The end-of-life trajectory of cancer patients in palliative care (PC) elicits an anticipatory grief (AG) process in family caregivers (FCs). Although widely recognized, AG lacks conceptual clarification. This study aims to qualitatively explore the experience of FCs of patients with terminal cancer to identify the core characteristics and the specific adaptive challenges related to AG in the context of end-of-life caregiving. Data were collected through in-depth semi-structured interviews conducted in a clinical sample of 26 FCs of cancer patients in PC. Findings from thematic analysis suggest that the AG experience is characterized by traumatic distress from being exposed to life-threatening conditions and the separation distress induced by loss anticipation and current relational losses, challenging the FCs to long-term emotional regulation effort demands. These results contribute to the conceptualization of AG and may inform intervention programs for the main challenges the FCs face when adjusting to loss during end-of-life caregiving.
We explored the adherence to a home-delivered, computer-based, cognitive remediation protocol in a first-episode psychosis outpatient cohort. Seventeen patients underwent a cognitive training protocol for 6 months using an online platform accessible from their home under the supervision of a qualified neuropsychologist. Neuropsychological, psychopathological, and functional data were collected at baseline and postintervention, whereas qualitative appraisal of the intervention was assessed monthly. Overall, participants' evaluation of the program was positive. This was reflected in a good adherence rate with 12 (70%) of 17 patients completing 80% of the prescribed sessions. Exploratory analysis revealed significant improvements in sustained attention (p = 0.020) and verbal memory (p = 0.018). A decrease in negative symptoms and an improvement on the Clinical Global Impression were also found (p = 0.009). We believe these are encouraging results to further explore the adopted delivery approach, which could facilitate access to cognitive training earlier and to a larger group of patients.
Overtime, in the electricity sector, there has been a technological transfer to renewable electricity generation. With this change, processes, in the economic and availability terms, are expected to improve. In this new paradigm, society demands electricity without an impact on the environment and with the lowest possible cost. The wind power (WP) integration appears in this evolution process by achieving important technological advances, supporting in 2017 a growth of 44% of new projects in Europe, higher than any other renewable technology. However, the renewable energy sources (RES) integration in the electricity networks still presents technical difficulties and challenges, leading to challenges in the electricity markets (EMs). Therefore, this work evaluates the importance of WP and its influence on the Iberian Electricity Market (MIBEL), at the level of the intraday electricity spot market (IESM). This is an innovative study because literature usually focuses on day-ahead WP impact and this study focuses on intraday markets, which are closer to the consumption periods. The goal was to make an analysis on the impacts when betting on WP sources, in order to improve the market interaction with WP integration, considering as criteria the consumer satisfaction, in terms of lower electricity prices and WP availability. For this study, the market bids registered by the Iberian Electricity Market Operator (OMIE), from 2015 to 2017, ran over a new market simulator, specially developed for this proposal, considering a virtual market condition, but not considering the bids made by WP producers. The comparison of the results allowed the evaluation of the WP influence on the EM quantitative, which is noteworthy.
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