ResumenEl desarrollo de nuevas tecnologías ha alcanzado prácticamente a todo el desarrollo humano. En el caso de la psicología clínica, ha significado nuevos avances en el conocimiento, evaluación y tratamientos psicológicos de diferentes problemas y trastornos. En este trabajo se revisan cuatro desarrollos que han tenido una expansión importante: el uso de internet para el tratamiento psicológico, el uso de la realidad virtual, el neurofeedback y la estimulación magnética transcraneal. Se presenta brevemente cada técnica o procedimiento, su aplicación a problemas concretos, sus ventajas y sus inconvenientes. Finalmente se discute el desarrollo de estos recursos y la necesidad de seguir aportando conocimientos que vayan mejorando su eficacia y su eficiencia, de acuerdo con tipos de pacientes, patologías, procedimiento específico, así como evitar efectos indeseables. Palabras clave: nuevas tecnologías, telesalud, realidad virtual, neurofeedback, estimulación transcraneal. NEW TECHNOLOGICAL DEVELOPMENTS APPLIED TO PSYCHOLOGICAL TREATMENT AbstractThe impact of new technologies has reached almost all human development. In the case of clinical psychology, has meant new advances in the understanding, assessment and treatment of various psychological problems and disorders. In this paper, four developments that have had a major expansion are reviewed: Internet-based psychological treatment, the use of virtual reality, neurofeedback, and transcranial magnetic stimulation. First, each technique or procedure is briefly presented. Then, its application to specific problems, its advantages and disadvantages are described. Finally, the development of these resources and the need to continue providing knowledge is discussed. These advances will improve their effectiveness and efficiency, according to types of patients, specific disorders, and to avoid side-effects.

Los efectos beneficiosos sobre la salud de la reexperimentación emocional mediante la utilización de la escritura expresiva de vivencias traumáticas están bien establecidos. La efectividad de la utilización de la reexperimentación parece verse afectada por ciertas condiciones. Entre las variables personales que han mostrado tener influencia sobre la recuperación de tales vivencias se ha destacado el optimismo y la alexitimia. El objetivo del presente trabajo fue evaluar los efectos de una intervención basada en la reexperimentación emocional sobre la salud mental. Se aplicó un diseño experimental intergrupo pre y posttratamiento. La muestra estuvo compuesta por un total de 60 participantes, de los que 40 llevaron a cabo un procedimiento de reexperimentación emocional mediante tres sesiones de escritura expresiva. El resto formaron el grupo control y escribieron sobre situaciones triviales. Todos fueron evaluados antes y después de la reexperimentación emocional en afecto positivo y negativo, ansiedad, depresión, pensamientos intrusivos y evitación cognitiva. Además, se controló el nivel de optimismo y la alexitimia. Los resultados mostraron la eficacia de la escritura expresiva sobre el afecto positivo y negativo y el nivel de depresión. Entre las covariables, únicamente el optimismo produjo un efecto significativo sobre las variables más emocionales. Se discuten las condiciones contextuales y personales que pueden favorecer el uso clínico de la reexperimentación emocional.

OBJECTIVES: To evaluate the costs and health outcomes of using Pioglitazone in combination with insulin compared to insulin mono-therapy in treating patients with Type 2 Diabetes Mellitus (T2DM) in Iran. METHODS: A model-based economic evaluation was performed. A systematic review and meta-analysis was conducted in order to evaluate the clinical effectiveness of the comparators. Relative randomized controlled trials, based on the inclusion criteria, were included. Treatment effect data including change in glycozilated hemoglobin (HbA1c), insulin daily dose, serum lipids, and Body Mass Index BMI) were taken from included trials. Costs were calculated from payer perspective. Quality-adjusted life years (QALYs) and life years gained (LY) were measured to evaluate the effectiveness of alternatives. The price list of pioglitazone and varied forms of insulin were extracted from Iran Food and Drug Administration website. One-way sensitivity analysis was performed for assessing the robustness of the model. RESULTS: The 7618 studies were found in the first phase of searching through databases. After eliminating duplicate studies and studies incompatible with the inclusion and exclusion criteria of our study, 12 study were selected. In meta-analysis, the mean reduction in HbA1c, for combination therapy of insulin with pioglitazone, was 0.64%, which was statistically significant (95% CI: -0.86, -0.41, p<0.00001). The combination therapy of Pioglitazone (15 and 30 mg dosage forms) plus insulin, was associated with an incremental cost-effectiveness ratio of 408.6 $ USD per QALY versus insulin mono-therapy. CONCLUSIONS: Our results suggest that the addition of pioglitazone to insulin regimen would be highly cost-effective treatment approach in Iranian T2DM patients.

IntroductionFoot reflexology is a type of complementary manual therapy that consists of applying pressure or massage to the sole of the foot to produce various therapeutic effects in other body areas or organs. This technique has been used in many different clinical indications, but there is uncertainty about its real effect. A health technology assessment (HTA) was conducted to analyze the efficacy and safety of foot reflexology within the framework of the “Health Protection Plan Against Pseudo-Therapies,” which was established in 2018 by the Spanish Ministry of Health and the Ministry of Science and Innovation.MethodsA systematic review and metanalysis was conducted to synthesize the available scientific literature on the efficacy and safety of foot reflexology in people of any age with any disease or medical condition.ResultsSixty-eight randomized controlled studies were included. Pooled estimates indicated that foot reflexology had no effect on pain, fatigue, depression, quality of life, quality of sleep, or blood pressure, compared with non-reflexological foot massage. Improvements in pain (standardized mean difference [SMD] −1.11, 95% CI: −1.70 - −0.52), fatigue (SMD −0.93, 95% CI: −1.36 - −0.51), sleep quality (SMD −1.11, 95% CI: −1.68 - −0.34), and systolic (mean difference [MD] −7.36, 95% CI: −8.49 - −6.23) and diastolic (MD −5.07, 95% CI: −0.98 - −0.22) blood pressure were obtained when reflexology was compared with usual care or no intervention. In the case of anxiety levels, the benefit obtained with foot reflexology compared with any comparator (SMD −0.6, 95% CI: −0.98 - −0.22) was attenuated when compared with non-reflexological foot massage (SMD −0.2, 95% CI: −0.36 - −0.03). Very few studies reported on the safety of foot reflexology.ConclusionsThere was no evidence for any specific effect of reflexology for any condition when compared with non-reflexological foot massage, except for a positive effect on anxiety levels.