psicología cultural, este trabajo indaga, por medio de una entrevista narrativa, los relatos de N = 40 personas (11 M y 29 F, entre 20-60 años) que han vivido una hospitalización por causa de un accidente o una enfermedad. Se parte de la hipótesis de que el hospital es una institución y un lugar físico impregnado de significados culturales y de vivencias emocionales personales. El objetivo consistió en explorar las modalidades con las cuales las y los participantes reconstruyeron narrativamente su experiencia hospitalaria y cómo se valoraron a sí mismos y a los otros en términos de recursos y vínculos. El corpus de las 40 entrevistas fue sometido a un análisis estadístico lexical por medio del software ALCESTE (Reinert, 1993), con el resultado de tres clases de discurso: (1) Solicitud de apoyo social, (2) el hospital como lugar de miedo e incertidumbre y (3) el hospital narrado con terminología médica. El análisis factorial de las correspondencias extrajo dos factores: el primero denominado “gravedad de la hospitalización” (polaridad mayor/menor) y el segundo denominado “focus de la narración” (polaridad interno/externo). Se concluye que el hospital, aunque se concibe como una institución que ayuda a sanar, interrumpe la rutina diaria, produce aislamiento y provoca miedo. Este tipo de estudio puede contribuir a poner de manifiesto aspectos psicológicos en el proceso salud-enfermedad que sirvan como puente de comunicación con el personal sanitario. Bringing together the most recent perspectives of Health Psychology and Cultural Psychology, this study uses the narrative interview to investigate the stories of N = 40 subjects (11 M and 29 F, between 20-60 years) who had experienced a hospitalization as a consequence of an accident or illness. The hypothesis is that the hospital is an institution and a physical place impregnated with cultural meanings and personal emotional experiences. The aim was to explore the categories the participants used to reconstruct their hospital experience in their narrations, looking for textual indications of sense-making, of self-assessment and of appreciation for others in terms of resources and bonds. The corpus of the 40 texts was submitted to a statistical lexical analysis with ALCESTE software (Reinert, 1993), resulting in three classes of discourse: (1) The demand for social support, (2) the hospital as a place of fear, and (3) the hospital narrated in medical terms. A factorial analysis of correspondences extracted two factors: The first, denominated “severity of the hospitalization” (polarity major/minor), and the second denominated “focus of narration” (polarity internal/external). We conclude that the hospital, although conceived as an institution that helps to heal, interrupts the daily routine, produces isolation and causes fear. This type of study may contribute to highlight psychological aspects of the health-illness process, which may be useful to provide a bridge for communication with healthcare personnel

Migranti per amore. Rinunce, risorse e opportunità nell’espatrio femminile dal Messico all’Italia

Il fenomeno dell’espatrio femminile ha assunto solo in tempi recenti specifiche ed interessanti sfaccettature. I dati ISTAT (2007) sui matrimoni in Italia mostrano un incremento considerevole dei matrimoni misti. Partendo dall’ipotesi che la migrazione dovuta al progetto di vita con un partner straniero è un processo che mobilita cambiamenti interni e costringe a ristrutturare l’identità, questo lavoro ha come obiettivo di analizzare le modalità di narrazione con cui 12 donne messicane ri-costruiscono e dotano di senso la loro esperienza di espatrio in Italia. Il corpus costituito dalle interviste narrative è stato sottoposto a diverse analisi, semantico-strutturale (Alceste) e categoriale-tematica (N-Vivo). I risultati mostrano che le donne immigrate per amore rinunciano a parti di Sé e soprattutto della loro identità sociale e professionale, ma sviluppano modalità di comportamento resilienti, frutto di un’esperienza “ponte” complessa, che tuttavia il paese di accoglienza raramente supporta. The phenomenon of women expatriation has only recently taken specific and interesting facets. ISTAT data (2007) on weddings in Italy show a considerable increase in mixed marriages. Assuming that the migration due to the project of life with a foreign partner is a process that mobilizes internal changes and forces to restructure their identity, this work aims to study the ways of storytelling in which 12 Mexican women re-build and give meaning to their experience of expatriation to Italy. The corpus, consistent of narrative interviews, was subjected to various analysis, semantic-structural (Alceste) and categorical thematic-(N-Vivo). The data show that women emigrant for love give up parts of themselves and especially their social and professional identity, but develop resilient mode of behavior as a result of a complex bridging experience, but this is rarely supported by the host country

Scalar Field Dark Matter: behavior around black holes

We present the numerical evolution of a massive test scalar fields around a Schwarzschild space-time. We proceed by using hyperboloidal slices that approach future null infinity, which is the boundary of scalar fields, and also demand the slices to penetrate the event horizon of the black hole. This approach allows the scalar field to be accreted by the black hole and to escape toward future null infinity. We track the evolution of the energy density of the scalar field, which determines the rate at which the scalar field is being diluted. We find polynomial decay of the energy density of the scalar field, and use it to estimate the rate of dilution of the field in time. Our findings imply that the energy density of the scalar field decreases even five orders of magnitude in time scales smaller than a year. This implies that if a supermassive black hole is the Schwarzschild solution, then scalar field dark matter would be diluted extremely fastComment: 15 pages, 21 eps figures. Appendix added, accepted for publication in JCA

Constraining scalar fields with stellar kinematics and collisional dark matter

The existence and detection of scalar fields could provide solutions to long-standing puzzles about the nature of dark matter, the dark compact objects at the centre of most galaxies, and other phenomena. Yet, self-interacting scalar fields are very poorly constrained by astronomical observations, leading to great uncertainties in estimates of the mass $m_\phi$ and the self-interacting coupling constant $\lambda$ of these fields. To counter this, we have systematically employed available astronomical observations to develop new constraints, considerably restricting this parameter space. In particular, by exploiting precise observations of stellar dynamics at the centre of our Galaxy and assuming that these dynamics can be explained by a single boson star, we determine an upper limit for the boson star compactness and impose significant limits on the values of the properties of possible scalar fields. Requiring the scalar field particle to follow a collisional dark matter model further narrows these constraints. Most importantly, we find that if a scalar dark matter particle does exist, then it cannot account for both the dark-matter halos and the existence of dark compact objects in galactic nucleiComment: 23 pages, 8 figures; accepted for publication by JCAP after minor change

The Aminopeptidase CD13 Induces Homotypic Aggregation in Neutrophils and Impairs Collagen Invasion.

Aminopeptidase N (CD13) is a widely expressed cell surface metallopeptidase involved in the migration of cancer and endothelial cells. Apart from our demonstration that CD13 modulates the efficacy of tumor necrosis factor-α-induced apoptosis in neutrophils, no other function for CD13 has been ascribed in this cell. We hypothesized that CD13 may be involved in neutrophil migration and/or homotypic aggregation. Using purified human blood neutrophils we confirmed the expression of CD13 on neutrophils and its up-regulation by pro-inflammatory agonists. However, using the anti-CD13 monoclonal antibody WM-15 and the aminopeptidase enzymatic inhibitor bestatin we were unable to demonstrate any direct involvement of CD13 in neutrophil polarisation or chemotaxis. In contrast, IL-8-mediated neutrophil migration in type I collagen gels was significantly impaired by the anti-CD13 monoclonal antibodies WM-15 and MY7. Notably, these antibodies also induced significant homotypic aggregation of neutrophils, which was dependent on CD13 cross-linking and was attenuated by phosphoinositide 3-kinase and extracellular signal-related kinase 1/2 inhibition. Live imaging demonstrated that in WM-15-treated neutrophils, where homotypic aggregation was evident, the number of cells entering IL-8 impregnated collagen I gels was significantly reduced. These data reveal a novel role for CD13 in inducing homotypic aggregation in neutrophils, which results in a transmigration deficiency; this mechanism may be relevant to neutrophil micro-aggregation in vivo.This work was funded by a Medical Research Council Research Training Fellowship to CAF (G0900329), Addenbrooke’s Charitable Trust (ACT), CUHNHSFT, Papworth Hospital NHS Foundation Trust and the NIHR Cambridge Biomedical Research Centre. CAF received a Raymond and Beverly Sackler Studentship.This is the final version of the article. It first appeared from the Public Library of Science via http://dx.doi.org/10.1371/journal.pone.016010

The experience and management of neck pain in general practice: the patients’ perspective

The objective of this study is to investigate the perspective and expectation of patients presenting with neck pain in general practice. The study design is a qualitative analysis of patient interviews and was conducted in a primary care setting in Germany. Twenty patients aged 20–78, according to theoretical sampling were included in the study. Patients tried to cope autonomously with the situation and consulted GPs only if their self-help had failed. When patients asked for external help, they usually focused on somatic treatment options such as massage, physiotherapy or injections. Most patients reported to have experiences with somatic therapies; however, they felt that some or all of these treatments were inefficient or led only to short-time improvements. Patients often avoided psychosocial themes when talking to doctors for fear of being branded as ‘neurotic’. Although neck pain is difficult to manage and a burden for patients, they have obviously found a way of both living with their pain and a pragmatic approach of talking about their symptoms with their doctor. According to the patients’ statements, the interaction between doctor and patient seems to be rather distant, ensuring that both sides avoid any issues that might touch upon psychological aspects of neck pain

ZikaPLAN: addressing the knowledge gaps and working towards a research preparedness network in the Americas.

Zika Preparedness Latin American Network (ZikaPLAN) is a research consortium funded by the European Commission to address the research gaps in combating Zika and to establish a sustainable network with research capacity building in the Americas. Here we present a report on ZikaPLAN`s mid-term achievements since its initiation in October 2016 to June 2019, illustrating the research objectives of the 15 work packages ranging from virology, diagnostics, entomology and vector control, modelling to clinical cohort studies in pregnant women and neonates, as well as studies on the neurological complications of Zika infections in adolescents and adults. For example, the Neuroviruses Emerging in the Americas Study (NEAS) has set up more than 10 clinical sites in Colombia. Through the Butantan Phase 3 dengue vaccine trial, we have access to samples of 17,000 subjects in 14 different geographic locations in Brazil. To address the lack of access to clinical samples for diagnostic evaluation, ZikaPLAN set up a network of quality sites with access to well-characterized clinical specimens and capacity for independent evaluations. The International Committee for Congenital Anomaly Surveillance Tools was formed with global representation from regional networks conducting birth defects surveillance. We have collated a comprehensive inventory of resources and tools for birth defects surveillance, and developed an App for low resource regions facilitating the coding and description of all major externally visible congenital anomalies including congenital Zika syndrome. Research Capacity Network (REDe) is a shared and open resource centre where researchers and health workers can access tools, resources and support, enabling better and more research in the region. Addressing the gap in research capacity in LMICs is pivotal in ensuring broad-based systems to be prepared for the next outbreak. Our shared and open research space through REDe will be used to maximize the transfer of research into practice by summarizing the research output and by hosting the tools, resources, guidance and recommendations generated by these studies. Leveraging on the research from this consortium, we are working towards a research preparedness network

Whole organisms or pure compounds? entourage effect versus drug specificity

As the therapeutic use of sacred plants and fungi becomes increasingly accepted by Western medicine, a tug of war has been taking place between those who advocate the traditional consumption of whole organisms and those who defend exclusively the utilization of purified compounds. The attempt to reduce organisms to single active principles is challenged by the sheer complexity of traditional medicine. Ayahuasca, for example, is a concoction of at least two plant species containing multiple psychoactive substances with complex interactions. Similarly, cannabis contains dozens of psychoactive substances whose specific combinations in different strains correspond to different types of therapeutic and cognitive effects. The “entourage effect” refers to the synergistic effects of the multiple compounds present in whole organisms, which may potentiate clinical efficacy while attenuating side effects. In opposition to this view, mainstream pharmacology is adamant about the need to use purified substances, presumably more specific and safe. In this chapter, I will review the evidence on both sides to discuss the scientific, economic, and political implications of this controversy. The evidence indicates that it is time to embrace the therapeutic complexity of psychedelics.2019-07-3

Global human footprint on the linkage between biodiversity and ecosystem functioning in reef fishes

Copyright: © 2011 Mora et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Difficulties in scaling up theoretical and experimental results have raised controversy over the consequences of biodiversity loss for the functioning of natural ecosystems. Using a global survey of reef fish assemblages, we show that in contrast to previous theoretical and experimental studies, ecosystem functioning (as measured by standing biomass) scales in a non-saturating manner with biodiversity (as measured by species and functional richness) in this ecosystem. Our field study also shows a significant and negative interaction between human population density and biodiversity on ecosystem functioning (i.e., for the same human density there were larger reductions in standing biomass at more diverse reefs). Human effects were found to be related to fishing, coastal development, and land use stressors, and currently affect over 75% of the world's coral reefs. Our results indicate that the consequences of biodiversity loss in coral reefs have been considerably underestimated based on existing knowledge and that reef fish assemblages, particularly the most diverse, are greatly vulnerable to the expansion and intensity of anthropogenic stressors in coastal areas