Dificultades diagnósticas en el autismo. Presentación de un caso

Terceres Jornades de Foment de la Investigació de la FCHS (Any 1997-1998)En la siguiente comunicación se comentan algunas de las dificultades diagnósticas en el campo del autismo, y que se relacionan con la conceptualización del trastorno, su clasificación y los procedimientos empleados para su evaluación. Asímismo, se presenta un caso clínico de un niño de tres años y medio y las tareas de evaluación realizadas con el objetivo de establecer un diagnóstico

La convivencia en las aulas de Secundaria: Programas Alumno Ayudante y Alumno Mediador

Quinzenes Jornades de Foment de la Investigació de la FCHS (Any 2009-2010

Análisis motivacional en adolescentes. El SMAT (Test de motivaciones en adolescentes)

Terceres Jornades de Foment de la Investigació de la FCHS (Any 1997-1998)El origen de la presente comunicación se sitúa en la realización de las prácticas correspondientes al Curso de Adaptación Pedagógica (C.A.P.) realizado en esta Universidad durante el curso 1997-98. En ellas realizamos una medición de los intereses motivacionales de los alumnos de dos cursos de 3º de B.U.P. a partir de la aplicación del Test de Motivaciones en Adolescentes (SMAT). Nuestro objetivo fundamental era valorar aspectos de la validez criterial del instrumento, en relación a su capacidad predictiva sobre el rendimiento escolar de los alumnos. Para ello, comparamos los resultados obtenidos en la prueba con los resultados académicos de los alumnos en la evaluación que en ese momento estaban realizando

Somatic complaints, mood states, and emotional awareness in adolescents

Las quejas somáticas constituyen un problema frecuente en adolescentes, aunque sólo en algunos casos es posible encontrar una causa médica clara. Por ello, existe una atención creciente hacia los factores psicológicos que podrían estar relacionados. Dos áreas del funcionamiento emocional son los principales referentes a este respecto: estados de ánimo negativos y conciencia emocional. En este trabajo se analizaba si la conciencia emocional contribuía a la predicción de las quejas somáticas, independientemente del estado de ánimo. Los participantes en este estudio, 441 adolescentes entre los 13 y los 15 años de edad, cumplimentaron cuestionarios de autoinforme sobre quejas somáticas, estados de ánimo y conciencia emocional. Los resultados mostraron que la conciencia emocional presentaba una limitada contribución independiente en la predicción de quejas somáticas. Esta contribución estaba moderada por los estados de ánimo, a excepción de dos aspectos de la conciencia emocional: con- ciencia corporal de las emociones y predisposición a tener en cuenta las emociones de los demás. Es- tos resultados refuerzan la hipótesis de que la conciencia emocional precede a los estados afectivos, los cuales, a su vez, poseen un efecto en la percepción que los jóvenes tienen sobre su saludHealth complaints are a common problem in adolescents, but a medical cause can only be found in few cases. Therefore, increasing attention is paid to psychological factors that might be related. Two areas of emotional functioning are frequently referred to in this respect: negative mood and emotional awareness. In this study, we examined whether emotional awareness contributes uniquely to the prediction of somatic complaints over and above negative mood. Self-report questionnaires of somatic complaints, mood states, and emotional awareness were completed in class by 441 adolescents, between 13 and 15 years old. Results showed that emotional awareness only presents a limited unique contribution to the prediction of somatic complaints. This contribution is moderated by mood states, except for two aspects of emotional awareness: bodily awareness of emotions and attending to others’ emotions. This strengthens the hypothesis that emotional awareness precedes affective states, which, in turn, have an effect on youngsters’ health perception

The minor offender as news: follow-up of a murder case

La representación en los medios de comunicación de los menores infractores resulta muy influyente en la formación de la opinión pública. Por ello, se realizó el seguimiento de un caso de asesinato de una menor, cometido por menores, en un momento de cambio legislativo de la responsabilidad penal juvenil en España. Se analizaron los diarios españoles ABC y El País durante los 6 meses siguientes a la comisión del crimen. Los análisis (cuantitativos y cualitativos) mostraron la existencia de un amplio margen de mejora de la prensa en el tratamiento de los derechos de menores, especialmente de aquella con planteamientos más conservadores. Todo ello, perjudica el interés superior del menor, así como su posibilidad de reinserción y reeducación.The youth offender representation in mass media has an important influence on the construction of public opinion on the topic. The follow-up of a murder case committed by minors, in a moment of law changes in juvenile criminal responsibility in Spain, was carried out in this study, including mass media from different ideologies. The Spanish journals ABC and El País were analysed during 6 months after the crime commission. The quantitative and qualitative analyses showed that there is still a chance of improvement for Spanish mass media in the treatment of minors´ rights, especially for the conservative press. All this jeopardizes the superior minor´s interest and the reintegration and reeducation goals for the youth offender

¿Son eficaces para disminuir el acoso escolar los programas de alumno mediador de reciente implantación?

En este estudio se analiza la eficacia de los sistemas de alumno mediador como medida para disminuir las situaciones de acoso escolar, teniendo en cuenta el tiempo de implantación en el centro. Para ello se compara un centro con programa de mediación (desde hace dos cursos) y otro sin programa de intervención, en T1 (línea base) y T2 (tras la intervención). Los participantes fueron 331 estudiantes, de 1º y 3º de ESO (media = 13.4 años), y las variables analizadas: actitudes pro-víctima, roles ante el acoso y clima de centro. Los resultados indican que las actitudes pro-víctima y los roles ante el acoso no cambiaron a pesar de la intervención. Incluso pudieron observarse puntuaciones más bajas en clima escolar en el centro con programa de mediación, atribuible quizás, al efecto de sensibilización y toma de conciencia que se producen en los primeros momentos de implementación del mismo. Se ha demostrado la ausencia de resultados positivos en los dos primeros años de la puesta en marcha del programa, siendo importante para conseguirlos la consolidación a largo plazo de una cultura de mediación en todo el centro.In this study, the effectiveness of a peer mediation program as a possible measure to diminish bullying behaviors is secondary education is analysed, taking into account time implementation in the center. Two centers are compared in Time 1 (baseline) and Time 2 (after program intervention), one with mediation program since two academic courses, and the other, with no mediation program. Participants were 331 students, from courses 1º and 3º ESO (mean = 13.4 years), and the variables assessed: pro-victim attitudes, the roles adopted by the youngsters and the school climate. Results showed that pro-victim attitudes and roles adopted did not change after program intervention. Even more, lower scores in school climate in T2 could be appreciated in the center with mediation program. Maybe this result is due to the effect of sensitivity and awareness about bullying than can appeared in the first phases of the intervention. In summary, this study offers the evidence of the lack of positive results in the first two years of program implementation, pointing out the importance of long-term consolidation of culture mediation in the centers

Características descriptivas de los participantes en acoso escolar: agresores, seguidores, víctimas, defensores y público

El acoso escolar tradicionalmente se ha analizado desde la perspectiva de la víctima y del agresor/es: su posición sociométrica dentro del grupo (Ortega y Mora-Merchán, 2008), su percepción de sí mismos (Andreou, 2006), etc. Sin embargo, los participantes implicados en este problema son además, un público o audiencia pasiva, el defensor de la víctima, el ayudante del agresor, etc. Estos roles participantes todavía se encuentran escasamente caracterizados, y sin embargo, resultan fundamentales en los programas de intervención sobre el acoso escolar. Por lo tanto, el objetivo es el de caracterizar los diferentes roles participantes en acoso en torno a variables descriptivas, fundamentalmente la edad, el sexo y su estatus sociométrico dentro del grupo de iguales. Los participantes fueron 441 menores (230 chicos y 211 chicas) con un rango de edad entre 13 y 15.11 años (media = 13.8), a los cuales se administró la Escala de Rol Participante (Salmivalli et al. 1996), para determinar su participación en el problema del acoso, así como un Cuestionario Sociométrico, corregido a través de procedimiento de Arruga (1983). Los resultados mostraron diferencias significativas entre los roles participantes en las variables de estatus sociométrico y sexo, pero no en la variable edadTraditionally, studies about bullying has focused mainly on the aggressors and the victims: their sociometric status in the peer group (Ortega & Mora-Merchán, 2008), their self- perception (Andreou, 2006). However, participants implicated in this problem are also an audience, a defender of the victim, a reinforcer of the aggressor, etc. These participant roles are still not well defined, and they become really important in intervention programs for bullying. Therefore, the objective is to characterize the different participant roles in bullying around several descriptive variables, mainly age, sex and sociometric status in the peer group. Participants were 441 students (230 boys and 211 girls) with an age range of 13-15.11 (mean: 13.8), that were administered the following scales: the Participant Role Scale (Salmivalli et al. 1996), to determine their implication in bullying, and a Sociometric Questionnaire (Arruga, 1983). Results yielded significant differences between participant roles in sociometric status and sex, but not in the variable ag

Fatty liver index as a predictor for type 2 diabetes in subjects with normoglycemia in a nationwide cohort study

Our aim was to evaluate whether fatty liver index (FLI) is associated with the risk of type 2 diabetes (T2DM) development within the Spanish adult population and according to their prediabetes status; additionally, to examine its incremental predictive value regarding traditional risk factors. A total of 2260 subjects (Prediabetes: 641 subjects, normoglycemia: 1619 subjects) from the [email protected] cohort study were studied. Socio-demographic, anthropometric, clinical data and survey on habits were recorded. An oral glucose tolerance test was performed and fasting determinations of glucose, lipids and insulin were made. FLI was calculated and classified into three categories: Low ( 60). In total, 143 people developed diabetes at follow-up. The presence of a high FLI category was in all cases a significant independent risk factor for the development of diabetes. The inclusion of FLI categories in prediction models based on different conventional T2DM risk factors significantly increase the prediction power of the models when all the population was considered. According to our results, FLI might be considered an early indicator of T2DM development even under normoglycemic condition. The data also suggest that FLI could provide additional information for the prediction of T2DM in models based on conventional risk factors

Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation