THE CONSTRUCTION OF THE PATHWAY TO THE BOND THAT LINKS THE ADOLESCENT MOTHER TO HER PRETERM BABY

Precocious maternity brings about risks for lhe adolescent mother and her baby. Among these risks, prematurity is seen as one of lhe reasons for lhe troubles found in lhe adolescentmother and lhe preterm baby bonding. This article intends to present a case study that describes the construction of the bond between an adolescent mother and her preterm baby, through the interventions of the health team, specially the speech pathology and audiology, in promotingbreastfeeding.A maternidade precoce traz consigo riscos para a mãe adolescente e seu bebe. Entre estes riscos, a prematuridade é vista como um dos possíveis fatores de dificuldade de vinculação da díade mãe-adolescente e bebe pré-tenno. Este artigo pretende apresentar um estudo de caso que descreve a construção do vínculo de uma mãe adolescente e seu bebé prematuro, através de intervenções da equipe de saúde e, em especial da fonoaudiologia, no incentivo ao aleitamento matemo

Survival strategies and metabolic interactions between Ruminococcus gauvreauii and Ruminococcoides bili, isolated from human bile

This work was funded by MINECO (Spanish Ministry of Economy and Competitiveness) under grant number AGL2013-44761-P, supported by FEDER (The European Regional Development Funds). N.M. was the recipient of an FPI Predoctoral Grant (BES-2014-068736) from MINECO. A.M. thanks the support of CSIC (PIE-201970E019 grant). N.M., A.M., and S.D. from the MicroHealth group would like to thank the grant of the “Plan for Research, Development and Innovation of the Principado de Asturias 2018–2020” (ref. IDI/2018/000236) co-financed by FEDER funds. S.H.D. and A.W.W. acknowledge core funding support for the Rowett Institute from the Scottish Government Rural and Environmental Sciences and Analytical Services (RESAS) as well as the support for E.C. from the Tenovus Charitable trust (Scotland). Donna Henderson from Rowett Institute (University of Aberdeen) is also acknowledged for carrying out the gas chromatography analysis.Peer reviewedPublisher PD

Spatial distribution and community structure of megabenthic bivalves in the subtidal area of the Gulf of Cádiz (SW Spain)

VENUSEstudio integral de los bancos naturales de moluscos bivalvos en el Golfo de Cádiz para su gestión sostenible y la conservación de sus hábitats asociado

Spatial distribution patterns of the striped venus clam (Chamelea gallina, L. 1758) natural beds in the Gulf of Cádiz (SW Spain)

VENUSEstudio integral de los bancos naturales de moluscos bivalvos en el Golfo de Cádiz para su gestión sostenible y la conservación de sus hábitats asociado

O Interaccionismo Simbólico e Teoría Fundamentada: um caminho para enfermagem para compreender os significados

Objetivo: Analizar los conceptos de significado, interaccionismo simbólico y teoría fundamentada, argumentado la diferenciación y proponerlos para la investigación cualitativa en enfermería. Metodología: Se realizó un ensayo teórico a partir del análisis de los conceptos de Significado, Interaccionismo simbólico y Teoría fundamentada en bibliografía referente al tema, interrelacionándolos a través de la reflexión para construir una argumentación que permita diferenciar los conceptos e integrarlos como propuesta para la investigación cualitativa en enfermería. Resultados: La investigación cualitativa parte de los datos expresados por los seres humanos de diversas maneras, generalmente son construcciones del mundo que les rodea y se representan por símbolos que son llamados significados. Esos significados están íntimamente relacionados con la vida misma, la salud, la enfermedad y el cuidado, por lo cual es imperante para enfermería comprender los significados que se dan en los seres humanos, esa comprensión se da por la interpretación de los mismos en los discursos mismos. Conclusiones: Es necesario distinguir el interaccionismo simbólico como eje teórico o referente y la teoría fundamentada como un eje metodológico. La teoría fundamentada da soporte metodológico para apoyar el proceso y conducir la interpretación de las interacciones humanas en las cuales se ve inmersa la enfermera.Objective: To analyze the concepts of meaning, symbolic interactionism and grounded theory, arguing the differentiation and proposing them for qualitative research in nursing. Methodology: A theoretical essay was performed based on the analysis of the concepts of Meaning, Symbolic Interaccionism and Grounded Theory based on bibliography related to the subject, interrelating them through reflection to build an argument that allows to differentiate the concepts and integrate them as a proposal for Qualitative Research in nursing. Results: Qualitative research departs from the data expressed by humans in various ways, generally they are constructions of the world around them and represented by symbols that are called meanings. These meanings are intimately related to life, health, disease and care, so it is imperative for nursing to understand the meanings that are given in humans, that understanding is given by the interpretation of the same in speeches. Conclusions: It is necessary to distinguish the symbolic interactionism as a theoretical or referential axis and the grounded theory as a methodological axis. The grounded theory gives methodological support in the process and leads the interpretation of human interactions in which the nurse is immersed.Objetivo: Analisar os conceitos de significado, o interacionismo simbólico e teoria fundamentada, argumentando a diferenciação afim de propor a pesquisa qualitativa em Enfermagem. Metodologia: Foi realizada uma resenha teórica com base na análise dos conceitos de significado, o interacionismo simbólico e teoria fundamentada em literatura sobre a temática, relacionando por meio da reflexão para construir um argumento para diferenciar os conceitos e integrá-los como uma proposta de pesquisa qualitativa em Enfermagem. Resultados: A pesquisa qualitativa parte dos dados expressos pelos seres humanos de várias maneiras, que geralmente são construções do mundo ao seu redor e são representadas por símbolos que são chamados de significados. Esses significados estão intimamente relacionados com a própria vida, saúde, doença e cuidado. Por isso é imperativo para Enfermagem compreender os significados dados nos seres humanos, dada pela sua interpretação nos seus discursos. Conclusões: É necessário distinguir o interacionismo simbólico como eixo teórico e a Teoria Fundamentada como eixo metodológico. A teoria fundamentada dá apoio metodológico no processo e conduz à interpretação das interações humanas em que a enfermeira está imersa

Evidence-Based Psychological Treatments for Adults: A Selective Review

Antecedentes: los tratamientos psicológicos han mostrado su efi cacia, efectividad y efi ciencia para el abordaje de los trastornos mentales; no obstante, considerando el conocimiento científi co generado en los últimos años, no se dispone de trabajos de actualización en español sobre cuáles son los tratamientos psicológicos con respaldo empírico. El objetivo fue realizar una revisión selectiva de los principales tratamientos psicológicos empíricamente apoyados para el abordaje de trastornos mentales en personas adultas. Método: se recogen niveles de evidencia y grados de recomendación en función de los criterios propuestos por el Sistema Nacional de Salud de España (en las Guías de Práctica Clínica) para diferentes trastornos psicológicos. Resultados: los resultados sugieren que los tratamientos psicológicos disponen de apoyo empírico para el abordaje de un amplio elenco de trastornos psicológicos. El grado de apoyo empírico oscila de bajo a alto en función del trastorno psicológico analizado. La revisión sugiere que ciertos campos de intervención necesitan una mayor investigación. Conclusiones: a partir de esta revisión selectiva, los profesionales de la psicología podrán disponer de información rigurosa y actualizada que les permita tomar decisiones informadas a la hora de implementar aquellos procedimientos psicoterapéuticos empíricamente fundamentados en función de las características de las personas que demandan ayuda.Background: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. Method: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. Results: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. Conclusions: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help

The H-ATOMIC Criteria for the Etiologic Classification of Patients with Intracerebral Hemorrhage

Background and Purpose There are no generally accepted criteria for the etiologic classification of intracerebral hemorrhage (ICH). For this reason, we have developed a set of etiologic criteria and have applied them to a large number of patients to determine their utility. Methods The H-ATOMIC classification includes 7 etiologic categories: Hypertension, cerebral Amyloid angiopathy, Tumour, Oral anticoagulants, vascular Malformation, Infrequent causes and Cryptogenic. For each category, the etiology is scored with three degrees of certainty: Possible(3), Probable(2) and Definite(1). Our aim was to perform a basic study consisting of neuroimaging, blood tests, and CT-angio when a numerical score (SICH) suggested an underlying structural abnormality. Combinations of >1 etiologic category for an individual patient were acceptable. The criteria were evaluated in a multicenter and prospective study of consecutive patients with spontaneous ICH. Results Our study included 439 patients (age 70.8 ± 14.5 years; 61.3% were men). A definite etiology was achieved in 176 (40.1% of the patients: Hypertension 28.2%, cerebral Amyloid angiopathy 0.2%, Tumour 0.2%, Oral anticoagulants 2.2%, vascular Malformation 4.5%, Infrequent causes 4.5%). A total of 7 patients (1.6%) were cryptogenic. In the remaining 58.3% of the patients, ICH was attributable to a single (n = 56, 12.7%) or the combination of 2 (n = 200, 45.5%) possible/probable etiologies. The most frequent combinations of etiologies involved possible hypertension with possible CAA (H3A3, n = 38) or with probable CAA (H3A2, n = 29), and probable hypertension with probable OA (H2O2, n = 27). The most frequent category with any degree of certainty was hypertension (H1+2+3 = 80.6%) followed by cerebral amyloid angiopathy (A1+2+3 = 30.9%). Conclusions According to our etiologic criteria, only about 40% patients received a definite diagnosis, while in the remaining patients ICH was attributable to a single possible/probable etiology or to more than one possible/probable etiology. The use of these criteria would likely help in the management of patients with ICH.This work was supported by Ministery of Health-Instituto de Salud Carlos III: RETICS (Redes temáticas de Investigación Cooperativa) INVICTUS RD012/0014 (JM-F, PC-R, AM-D, LP-S, RD-M), FEDER (Fondo Europeo de Desarrollo Regional)

Use of colonoscopy as a primary screening test for colorectal cancer in average risk people

The use of colonoscopy as a primary screening test for colorectal cancer (CRC) in average risk adults is a subject of controversy. Our primary objective was to build a predictive model based on a few simple variables that could be used as a guide for identifying average risk adults more suitable for examination with colonoscopy as a primary screening test. METHODS: The prevalence of advanced adenomas was assessed by primary screening colonoscopy in 2210 consecutive adults at least 40 yr old, without known risk factors for CRC. Age, gender, and clinical and biochemical data were compared among people without adenomas, those with non-advanced adenomas, and those with any advanced neoplasm. A combined score to assess the risk of advanced adenomas was built with the variables selected by multiple logistic regression analysis. RESULTS: Neoplastic lesions were found in 617 subjects (27.9%), including 259 with at least one neoplasm that was 10 mm or larger, villous, or with moderate-to-severe dysplasia, and 11 with invasive cancers. Advanced lesions were more frequent among men, older people, and those with a higher body mass index (BMI). These three variables were independent predictors of advanced adenomas in multivariate analysis. A score combining age, sex, and BMI was developed as a guide for identifying individuals more suitable for screening colonoscopy. CONCLUSIONS: Age, gender, and BMI can be used to build a simple score to select those average risk adults who might be candidates for primary screening colonoscop

Diagnostic value of distal colonic polyps for prediction of advanced proximal neoplasia in an average-risk population undergoing screening colonoscopy

For colorectal cancer screening, the predictive value of distal findings in the ascertainment of proximal lesions is not fully established. The aims of this study were to assess distal findings as predictors of advanced proximal neoplasia and to compare the predictive value of endoscopy alone vs. combined endoscopic and histopathologic data. METHODS: Primary colonoscopy screening was performed in 2210 consecutive, average-risk adults. Age, gender, endoscopic (size, number of polyps), and histopathologic distal findings were used as potential predictors of advanced proximal neoplasms (i.e., any adenoma > or =1 cm in size, and/or with villous histology, and/or with severe dysplasia or invasive cancer). Polyps were defined as distal if located in the descending colon, the sigmoid colon, or the rectum. Those in other locations were designated proximal. RESULTS: Neoplastic lesions, including 11 invasive cancers, were found in 617 (27.9%) patients. Advanced proximal neoplasms without any distal adenoma were present in 1.3% of patients. Of the advanced proximal lesions, 39% were not associated with any distal polyp. Older age, male gender, and distal adenoma were independent predictors of advanced proximal neoplasms. The predictive ability of a model with endoscopic data alone did not improve after inclusion of histopathologic data. In multivariate logistic regression analysis, the predictive ability of models that use age, gender, and any combination of distal findings was relatively low. The proportion of advanced proximal neoplasms identified if any distal polyp was an indication for colonoscopy was only 62%. CONCLUSIONS: A strategy in which colonoscopy is performed solely in patients with distal colonic findings is not effective screening for the detection of advanced proximal neoplasms in an average-risk populatio

Episodic Arctic CO2 Limitation in the West Svalbard Shelf

The European Sector of the Arctic Ocean is characterized by low CO2 concentrations in seawater during spring and summer, largely due to strong biological uptake driven by extensive plankton blooms in spring. The spring plankton bloom is eventually terminated by nutrient depletion and grazing. However, low CO2 concentrations in seawater and low atmospheric resupply of CO2 can cause episodes during which the phytoplankton growth is limited by CO2. Here, we show that gross primary production (GPP) of Arctic plankton communities increases from 32 to 72% on average with CO2 additions in spring. Enhanced GPP with CO2 additions occur during episodes of high productivity, low CO2 concentration and in the presence of dissolved inorganic nutrients. However, during summer the addition of CO2 supresses planktonic Arctic GPP. Events of CO2 limitation in spring may contribute to the termination of the Arctic spring plankton blooms. The stimulation of GPP by CO2 during the spring bloom provides a biotic feedback loop that might influence the global role played by the Arctic Ocean as a CO2 sink in the future