The Therapeutic Church

This project aims to develop Nexus Point Church as a therapeutic environment. The Therapeutic Church environment is a supportive community, one member to another, ministering to each other empathetically, not service dependent or a dispenser of services. It is “Pew Neighbor” supportive and crisis intervention ready. The Therapeutic Church provides a therapeutic environment that heals interactively in spirit, mind, body, and relationship to improve the quality of life for the church member and those seeking help. This project identifies members as “Pew Neighbors” due to the proximity and continual closeness shared with those within the church community. Pew neighbors serve one another through love via the new commandment Jesus gave that identifies His disciples: “A new commandment I give to you, that you love one another, even as I have loved you, that you also love one another. By this all men will know that you are My disciples, if you have love for one another” (John 13:34–35, NASB). Through an insider’s perspective method, the results of a pre-survey/questionnaire, an 8 Session Course: Elements of a Therapeutic Church, and a post-survey/questionnaire measured the participants’ knowledge and understanding of a Therapeutic Church environment to determine the plausibility of developing a Therapeutic Church ministry emulating Jesus’ approach to preaching the gospel and integrative healing in spirit, mind, body, and relationship (Luke 4:14–21). Research results indicated a significant improvement in participants’ knowledge and understanding of a Therapeutic Church environment after completing the course, thus determining the favorable plausibility of developing Nexus Point as a Therapeutic Church

Evolution of tyrosinemia type 1 disease in patients treated with nitisinone in Spain

Nephrocalcinosis; Phenotype; Severe liver dysfunctionNefrocalcinosis; Fenotipo; Disfunción hepática graveNefrocalcinosi; Fenotip; Disfunció hepàtica greuTreatment with nitisinone (NTBC) has brought about a drastic improvement in the treatment and prognosis of hereditary tyrosinemia type I (HT1). We conducted a retrospective observational multicentric study in Spanish HT1 patients treated with NTBC to assess clinical and biochemical long-term evolution.We evaluated 52 patients, 7 adults and 45 children, treated with NTBC considering: age at diagnosis, diagnosis by clinical symptoms, or by newborn screening (NBS); phenotype (acute/subacute/chronic), mutational analysis; symptoms at diagnosis and clinical course; biochemical markers; doses of NTBC; treatment adherence; anthropometric evolution; and neurocognitive outcome.The average follow-up period was 6.1 ± 4.9 and 10.6 ± 5.4 years in patients with early and late diagnosis respectively. All patients received NTBC from diagnosis with an average dose of 0.82 mg/kg/d. All NBS-patients (n = 8) were asymptomatic at diagnosis except 1 case with acute liver failure, and all remain free of liver and renal disease in follow-up. Liver and renal affectation was markedly more frequent at diagnosis in patients with late diagnosis (P T.After NTBC treatment a reduction in tyrosine and alpha-fetoprotein levels was observed in all the study groups, significant for alpha-fetoprotein in no NBS-group (P = .03), especially in subacute/chronic forms (P = .018).This series confirms that NTBC treatment had clearly improved the prognosis and quality of life of HT1 patients, but it also shows frequent cognitive dysfunctions and learning difficulties in medium-term follow-up, and, in a novel way, a high percentage of overweight/obesity

The Medieval and Modern Investigation Centre (CIMM). Documentary contributions

The present article is about the study of the medieval and modern painting in the Crown of Aragon with the documentation located for Centre Modern d Investigació Medieval (CIMM) of the Universitat Politècnica of València and the Universitat de Lleida. This study includes a total of eighteen documents, ten of which are previously unpublished. The remaining eight were known, but have been revised and completed in the archives and perfectly transcribed again for this publication. Although the first documents date from before 1450, these documents are very important for a full understanding of the stylistic switch to the late Gothic of Flemish influence that began in Valencia in the mid-fifteenth century, and continued until the early decades of the sixteenth. Although many of the documents on Jacomart are very brief, they contribute to a better overall profile of this important artist, painter to King Alfonso V the Magnanimous.Aliaga-Morell, J.; Company Climent, J.; Tolosa Robledo, LM.; Puig Sanchis, I.; Ramón Marqués, LN.; Rusconi, S.; Franco Llopis, B. (2014). The Medieval and Modern Investigation Centre (CIMM). Documentary contributions. Imago Temporis. Medium Aevum. VIII:329-356. http://hdl.handle.net/10251/65406S329356VII

Joan de la Rua (Maestro de Cervera) : un pintor aragonés en el taller de Joan Reixac

La antigua personalidad artística del Maestro de Cervera, erróneamente identificado con Pere Girart, y al que se le atribuían toda una serie de pinturas en la órbita de Jacormart-Reixach, ha sido recientemente desvelada: Joan de Rua, aragonés. Ahora se presenta aquí un documento que, nos permite confirmar una estancia formativa que hasta ahora tan solo se le presuponía, en el taller de Joan Reixach. El presente artículo desgrana la relación entre Joan de Rua y Reixach y plantea una serie de reflexiones sobre su estilo y su técnica, para acabar proponiendo un somero borrador de obras que quizás deban atribuírseleTraditionally, the artistic personality of the unknown Master of Cervera, has been mistakenly identified with Pere Girart, and to whom a whole series of paintings in the orbit of Jacomart-Reixach were attributed. Its proper identification has recently been revealed: his name was Joan de Rua, from Aragon. Now a new document is presented here. It allows us to confirm a training stay that until now was only presupposed, in Joan Reixach's workshop. This paper describes the rela-tionship between Joan de Rua and Reixach and presents some considerations on his style and technique, to end up proposing a brief draft of works that perhaps should be attributed to hi

Observando a través de los estratos: fotografía infrarroja transmitida (IRT) aplicada al estudio técnico y documental de pinturas sobre lienzo

El presente artículo versa sobre el uso de la fotografía infrarroja transmitida (IRT), una técnica todavía muy desconocida, pese a que paradójicamente aporta una información fundamental en el estudio y documentación de las pinturas sobre lienzo. A diferencia de la fotografía infrarroja (IR), esta técnica opera por transmisión y no por reflexión, por lo ofrece imágenes transversales de todos los estratos de la obra. Fundamentalmente arroja evidencias sobre el diseño y la composición, visibilizando sus cambios; el método de ejecución empleado; pesquisas sobre los materiales; y evidencias del estado de conservación, pudiendo considerarse una de las técnicas más ricas de imagen multi-banda; procedimiento que además puede realizarse con escasa inversión. El objetivo de este artículo es darla a conocer para fomentar su uso entre conservadores e investigadores, así como mostrar ejemplos de sus aportaciones, ofreciendo claves de lectura para su correcta interpretación

Spanish Rheumatology Society and Hospital Pharmacy Society Consensus on recommendations for biologics optimization in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

The aim of this study was to establish guidelines for the optimization of biologic therapies for health professionals involved in the management of patients with RA, AS and PsA. Recommendations were established via consensus by a panel of experts in rheumatology and hospital pharmacy, based on analysis of available scientific evidence obtained from four systematic reviews and on the clinical experience of panellists. The Delphi method was used to evaluate these recommendations, both between panellists and among a wider group of rheumatologists. Previous concepts concerning better management of RA, AS and PsA were reviewed and, more specifically, guidelines for the optimization of biologic therapies used to treat these diseases were formulated. Recommendations were made with the aim of establishing a plan for when and how to taper biologic treatment in patients with these diseases. The recommendations established herein aim not only to provide advice on how to improve the risk:benefit ratio and efficiency of such treatments, but also to reduce variability in daily clinical practice in the use of biologic therapies for rheumatic diseasesSociedad Española de Reumatología4.524 JCR (2015) Q1, 6/32 RheumatologyUE

Urea cycle disorders in Spain: an observational, cross-sectional and multicentric study of 104 cases

Background: Advances in the diagnosis and treatment of urea cycle disorders (UCDs) have led to a higher survival rate. The purpose of this study is to describe the characteristics of patients with urea cycle disorders in Spain.Methods Observational, cross-sectional and multicenter study. Clinical, biochemical and genetic data were collected from patients with UCDs, treated in the metabolic diseases centers in Spain between February 2012 and February 2013, covering the entire Spanish population. Heterozygous mothers of patients with OTC deficiency were only included if they were on treatment due to being symptomatic or having biochemistry abnormalities. Results 104 patients from 98 families were included. Ornithine transcarbamylase deficiency was the most frequent condition (64.4%) (61.2% female) followed by type 1 citrullinemia (21.1%) and argininosuccinic aciduria (9.6%). Only 13 patients (12.5%) were diagnosed in a pre-symptomatic state. 63% of the cases presented with type intoxication encephalopathy. The median ammonia level at onset was 298 μmol/L (169-615). The genotype of 75 patients is known, with 18 new mutations having been described. During the data collection period four patients died, three of them in the early days of life. The median current age is 9.96 years (5.29-18), with 25 patients over 18 years of age. Anthropometric data, expressed as median and z-score for the Spanish population is shown. 52.5% of the cases present neurological sequelae, which have been linked to the type of disease, neonatal onset, hepatic failure at diagnosis and ammonia values at diagnosis. 93 patients are following a protein restrictive diet, 0.84 g/kg/day (0.67-1.10), 50 are receiving essential amino acid supplements, 0.25 g/kg/day (0.20-0.45), 58 arginine, 156 mg/kg/day (109-305) and 45 citrulline, 150 mg/kg/day (105-199). 65 patients are being treated with drugs: 4 with sodium benzoate, 50 with sodium phenylbutyrate, 10 with both drugs and 1 with carglumic acid. Conclusions Studies like this make it possible to analyze the frequency, natural history and clinical practices in the area of rare diseases, with the purpose of knowing the needs of the patients and thus planning their care.Ye