Perfil cognitivo de un paciente con trastorno adaptativo mixto: estudio de caso

Nuestras experiencia marcan el recorrido de nuestra vida, estas imprimen una pauta de comportamiento, programando así nuestras respuestas y estilos de afrontamiento, así mismo casos en los cuales estas situaciones no se logran resolver y el afrontamiento de las mismas no se da de manera adecuada, generando como consecuencia un malestar significativo que interfiere con la cotidianidad del individuo que afecta sus diferentes dimensiones. Es así como una reacción desadaptada, que tiene como característica ser más intensa y prolongada de lo que se espera, se constituye en la base de los trastornos adaptativos T.A. Para este estudio de caso único la atención de la paciente se centró en el manejo del TA mixto con síntomas de ansiedad y depresión, así mismo en el reforzamiento de características conductuales de la paciente asociadas al TOCP, el cual aporta a la paciente una búsqueda de equilibrio y esfuerzo por superar la situación de alta tensión que experimenta, el trabajo se orienta, a la identificación, reconocimiento y reducción de síntomas, y reorientación en cuanto al estilo de afrontamiento personal frente a la situación; psicoeducación del modelo cognitivo conductual. Los logros se resalta que, la presencia de rasgos de personalidad obsesivo compulsivo aporta a la paciente herramientas para disminuir síntomas asociados al TA, logrando reducir síntomas depresogénicos

Scaling properties reveal regulation of river flows in the Amazon through a “forest reservoir”

ABSTRACT: Many natural and social phenomena depend on river flow regimes that are being altered by global change. Understanding the mechanisms behind such alterations is crucial for predicting river flow regimes in a changing environment. Here we introduce a novel physical interpretation of the scaling properties of river flows and show that it leads to a parsimonious characterization of the flow regime of any river basin. This allows river basins to be classified as regulated or unregulated, and to identify a critical threshold between these states.We applied this framework to the Amazon river basin and found both states among its main tributaries. Then we introduce the “forest reservoir” hypothesis to describe the natural capacity of river basins to regulate river flows through land–atmosphere interactions (mainly precipitation recycling) that depend strongly on the presence of forests. A critical implication is that forest loss can force the Amazonian river basins from regulated to unregulated states. Our results provide theoretical and applied foundations for predicting hydrological impacts of global change, including the detection of early-warning signals for critical transitions in river basins

Interventions in health organisations to reduce the impact of adverse events in second and third victims

Background Adverse events (AE) are also the cause of suffering in health professionals involved. This study was designed to identify and analyse organization-level strategies adopted in both primary care and hospitals in Spain to address the impact of serious AE on second and third victims. Methods A cross-sectional study was conducted in healthcare organizations assessing: safety culture; health organization crisis management plans for serious AE; actions planned to ensure transparency in communication with patients (and relatives) who experience an AE; support for second victims; and protective measures to safeguard the institution’s reputation (the third victim). Results A total of 406 managers and patient safety coordinators replied to the survey. Deficient provision of support for second victims was acknowledged by 71 and 61 % of the participants from hospitals and primary care respectively; these respondents reported there was no support protocol for second victims in place in their organizations. Regarding third victim initiatives, 35 % of hospital and 43 % of primary care professionals indicated no crisis management plan for serious AE existed in their organization, and in the case of primary care, there was no crisis committee in 34 % of cases. The degree of implementation of second and third victim support interventions was perceived to be greater in hospitals (mean 14.1, SD 3.5) than in primary care (mean 11.8, SD 3.1) (p?<?0.001). Conclusions Many Spanish health organizations do not have a second and third victim support or a crisis management plan in place to respond to serious AEs

The aftermath of adverse events in spanish primary care and hospital health professionals

Background Adverse events (AEs) cause harm in patients and disturbance for the professionals involved in the event (second victims). This study assessed the impact of AEs in primary care (PC) and hospitals in Spain on second victims. Methods A cross-sectional study was conducted. We carried out a survey based on a random sample of doctors and nurses from PC and hospital settings in Spain. A total of 1087 health professionals responded, 610 from PC and 477 from hospitals. Results A total of 430 health professionals (39.6%) had informed a patient of an error. Reporting to patients was carried out by those with the strongest safety culture (Odds Ratio –OR- 1.1, 95% Confidence Interval –CI- 1.0-1.2), nurses (OR 1.9, 95% CI 1.5-2.3), those under 50 years of age (OR 0.7, 95% CI 0.6-0.9) and primary care staff (OR 0.6, 95% CI 0.5-0.9). A total of 381 (62.5%, 95% CI 59-66%) and 346 (72.5%, IC95% 69-77%) primary care and hospital health professionals, respectively, reported having gone through the second-victim experience, either directly or through a colleague, in the previous 5 years. The emotional responses were: feelings of guilt (521, 58.8%), anxiety (426, 49.6%), re-living the event (360, 42.2%), tiredness (341, 39.4%), insomnia (317, 38.0%) and persistent feelings of insecurity (284, 32.8%). In doctors, the most common responses were: feelings of guilt (OR 0.7 IC95% 0.6-0.8), re-living the event (OR 0.7, IC95% o.6-0.8), and anxiety (OR 0.8, IC95% 0.6-0.9), while nurses showed greater solidarity in terms of supporting the second victim, in both PC (p?=?0.019) and hospital (p?=?0.019) settings. Conclusions Adverse events cause guilt, anxiety, and loss of confidence in health professionals. Most are involved in such events as second victims at least once in their careers. They rarely receive any training or education on coping strategies for this phenomenon

Futuros filólogos. Competencia laboral en tratamiento de textos y gestión de patrimonio bibliográfico

Memoria ID-300. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2013-2014

Futuros filólogos (2): competencias digitales en tratamiento de textos y enseñanza de idiomas

Memoria ID-0098. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

Evaluación de competencias en lengua francesa conforme al Marco Común Europeo de Referencia para las lenguas (IIª fase)

Memoria ID12-0229. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013

Hacia una internacionalización del sistema de enseñanza español: la enseñanza bilingüe francés-español

Memoria ID-0243. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2015-2016

Coordinación y promoción del grado en estudios franceses: taller de teatro en lengua francesa

Memoria ID-301. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2013-2014

Seguimiento, acreditación y promoción del Grado en Estudios Franceses: XVIIº taller de teatro en lengua francesa

Memoria ID-0282. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015