Protocol for the Implementation and Evaluation of a Mindfulness-Based Intervention for Caregivers of Children with Mental Disorders in a Clinical Setting

Being a parent is complicated in typical circumstances, with a great psychological impact as well as feelings and experiences of great intensity. This impact is greater in families in vulnerable situations, such as those with children with mental health problems, receiving treatment in a clinical setting. Due to these challenges, parenting in these circumstances is often accompanied by experiences of stress. An approach that has shown evidence of effectiveness in mitigating the negative impact of stress is mindfulness-based interventions, including the Mindfulness-Based Stress Reduction intervention program. The Mindfulness-Based Stress Reduction intervention program is designed as a psychoeducational, instructional, multimodal, and structured program whose main objective is to provide strategies for the management, coping, and awareness of stress in order to reduce it. In this paper, a protocol for the implementation and evaluation of the original Mindfulness-Based Stress Reduction intervention program with the added positive parenting component is presented, in order to systematize the incorporation of a parenting component in the Mindfulness-Based Stress Reduction intervention program, analyze its effectiveness for parents whose children have mental health problems (in terms of stress, mindfulness, emotional intelligence, general health, and parental role), explore the mechanisms of change operating in this intervention as perceived by the participants, and examine the application of acquired strategies to daily life

Actitudes de profesionales del ámbito de la intervención familiar hacia las prácticas basadas en la evidencia

A la hora de poner en marcha procesos de innovación en los servicios de intervención familiar que supongan la incorporación de programas basadas en la evidencia (PBE), es fundamental considerar el papel que desempeñan los/ as profesionales, ya que de ellos depende en gran parte la fidelidad y calidad de la implementación de los programas. Este estudio se centra en analizar las actitudes de profesionales hacia las prácticas basadas en la evidencia, así como su percepción y valoración del Programa de Intervención Familiar (PIF), desarrollado en el Ayuntamiento de Pamplona (España) dentro de la cartera de servicios de preservación familiar. Los participantes fueron los/as 27 profesionales que aplican el PIF, que cumplimentaron la escala Evidence-Based Practice Attitude Scale (EBPAS) y la de Expectativas y Valoración Inicial del PIF (EVI-PIF). Los resultados obtenidos mostraron la relación existente entre las actitudes hacia las prácticas basadas en la evidencia y algunas características de los/as profesionales. Asimismo, también se encontró relación significativa entre una alta valoración del PIF y unas actitudes positivas hacia los PBE. Estos resultados avalan la importancia de las actitudes profesionales como elementos que pueden facilitar o dificultar los procesos de innovación y mejora en los servicios de atención e intervención familiar.When implementing innovation processes in family intervention services that involve the incorporation of evidence-based programmes (EBP), it is essential to take into consideration the role played by professionals, since the fidelity and quality of the implementation of the programmes largely depends on them. This study focuses on analysing the attitudes of professionals towards EBP, as well as their perception and assessment of the Family Intervention Programme (FIP), developed in the family prevention services of Pamplona City Council (Spain). The participants in the study were the 27 professionals who implement the FIP, who completed the Evidence-Based Practice Attitude Scale (EBPAS) and the Expectations and Initial Assessment of the FIP (EVI-FIP). The results obtained showed the relationship between attitudes towards evidence-based practice and some characteristics of the professionals. A significant relationship was also found between a high valuation of the FIP and positive attitudes towards EBP. These results support the importance of professional attitudes as elements that can facilitate or hinder innovation and improvement processes in family care and intervention services.Cooperativa Kamir

Characterization in vitro and in vivo of a pandemic H1N1 influenza virus from a fatal case

Pandemic 2009 H1N1 (pH1N1) influenza viruses caused mild symptoms in most infected patients. However, a greater rate of severe disease was observed in healthy young adults and children without co-morbid conditions. Here we tested whether influenza strains displaying differential virulence could be present among circulating pH1N1 viruses. The biological properties and the genotype of viruses isolated from a patient showing mild disease (M) or from a fatal case (F), both without known co-morbid conditions were compared in vitro and in vivo. The F virus presented faster growth kinetics and stronger induction of cytokines than M virus in human alveolar lung epithelial cells. In the murine model in vivo, the F virus showed a stronger morbidity and mortality than M virus. Remarkably, a higher proportion of mice presenting infectious virus in the hearts, was found in F virus-infected animals. Altogether, the data indicate that strains of pH1N1 virus with enhanced pathogenicity circulated during the 2009 pandemic. In addition, examination of chemokine receptor 5 (CCR5) genotype, recently reported as involved in severe influenza virus disease, revealed that the F virus-infected patient was homozygous for the deleted form of CCR5 receptor (CCR5Δ32).Funding Statement: This work was supported by Instituto de Salud Carlos III (Programa especial de investigación sobre la gripe pándemica GR09/0023, GR09/0040, GR09/0039) and Ciber de Enfermedades Respiratorias. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Protocol for the Implementation and Evaluation of a Mindfulness-Based Intervention for Caregivers of Children with Mental Disorders in a Clinical Setting

Being a parent is complicated in typical circumstances, with a great psychological impact as well as feelings and experiences of great intensity. This impact is greater in families in vulnerable situations, such as those with children with mental health problems, receiving treatment in a clinical setting. Due to these challenges, parenting in these circumstances is often accompanied by experiences of stress. An approach that has shown evidence of effectiveness in mitigating the negative impact of stress is mindfulness-based interventions, including the Mindfulness-Based Stress Reduction intervention program. The Mindfulness-Based Stress Reduction intervention program is designed as a psychoeducational, instructional, multimodal, and structured program whose main objective is to provide strategies for the management, coping, and awareness of stress in order to reduce it. In this paper, a protocol for the implementation and evaluation of the original Mindfulness-Based Stress Reduction intervention program with the added positive parenting component is presented, in order to systematize the incorporation of a parenting component in the Mindfulness-Based Stress Reduction intervention program, analyze its effectiveness for parents whose children have mental health problems (in terms of stress, mindfulness, emotional intelligence, general health, and parental role), explore the mechanisms of change operating in this intervention as perceived by the participants, and examine the application of acquired strategies to daily life

Donde fueres haz lo que vieres. Aportaciones de la neurociencia al desarrollo de la competencia pragmática. un nuevo horizonte en la enseñanza del ele: El serious game

The current trend in teaching foreign languages is to conceive the development of pragmatic competence as an essential and inseparable part of communicative competence. Today, progress of Cognitive Neuroscience enables one to consider social behavior in neuroanatomical terms: knowing how the brain integrates complex concepts of pragmatic competence proves highly effective in developing methodologies used in the language classroom to address these issues. The use of games and learning by doing in virtual worlds may be regarded as a very interesting option in order to acquire this competence. In this contribution, we have aimed at combining theoretical principles of Neuroscience and didactics to offer, in the specific case of Teaching Spanish as a Foreign Language (TSFL), a relatively new type of teaching material: the Serious Game, as well as to present the results of a first qualitative study of the use of this type of material in the field of language acquisition.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Lymphomas associated with HIV infection in patients at the hospital San borja arriarán /fundación arriarán 2001-2008, Santiago, Chile Linfomas asociados a infección por VIH en pacientes del hospital clínico san borja arriarán /fundación arriarán 2001-2008

Introduction: Hodgkin lymphomas (HL) and non Hodgkin lymphomas (NHL) are frequently associated to acquired immunodeficiency syndrome in adults. Objective: To systematize the clinical features and histological characteristics of lymphomas in AIDS patients, its treatment and outcomes in our institution. Patients and Methods: Retrospective analysis of patients with HIV-associated lymphoma between January 2001 and December 2008 at the San Borja Arriarán Hospital complex. Results: Information was obtained from 30 patients with NHL and 7 with HL, with a median of 40 years. The majority of tumors were Burkitt lymphoma (47%), diffuse large cell lymphoma B-cell (37%) and NHL of T lineage (10%). There was no CNS or cavities lymphoma. Almost all patients (86.7%) with NHL were treated with CHOP chemotherapy, 57% of those receiving treatment had progression or relapse from complete remission. A rescue chemotherapy was indicated in 4 patients. 73% of patients receiving CHOP, complete 5 to 6 cycles