The idea that internal conflicts play a significant role in mental health has been extensively addressed in various psychological traditions, including personal construct theory. In the context of the latter, several measures of conflict have been operationalized using the Repertory Grid Technique (RGT). All of them capture the notion that change, although desirable from the viewpoint of a given set of constructs, becomes undesirable from the perspective of other constructs. The goal of this study is to explore the presence of cognitive conflicts in a clinical sample (n = 284) and compare it to a control sample (n = 322). It is also meant to clarify which among the different types of conflict studied provides a greater clinical value and to investigate its relationship to symptom severity (SCL-90-R). Of the types of cognitive conflict studied, implicative dilemmas were the only ones to discriminate between clinical and nonclinical samples. These dilemmas were found in 34% of the nonclinical sample and in 53% of the clinical sample. Participants with implicative dilemmas showed higher symptom severity, and those from the clinical sample displayed a higher frequency of dilemmas than those from the nonclinical sample.

Aims: This study aimed to investigate the prognostic impact of the SYNTAX score II (SS-II) on ST-segment elevation myocardial infarction (STEMI) patients undergoing a primary percutaneous coronary intervention (pPCI). Methods and results: This retrospective cohort study included 1,689 patients with STEMI who underwent pPCI between January 2008 and December 2016. The patients were categorised into three groups based on SS-II tertiles (SS-II low tertile <24 [n=585], SS-II intermediate tertile ≥24 and ≤34 [n=567], and SS-II high tertile >34 [n=537]). In-hospital mortality was significantly lower in patients with low and mid SS-II when compared with high SS-II (0.7% vs 0.5% vs 16.4%, p=0.001). During follow-up (median 2.35 years), a high SS-II was positively correlated with MACE (12.3% for low SS-II vs 18.3% for mid SS-II vs 43.2% for high SS-II, p=0.001), all-cause mortality (1.5% vs 3.9% vs 14.2%, p=0.001) and heart failure (0.3% vs 2.7% vs 8.2%, p=0.001). The SS-II showed additive value on top of GRACE, anatomical SYNTAX score and residual SYNTAX score. Conclusions:The SS-II in patients with STEMI undergoing pPCI adds important prognostic information regarding midterm adverse outcomes, being an independent and powerful predictor of MACE, heart failure and all-cause mortality during follow-up.

Here we present the first reconstruction of changes in surface primary production during the last century from the Puyuhuapi fjord in southern Chile, using a variety of parameters (diatoms, biogenic silica, total organic carbon, chlorins, and proteins) as productivity proxies. Two sediment cores from the head and the center of the fjord were analyzed and compared to gain insights on past changes in productivity in these two different depositional environments. Higher sedimentation rates found at the head of the fjord result from the combination of a shallower water column and a restricted circulation by the occurrence of a sill. Additionally, sediment mixing depths estimated from 210 Pb data suggest that suboxic conditions may dominate the bottom water and the sediment-water interface in this location.Productivity of the Puyuhuapi fjord during the last century was characterized by a constant increase from the late 19 th century to the early 1980s, then decreased until the late-1990s, and then rose again to present-day values. The influence of rainfall on productivity was most noticeable during periods of low rainfall, which coincided with decreased overall productivity within the Puyuhuapi fjord.Simultaneous variations in productivity and rainfall in the study area suggest that marine productivity could respond to atmospheric-oceanic interactions at a local scale. At a regional scale, marine productivity of the area may be related to other large-scale processes such as the El Niño SouthernOscillation.4

In this chapter, we introduce readers to the varied groups of psychotherapists who participated in our study. In doing this, we have two aims in mind. The first is to provide a context for understanding variations in responses to the questions posed in the Development of Psychotherapists Common Core Questionnaire. Psychotherapists share certain basic characteristics, but they also differ in many ways from one another. A detailed description of our therapists' varied characteristics will help readers 27

In this article, we focus on the theoretical orientations of Spanish psychotherapists with reference to the concepts of integration and eclecticism associated respectively with the cultural patterns of modernity and postmodernity. Data are reported from 179 Spanish therapists who responded to the Development of Psychotherapists Common Core Questionnaire (Orlinsky et al., 1999). The results indicated that these Spanish therapists do not show a tendency toward postmodern eclecticism, suggesting that present clinical practice in Spain still needs high-profile theoretical constructs.