Psicologia cultural: introdução e visão geral

The article provides an introduction to and overview of cultural psychology. It begins by introducing the three major figures of the Vygotsky Circle in the 1920s and 30s: Lev Vygotsky, Alexander Luria, and Aleksei Leontiev. Their collaboration is important not least because it demonstrates that study of culture and of neurobiology are not opposed lines of investigation but complementary. It also provides context to the founding of the International Society for Cultural and Activity Research (Iscar) in 2002 through merger of the International Society for Cultural Research and Activity Theory (Iscrat) and the Conference for Sociocultural Research. The article then briefly sketches the history of cultural psychology in the English-speaking world and introduces some of the major figures. It turns to consider Vygotsky’s project in more detail, explaining his diagnosis of the crisis in the psychology of his time and his solution for avoiding dualism. It then focuses on the key features of Vygotsky’s account of children’s development, outlining his reconstruction of the stages and transitions of ontogenesis and offering an interpretation of the process of internalization. It concludes with a discussion of research methodology in cultural psychology, explaining how it differs from the quasi-experimental designs that are typical in cross-cultural psychology.Este artículo proporciona una introducción y una visión general de la psicología cultural. Comienza con la introducción de las tres figuras principales del Círculo Vygotskiano en las décadas de los veinte y los treinta: Lev Vygotsky, Alexander Luria y Alekséi Leontiev, ya que la colaboración entre ellos es importante porque demuestra que el estudio de la cultura y de la neurobiología no son líneas de investigación opuestas, sino complementarias. Seguido a esto, se bosqueja brevemente la historia de la psicología cultural en el mundo de habla inglesa y se presentan algunas de sus principales figuras. Después, se hace énfasis en el proyecto de Vygotsky, explicando su diagnóstico de la crisis en la psicología y su solución para evitar el dualismo. Luego, se hace foco en las características clave del relato de Vygotsky sobre el desarrollo de los niños, describiendo su reconstrucción de las etapas y transiciones de la ontogénesis y ofreciendo una interpretación del proceso de internalización. Concluye con una discusión de la metodología de la investigación en psicología cultural, explicando en qué se diferencia de los diseños cuasi experimentales típicos de la psicología transcultural.O artigo proporciona uma introdução e uma visão geral da psicologia cultural. Começa com a introdução das três figuras principais do “Círculo Vygotskiano” nos anos 20 e 30: Lev Vygotsky, Alexander Luria e Alekséi Leontiev. A colaboração entre eles é importante, não só porque demostra que o estudo da cultura e da neu- robiologia não são linhas de pesquisa opostas, mas complementárias. O artigo logo esboça brevemente a história da psicologia cultural no mundo de língua inglesa e apresenta algumas de suas principais figuras. Depois passa a considerar o projeto de Vygotskycom mais detalhe, explicando seu diagnóstico da crise na psicologia e sua solução para evitar o dualismo. Após, enfoca-se nas características chave do relate de Vygotsky sobre o desenvolvimento das crianças, descrevendo sua reconstrução das etapas e transições da ontogênese e oferecendo uma interpretação do processo de interna- lização. Conclui com uma discussão da metodologia da pesquisa em psicologia cultural, explicando em que se diferencia dos desenhos quase experimentais típicos da psicologia transcultural

Efficacy of sacubitril/valsartan relative to a prior decompensation: the PARADIGM-HF trial

Objectives: This study assessed whether the benefit of sacubtril/valsartan therapy varied with clinical stability. Background: Despite the benefit of sacubitril/valsartan therapy shown in the PARADIGM-HF (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial, it has been suggested that switching from an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker should be delayed until occurrence of clinical decompensation. Methods: Outcomes were compared among patients who had prior hospitalization within 3 months of screening (n = 1,611 [19%]), between 3 and 6 months (n = 1,009 [12%]), between 6 and 12 months (n = 886 [11%]), >12 months (n = 1,746 [21%]), or who had never been hospitalized (n = 3,125 [37%]). Results: Twenty percent of patients without prior HF hospitalization experienced a primary endpoint of cardiovascular death or heart failure (HF) hospitalization during the course of the trial. Despite the increased risk associated with more recent hospitalization, the efficacy of sacubitril/valsartan therapy did not differ from that of enalapril according to the occurrence of or time from hospitalization for HF before screening, with respect to the primary endpoint or with respect to cardiovascular or all-cause mortality. Conclusions: Patients with recent HF decompensation requiring hospitalization were more likely to experience cardiovascular death or HF hospitalization than those who had never been hospitalized. Patients who were clinically stable, as shown by a remote HF hospitalization (>3 months prior to screening) or by lack of any prior HF hospitalization, were as likely to benefit from sacubitril/valsartan therapy as more recently hospitalized patients. (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure [PARADIGM-HF]; NCT01035255)

Hacia una ontología social del aprendizaje

Introducción Los recientes intentos de desarrollar teorías sociales o culturales del aprendizaje asumen, a menudo irreflexivamente, que la experiencia vivida así entendida es “cotidiana” en su naturaleza. En la lingüística hay movimientos en esta dirección (por ejemplo, en torno a temas de la pragmática, la deixis, la sociolingüística, el uso del lenguaje como práctica social), así como en otros contextos disciplinarios (psicología, sociología, educación y estudios culturales). Estos intentos..

Dementia-related adverse events in PARADIGM-HF and other trials in heart failure with reduced ejection fraction.

Aims: Inhibition of neprilysin, an enzyme degrading natriuretic and other vasoactive peptides, is beneficial in heart failure with reduced ejection fraction (HFrEF), as shown in PARADIGM-HF which compared the angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan with enalapril. As neprilysin is also one of many enzymes clearing amyloid-β peptides from the brain, there is a theoretical concern about the long-term effects of sacubitril/valsartan on cognition. Therefore, we have examined dementia-related adverse effects (AEs) in PARADIGM-HF and placed these findings in the context of other recently conducted HFrEF trials. Methods and results: In PARADIGM-HF, patients with symptomatic HFrEF were randomized to sacubitril/valsartan 97/103 mg b.i.d. or enalapril 10 mg b.i.d. in a 1:1 ratio. We systematically searched AE reports, coded using the Medical Dictionary for Regulatory Activities (MedDRA), using Standardized MedDRA Queries (SMQs) with ‘broad’ and ‘narrow’ preferred terms related to dementia. In PARADIGM-HF, 8399 patients aged 18–96 years were randomized and followed for a median of 2.25 years (up to 4.3 years). The narrow SMQ search identified 27 dementia-related AEs: 15 (0.36%) on enalapril and 12 (0.29%) on sacubitril/valsartan [hazard ratio (HR) 0.73, 95% confidence interval (CI) 0.33–1.59]. The broad search identified 97 (2.30%) and 104 (2.48%) AEs (HR 1.01, 95% CI 0.75–1.37), respectively. The rates of dementia-related AEs in both treatment groups in PARADIGM-HF were similar to those in three other recent trials in HFrEF. Conclusion: We found no evidence that sacubitril/valsartan, compared with enalapril, increased dementia-related AEs, although longer follow-up may be necessary to detect such a signal and more sensitive tools are needed to detect lesser degrees of cognitive impairment. Further studies to address this question are warranted

Presentación. Psicología y cultura

Tradicionalmente, la psicología ha tenido relaciones problemáticas con la cultura. Una posición ha sido omitirla de los análisis. Como se recordará, la propuesta de la psicología de los pueblos (Volkerpsychologie) de Wundt, aunque no completamente desterrada de la escena, fue rechazada por el conductismo metodológico que se impuso en la psicología a comienzos del siglo XX. La psicología experimental dispuso que la cultura fuera un ruido por controlar en el diseño de investigación y que se inv..

Influence of Sacubitril/Valsartan (LCZ696) on 30-day readmission after heart failure hospitalization

Background: Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. Objectives: This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. Methods: We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril. Results: Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1,076 (45.2%) occurred in subjects assigned to LCZ696 and 1,307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in LCZ696-assigned subjects and 21.0% in enalapril-assigned subjects (odds ratio: 0.74; 95% confidence interval: 0.56 to 0.97; p = 0.031). Rates of readmission for HF at 30-days were also lower in subjects assigned to LCZ696 (9.7% vs. 13.4%; odds ratio: 0.62; 95% confidence interval: 0.45 to 0.87; p = 0.006). The reduction in both all-cause and HF readmissions with LCZ696 was maintained when the time window from discharge was extended to 60 days and in sensitivity analyses restricted to adjudicated HF hospitalizations. Conclusions: Compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization

A concrete psychological investigation of ifá divination/ una investigación psicológica concreta de la adivinación de ifá/ uma pesquisa psicológica concreta da adivinhação de ifá

Divination -the consultation of an oracle in order to determine a course for future action- has long been considered a practice characteristic of "primitive mentality." We describe research with the babalawo of Santería, who are expert in the divinatory system of Ifá. Our first goal is to offer an example of what Vygotsky called "concrete psychology": the study of particular systems of psychological functions in the concrete circumstances of specific professional complexes. Our second goal is to explore the character of divination as psychological and social process, given the somewhat negative views of divination expressed by many social scientists, including Lévy-Bruhl and Vygotsky himself. Analysis of a recorded consultation identified features characteristic of institutional discourse. We argue that the institutional facts of divination may constitute an unfamiliar ontology, but the epistemology -the appeal to logic and to empirical evidence- is a familiar one

Behavioral Interventions as an Adjunctive Treatment for Canine Epilepsy: A Missing Part of the Epilepsy Management Toolkit?

Epilepsy is a common, complex and often challenging neurological disorder to treat in the dog, with 20–30% of dogs resistant to conventional medical therapies, and associated with cognitive and behavioral comorbidities and early death. Behavioral interventions are an emerging area of focus in the adjunctive treatment of drug-resistant human epilepsy patients, with studies indicating positive effects of a variety of interventions including relaxation-based techniques and behavioral therapy interventions. Behavioral interventions have the potential not only to improve seizure control, but also improve behavioral comorbidities and general quality of life in this hard to treat patient group. Despite striking similarities between human and canine epilepsy patients, including the recognition of co-morbid anxiety in epilepsy patients, behavioral interventions have yet to be studied in dogs. This is compounded by several licensed psychopharmaceutical agents for dogs being contra-indicated in epilepsy patients. We present evidence from human studies of the efficacy of behavioral interventions to improve seizure control, psychiatric comorbidities and quality of life, and propose that adapting such interventions for canine patients may be a valuable addition to the epilepsy management toolkit. There is a need for multi-center, double-blinded, placebo-controlled trials to confirm the effects of behavioral interventions on seizure frequency in veterinary medicine. In the absence of such evidence to date, the use of established behavioral medicine techniques to reduce stress and improve the mental health of these often sensitive and challenging patients is advocated, with a greater role for behaviorists in the management of epilepsy patients alongside neurologists and general practitioners

Effects of sacubitril/valsartan in the PARADIGM-HF Trial (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) according to background therapy

Background—In the PARADIGM-HF trial (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure), the angiotensin receptor neprilysin inhibitor sacubitril/valsartan was more effective than the angiotensin-converting enzyme inhibitor enalapril in patients with heart failure and reduced ejection fraction. We examined whether this benefit was consistent irrespective of background therapy. Methods and Results—We examined the effect of study treatment in the following subgroups: diuretics (yes/no), digitalis glycoside (yes/no), mineralocorticoid receptor antagonist (yes/no), and defibrillating device (implanted defibrillating device, yes/no). We also examined the effect of study drug according to β-blocker dose (≥50% and <50% of target dose) and according to whether patients had undergone previous coronary revascularization. We analyzed the primary composite end point of cardiovascular death or heart failure hospitalization, as well as cardiovascular death. Most randomized patients (n=8399) were treated with a diuretic (80%) and β-blocker (93%); 47% of those taking a β-blocker were treated with ≥50% of the recommended dose. In addition, 4671 (56%) were treated with a mineralocorticoid receptor antagonist, 2539 (30%) with digoxin, and 1243 (15%) had a defibrillating device; 2640 (31%) had undergone coronary revascularization. Overall, the sacubitril/valsartan versus enalapril hazard ratio for the primary composite end point was 0.80 (95% confidence interval, 0.73–0.87; P<0.001) and for cardiovascular death was 0.80 (0.71–0.89; P<0.001). The effect of sacubitril/valsartan was consistent across all subgroups examined. The hazard ratio for primary end point ranged from 0.74 to 0.85 and for cardiovascular death ranged from 0.75 to 0.89, with no treatment-by-subgroup interaction. Conclusions—The benefit of sacubitril/valsartan, over an angiotensin-converting enzyme inhibitor, was consistent regardless of background therapy and irrespective of previous coronary revascularization or β-blocker dose