Contingential Analysis: Interbehavioral Methodology for the Applied Field

The main purpose of this chapter is to introduce contingential analysis and to generate interest on this subject. This is an interbehavioral methodology for applied field. Theoretical and philosophical foundations are briefly described at first; this was considered important because this methodology is an alternative and naturalistic way to approach professional work. Its basis is found on the interbehavioral model developed by Kantor such as on the functional taxonomy developed by Ribes and López in 1985. This system has five steps: microcontingential analysis, macrocontingential analysis, behavior origin, solution analysis, and selection, design, and application of intervention strategies; each one is explained in this text. Finally, some effective applications of the methodology are mentioned

Proposta educativa para a saúde do paciente com diabete mellitus tipo 2

Health psychology focuses on the study of the psychological processes involved in health and illness, and incorporates a wide range of activities: health promotion, illness prevention, and attention for both the sick and for people suffering the aftereffects of illness. It also plays a role in the provision of health services according to the needs of the recipients. Given the worldwide prevalence of diabetes mellitus type 2, the conditions and quality of life of people with this disease has become a public health issue that must be addressed seriously. Although the treatment of diabetes is the direct responsibility of professionals and institutions working in this area, a multidisciplinary effort would help greatly in finding a solution or improving the condition, and psychology, as a generator of knowledge that could be applied, therefore has a place in this wider working team. The objective of this research study was to design an educational proposal based on the psychological model of biological health (Ribes, 1990) to promote preventative behavior in patients with diabetes mellitus type 2.La psicología de la salud se aboca al estudio de aquellos procesos psicológicos que participan en el proceso salud-enfermedad. Comprende un plano amplio de actividades: promoción de la salud, prevención de enfermedades, atención tanto de enfermos como de personas con diversas secuelas de enfermedades y de igual manera interviene en la adecuación de los servicios de salud a las necesidades de los que los reciben. Dada la prevalencia de personas con diabetes mellitus tipo 2 en el mundo, las afecciones y la calidad de vida de quien padece esta enfermedad se han convertido en un problema de salud pública que debe ser atendido con seriedad. Si bien es cierto que la atención de la diabetes le atañe a los profesionales y a las instituciones encargados de esa dimensión, sumar esfuerzos en un nivel multidisciplinario debe favorecer en gran medida la solución o mejora de esa condición, por lo que la psicología, como generadora de conocimiento susceptible de ser aplicado, se agrega desde su dimensión al equipo de trabajo. El objetivo de esta investigación fue diseñar una propuesta educativa fundamentada en el modelo psicológico de la salud biológica (Ribes, 1990) para promover conductas de prevención en pacientes con diabetes mellitus tipo 2.A psicologia da saúde se dedica ao estudo daqueles processos psicológicos que participam do processo saúde-doença. Compreende um plano amplo de atividades: promoção da saúde, prevenção de doenças, atendimento tanto de doentes quanto de pessoas com diversas sequelas de doenças, além de intervir na adequação dos serviços de saúde às necessidades dos que os recebem. Tendo em vista a prevalência de pessoas com diabete mellitus tipo 2 no mundo, as afecções e a qualidade de vida de quem padece dessa doença se converteram num problema de saúde pública que deve ser atendido com seriedade. Embora seja certo que o atendimento da diabete corresponda aos profissionais e às instituições encarregadas dessa dimensão, somar esforços num nível multidisciplinar deve favorecer, em grande medida, a solução ou melhora dessa condição; razão pela qual a psicologia, como geradora de conhecimento suscetível de ser aplicado, se soma, sob sua dimensão, à equipe de trabalho. O objetivo desta pesquisa foi desenhar uma proposta educativa fundamentada no modelo psicológico da saúde biológica (Ribes, 1990) para promover condutas de prevenção em pacientes com diabete mellitus tipo 2

ENTRENAMIENTO CONDUCTUAL EN HABILIDADES DE COMUNICACIÓN SEXUAL EN LA PAREJA Y USO CORRECTO DEL CONDÓN

This study assessed the effects of sexual communication and condom use skills training on 50 sexually active college students’ consistent condom use. In vivo sexual communication and condom use skills postintervention assessments showed that intervention group participants acquired the skills trained and were significantly better than control group participant in openly talking about sex (pEl presente estudio evalúa los efectos de un entrenamiento conductual en habilidades de comunicación sexual en la pareja y uso correcto del condón sobre la consistencia en el uso del condón en una muestra de 50 estudiantes universitarios sexualmente activos. En la postevaluación de las variables medidas a través de la observación directa se encontró una ejecución significativamente más alta en el grupo de intervención que la obtenida en el grupo control en la habilidad para iniciar y mantener una conversación sobre sexualidad (

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Estrés: una propuesta naturalista

Some of the stress related topics, especially from the conceptual framework of Lazarus and Folkman are reviewed on this work. It is sustained that this approach is dualistic and that the research made from this view is made on the basis of morphological criteria that don�t allow studying important elements of this kind of behavior. From an interbehavioral approach three functional criteria are proposed to study this phenomenon: the functional nature of situations, aptitude levels of behavior, and its three dimensions. Emphasis is made on the singular and individual nature of stress reactions. Finally it is suggested to take into account these functional criteria to develop a generic situational taxonomy to study these reactions as parts of complex behavioral patterns.En este texto se revisan algunos de los aspectos planteados en el estudio del estrés, particularmente, desde la concepción de Lazarus y Folkman (1991). Se sostiene que esta aproximación es dualista y que las investigaciones llevadas a cabo desde esta perspectiva emplean criterios morfológicos que no han permitido dar cuenta de aspectos importantes de este fenómeno. Con base en una perspectiva interconductual, se propone tomar en cuenta tres criterios para estudiar este tipo de comportamiento: la naturaleza funcional de la situación, los niveles de aptitud funcional del comportamiento y sus diferentes dimensiones. Se enfatiza el carácter individual de las reacciones de estrés y se sugiere que a partir de los criterios propuestos se elabore una taxonomía de situaciones genéricas para estudiar dichas reacciones, como parte de patrones comportamentales complejos

Adherencia a la dieta en pacientes diabéticos: efectos de una intervención

The purpose of the present study was to assess the effect of an intervention program on the self-reported adherence to a prescribed diet for diabetic patients. Because of the impact and consequences of this chronic illness, it is important to make the necessary efforts in order to achieve this dietary adherence goal, since diet is one of the main bases for the treatment of diabetes. According to an interbehavioral approach, an intervention program was designed and applied to ninety diabetic patients from different Mexican public health institutions. This program was developed in three stages. The first stage consisted of a pre-test to assess body weight and habits related to daily meals. The second stage comprehended an intervention divided in two parts, the first one to provide patients with useful knowledge about diabetes and nutrition and the second one to train several behavioral techniques a post-test was applied to participants. Results showed that each intervention´s part had a positive effect on self-reported adherence to diet, and so the complete program. These results were supported by weight data. In this sense, it was found a statistically significant difference between pre and post-test values. It is suggested to continue these efforts in order to contribute on the solution of this public health problem.El presente trabajo tuvo como objetivo evaluar el efecto de un programa de intervención en la adherencia auto reportada a la dieta prescrita para pacientes diabéticos. Dado el costo y consecuencias de esta enfermedad, resulta muy importante lograr este objetivo que constituye la piedra angular del tratamiento. Desde la perspectiva interconductual, se diseñó un programa de intervención que se aplicó a 90 pacientes diabéticos captados en distintos centros de salud de la ciudad de México. El programa constó de una fase de pre-evaluación, en la que se midió el peso y se registraron prácticas alimenticias; una intervención en dos bloques, el primero educativo y el segundo en el que se entrenó en el manejo de algunas técnicas conductuales; y una fase de post-evaluación. Se encontró que cada bloque de intervención tuvo un efecto positivo en la adherencia autoreportada a la dieta y, por ende, el programa en su totalidad fue efectivo en esta muestra de pacientes. Los resultados se corroboraron con las medidas de peso en las que también se encontró una diferencia estadísticamente significativa entre el pre-test y el post-test. Se sugiere continuar buscando estrategias cada vez más efectivas para el logro de este objetivo