Experiences of intensive home treatment for a mental health crisis during the perinatal period: A UK qualitative study.

Some women with severe perinatal mental health difficulties in England are cared for by acute home treatment services, known as Crisis Resolution Teams (CRTs), which provide short-term home-based treatment for adults experiencing a mental health crisis. Intensive home treatment has been trialed in a number of countries, but it is not known how well suited it is to the needs of perinatal women. This qualitative study aimed to explore how women and practitioners experience the provision of intensive home treatment for perinatal mental health problems. Semi-structured interviews were conducted with women who had received intensive home treatment in the perinatal period (n = 15), and focus groups were held with practitioners working in CRTs or in specialist perinatal mental health services (3 groups, n = 25). Data were analysed thematically. Women commonly found intensive home treatment problematic, experiencing it as intrusive and heavily risk-focused, with poor staff continuity and little tailoring to the perinatal context. However, women valued emotional support when provided, particularly when it had a perinatal focus, sometimes based on practitioners sharing their own experiences. Some women also appreciated avoiding hospital admission, but choice was often limited. Practitioners reported a lack of perinatal training among CRT staff and described difficulties tailoring treatment to perinatal women's needs. Currently, intensive home treatment, as offered by CRTs, may not be well suited to women with perinatal mental health difficulties. Findings suggest a need to develop community crisis responses that are better tailored to the needs of this population.

Anti-JC virus seroprevalence in a Spanish multiple sclerosis cohort: JC virus seroprevalence in Spain.

OBJECTIVE: To estimate the seroprevalence of anti-JCV antibodies, seroconverting rates and evolution of antibody levels in a multiple sclerosis (MS) Spanish cohort. METHODS: Multicenter, retrospective cross-sectional and longitudinal study. The JCV seroprevalence was analyzed in 711 MS patients by using 1st (STRATIFY-1) and 2nd generation (STRATIFY-2) two-step ELISA over 2.65 (±0.97) years. Seroconversion rate was obtained over 2 samples from 314 patients, and index stability from 301 patients with 3 or more samples available. The effect of each ELISA generation, demographics, clinical characteristics and therapy on seroprevalence was assessed by logistic regression. RESULTS: The overall anti-JCV seroprevalence was 55.3% (51.6-58.9), similar across regions (p=0.073). It increased with age (p<0.000) and when STRATIFY-2 was used (60.5%, p=0.001). Neither sex nor immunosuppressive therapy had any influence. Yearly seroconversion rate was 7% (considering only STRATIFY-2). Serological changes were observed in 24/301 patients, 5.7% initially seropositive reverted to seronegative and 7% initially seronegative changed to seropositive and again to seronegative, all these cases had initial index values around the assay's cut-off. CONCLUSIONS: JCV seroprevalence in Spanish MS patients was similar to that reported in other European populations. Changes in serostatus are not infrequent and should be considered in clinical decisions.

Embolización selectiva en un paciente con hemoptisis secundaria a tuberculosis pulmonar / Selective embolization in a patient with hemoptysis secondary to pulmonary tuberculosis

Resumen La tuberculosis pulmonar es una infección frecuente en nuestro medio. Generalmente se presenta con síntomas sistémicos como tos, expectoración, fiebre y diaforesis. En algunos casos puede presentarse con hemoptisis cuyo espectro va desde leve hasta masiva. Una vez iniciado el tratamiento, los síntomas de sangrado generalmente resuelven. Presentamos el caso de un paciente masculino de 38 años, con hemoptisis secundaria a una tuberculosis pulmonar, el cual a pesar del inicio del tratamiento, continuó con sangrado activo, por lo que fue llevado a embolización arterial selectiva como alternativa terapéutica con resolución del sangrado. (Acta Med Colom 2018; 43: 45-48).

Abstract Pulmonary tuberculosis is a frequent infection in our environment. It usually presents with systemic symptoms such as cough, expectoration, fever and diaphoresis. In some cases it can present with hemoptysis whose spectrum ranges from mild to massive. Once the treatment is started, the symptoms of bleeding usually resolve. The case of a 38-year-old male patient with hemoptysis secondary to pulmonary tuberculosis is presented. Despite the initiation of treatment, he continued with active bleeding, which led to selective arterial embolization as a therapeutic alternative with resolution of bleeding. (Acta Med Colom 2018; 43: 45-48).

La investigación científica en el campo de la Comunicación Social en centros universitarios cubanos: un acercamiento a su correcta gestión / Scientific research in the field of Social Communication in Cuban university institutions: An approach to its proper management / A investigação científica no campo da Comunicação Social nas universidades cubanas: Uma abordagem para a sua gestão adequada

El presente estudio tiene como objetivo proponer acciones estratégicas que encaminen y articulen la investigación científica en el campo de conocimiento de la Comunicación Social desde las funciones fundamentales de la gestión, particularmente en los centros universitarios cubanos. Para esto se utilizaron técnicas como el análisis documental, la entrevista a expertos y la herramienta estratégica Matriz DAFO. Se considera que la investigación en Comunicación Social en el dicho contexto de análisis tiene elementos distintivos como: insuficiente cultura investigativa de los actores, no existen pautas que rijan la gestión de la investigación y bajo nivel de prioridad para la actividad científica. Se ayuda a visualizar la importancia de la gestión de la investigación y a aumentar una cultura científica necesaria en los investigadores a partir de un marco estratégico que permita reconocer al campo de estudio no solo como campo profesional sino también como espacio científico y académico.

The purpose of the present study is to propose strategic actions aimed at steering and articulating scientific research in the field of Social Communication from the perspective of core management functions, particularly in Cuban university institutions. Use was made of techniques such as document analysis, expert interviews and SWOT analysis. In this context of analysis, Social Communication research is considered to have the following distinctive features: insufficient research culture among researchers, lack of guidelines governing research management, and low priority awarded to scientific research. The study helps visualize the importance of research management and improve scientific culture among researchers in a strategic framework enabling perception of the field of study not only as a professional field, but also as a scientific and academic space.

O presente estudo tem como objetivo propor ações estratégicas que encaminhem e articulem a investigação científica no campo de conhecimento da Comunicação Social desde as funções fundamentais da gestão, particularmente nos centros universitários cubanos. Para isto se utilizaram técnicas como a análise documental, a entrevista a expertos e a ferramenta estratégica Matriz DAFO. Julga-se que a investigação em Comunicação Social no referido contexto de análise tem elementos distintivos como: insuficiente cultura investigativa dos atores, não existem pautas que regerem a gestão da investigação e baixo nível de prioridade para a atividade científica. Ajuda-se a visualizar a importância da gestão da investigação e a aumentar uma cultura científica necessária nos investigadores a partir dum enquadramento estratégico que permita reconhecer ao campo de estudo não só como campo profissional mas também como espaço científico e acadêmico.

La orientación profesional de los alumnos que ingresan a la educación superior / A orientação profissional de alunos da educação superior / Professional guidance of students that have enrolled in higher education

El propósito de la investigación fue describir la percepción sobre la Orientación profesional de los alumnos que ingresan a la Educación Superior en Cuba. Desarrollada desde una perspectiva interpretativa, utilizó como marco metodológico el cualitativo y se apoyó en un muestreo no probabilístico, intencional y razonado que definió tres grupos de informantes claves: alumnos, padres y profesores. Las técnicas empleadas fueron, el análisis de documentos, la entrevista y el grupo de discusión; corroborándose que la orientación profesional en la muestra estudiada es insuficiente, pues no se aprecia una elección autodeterminada de su futura profesión, la familia no juega el rol que le corresponde, al no propiciar una orientación consciente y el trabajo orientador de los profesores se limita solo a la información vocacional.

O propósito da investigação foi descrever a percepção sobre a orientação profissional de alunos matriculados na Educação Superior em Cuba. O estudo foi desenvolvido a partir de uma perspectiva interpretativa, utilizando-se o referencial metodológico qualitativo, com base em uma amostragem não probabilística intencional. Definiram-se três grupos de informantes chaves: alunos, pais e professores. As técnicas utilizadas foram a análise de documentos, entrevistas e grupo de discussão. Os resultados indicam que a orientação profissional na amostra analisada foi insuficiente, pois não se observou escolha autodeterminada da futura profissão, a família não desempenhou sua função, ao não favorecer uma orientação consciente, e o trabalho orientador dos professores limitou-se à informação vocacional.

The purpose of this investigation was to describe the perception about the professional guidance of students that have enrolled in higher education in Cuba. The study was developed from an interpretative perspective, and uses a methodological procedure underpinned by the qualitative approach. From a non-probable intentional sample, three groups provided information: students, parents and teachers. The techniques used were the analysis of documents, interviews and discussion groups. The results showed that the professional guidance with the sample was insufficient because of some factors: the students did not seem to have made a self-determined choice of their future career, the family had not played their role in not giving a conscious guidance and the guidance by their teachers was limited to vocational information only.