miR-146a-/- mice model reveals that NF-κB inhibition reverts inflammation-driven myelofibrosis-like phenotype.

Emerging evidence shows the crucial role of inflammation (particularly NF-κB pathway) in the development and progression of myelofibrosis (MF), becoming a promising therapeutic target. Furthermore, tailoring treatment with currently available JAK inhibitors (such as ruxolitinib or fedratinib) does not modify the natural history of the disease and has important limitations, including cytopenias. Since recent studies have highlighted the role of miR-146a, a negative regulator of the NF-κB pathway, in the pathogenesis of MF; here we used miR-146a-/- (KO) mice, a MF-like model lacking driver mutations, to investigate whether pharmacological inhibition of JAK/STAT and/or NF-κB pathways may reverse the myelofibrotic phenotype of these mice. Specifically, we tested the JAK1/2 inhibitor, ruxolitinib; the NF-κB inhibitor via IKKα/ß, BMS-345541; both inhibitors in combination; or a dual inhibitor of both pathways (JAK2/IRAK1), pacritinib. Although all treatments decreased spleen size and partially recovered its architecture, only NF-κB inhibition, either using BMS-345541 (alone or in combination) or pacritinib, resulted in a reduction of extramedullary hematopoiesis, bone marrow (BM) fibrosis and osteosclerosis, along with an attenuation of the exacerbated inflammatory state (via IL-1ß and TNFα). However, although dual inhibitor improved anemia and reversed thrombocytopenia, the combined therapy worsened anemia by inducing BM hypoplasia. Both therapeutic options reduced NF-κB and JAK/STAT signaling in a context of JAK2V617F-driven clonal hematopoiesis. Additionally, combined treatment reduced both COL1A1 and IL-6 production in an in vitro model mimicking JAK2-driven fibrosis. In conclusion, NF-κB inhibition reduces, in vitro and in vivo, disease burden and BM fibrosis, which could provide benefits in myelofibrosis patients.

Self-management of Risk for the Prevention of Traffic Accidents from a Health Perspective: A Qualitative Study.

Introduction: In the world, deaths and injuries caused by traffic collisions have been considered a public health problem. In Colombia, 7.238 fatalities were recorded in 2021, with motorcycle riders representing the largest group of victims at 59.7%. Methods: The aim of this qualitative phenomenological study is to describe the risky experiences and deliberate actions of diverse road users that influence the self-management of the risk of traffic collisions. Results: Data were obtained from 22 participants: motorists, pedestrians and drivers. The content analysis describes various human conditions that affect self-management of the risk of traffic accidents, such as unsafe behaviors, non-compliance with traffic regulations by the different road actors, competitive culture among drivers, eagerness, among others. Additionally, factors related to care were determined: healthy recreational activities, promoting the value of one's own life and that of others, adequate time management and preventive behaviors by some road users. Conclusion: This research provides information on social and cultural aspects, experiences and risky behaviors of different road actors that influence the incidence of traffic accidents in Colombia.

Incidence, characteristics, and predictive factors of post-colonoscopy colorectal cancer.

BACKGROUND: Post-colonoscopy colorectal cancer (PCCRC) is colorectal cancer (CRC) diagnosed after a colonoscopy in which no cancer is found. OBJECTIVE: As PCCRC has become an important quality indicator, we determined its rates, characteristics, and index colonoscopy-related predictive factors. METHODS: We carried out a multicenter, observational, retrospective study between 2015 and 2018. Rates were calculated for PCCRC developing up to 10 years after colonoscopy. PCCRC was categorized according to the most plausible explanation using World Endoscopy Organization methodology. Our PCCRC population was compared to a control cohort without CRC matched 1:4 by sex, age, index colonoscopy date, indication, endoscopist, and hospital. RESULTS: One hundred seven PCCRC and 2508 detected CRC were diagnosed among 101,524 colonoscopy (0.1%), leading to rates of 0.4%, 2.2%, 3.1%, and 4.1% at 1, 3, 5, and 10 years, respectively. PCCRC was in right (42.4%), left (41.4%), and transverse (16.4%) colon with 31.5% at stage I, 24.7% stage II, 32.6% stage III, and 11.2% stage IV. Twenty point three percent were classified as incomplete resection, 5.4% as unresected lesions, 48.6% as missed lesions with adequate colonoscopy, and 25.7% as missed lesions with inadequate colonoscopy. The median time from colonoscopy to PCCRC was 42 months. Previous inadequate preparation (OR 3.05, 95%CI 1.73-5.36) and piecemeal polypectomy (OR 19.89, 95%CI 8.67-45.61) were independently associated with PCCRC. CONCLUSIONS: In our population, 4.1% of CRC cases were PCCRC. Most of these lesions were in right colon and attributable to lesions not visualized despite adequate bowel cleansing. Previous inadequate cleansing and piecemeal polypectomy were associated with PCCRC.

A Pilot Nurse-Administered CBT Intervention for Insomnia in Patients with Schizophrenic Disorder: A Randomized Clinical Effectiveness Trial.

Insomnia is a highly prevalent disorder among the population with schizophrenia and has a significant impact on their quality of life. Cognitive behavioural therapies (CBT) have shown effectiveness in the treatment of insomnia in the general population. The aim of this this pilot study was to evaluate the effectiveness of a group intervention led by nurses in an outpatient mental health centre. The group work combined cognitive behavioural and psychoeducational therapeutic interventions to improve insomnia in patients with schizophrenic disorder and their health-related quality of life. This randomized clinical trial included intervention and control groups with follow-up assessments at 6 and 9 months, using the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and EuroQol-5D (EQ-5D) scales. The inclusion criteria were as follows: over 18 years of age, diagnosis of schizophrenia, and a score of >7 on the ISI scale. The total sample was 40 participants. The ISI scale showed a mean difference of 3.63 (CI 95%: 2.02-5.23) (p = 0.000) and 4.10 (CI 95%: 2.45-5.75) (p = 0.000) and a large effect size (F: 28.36; p = 0.000; ηp2: 0.427). Regarding the PSQI scale, the mean difference was 3.00 (CI 95%: 1.53-4.49) (p = 0.000) and 2.30 (CI 95%: 0.85-3.75) (p = 0.000), with a medium effect size (F: 18.31; p = 0.000 ηp2: 0.325). The EQ-VAS scale showed a difference in mean scores between the groups of 10.48 (CI 95%: -19.66--1.29) (p = 0.027). CBT adapted for populations with mental disorders, carried out by nurses, is effective in improving insomnia and health-related quality of life.

[Relationship between season of the year and severity of symptoms in patients with fibromyalgia]. / Relación entre la estación del año y la gravedad de los síntomas en pacientes con fibromialgia.

BACKGROUND AND OBJECTIVE: Fibromyalgia patients often report that certain seasons aggravate their symptoms. The main objective was to determinate the association between key symptoms of fibromyalgia and the season of the year. A secondary objective was to determinate the existence of differences based on levels of anxiety or depression. MATERIAL AND METHOD: Convenience sample made up of 471 participants with fibromyalgia evaluated before starting multidisciplinary treatment. Demographic and meteorological data were collected. Clinical data were assessed with standardized instruments of pain intensity, functionality, fatigue, stiffness, sleep quality, anxiety and depression. RESULTS: The different groups of participants were homogeneous for age, gender, educational level, marital status and employment situation. No significant differences were found in pain intensity (F=1.334; P=.265), functionality (F=.402; P=.669), fatigue (F=.714; P=.490), stiffness (F=.299; P=.741), anxiety (F=.376; P=.687), depression (F=.608; P=.545), psychological distress (F=.261; P=.770), sleep quantity (F=1.507; P=.223) or sleep disturbances (F=.343; P=.710). CONCLUSIONS: No differences were found in the intensity of fibromyalgia symptoms, nor in the percentages of severity among the different seasons of the year. Anxiety was more prevalent than depression, possibly due to the characteristics of the sample itself, with the majority of patients with a dysfunctional profile.

Analysis of Psychosomatic Disorders According to Age and Sex in a Rural Area: A Population-Based Study.

Psychosomatic disorders can develop unevenly depending on certain health determinants; therefore, the aim of this study was to analyze the prevalence of psychosomatic disorders and the differences by age and sex in a rural area. We conducted an observational descriptive retrospective population study to determine the prevalence of 201 diagnoses of psychosomatic nature grouped into 25 diagnostic categories by sex and age groups. A total of 33,680 participants with a diagnosis of psychosomatic disorder were identified (64.6% women, 35.4% men). We found statistically significant differences based on sex in 13 of the 25 diagnostic categories previously defined. When we analyzed these categories by age, we found that women showed a higher probability, between 1.23 and 10.85 times, of suffering from most of these health issues. We also observed that the older the age group, the most often they had a diagnosis. Notably, more women seem to suffer from psychosomatic disorders when compared to men in the same situation. In most of these disorders, being of the female sex was a risk factor, and the older the participants, the greater the probability of developing a disorder.

Beyond the clinical context: the process of losing oneself living with Huntington's disease.

BACKGROUND: People with Huntington's disease (HD) have increased functional and cognitive dependence. While numerous clinical, genetic, and therapeutic management studies have been carried out, few studies have investigated the disease from the personal experience and the context of people living with HD. To better serve these patients, our purpose is to understand, from the perspective of the patient and their families, how people with HD cope with their daily lives outside the clinical setting. METHODS: Thirty-three affected or at-risk people participated in this study. Participants were interviewed at their homes on distinct occasions during a family visit. We analyzed the data using Grounded Theory, which allowed us to understand how people live with the disease on their own terms. RESULTS: Living with HD is a process that begins with acceptance or denial that one is at risk for the disease or, growing awareness of the condition due to motor, behavioral, and cognitive changes, and, finally, loss of autonomy with physical dependence on another person, and loss of sense of self and family. CONCLUSION: While the daily life of patients before disease onset was characterized by physical and mental/cognitive independence, with HD they become increasingly trapped in their bodies, and their complications are due to the lack of effective curable therapy.

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory.

OBJECTIVE: To analyze the planning and implementation of the care offered by nurses to elders with coronary disease during the hospital-house transition. METHODS: Qualitative research that used the Transitions Theory as a theoretical reference. The participants were 12 nurses who work in a hospital that specializes in cardiology, in the city of Salvador-BA. A semistructured interview was carried out from January to February 2018, and the data was analyzed using the Content Analysis technique. RESULTS: Transition care takes place on the day of discharge. The presence of the family was found to be a facilitator; low adherence, poor financial situations, the low educational levels inhibited its implementation. The rehospitalization is an indicator of the results of the transition of care. FINAL CONSIDERATIONS: The planning and implementation of transition care is not effective. It must provide safety in the management of self-care in the home of elders with coronary disease and their families.

Validation and psychometric properties of the Spanish version of the questionnaire for assessing the childbirth experience (QACE).

OBJECTIVE: When evaluating childbirth experience, some of the factors considered by women include their previous births experience, pain management during birth, and companion and healthcare professional support received. The objective of this paper is to validate the Questionnaire for Assessing the Childbirth Experience (QACE) into the Spanish population by assessing its psychometric properties. METHODS: Due to the differences between the Spanish and English languages, a careful translation process was the first step to making the QACE useable to Spanish speaking cohorts, once thoroughly translated their conceptual equivalence was evaluated by a group of experts and tested later via interviews with postpartum women for comprehensibility evaluation. Secondly, the validation process was obtained throughout the factorial analysis, internal consistency, test-retest evaluation and convergent and discriminant validity. RESULTS: A total of 268 postpartum women participated in the validity study. The KMO (0.84) and Bartlett test (p < 0.001) confirmed the adequacy of factor analysis and the Screen plot showed four factors with the predictive power of 52.63%, which supported total variance. Confirmatory factor analysis indicated an adequate/good fitness for the new model (χ2/df = 1.47, GFI = 0.979, RMSEA = 0.052, CFI = 0.889, NFI = 0.727, NNFI = 0.873, and SRMR = 0.155). Internal consistency was confirmed with McDonal's Omega level of 0.818. Test-retest evaluation supported test stability (r = 0.79, p < 0.01). Convergent and discriminant validity were obtained with 0.803 and 0.475 Pearson coefficients respectively. CONCLUSIONS: The Spanish version of QACE is a relevant tool for measuring childbirth experience into the Spanish context with acceptable validity and stability.

The Experience of Insomnia in Patients With Schizophrenic Disorder: A Qualitative Study.

BACKGROUND: Insomnia is a health problem that particularly affects people with schizophrenia. Its repercussions go beyond the disorder itself and affect many areas of life. The aim of the present study is to explore the clinical symptoms and consequences of insomnia in patients diagnosed with schizophrenic disorder and the perceptions of these patients regarding the care they receive. METHODS: The study takes a qualitative approach and uses semi-structured interviews to conduct a descriptive and interpretive analysis of 3 clinically different clusters of patients. These 3 clusters have been defined by using two-step cluster analysis based on the results of the ISI (Insomnia Severity Index) and EQ-5D scales (EuroQol-5D) and the presence of certain diagnostic symptoms in a sample of 170 patients. The final sample was 31 subjects. The analysis was based on a hermeneutic analysis of the patients' narratives regarding their experiences of insomnia. RESULTS: The patients' narratives show differences in the intensity and experience of insomnia depending on the severity, as well as its impact on their quality of life. Insomnia has a huge emotional impact. Participants describe ruminations and obsessive thoughts as a key factor hindering falling asleep. Some of the everyday actions they perform encourage the chronicity of insomnia. The desired health response must include interventions that are effective, such as cognitive-behavioural therapy, and powerful, such as pharmacological solutions. Psychoeducation and advice on sleep hygiene are highly valued tools as preventive strategies. CONCLUSIONS: To know the experience of users gives us a more comprehensive understanding of insomnia complexities and brings some new intervention strategies in patients with mental disorders. It is important that health professionals intervene preventively to stop the disorder from becoming chronic.

Intestinal Protists in Captive Non-human Primates and Their Handlers in Six European Zoological Gardens. Molecular Evidence of Zoonotic Transmission.

We assessed the occurrence, genetic diversity, and zoonotic potential of four protozoan (Cryptosporidium spp., Entamoeba histolytica, Entamoeba dispar, Giardia duodenalis), one stramenopile (Blastocystis sp.), one microsporidia (Enterocytozoon bieneusi), and two ciliate (Balantioides coli, Troglodytella abrassarti) intestinal parasite or commensal protist species in captive non-human primates (NHP) and their zookeepers from six European zoological gardens in France (n = 1), Germany (n = 1), and Spain (n = 4). Faecal samples from NHP (n = 454) belonging to 63 species within 35 genera and humans (n = 70) were collected at two sampling periods in each participating institution between October 2018-August 2021. Detection and species identification was accomplished by PCR and Sanger sequencing of the ssu rRNA and/or ITS genes. Sub-genotyping analyses using specific markers were conducted on isolates positive for G. duodenalis (gdh, bg, tpi) and Cryptosporidium spp. (gp60). Overall, 41.0% (186/454) and 30.0% (21/70) of the faecal samples of NHP and human origin tested positive for at least one intestinal protist species, respectively. In NHP, Blastocystis sp. was the most prevalent protist species found (20.3%), followed by G. duodenalis (18.1%), E. dispar (7.9%), B. coli and T. abrassarti (1.5% each), and Cryptosporidium spp. and E. bieneusi (0.9% each). Occurrence rates varied largely among NHP host species, sampling periods, and zoological institutions. The predominant protist species found in humans was Blastocystis sp. (25.7%), followed by Cryptosporidium spp. (2.9%), E. dispar (1.4%), and G. duodenalis (1.4%). Sequencing of PCR-positive amplicons in human and/or NHP confirmed the presence of Cryptosporidium in six isolates (C. hominis: 66.7%, C. parvum: 33.3%), G. duodenalis in 18 isolates (assemblage A: 16.7%, assemblage B: 83.3%), Blastocystis in 110 isolates (ST1:38.2%, ST2:11.8%, ST3: 18.2%, ST4: 9.1%, ST5: 17.3%, ST8: 2.7%, ST13: 0.9%), and E. bieneusi in four isolates (CM18: 75.0%, Type IV: 25.0%). Zoonotic transmission events involving Blastocystis ST1-ST4 were identified in four zoological institutions. Zoonotic transmission of C. hominis was highly suspected, but not fully demonstrated, in one of them. Monitoring of intestinal protist species might be useful for assessing health status of captive NHP and their zookeepers, and to identify transmission pathways of faecal-orally transmitted pathogens.

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory / Cuidado de enfermeras a ancianos con enfermedad arterial coronaria en la perspectiva de la Teoría de las Transiciones / Cuidado de enfermeiras a idosos com doença arterial coronariana na perspectiva da Teoria das Transições

ABSTRACT Objective: To analyze the planning and implementation of the care offered by nurses to elders with coronary disease during the hospital-house transition. Methods: Qualitative research that used the Transitions Theory as a theoretical reference. The participants were 12 nurses who work in a hospital that specializes in cardiology, in the city of Salvador-BA. A semistructured interview was carried out from January to February 2018, and the data was analyzed using the Content Analysis technique. Results: Transition care takes place on the day of discharge. The presence of the family was found to be a facilitator; low adherence, poor financial situations, the low educational levels inhibited its implementation. The rehospitalization is an indicator of the results of the transition of care. Final considerations: The planning and implementation of transition care is not effective. It must provide safety in the management of self-care in the home of elders with coronary disease and their families.

RESUMEN Objetivo: Analizar el planeamiento e implementación del cuidado de transición hospital-domicilio de enfermeras a ancianos con enfermedad arterial coronaria. Métodos: Investigación cualitativa que utilizó como referencial teórico la Teoría de las Transiciones. Participaron 12 enfermeras actuantes en un hospital-referencia en cardiología de Salvador-BA. Realizó entrevista semiestructurada entre los meses de enero y febrero de 2018; y analizaron los datos por la técnica de Análisis de Contenido. Resultados: El cuidado de transición es efectuado en el día de la alta. La presencia del familiar fue considerada facilitadora; y la baja adhesión, condición financiera y nivel de escolaridad fueron apuntados como inhibidores de su implementación. La reinternación es el indicador de resultado del cuidado de transición. Consideraciones finales: El cuidado de transición es planeado e implementado de manera ineficaz. Es necesario que él proporcione seguridad en la gestión del autocuidado en domicilio del anciano con enfermedad coronaria y de su familia.

RESUMO Objetivo: Analisar o planejamento e implementação do cuidado de transição hospital-domicílio de enfermeiras à pessoa idosa com doença arterial coronariana. Métodos: Pesquisa qualitativa que utilizou como referencial teórico a Teoria das Transições. Participaram 12 enfermeiras atuantes em um hospital-referência em cardiologia da cidade de Salvador-BA. Realizou-se entrevista semiestruturada entre os meses de janeiro e fevereiro de 2018; e analisaram-se os dados pela técnica de Análise de Conteúdo. Resultados: O cuidado de transição é efetuado no dia da alta. A presença do familiar foi considerada facilitadora; e a baixa adesão, condição financeira e nível de escolaridade foram apontados como inibidores da sua implementação. A reinternação é o indicador de resultado do cuidado de transição. Considerações finais: O cuidado de transição é planejado e implementado de maneira ineficaz. É necessário que ele proporcione segurança na gestão do autocuidado em domicílio do idoso com doença coronariana e de sua família.

Significados do uso de plantas medicinais para docentes do curso de enfermagem na Catalunha / Meanings of use of medicinal plants for nursing teachers in Catalonia

Resumo O objetivo deste trabalho é conhecer os significados que o uso de plantas medicinais como terapia complementar no cuidado à saúde tem para docentes do curso de enfermagem na Catalunha. Trata-se de uma pesquisa qualitativa, do tipo exploratória e descritiva, realizada por meio de entrevista semiestruturada com quatro docentes do curso de enfermagem de uma universidade espanhola situada na região da Catalunha, no mês de maio de 2016. Para interpretação dos dados foi utilizada a análise de conteúdo proposta por Bardin. Na análise de conteúdo, emergiram dois temas: conhecimento e utilização de terapias complementares; e a cultura familiar influenciando o uso das plantas medicinais. Na primeira categoria, destacou-se que, além de conhecer, os professores também faziam uso das plantas frequentemente. Na segunda, ressalta-se como a influência familiar esteve presente e foi importante para perpetuar o conhecimento e formas de utilização durante as gerações. Evidenciou-se a popularização das terapias complementares e, portanto, é indispensável a articulação da prática pelos profissionais de saúde desde o processo de formação, sobretudo na enfermagem, tendo em vista a integralidade do cuidado oferecido ao usuário.

Abstract This study aims to learn the meanings for teachers of the Nursing course in Catalonia about the use of medicinal plants as complementary therapy in health care. This is a qualitative, exploratory and descriptive research, conducted through semi-structured interviews, with four professors of the Nursing course at a Spanish University located in the region of Catalonia, in May 2016. For the interpretation of the content analysis proposed by Bardin was used. In the content analysis, two themes emerged: Knowledge and use of complementary therapies and Family culture influencing the use of medicinal plants. In the first category, it was emphasized that, in addition to knowing, teachers also used plants frequently. In the second, it is emphasized how the family influence was present and was important to perpetuate the knowledge and forms of use during the generations. The popularization of complementary therapies became evident and, therefore, the articulation of the practice by health professionals is essential, since the training process, especially in nursing, considering the comprehensive care offered to the user.

Experience of People in Mild and Moderate Stages of Alzheimer's Disease in Spain / Experiencia de personas con Alzheimer en fases leves y moderadas en España / A experiência de pessoas com Alzheimer na Espanha nas fases leve e moderada

Objetivo: analizar el significado que adquiere la enfermedad para las personas afectadas por Demencia, proporcionándoles voz. Material y métodos: aproximación a la fenomenología descriptiva a través de entrevistas a personas de ambos sexos y mayores de 50 años residentes en Tarragona (España) con un diagnóstico de Demencia leve o moderada, principalmente enfermedad tipo Alzheimer. Resultados: surgieron tres grandes temáticas: 1) normalización de la pérdida de memoria en fases incipientes en relación al proceso natural de envejecimiento; 2) autopercepción de que existe un problema de memoria instaurándose que se disimula frente a su entorno y 3) procesos de adaptación y aprendizaje de estrategias para convivir con su condición tras el diagnóstico. Conclusiones: la falta de infraestructuras especializadas dentro del sistema sanitario en materia de cuidados, programas de prevención y detección precoz son los aspectos más evidentes remarcados.

Objective: To analyze the meaning of dementia by those affected by it, and to give them a voice. Material and methods: Descriptive phenomenology through interviews with people of both genders who are over 50 years old and living in Tarragona (Spain), with a diagnosis of mild or moderate dementia, mainly related to Alzheimer's disease. Results: Three main themes emerged: 1) normalization of memory loss in early stages as part of the natural aging process; 2) self-awareness of progressive memory decline, which is concealed from others, and 3) adaptation processes and strategies to coexist with their condition after diagnosis. Conclusions: The most evident features were the lack of specialized infrastructures within the health system in terms of care, prevention programs, and early detection.

Objetivo: Analisar o significado que a doença adquire para as pessoas afetadas pela demência, dando voz a elas. Material e Métodos: Abordagem da fenomenologia descritiva por meio de entrevistas com pessoas residentes em Tarragona (Espanha) com diagnóstico de demência leve ou moderada, principalmente doença do tipo Alzheimer de ambos os sexos e com mais de 50 anos. Resultados: Surgiram três grandes temas: 1) Normalização da perda de memória em fases incipientes relacionadas ao processo natural de envelhecimento; 2) Autopercepção de que existe um problema de memória que se esconde do ambiente; 3) Processo de adaptação e estratégias de aprendizado para conviver com sua condição após o diagnóstico. Conclusões: A falta de infra-estruturas especializadas no sistema de saúde, programas de prevenção e detecção precoce são os aspectos mais evidentes.

Insomnia in Schizophrenia Patients: Prevalence and Quality of Life.

Sleep disorders are often not regarded as an important health problem, despite their impact on heath. Insomnia is the most frequent sleep disorder in mental health. The aim is to quantify the prevalence of insomnia in a population with schizophrenic disorder and assess its influence on quality of life. This is a descriptive, analytical and cross-sectional study conducted in a sample of 267 schizophrenic patients over 18 years of age using consecutive non-probabilistic sampling. The variables of interest were collected by means of the "Cuestionario Oviedo de Sueño," "Insomnia Severity Index" and EuqoQol-5D. The estimation of insomnia in our schizophrenic population according to the International Classification of Disease (ICD-10) criteria was 23.2%. The likelihood of insomnia when there are problems in the quality of life is significant in all its dimensions: mobility OR: 3.54 (95% CI 1.88- 6.65), self-care OR: 2.69 (95% CI 1.36-5.32), usual activities OR: 3.56 (95% CI 1.97-6.44), pain/discomfort OR: 4.29 (95% CI 2.37-7.74) and anxiety/depression OR: 3.01 (95% CI 1.61-5.65). The prevalence of insomnia fluctuates depending on the diagnostic criteria; however, the schizophrenic population shows high prevalence in some clinical characteristics. People with insomnia have a lower quality of life.

Procesamiento de estímulos novedosos como terapia de remediación cognitiva en pacientes con trastorno alimentario / Processing of novel stimuli as cognitive remediation therapy in patients with eating disorder

Resumen Estudios previos han indicado la utilidad de la terapia de remediación cognitiva (TRC) en pacientes con trastornos de conducta alimentaria (TCA). El objetivo de este estudio fue evaluar una nueva técnica de innovación cognitiva llamada "Con la cabeza en las nubes" (CCN). Participaron 22 mujeres con TCA (13 con anorexia nerviosa y 9 con bulimia nerviosa), de entre 14 y 29 años de edad (M = 19.0, DE = 3.4), quienes completaron las seis sesiones grupales de que consta dicha técnica. Bajo un diseño pre-post intervención, las participantes fueron evaluadas en cuanto a: funciones viso-constructivas (Copia de la Figura Compleja de Rey-Osterrieth [CFCR]), pensamiento creativo (Test de Pensamiento Creativo de Torrance [TPCT]), flexibilidad cognitiva (CFCR y TPCT) y control cognitivo (Test de Stroop). La intervención generó una mejora en distintos dominios cognitivos, como son: mayor coherencia global, pensamiento creativo y resistencia al cierre, así como menor fragmentación. Basada en la TRC, encaminada a estimular el procesamiento novedoso de estímulos visuales, la técnica CCN mostró mejorar algunos de los procesos cognitivos implicados en la generación de los síntomas de pacientes con TCA.

Abstract Previous studies have shown the usefulness of cognitive remediation therapy (CRT) in patients with eating disorders (ED). The objective of this study was to assess a new cognitive technique called "With the head in the clouds" (WHC). A total of 22 women with ED (13 with anorexia nervosa and nine with bulimia nervosa), between 14 and 29 years (M = 19.0, SD = 3.4), completed the six group sessions of this technique. Under a design pre-post intervention, participants were assessed in: visuo-constructive functions (Copy of the Rey-Osterrieth Complex Figure [CRCF]), creative thinking (Torrance Creative Thinking Test [TCTT]), cognitive flexibility (CRCF and TCTT), and cognitive control (Stroop Test). The intervention improved different cognitive domains, such as: greater global coherence, creative thinking and resistance to closure, as well as less fragmentation. Based on CRT, aimed at stimulating the new processing of visual stimuli, the technique WHC showed an improvement in some of the cognitive processes involved in the onset of symptoms in patients with ED.

Contribución del servicio de policía a la conformación del Estado-nación durante el conflicto armado en Colombia, de 1970 al año 2006. Aproximaciones desde los conceptos de globalización y glocalización / Police service contribution to the conformation of the Nation-State during the armed conflict in Colombia, from 1970 to 2006. Approaches from the concepts of globalization and glocalization / A contribuição do serviço das polícias à conformação do Estado-Nação ddurante o conflito armado na Colômbia, de 1970 ao ano 2006. Aproximações dos conceitos da globalização e do glocalização

Resumen El objetivo es abordar los factores que determinaron la contribución y evolución del servicio de la Policía Nacional de Colombia durante el conflicto armado, a la luz de la explicación del fenómeno del narcotráfico y de los hechos terroristas acaecidos el 11 de septiembre del 2001 -como dos circunstancias que cambiaron la historia mundial y que rompieron paradigmas en temas de convivencia y seguridad-, dada su incidencia en la redefinición de la lucha contra el delito transnacional. La metodología abordó la correlación de hitos históricos del periodo comprendido entre los años de 1970 y 2006. La hipótesis de esta investigación expresa que la conexión entre procesos, doctrina policial y políticas gubernamentales para afrontar los delitos de narcotráfico y terrorismo, desde la perspectiva de los conceptos de globalización y glocalización, contribuyó a la conformación del Estado-Nación en temas de gobernabilidad, durante el desafío que representó el conflicto armado, el cual internacionalizó el servicio de policía de Colombia y lo transformó en eje de referenciación doctrinal y operacional en el ámbito hemisférico y mundial. La investigación hace parte de las discusiones académicas y de los análisis de la Unidad para la Edificación de la Paz - UNIPEP, para la preparación de escenarios de atención policial, durante la transición de Colombia hacia una paz estable y duradera.

Abstract The objective in this article consists of addressing the factors having determined the contribution and evolution of the Colombian National Police service during the armed conflict, in the light of the drug trafficking phenomenon and the terrorist events occurring in September 11, 2001 - explained as two circumstances that changed world history and broke paradigms in issues dealing with coexistence and security, by reason of its impact in the redefinition of the war against transnational crime. The methodology approached the correlation of historical milestones ranging from events taking place in the period between 1970 and 2006. The hypothesis of this research expresses that the connection between processes, police doctrine, and government policies established to deal with drug trafficking and terrorism crimes from the perspective of the globalization and glocalization concepts contributed to the conformation of the Nation-State in governance issues, during the challenge posed by the armed conflict having internationalized the Colombian police service and transformed it into a doctrinal and operational reference axis in the hemispherical and global environment. Research makes part of the academic discussions and analyses carried out by the Police Unit for the Construction of Peace ("Unidad Policial para la Edificacion de la Paz" (UNIPEP) for the preparation of police attention scenarios during Colombia's transition from the armed conflict into stable and lasting peace.

Resumo O objetivo é abordar os fatores que determinaram a contribuição e a evolução do serviço da Policia Nacional da Colômbia durante o conflito armado, à luz da explicação do fenômeno de narcotráfico e dos fatos terroristas acontecidos o 11 de setembro de 2001, -como duas circunstâncias que mudaram a história do mundo e que quebraram paradigmas em assuntos de coexistência e segurança- dada sua incidência na redefinição da luta contra o crime transnacional. A metodologia abordou a correlação de marcos históricos do período entre os anos 1970 e 2006. A hipótese desta pesquisa expressa que a conexão entre processos, doutrina policial e políticas governamentais para confrontar os crimes de narcotráfico e de terrorismo, da perspectiva dos conceitos de globalização e glocalização, contribuiu à conformação do Estado-Nação em assuntos do governabilidade, durante o desafio que representou o conflito armado, que internacionalizou o serviço das polícias de Colômbia e o transformou na linha central de referenciação doutrinal e operacional no âmbito hemisférico e mundial. A pesquisa faz parte das discussões acadêmicas e das análises da Unidade para a Construção da Paz - UNIPEP, para a preparação dos cenários da atenção policial, durante a transição de Colômbia para uma paz estável e durável.