Burnout en el contexto deportivo: análisis teórico-práctico del estado de la cuestión / Burnout in the sporting context: theoretical and practical analysis of the state of the

Con este trabajo pretendemos aproximarnos a la situación actual que, en materia de invstigación y aplicación, podemos encontrar con relación al síndrome de burnout en el contexto deportivo. Para ello hemos analizado los trabajos científicos más recientes, con la finalidad de obtener aquellas tendencias que actualmente está adquiriendo la investigación de este sindrome, siempre desde la perspectiva deportiva que nos ocupa. Para ello, además, hemos buscado las aplicaciones prácticas que dichas investigaciones pueden tener para el psicólogo del deporte que trabaja directamente con deportistas y entrnadores, principalmente. Como se irá desarrollando, a lo largo de la descripción ofrecida, empiezan a exitir pilares sólidos en esta línea de estudio y trabajo aplicado, tanto desde la perspectiva avaluativa, como desde los planteamientos teóricos y prácticos más recientes. Se concluye acerca de las líneas principales de trabajo a las que hábra que atender cuando el psicólogo se erncuentre con deportistas y entrenadores con burnout, bien desde la intervención directa, bien desde planteamientos preventivos(AU)

With this work we try to come closer the current situation that, as for invstigación and application, we can find with relation to the syndrome of burnout in the sports context. For it we have analyzed the most recent scientific works, with the purpose of obtaining those trends that nowadays there is acquiring the investigation of this syndrome, always from the sports perspective quenos occupies. For it, in addition, we have looked for the applications practical that the above mentioned investigations can have for the psychologist of the sport who works directly with sportsmen and entrnadores, principally. Since it will be developing, along the offered description, they begin to exitir solid props in this line of study and applied work, so much from the perspective avaluativa, since from the most recent theoretical and practical expositions. He concludes brings over of the principal lines of work to which hábra to that to attend when the psychologist erncuentre with sportsmen and trainers with burnout, well from the direct intervention, well from preventive expositions (AU)

Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: a randomized controlled study.

OBJECTIVE: To evaluate the effects of a cognitive behavioural training programme and a physical activity programme for patients with stress-related illnesses. DESIGN: In a randomized controlled study, patients were allocated randomly to 1 of 3 groups, where group 1 participated in a cognitive behavioural training programme, group 2 participated in a physical activity programme, and group 3, the control group, was offered usual care for the course of the study. SUBJECTS: A total of 75 patients participated in the study. They had been on sick leave for at least 50% of the time for between 1 month and 2 years due to stress-related illnesses. METHODS: Measurements of autonomic activity, pressure-pain thresholds and subjective ratings of health and behaviour were made before and after a 10-week intervention period, and at 6 and 12 months after the intervention. RESULTS: Minor differences in autonomic activity and pressure-pain thresholds were found between the groups immediately after the intervention. At the 6- and 12-month follow-up assessments, the differences were no longer present. Patients in the cognitive behavioural training group improved their ratings of general health compared with the physical activity group throughout the study. CONCLUSION: The study showed little difference in the effect of cognitive behavioural training and physical activity, compared with usual care, for patients with stress-related illnesses.

Rehabilitation of research chimpanzees: stress and coping after long-term isolation.

We report on the permanent retirement of chimpanzees from biomedical research and on resocialization after long-term social isolation. Our aim was to investigate to what extent behavioral and endocrine measures of stress in deprived laboratory chimpanzees can be improved by a more species-typical social life style. Personality in terms of novelty responses, social dominance after resocialization and hormonal stress susceptibility were affected by the onset of maternal separation of infant chimpanzees and duration of deprivation. Chimpanzees, who were separated from their mothers at a younger age and kept in isolation for more years appeared to be more timid personalities, less socially active, less dominant and more susceptible to stress, as compared to chimpanzees with a less severe deprivation history. However, permanent retirement from biomedical research in combination with therapeutic resocialization maximizing chimpanzees' situation control resulted in reduced fecal cortisol metabolite levels. Our results indicate that chimpanzees can recover from severe social deprivation, and may experience resocialization as less stressful than solitary housing.

[Dermato-oncological rehabilitation]. / Dermatoonkologische Rehabilitation.

National insurance companies in Germany support health cures for patients with malignant tumors (malignant melanoma, squamous cell carcinoma, Merkel cell tumor, malignant cutaneous lymphoma). The clinical requirements are an invasively growing tumor, problems of self-assurance, and dis-integration of the patient regarding his social and/or professional environment. The decision for a health cure is made by the treating dermatologist in the hospital. In this context, the following sociomedical criteria should be applied: impairment, disability, and handicap. Usually, rehabilitation starts after the patient is discharged from the hospital. The inpatient rehabilitation program should be performed at an institution capable of providing dermatological and psychological treatment. The dermatologist acts as a manager for the members of the rehabilitation team (psychologists, physiotherapists, social workers, and ergo-therapists). In conclusion, dermato-oncologic rehabilitation plays an important role in re-integrating the patient into his professional life to avoid retirement.

[Aspects of rehabilitation in HIV and AIDS]. / Aspekte der Rehabilitation bei HIV und AIDS.

Medical treatment of HIV infection has changed dramatically since 1997. The uncontrollable threat became a chronic disease. On the other hand, many HIV-infected people suffer from high psychological distress and multiple physical complaints. Interaction in HIV prevention could transform into psychological counseling. Counselors should initiate rehabilitation measures and occupational reintegration by utilizing all legal possibilities for handicapped people. Patients and physicians, psychologists and social workers as well as self-help groups should initiate successful reintegration into the workforce and daily life; this could positively influence compliance behavior.

Exercise improves biomarkers of health and stress in animals fed ad libitum.

Voluntary and forced exercise decrease morbidity and mortality in laboratory animals. Caloric restriction has similar effects on health and unique benefits on life span. Nonetheless, in most experiments, animals do not have access to physical activity and are fed ad libitum (AL). We hypothesized that with regular access to either unlimited running wheel exercise (EX) or limited physical activity (PA), key biomarkers of health would be enhanced enough to counter some consequences of a sedentary AL lifestyle. This 16-month study compared body weight, tumor number and size, tissue lesions, oxidative stress, and reactive stress in (1) sedentary animals with no access to physical activity (SED); (2) animals with access to hour-long, twice weekly activity in a large box (PA); and (3) animals with access every other day to a running wheel (EX). At the end of the study, EX body weight was 8-9% lower than PA and SED. In addition, EX had no kidney lesions versus 50% in PA and SED, and had smaller tumor size (10+/-2 vs. 14+/-4 and 30+/-4 mm). Exhaustive exercise lowered glutathione/oxidized glutathione ratio in EX and PA, but in SED, the ratio was depressed even in resting animals. In all treatments, prolactin (PRL) levels were lower in resting animals than in acutely exercised animals. In conclusion, EX had the most favorable health biomarkers while SED had the least. PA did not confer gross health benefits different than the SED group, but was biochemically more similar to EX animals.

[The problem of health state assessment from the point of view of adaptational reactions theory]. / Problema vyznachennia stanu zdorov'ia z tochky zoru teoriï adaptatsiinykh reaktsii.

Human health condition can be estimated only using adaptive responses theory. We include overactivation responses and incomplete adaptation in addition to stress reactions in the distress-group. Quiet and raised activation reactions were included into the eustress-group. All health spectrum should be divided in three groups. For health persons: 1) physiologic standard = safe health level = eustress reactions of high reactivity level 2) prenosological conditions = eustress reactions of low reactivity level, orientation, 3) premorbid conditions = adaptation mechanism breaking = distress reaction. For patients: 1) auspicious course of the disease = complete remission = eustress reactions of high reactivity level, 2) indefinite course of the disease = partial remission = eustress reactions of low reactivity level, orientation, 3) severe course of the disease = absence of remission = unfavorable prognosis = distress reaction.

Women's hearts need special treatment.

Coronary heart disease (CHD) is the leading cause of death for both men and women in the Western world. Some studies show that the observed decline in cardiovascular mortality is not as pronounced among women as among men. There is a growing awareness that most earlier studies both on primary and secondary risk factors, diagnosis, prognosis, and rehabilitation have focused mainly on men. Thus, there is a need to develop knowledge about women with CHD and to address gender issues in treatment and rehabilitation strategies. Negative affect and emotions increase risk and may interfere with effective cardiac rehabilitation. Therefore, methods for coping with emotional stress need to be included in treatment regimens after a coronary event. The feasibility of a stress management program for women with CHD was assessed in a pilot study. The program consisted of twenty 2-hr group sessions during 1 year, with 5 to 9 participants per group. The pilot study showed that this treatment program had a low dropout rate and resulted in improvement in quality of life and reduction in stress and symptoms. Further work to optimize psychosocial interventions for women with CHD is needed.

Physical exercise and psychological well being: a critical review.

The relation between physical exercise and psychological health has increasingly come under the spotlight over recent years. While the message emanating from physiological research has extolled the general advantages of exercise in terms of physical health, the equivalent psychological literature has revealed a more complex relation. The paper outlines the research evidence, focusing on the relation between physical exercise and depression, anxiety, stress responsivity, mood state, self esteem, premenstrual syndrome, and body image. Consideration is also given to the phenomena of exercise addiction and withdrawal, and implications for exercise prescription are discussed.

[Crenotherapy in sports medicine: the state of the art]. / La crenoterapia nella medicina sportiva: lo stato dell'arte.

The existing relationship linking thermal and sport medicine has developed with time. This is shown by the established beneficial effects of thermal treatments (mineral waters, mud baths, balneotherapy, aerosol applications) in a wide range of sport and non-sport related injuries. The muscle fatigue syndrome is a condition particularly worrisome for sports practising individuals. This condition impairs the cardiovascular system, as well as hematologic, renal and gastrointestinal functions, acting via biochemical and metabolic modifications of the organism, which have effects also on the psyche of the subject. The treatment of this syndrome includes the use of specific mineral waters, which underscores that the correct hydration of the organisms is a precondition to achieve high performance levels. Traumas involving muscles and skeletal segments, and precocious arthrosis occur with higher frequency in sportsmen after continuous and intense stresses. Within the scope of rheumatology, mud-baths and balneotherapy have curative and rehabilitative potentials leading to a reduction, and often a disappearance, of pain with a faster recovery of the locomotory system. The gastrointestinal system is a target of psychic as well as physical stresses displaying symptoms or diseases which may be favourably addressed with the aid of mineral waters. This treatment has proved effective in secretory and motility dysfunctions of the biliary tree allowing a rapid functional recovery. Mineral water treatments are successfully employed in the treatment of urologic disturbance and ORL and dermatological pathologies, where local applications such as mud baths, balneotherapy, showers and aerosols, play a critical role.

Occupational stress intervention.

The topic of occupational stress has received considerable research attention during the last decade and has emerged as an important occupational safety and health concern. Worker compensation claims for stress-related illnesses, for example, were the fastest growing type of claim in the 1980s, comprising more that 11% of all such claims. Concern over problems associated with occupational stress and their costs has fostered interest in intervention strategies. While specific work stressors and their resulting physical and mental health consequences have been identified, relatively few successful interventions have been documented in the literature. This article discusses primary, secondary, and tertiary interventions efforts in the area of occupational stress and argues for efforts to increase understanding of the occupational stress intervention process.

Prevalencia de disturbios mentales en la Población Urbana del Cantón Macará, Provincia de Loja

Las consecuencias emocionales de los desastres, especialmente de aquellos en los que la intervención de la mano del hombre es innegable, han sido abordados por un sector especializado de Salud Mental, sin embargo, las acciones orientadas a la detección y manejo de los problemas emocionales en las víctimas de este tipo de acontecimientos no han sido conducidas con el mismo interés. En el Cantón Macará, Provincia de Loja, asentada prácticamente sobre el Límite Político Internacional, se encuentra su capital Macará, que posee aproximadamente 19.083 habitantes. las condiciones climáticas adversas, sus escasos y pobres recursos y las limitadas fuentes de trabajo, han ido configurando una población de bajos ingresos, poseedora de elevados índices de pobreza, desocupación y migración. A estos aspectos, se añade otro de carácter catastrófico; el fantasma latente de un conflicto armadomque se superpone a las insuperables secuelas de la invasión peruana de 1.941 y a las amenazas de conflictos armados manifiestos en los años 1.981, 1.991 y 1.995. Confrontamos entonces a una población con evidente vulnerabilidad biológica, ecológica, económica y social; bajo una amenaza latente de un conflicto armado y con elevado riesgo para la salud de sus habitantes. Este es el espacio en el cual se realizó la investigación orientada fundamentalmente a la búsqueda de la Prevalencia de los siguientes disturbios emocionales: Neurosis, Psicosis, Epilepsia y Alcoholismo. Por otro lado también se realizó el diagnóstico de riesgo para la salud de los habitantes de esta misma población. Para dar cumplimiento al objetivo propuesto, fueron empleados tres instrumentos: el Self Reporting Questionnaire (SRQ) para disturbios emocionales, el Instrumento de Valoración Socioeconómica (CEIAS-CEAS-FBPNQ) y la Ponderación de los Parámetros que conforman la Vulnerabilidad y la Amenaza, para riesgo. El estudio se realizó según un tipo de diseño transversal en la población urbana de ambos sexos mayor de 15 años. La muestra estuvio constituida por 356 habitantes y el muestreo fue de tipo aleatorio, simple.

[Stress in school-age children]. / Le stress de l'écolier.

In April 1988, following preliminary research, Notre Dame Elementary School in Edmunston, N.B. initiated a pilot project entitled Management of Children's Stress. Using a three-dimensional process, parents, teachers and students collaborated to empower all students enrolled at the school to effectively manage their day-to-day stress. To prepare, the children, parents and teachers participated in nine- and 15-hour education sessions, respectively. Various techniques, including deep breathing exercises, stretching, relaxation techniques and listening to music, were considered. Visualization, maximizing the mind's potential to envision relaxing images, became the preferred technique. In addition to complementing other relaxation techniques used by the children, visualization facilitated their learning; developed and improved their concentration, motivation and self-confidence; gave them a positive self-image; and reduced health problems. The project has surpassed all expectations. In March 1993, it became part of a Quality of Life Education Project at the school.

[The differential use of electrosleep for restoring the work capacity of athletes]. / Differentsirovannoe primenenie élektrosna dlia vosstanovleniia rabotosposobnosti sportsmenov.

A comparative study has been made of the effects which might be produced on body functions of athletes by electric sleep. The induction of the sleep was conducted using square electric pulses with 10 and 100 Hz frequencies. The latter frequency (8-10 sleep procedures) stimulated the examinees somatically and psychologically, whereas electrotherapeutic sleep procedures at 10 Hz displayed sedative effects and thus were indicated for overstrained sportsmen and in some diseases.

Stretch-based relaxation training.

This paper is a review of progressive relaxation training based on muscle stretching exercises. Stretch-based relaxation training is an alternative to traditional tense-release methods for teaching self-regulation of muscle activity. The rationale and basic procedures for stretch-based relaxation are presented, along with a review of research studies exploring the clinical efficacy of the techniques. Experimental evidence has demonstrated decreases in subjective measures of muscle tension and activation, as well as decreases in EMG activity at selected target muscle sites when stretch-based relaxation procedures are employed. The clinical application of stretch-based relaxation is presented and illustrated with a case study describing the use of these procedures to assist in the treatment of neck tension/pain and anxiety. Discussion centers on the potential role of stretch-based relaxation in the management of anxiety and musculoskeletal disorders.