The effects of telehealth-delivered mindfulness meditation, cognitive therapy, and behavioral activation for chronic low back pain: a randomized clinical trial.

BACKGROUND: Chronic low back pain (CLBP) is a significant problem affecting millions of people worldwide. Three widely implemented psychological techniques used for CLBP management are cognitive therapy (CT), mindfulness meditation (MM), and behavioral activation (BA). This study aimed to evaluate the relative immediate (pre- to post-treatment) and longer term (pre-treatment to 3- and 6-month follow-ups) effects of group, videoconference-delivered CT, BA, and MM for CLBP. METHODS: This is a secondary analysis of a three-arm, randomized clinical trial comparing the effects of three active treatments-CT, BA, and MM-with no inert control condition. Participants were N = 302 adults with CLBP, who were randomized to condition. The primary outcome was pain interference, and other secondary outcomes were also examined. The primary study end-point was post-treatment. Intent-to-treat analyses were undertaken for each time point, with the means of the changes in outcomes compared among the three groups using an analysis of variance (ANOVA). Effect sizes and confidence intervals are also reported. RESULTS: Medium-to-large effect size reductions in pain interference were found within BA, CT, and MM (ds from - .71 to - 1.00), with gains maintained at both follow-up time points. Effect sizes were generally small to medium for secondary outcomes for all three conditions (ds from - .20 to - .71). No significant between-group differences in means or changes in outcomes were found at any time point, except for change in sleep disturbance from pre- to post-treatment, improving more in BA than MM (d = - .49). CONCLUSIONS: The findings from this trial, one of the largest telehealth trials of psychological treatments to date, critically determined that group, videoconference-delivered CT, BA, and MM are effective for CLBP and can be implemented in clinical practice to improve treatment access. The pattern of results demonstrated similar improvements across treatments and outcome domains, with effect sizes consistent with those observed in prior research testing in-person delivered and multi-modal psychological pain treatments. Thus, internet treatment delivery represents a tool to scale up access to evidence-based chronic pain treatments and to overcome widespread disparities in healthcare. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03687762.

Prevalence of digestive disorders associated with imported Chagas disease (PADChI study): an observational study.

BACKGROUND: Chagas disease (CD) is a parasitic disease caused by Trypanosoma cruzi, in which up to 10-20% of those affected may suffer digestive disorders. Multiple studies have been carried out on CD in non-endemic countries, mainly related to cardiological involvement. However, digestive disorders have not been analyzed in such depth. The objective of the study was to determine the prevalence of digestive disorders in imported CD at the time of first care. METHODS: An observational cross-sectional descriptive analysis of imported CD was performed. Chagasic structural damage and infectious digestive comorbidity were evaluated. The association between Chagasic structural damage and heart disease in Chagas patients was also investigated. RESULTS: After reviewing a total of 1,216 medical records, those of 464 patients were selected for analysis. Globally, the prevalence of digestive disorders in imported Chagas was 57.76%, 95% CI (53.25-62.27). The prevalence of comorbidity of infectious diseases was 40.73% CI 95% (36.25-45.22). Colonic abnormalities were found in 84 of 378 barium enema patients. CD-related esophageal abnormalities were present in 63 of 380 patients studied with esophagogram. CONCLUSIONS: The prevalence of digestive disorders associated with CD is high, so the presence of infectious diseases (mainly parasitic and H. pylori infection) should be ruled out. It is important to exclude structural involvement in all symptomatic patients, and asymptomatic patients should also be considered and offered.

Age progression in hypnosis for pain and fatigue in individuals with disabilities.

The purpose of this paper is to describe in detail a specific age progression approach that we use in our clinical practice and clinical trials in interventions including hypnosis for chronic pain and fatigue in individuals with disabilities. Moreover, we present preliminary evidence regarding the effects of the hypnosis sessions that use age progression suggestions compared to hypnosis sessions that provide different suggestions, as well as to sessions that did not include hypnotic procedures. Findings indicate that age progression suggestions for pain management with individuals participating in hypnosis treatment resulted in substantial immediate reductions in pain intensity, which were greater than pain reductions associated with treatments sessions providing pain education or cognitive therapy. In addition, age progression sessions provided to individuals receiving online hypnosis treatment for fatigue resulted in immediate large reductions in fatigue severity. Although the design of these two studies does not allow to report specific or long-term effects of the age progression techniques, findings indicate that including age progression suggestions to hypnosis protocols for pain and fatigue management is effective for reducing the immediate level of both symptoms. The development and continued evaluation of hypnotic interventions that increase or restore hope in, and optimism, for the future has the potential for enhancing the psychosocial well-being and quality of life of individuals with pain and fatigue.

Attitudes Toward Hypnosis Based on Source of Information and Experience With Hypnosis.

Attitudes and beliefs toward hypnosis are relevant in promoting hypnotic responses, in predicting the efficacy of interventions that include hypnosis, and in reducing iatrogenic effects in hypnotized individuals. The goal of the present study is to test the impact of previous knowledge about hypnosis and past experiences being hypnotized on attitudes and beliefs about hypnosis. A sample of 1,977 Portuguese students participated in the study; they responded to the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client Version (VSABH-C) on two different occasions (test-retest method). Significant differences were found (p ≤ 0.001) on participants' attitudes and beliefs about hypnosis depending on the source of knowledge about hypnosis. Results also showed significant differences (p ≤ 0.001) in the multivariate profile analysis of the scale's factors based on whether participants had a previous history of hypnosis and depending on who hypnotized them. Participants who reported no previous knowledge about hypnosis or who acquired their knowledge from nonscientific sources scored significantly higher in the negative factors (fear, memory, magical, and marginal), therefore reporting more negative beliefs. Likewise, these participants scored lower in the positive factors (help, control, collaboration, and interest). Participants who had been previously hypnotized showed higher scores in the positive factors. In addition, when hypnosis had been utilized by a psychologist, these scores were even higher. However, some participants who had been previously hypnotized scored high in some of the negative factors (memory and magical), which indicates that some professionals using hypnosis are fostering some misconceptions about hypnosis.

Efecto de bloques con propionato de calcio sobre respuestas productivas en corderos y GEI in vitro / Effect of blocks with calcium propionate on lamb productive performance and in vitro GHG

RESUMEN Objetivo. Evaluar bloques multinutricionales con y sin propionato de calcio (Pr-Ca) en la digestibilidad y cambios de peso de corderos y en la emisión de gases in vitro. Materiales y métodos. Se utilizaron doce borregos (20.17 ± 2.35 Katahdin x criollo) en tres tratamientos: Dieta basal (DB 70% paja de avena; 30% concentrado), DB+ Bloque sin Pr-Ca y DB + Bloque con 1.5% de Pr-Ca, por 50 días. Se midió producción de gas (PG) in vitro y parâmetros de cinética (Vmax, S, Lag). Se estimó la digestibilidad, CH4 y CO2 in vitro e in vivo. Resultados. El consumo de materia seca fue menor (p<0.0001) en borregos sin bloque (753 g/d) en comparación con bloque sin (839 g) o con Pr-Ca (828 g) al incluir bloques aumentó metano (16.16 y 16.18 g/d; 0 y 1.5% Pr-Ca respectivamente) que con DB (13.93 g/d). La PG in vitro fue mayor (p=0.0001) con la DB (380.76 ml) sin diferencias entre bloques (335.76 y 341.13 ml, 0 y 1.5% Pr-Ca respectivamente), y la DB tuvo mayor (p=0.0001) producción de CH4 (47.16 mol) y CO2 (200.04 mol) que con bloques (42.25 y 41.58 mol CH4; 179.21 y 176.39 moles CO2; 0 y 1.5% Ca-Pr respectivamente). Conclusiones. La suplementación con bloques mejora el consumo de materia seca. Los bloques disminuyeron la producción de gas in vitro e incrementaron la digestibilidad reduciendo CH4 y CO2.

ABSTRACT Objective. Evaluate multinutritional blocks with and without calcium propionate (Ca-Pr) on digestibility and live weight changes of lambs and in the green house emission in vitro. Materials and methods. Twelve lambs were used (20.17±2.35 Katahdin x criollo) in three treatments: Basal diet (BD 70% oat straw, 30% concentrate), BD+ Block without Ca-Pr and BD+ Block with 1.5% Ca-Pr in 50 days assay. In vitro gas production (GP) and kinetic parameters were estimated (Vmax, S, Lag). In vitro and in vivo, CH4, CO2 and digestibility were estimated. Results. The dry matter intake was the lowest (p<0.0001) in lambs without block (753 g/d) compared lambs supplemented with block without (839 g) or with Ca-Pr (828 g); including blocks increased methane (16.16 and 16.18 g/d; 0 and 1.5% Ca-Pr respectively) than BD (13.93 g/d). The GP in vitro was higher (p=0.0001) with BD (380.76, ml) than with blocks without differences among blocks (335.76 and 341.13 ml, 0 and 1.5% Ca-Pr respectively), and the BD had higher (p=0.0001) production of CH4 (47.16 mol) and CO2 (200.04 mol) than with blocks (42.25 and 41.58 mol CH4; 179.21 and 176.39 mol CO2; 0 and 1.5% Ca-Pr respectively). Conclusions. Block supplementation improved dry matter intake. Blocks reduced in vitro gas production and increased digestibility by reducing CH4 and CO2.

Case Study: Cognitive Restructuring Hypnosis for Chronic Pain in a Quadriplegic Patient.

This case study reports on a 28-year-old male with spinal cord injury (SCI), quadriplegia, and chronic pain with neuropathic characteristics. The treatment had to be adapted to address the patient's needs, as he was on a respirator and paralyzed from the chin down. The intervention consisted of eight 90-minute sessions. The first four sessions were based on a standardized hypnotic cognitive therapy protocol developed for a randomized controlled trial (RCT). The sessions included training in cognitive restructuring skills and a hypnosis session with suggestions that was audiorecorded. Instructions to practice at home, both with the recording and by using self-hypnosis, were provided as well. Most of the outcome domains assessed (i.e., pain intensity, pain interference, sleep quality) showed clinically meaningful improvements that were maintained (or increased) at one-year follow-up. The patient reported that he was still using self-hypnosis at one-year follow-up. His subjective impression of change was positive and he did not report any negative side effects. Results show that the hypnotic cognitive therapy protocol used is a promising intervention that can benefit individuals with SCI presenting with complex symptomatology. Such therapy helps patients by teaching them effective coping strategies that they can use on their own to manage pain and its effects. In addition, it is important to note that this therapy provided benefits to someone who had not experienced any benefits from numerous medications he had tried before treatment. Therefore, the findings support continued efforts to make this treatment more accessible to patients who could benefit from this approach.

Valencia Model of Waking Hypnosis: Background, Research, and Clinical Applications.

The goal of this article is to provide a comprehensive review of the historical background, methods, and clinical applications of the Valencia Model of Waking Hypnosis (VMWH). The active-alert-waking methods have been developed and used since the 19th century as an alternative when the suggestions for relaxation and drowsiness were not helpful for specific cases, or when the person needed to use hypnotic suggestions in situations that required them to be alert and with their eyes open (i.e. in vivo exposure, sports performance, academic work, etc.). In most of these methods, the hypnotized person keeps their eyes open, and the suggestions given are for alertness, focused attention, mind expansion, and excitement. Physical relaxation is mostly not suggested, but tension or certain physical movements are used to elicit the activation of the hypnotized person. The VMWH consists of a number of methods combined to change attitudes and maximize the effects of the hypnotic suggestions. The procedures have empirical validation, and are straightforward and pleasant for patients as well as easy to learn and apply. It is structured, although its sequence is flexible and can be adapted to the needs of the intervention. Finally, research has revealed that this model has numerous advantages, and is potentially useful in clinical practice. Therefore, its incorporation into therapy may have great benefits for the patients.

Confirmatory Factor Analysis of the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-client Version in a Portuguese Sample.

Research literature about hypnosis highlights the importance of clients' attitudes and beliefs toward hypnosis because they promote hypnotic responses and may predict the effectiveness of hypnotic interventions as well as minimize iatrogenic effects for clients. This study analyzes the factorial structure and psychometric properties with confirmatory methodology of the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client Version, using a Portuguese sample. We expected to replicate the results obtained in previous research conducted with samples from various countries. The Portuguese sample comprised 1,977 participants. We found a structure of 8 factors, with an adequate internal consistency and test-retest reliability. Results are similar to those found in exploratory and confirmatory factor analyses with samples from other countries.

Randomized controlled trial of the Valencia model of waking hypnosis plus CBT for pain, fatigue, and sleep management in patients with cancer and cancer survivors.

BACKGROUND: This study evaluated the efficacy of an intervention combining the Valencia model of waking hypnosis with cognitive-behavioral therapy (VMWH-CBT) in managing cancer-related pain, fatigue, and sleep problems in individuals with active cancer or who were post-treatment survivors. We hypothesized that four sessions of VMWH-CBT would result in greater improvement in participants' symptoms than four sessions of an education control intervention. Additionally, we examined the effects on several secondary outcome domains that are associated with increases in these symptoms (depression, pain interference, pain catastrophizing, and cancer treatment distress). METHODS: The study design was a randomized controlled crossover clinical trial comparing the VMWH-CBT intervention with education control. Participants (N = 44) received four sessions of both treatments, in a counterbalanced order (n = 22 per order condition). RESULTS: Participants were 89% female (N = 39) with mean age of 61 years (SD = 12.2). They reported significantly greater improvement after receiving the active treatment relative to the control condition in all the outcome measures. Treatment gains were maintained at 3-month follow-up. CONCLUSIONS: This study supports the beneficial effects of the VMWH-CBT intervention relative to a control condition and that treatment gains remain stable. VMWH-CBT-trained clinicians should be accessible for managing symptoms both during and after cancer treatment, though the findings need to be replicated in larger samples of cancer survivors.

The Associations Between Pain-related Beliefs, Pain Intensity, and Patient Functioning: Hypnotizability as a Moderator.

OBJECTIVES: On the basis of the idea that thoughts held about pain may represent "self-suggestions" and evidence indicating that people with higher levels of trait hypnotizability are more responsive to suggestions, the current study evaluated hypothesized moderating effects of hypnotizability on the associations between pain-related thoughts and both pain intensity and pain interference. METHODS: Eighty-five individuals with chronic pain were given measures of hypnotizability, pain intensity, pain interference, and pain-related thoughts (control beliefs, catastrophizing). RESULTS: Analyses supported a moderating role of hypnotizability on the association between control beliefs and pain interference. Specifically, the negative association between pain control beliefs and pain interference were stronger among those with higher trait hypnotizability than between those with lower trait hypnotizability. DISCUSSION: The study findings, if replicated in additional samples of individuals with chronic pain, have important clinical and theoretical implications. For example, if trait hypnotizability is found to predict an individual's response to a particular technique of cognitive therapy-such as focusing on and repeating pain control belief self-statements-measures of hypnotizability could be used to identify individuals who might be most responsive to this technique. The current findings indicate that research to further examine this possibility is warranted.

Hipnosis Clínica: Evaluación de su Eficacia y Calidad de la Investigación en Medicina / Clinical Hypnosis: Assessment of its Effectiveness and the Quality of the Investigation of it in Medicine

Introducción: La utilización de la hipnosis para condiciones médicas es muy antigua, ha progresado con el paso del tiempo a partir de estudios cada vez mejor diseñados, razón por la que se considera importante el conocimiento de su valor terapéutico. Objetivo: Evaluar la calidad de la investigación sobre la eficacia de la hipnosis clínica en Medicina, así como sistematizar su evidencia empírica en este campo. Método: En este trabajo se revisaron estudios publicados hasta el 2015. Los criterios para la selección de los estudios fueron los de Chambless y Hollon de 1998 y los de Nathan y Gorman (1998, 2015). Las bases de datos consultadas fueron: PubMed, PsycInfo, PsycArticles, Psyke y Psicodoc. Resultados: La hipnosis se considera eficaz como coadyuvante a la terapia cognitivo-comportamental para varias condiciones médicas, como coadyuvante es probablemente eficaz en procederes oncológicos y odontológicos y una intervención prometedora en la diabetes y el virus del papiloma humano. Desde el 2009 hasta el 2015se han producido un incremento de estudios, aunque como tendencia la calidad de las investigaciones no ha mejorado, y la inclusión de la hipnosis en guías de intervención no está lo suficientemente extendida. Conclusiones: Se considera importante la realización de futuros estudios con metodologías más rigurosas, sobre todo en áreas de la medicina que todavía no cuentan con estudios de suficiente calidad, así como, la formación de los profesionales de la salud en su manejo y la inclusión de la hipnosis en protocolos médicos en las áreas donde hay suficiente evidencia(AU)

Introduction: The use of hypnosis for medical conditions is very old, and it has progressed with the time from studies better and better designed. Thats why, it is considered important the knowledge of its therapeutic value. Objective: Assess the quality of the investigation about the effectiveness of clinical hypnosis in Medicine, and systematize its empirical evidence in this field. Methods: Studies published up to 2015 were reviewed in this paper. Chambless and Hollons (1998) and Nathan and Gormans (1998, 2015) criteria were taken into account for the selection of the studies. PubMed, PsycInfo, PsycArticles, Psyke and Psicodoc were the database consulted.Results: Hypnosis is considered effective as something that helps cognitive-behavioral therapy for several medical conditions. It is probably effective in oncological and odontological procedures, and a promising intervention in diabetes and the human papilloma virus. Since 2009 till 2015 there has been an increase of studies about hypnosis, however as a tendency, the quality of the investigations has not improved, and the inclusion of it in intervention guides is not sufficiently extended. Conclusions: Future studies using more thorough methodology, above all in some fields of Medicine that do not have studies of good quality yet, as well as the training of health professionals in the management of hypnosis, and the inclusion of it in medical protocols in areas where there is enough evidence, are considered very important(AU)

Hipnosis Clínica: Evaluación de su Eficacia y Calidad de la Investigación en Psicología / Clinical Hypnosis: Evaluation of its efficacy and quality of research in Psychology

Introducción: La hipnosis, es un campo de investigación experimental, pero también un conjunto de procedimientos terapéuticos. La investigación y el conocimiento actualizado sobre su valor clínico son necesarios para profesionales vinculados a la práctica y a la investigación en esta esfera. Objetivo: Valorar la calidad de la investigación sobre la eficacia de la hipnosis clínica en Psicología, así como revisar cualitativamente su evidencia empírica en este campo. Método: En este trabajo se revisaron estudios publicados hasta 2015. Los criterios para la selección de los estudios fueron los de Chambless y Hollon de 1998 y los de Nathan y Gorman de 1998 y 2015. Las bases de datos consultadas fueron: PubMed, PsycInfo, PsycArticles, Psyke y Psicodoc. Resultados: En relación con la calidad y cantidad predominan los estudios con un rigor metodológico que debe mejorarse, excluyendo el ámbito del dolor. Además, la revisión cualitativa sugiere que no hay evidencias concluyentes sobre la eficacia de la hipnosis como única intervención ni como coadyuvante en Psicología, excepto, de nuevo, para el caso del dolor. Conclusiones: Hasta el momento no se aprecian adelantos significativos relacionados con la eficacia y la calidad de la investigación sobre hipnosis clínica en Psicología. Es perentorio realizar más investigaciones con metodología rigurosa y seguimientos más largos que mejoren la calidad de los estudios(AU)

Introduction: Hypnosis is an experimental field of research, but also a set of therapeutic procedures. Research and updated knowledge about its clinical value are necessary for professionals involved in the practice and research in this field.Objective: To assess the quality of research on the efficacy of clinical hypnosis in Psychology, as well as to review qualitatively its empirical evidence in this field. Method: In this paper studies published until the year 2015 were reviewed. The criteria for selection of studies reviewed were those of Chambless and Hollonof 1998 and Nathan and Gorman (1998, 2015). The databases examined were PubMed, PsycINFO, PsycArticles, Psyke and Psicodoc. Results: Regarding the quality and quantity, predominated studies with methodological rigor to be improved, excluding the area of ​​pain. In addition, qualitative review suggests that there is no conclusive evidence on the efficiency of hypnosis as unique intervention or as an adjunct in psychology, except, again, for the case of pain. Conclusions: So far, no significant developments relevant to efficiency and quality of research on clinical hypnosis in Psychology are appreciated. More research is imperative, with rigorous methodology and longer follow-ups to improve the quality of the studies(AU)

Psychological and behavioral approaches to cancer pain management.

This review examines evidence for psychological factors that affect pain across the cancer continuum from diagnosis through treatment and long-term survivorship or end of life. Evidence is convincing that emotional distress, depression, anxiety, uncertainty, and hopelessness interact with pain. Unrelieved pain can increase a desire for hastened death. Patients with cancer use many strategies to manage pain, with catastrophizing associated with increased pain and self-efficacy associated with lower pain reports. A variety of psychological and cognitive behavioral treatments can reduce pain severity and interference with function, as indicated in multiple meta-analyses and high-quality randomized controlled trials. Effective methods include education (with coping skills training), hypnosis, cognitive behavioral approaches, and relaxation with imagery. Exercise has been tested extensively in patients with cancer and long-term survivors, but few exercise studies have evaluated pain outcomes. In survivors post-treatment, yoga and hypnosis as well as exercise show promise for controlling pain. Although some of these treatments effectively reduce pain for patients with advanced disease, few have been tested in patients at the end of life. Given the clear indicators that psychological factors affect cancer pain and that psychological and behavioral treatments are effective in reducing varying types of pain for patients with active disease, these methods need further testing in cancer survivors post-treatment and in patients with end-stage disease. Multidisciplinary teams are essential in oncology settings to integrate analgesic care and expertise in psychological and behavioral interventions in standard care for symptom management, including pain.

Composición química y capacidad anti-irritante de extractos de cuerpo entero de Ulomoides dermestoides (Coleoptera, Tenebrionidae) / Chemical composition and anti-irritant capacity of whole body extracts of Ulomoides dermestoides (Coleoptera, Tenebrionidae)

Background: In traditional medicine of Central and South America, the tenebrionid beetle Ulomoides dermestoides is used as an a phrodisiac, for the treatment of inflammatory diseases and cancer. Recently was reported cytotoxic and genotoxic properties of non-polar extract of U. dermestoides; also anti-inflammatory and immunomodulatory activity of aqueous whole body extract of beetle was reported, it suggests the existence of components with potential pharmacology use. On the other hand, it is necessary to identify those polar and non-polar extracts of U. dermestoides with anti-irritant properties for the membranes and blood vessels, which will be used in subsequence biological test and clinical assays. Objectives: The purpose of this research was to identify the chemical composition of methanolic and hexanic extracts of U. dermestoides, and to assess their anti-irritant capacity. Methods: The extracts were obtained from adult beetles of U. dermestoides. The chemical composition of the extracts was determined by gas chromatography-mass spectrometry (GC-MS) and the anti-irritant effect of each extract was evaluated by means of a modified assay of irritation of the chorioallantoic membrane (CAM) of fertilized chicken eggs (HET-CAM); the results were expressed as irritation index (IR). Results: Six common compounds were identified in both extracts: limonene, myristic, palmitic, estearic, oleic, and linoleic fatty acids. But in the alone methanolic extract were found: 1-pentadecanol, alpha-pinene, beta-phellandrene and alpha-terpinene, whereas in the hexanic extract were found: 2-methyl-p-benzoquinone, 2,4-dihidroxy-1-ethylbenzene, 2,5-dimethyl-quinone, saturated and unsaturated hydrocarbons and alcohols. The methanolic extract of U. dermestoides showed potential anti-irritant effect in the HET-CAM test (IR = 3.09 ± 0.11), similar to that observed with Nimesulida (IR = 2.05 ± 0.14)...

Volatile compounds and antioxidative activity of Porophyllum tagetoides extracts.

Porophyllum tagetoides is an annual warm-weather herb that has an intense typical smell. Its leaves are commonly used in soup preparation and traditional medicine for treatment of inflammatory diseases. Its volatile compounds and antioxidant properties were evaluated in crude, aqueous and ethanol leaf extract and an oil emulsion using different antioxidant assays in vitro, such as: DPPH radical scavenging activity, redox potential, polyphenol content, reducing power and optical density. A high antioxidative activity was found when comparing leaves with stems. The crude extract from leaves showed a very high reducing power (2.88 ± 0.20 O.D.) and DPPH radical-scavenging activity (54.63 ± 4.80%), in concordance with a major concentration of vitamin C (23.97 ± 0.36 mg/100 g). Instead, the highest polyphenol content (264.54 ± 2.17 mg GAE/g of sample) and redox potential (561.23 ± 0.15 mV) were found by the ethanol and aqueous extract, respectively. Aldehydes and terpenes such as nonanal, decanal, trans-pineno, ß-myrcene and D-limonene were the major volatiles found. This study suggests that Porophyllum tagetoides extracts could be used as antioxidants.

Neurophysiology of pain and hypnosis for chronic pain.

In the past decade there has been a dramatic increase in (1) understanding the neurophysiological components of the pain experiences, (2) randomized clinical trials testing the efficacy of hypnotic treatments on chronic pain, and (3) laboratory research examining the effects of hypnosis on the neurophysiological processes implicated in pain. Work done in these areas has not only demonstrated the efficacy of hypnosis for treating chronic pain but is beginning to shed light on neurophysiological processes that may play a role in its effectiveness. This paper reviews a selection of published studies from these areas of research, focusing on recent findings that have the most potential to inform both clinical work and research in this area. The paper concludes with research and clinical recommendations for maximizing treatment efficacy based on the research findings that are available.

Percepción de docentes y alumnos sobre documentos Odontológicos legales utilizados en la práctica clínica de Facultades de Odontología del Paraguay año 2011 / Perception of teachers and students on legal documents used in the Dental Clinical Practice of Dental Schools in Paraguay in 2011

El odontólogo tiene grandes responsabilidades en la sociedad, en función de la misma existen normas éticas y legales que le dan un norte a ese profesional. Todas las actividades odontológicas deben ser plasmadas en documentaciones que son el medio por el cual se demuestra la actuación del mismo. La confección del consentimiento informado es obligatoria según los Códigos Penal y Sanitario y la historia clínica lo es para asegurar una medicina de calidad. El mejor lugar para impartir esta enseñanza es la facultad durante la formación del estudiante. Se evaluó la percepción de docentes y estudiantes sobre documentos odontológicos legales utilizados en la práctica clínica de Facultades del Paraguay con el propósito de tomar medidas correctivas necesarias inculcando el verdadero objetivo de estos documentos en la Institución. Es un estudio observacional descriptivo y componente analítico, se aplicó un cuestionario auto administrado a 233 sujetos. Se observó percepción del 63%; sólo el 3% considera la confección del consentimiento informado como un acto médico y el 92% cree necesario un centro de admisión de pacientes en su Institución. No se observó significancia estadística en relación del tipo de Institución pública o privada y la percepción sobre los documentos odontológicos p= 0,1 p> 0,05

Impact of a lecture about empirical bases of hypnosis on beliefs and attitudes toward hypnosis among Cuban health professionals.

The aim of this study was to examine whether a lecture on hypnosis can modify attitudes and misconceptions about hypnosis. The sample consisted of 97 health professionals from institutions in Havana City, Cuba. Group 1 consisted of 46 participants who received a lecture on hypnosis. Group 2 consisted of 51 participants who received a lecture about urology. and Beliefs toward Hypnosis-Therapist was applied before and after the lecture. Results indicated that there were significant differences between the groups: Group 1 showed more positive attitudes toward hypnosis. However, both groups showed similar misconceptions about hypnosis and memory, which changed significantly in Group 1 after receiving the lecture about hypnosis but not in Group 2. Therefore, the lecture about hypnosis had a significant impact in correcting participants' misconceptions about memory and hypnosis.