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Evaluación de la eficacia de la implantación de evidencias mediante una investigación-acción-participante en una unidad de enfermería oncohematológica

  • Abad-Corpa, Eva
  • Cabrero-García, Julio
  • Delgado-Hito, Pilar
  • Carrillo-Alcaraz, Andrés
  • Meseguer-Liza, Cristobal
  • Martínez-Corbalán, José Tomás
La finalidad fue evaluar la efectividad de la implantación de evidencias mediante una investigación-acción-participante (IAP). Diseño cuasi-experimental prospectivo con dos grupos no equivalentes ni concurrentes (2006 a 2008) en una unidad de enfermería de trasplante de medula ósea de un hospital español de tercer nivel. La intervención estudiada fue la implantación de evidencias mediante una IAP. Las variables dependientes: desempeño profesional y resultados de salud (área psico-emocional y efectos adversos). Se reclutaron 125 pacientes (1er grupo=56; 2º grupo=69). Se aprecia una mejoría significativa en el segundo grupo en la calidad de los registros de valoración de signos y síntomas. En el área psico-emocional, el ajuste psico-social mejora significativamente; no hay cambios en la sobrecarga ni la satisfacción. En efectos adversos, la obstrucción e infección relacionada con catéter mejoran significativamente; no hay diferencias en dolor y mucositis. La IAP ha servido para implantar evidencias y mejorar los resultados de salud.

La virtud política de la copia en los museos

  • Matas Pons, Álex
Este artículo analiza la función política y didáctica de lso museos a partir de las nociones de autenticidad y originalidad. Para ello, se estudia la obra de Max Aub y André Malraux, dos escritores contemporáneos que abordaron de un modo divergente las posibilidades artísticas de las diversas tecnologías de la reproducción y sus consecuencias para la cultura muéística y política d ela postguerra europea.

Detecting differential item functioning in behavioral indicators across parallel forms

  • Gómez Benito, Juana
  • González, Andrés
  • Widaman, Keith F.
  • Padilla, José Luis
  • Balluerka, Nekane
Background: Despite the crucial importance of the notion of parallel forms within Classical Test Theory, the degree of parallelism between two forms of a test cannot be directly verified due to the unobservable nature of true scores. We intend to overcome some of the limitations of traditional approaches to analyzing parallelism by using the Differential Item Functioning framework. Method: We change the focus on comparison from total test scores to each of the items developed during test construction. We analyze the performance of a single group of individuals on parallel items designed to measure the same behavioral criterion by several DIF techniques. The proposed approach is illustrated with a dataset of 527 participants that responded to the two parallel forms of the Attention Deficit-Hyperactivity Disorder Scale (Caterino, Gómez-Benito, Balluerka, Amador-Campos, & Stock, 2009). Results: 12 of the 18 items (66.6%) show probability values associated with the Mantel χ2 statistic of less than .01. The standardization procedure shows that half of DIF items favoured Form A and the other half Form B. Conclusions: The "differential functioning of behavioral indicators" (DFBI) can provide unique information on parallelism between pairs of items to complement traditional analysis of equivalence between parallel test forms based on total scores.

Introduction to monograph on observational data analysis

  • Anguera Argilaga, María Teresa
In our introduction, we express our gratitude to Anales de Psicología for publishing this monograph, which embodies many of the achievements that have been made in observational data analysis over the past quarter of a century. Scientific production in the area of observational methodology has improved both quantitatively and qualitatively over this period, helping to overcome the negative perceptions perpetuated by critics who viewed it as a merely descriptive methodology. Another source of satisfaction is the growing interest in the study of everyday behavior from multiple angles and perspectives, and the methodological advances that have paved the way for even further developments. Thanks to this progress, the publication and dissemination of research grounded in observational methodology has reached satisfactory levels. The introduction concludes with a brief description of the articles included in the monograph.

Detection and selection of behavioral patterns using Theme: a concrete example in grassroots soccer

  • Amatria, Mario
  • Lapresa, Daniel
  • Arana, Javier
  • Anguera Argilaga, María Teresa
  • Jonsson, Gudberg K.
Observational methodology provides a rigorous yet flexible framework for capturing behaviors over time to allow for the performance of subsequent diachronic analyses of the data captured. Theme is a specialized software program that detects hidden temporal behavioral patterns (T-patterns) within data sets. It is increasingly being used to analyze performance in soccer and other sports. The aim of this study was to show how to select and interpret T-patterns generated by the application of three "quantitative" sort options in Theme and three "qualitative" filters established by the researchers. These will be used to investigate whether 7-a-side (F7) or 8-a-side (F8) soccer is best suited to the learning and skills development needs of 7- and 8-year-old male soccer players. The information contained in the T-patterns generated allowed us to characterize patterns of play in children in this age group. For both formats, we detected technical-tactical behaviors showing that children of this age have difficulty with first-touch actions and controlling the ball after a throw-in. We also found that ball control followed by a pass or a shot at the goal are common in the central corridor of the pitch. Further, depth of play is achieved by ball control, followed by dribbling and a pass or shot. In F8, we saw that depth of play was achieved through ball control, followed by dribbling and passing of one or more opponents leading to a pass or shot. However, in F7, we saw that players succeeded in advancing from their goal area to the rival goal area through a sequence of actions.

Gut epithelial barrier markers in patients with obstructive sleep apnea

  • Barceló, Antonia
  • Esquinas López, Cristina
  • Robles, Juan
  • Piérola, Javier
  • Peña, Mónica de la
  • Aguilar, Irene
  • Morell-Garcia, Daniel
  • Alonso, Alberto
  • Toledo, Nuria
  • Sánchez de la Torre, Manuel
  • Barbé, Ferran
Background: obstructive sleep apnea (OSA) is now being recognized as an additional contributing factor to the pathogenesis of obesity-related comorbidities. At the same time, there is now increasing evidence to suggest that intestinal wall permeability plays a role in the development of metabolic syndrome. In the present study, circulating zonulin and fatty acid binding protein (I-FABP) were measured in association with metabolic, hepatic, and inflammatory parameters. Results: compared with controls, plasma I-FABP levels were significantly higher in patients with OSA (571 pg/mL [IQR 290-950] vs 396 pg/mL [IQR 234-559], p = 0.04). Zonulin levels were similar between groups. Significant relationships were observed between zonulin levels and waist circumference (p < 0.05), glucose (p < 0.05), and insulin (p < 0.05). In addition, in the OSA group, zonulin levels correlated negatively with the mean nocturnal oxygenation saturation (p < 0.05) and positively with total cholesterol (p < 0.05), alanine aminotransferase (ALT) (p < 0.005), aminotransferase (AST) (p < 0.01), gamma glutamyltransferase (GGT) (p < 0.005), and high-sensitivity C-reactive protein (hs-CRP) (p < 0.05). Multivariate analysis showed that associations between zonulin and ALT, AST, and hs-CRP were attenuated, but not eliminated, after adjustment for other variables. Conclusions: the results of this study suggest that OSA is a risk factor for intestinal damage, regardless of metabolic profile, and that intestinal permeability might be a possible contributor to nonalcoholic fatty liver disease in patients with OSA.

Extracellular calcium promotes bone formation from bone marrow mesenchymal stem cells by amplifying the effects of BMP-2 on SMAD signalling

  • Aquino Martínez, Rubén Francisco
  • Artigas, Natalia
  • Gamez Molina, Beatriz
  • Rosa López, José Luis
  • Ventura Pujol, Francesc
Understanding the molecular events that regulate osteoblast differentiation is essential for the development of effective approaches to bone regeneration. In this study, we analysed the osteoinductive properties of extracellular calcium in bone marrow-derived mesenchymal stem cell (BM-MSC) differentiation. We cultured BM-MSCs in 3D gelatin scaffolds with Ca2+ and BMP-2 as osteoinductive agents. Early and late osteogenic gene expression and bone regeneration in a calvarial critical-size defect model demonstrate that extracellular Ca2+ enhances the effects of BMP-2 on Osteocalcin, Runx2 and Osterix expression and promotes bone regeneration in vivo. Moreover, we analysed the molecular mechanisms involved and observed an antagonistic effect between Ca2+ and BMP-2 on SMAD1/5, ERK and S6K signalling after 24 hours. More importantly, a cooperative effect between Ca2+ and BMP-2 on the phosphorylation of SMAD1/5, S6, GSK3 and total levels of β-CATENIN was observed at a later differentiation time (10 days). Furthermore, Ca2+ alone favoured the phosphorylation of SMAD1, which correlates with the induction of Bmp2 and Bmp4 gene expression. These data suggest that Ca2+ and BMP-2 cooperate and promote an autocrine/paracrine osteogenic feed-forward loop. On the whole, these results demonstrate the usefulness of calcium-based bone grafts or the addition of exogenous Ca2+ in bone tissue engineering.

Characterisation of pellicles formed by acinetobacter baumannii at the air-liquidi interface

  • Nait Chabane, Yassine
  • Marti, Sara
  • Rihouey, Christophe
  • Alexandre, Stéphane
  • Hardouin, Julie
  • Lesouhaitier, Olivier
  • Vila Estapé, Jordi
  • Kaplan, Jeffrey B.
  • Jouenne, Thierry
  • Dé, Emmanuelle
The clinical importance of Acinetobacter baumannii is partly due to its natural ability to survive in the hospital environment. This persistence may be explained by its capacity to form biofilms and, interestingly, A. baumannii can form pellicles at the air-liquid interface more readily than other less pathogenic Acinetobacter species. Pellicles from twenty-six strains were morphologically classified into three groups: I) egg-shaped (27%); II) ball-shaped (50%); and III) irregular pellicles (23%). One strain representative of each group was further analysed by Brewster's Angle Microscopy to follow pellicle development, demonstrating that their formation did not require anchoring to a solid surface. Total carbohydrate analysis of the matrix showed three main components: Glucose, GlcNAc and Kdo. Dispersin B, an enzyme that hydrolyzes poly-N-acetylglucosamine (PNAG) polysaccharide, inhibited A. baumannii pellicle formation, suggesting that this exopolysaccharide contributes to pellicle formation. Also associated with the pellicle matrix were three subunits of pili assembled by chaperon-usher systems: the major CsuA/B, A1S_1510 (presented 45% of identity with the main pilin F17-A from enterotoxigenic Escherichia coli pili) and A1S_2091. The presence of both PNAG polysaccharide and pili systems in matrix of pellicles might contribute to the virulence of this emerging pathogen.

The prognostic impact of minimal residual disease in patients with chronic lymphocytic leukemia requiring first-line therapy.

  • Santacruz, Rodrigo
  • Villamor i Casas, Neus
  • Aymerich Gregorio, Marta
  • Martínez Trillos, Alejandra
  • López, Cristina
  • Navarro López, Alba
  • Rozman, María
  • Beà Bobet, Sílvia M.
  • Royo Moreno, Cristina
  • Cazorla, Maite
  • Colomer Pujol, Dolors
  • Giné Soca, Eva
  • Pinyol, Magda
  • Puente, Xose S.
  • López-Otín, Carlos
  • Campo Güerri, Elias
  • López Guillermo, Armando
  • Delgado, Julio (Delgado González)
A proportion of patients with chronic lymphocytic leukemia achieve a minimal residual disease negative status after therapy. We retrospectively evaluated the impact of minimal residual disease on the outcome of 255 consecutive patients receiving any front-line therapy in the context of a detailed prognostic evaluation, including assessment of IGHV, TP53, NOTCH1 and SF3B1 mutations. The median follow-up was 73 months (range, 2-202) from disease evaluation. The median treatment-free survival durations for patients achieving a complete response without or with minimal residual disease, a partial response and no response were 76, 40, 11 and 11 months, respectively (P<0.001). Multivariate analysis revealed that three variables had a significant impact on treatment-free survival: minimal residual disease (P<0.001), IGHV status (P<0.001) and β2-microglobulin levels (P=0.012). With regards to overall survival, factors predictive of an unfavorable outcome were minimal residual disease positivity (P=0.014), together with advanced age (P<0.001), unmutated IGHV status (P=0.001), TP53 mutations (P<0.001) and elevated levels of β2-microglobulin (P=0.003). In conclusion, for patients requiring front-line therapy, achievement of minimal residual disease negativity is associated with significantly prolonged treatment-free and overall survival irrespective of other prognostic markers or treatment administered.

Terapia familiar cognitivo-conductual con cuatro adultos

  • Muñoz, Encarnación
  • Canales, Alicia
  • Bados López, Arturo
  • Saldaña García, Carmina
The case of a family of four members is presented. Starting from a stroke suffered by the mother three years ago, there was a change of roles and the emergence of family conflicts. After assessment, the family agreed that the problems were not just something of the mother, but involved a dysfunctional family dynamics. The therapy was applied over 24 sessions plus some parallel individual brief contacts, and included development of empathy, skills training in communication, negotiation and problem solving, cognitive restructuring, and enhancement of positive affect and pleasurable activities. According to the family and therapists, the proposed objectives were largely achieved, and this was endorsed by several questionnaires. The improvements were maintained at 10-months follow-up. Good results could be explained by the large family motivation for change, good therapeutic relationship and the application of empirically supported techniques

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