Abordando el cambio químico desde una perspectiva de modelización y contextualización : avance de resultados

Se analizan los progresos en el aprendizaje en una muestra de 23 estudiantes de 3er curso de educación secundaria obligatoria, a lo largo de una unidad didáctica sobre química enfocada desde estrategias de modelización y contextualizada en el problema de la contaminación atmosférica. Como indicadores de aprendizaje se emplearon el desempeño del alumnado al pasar de representaciones simbólicas a moleculares y viceversa a la hora de modelizar la composición de la materia, y la comprensión que tenían sobre la naturaleza de los modelos. Los resultados obtenidos mostraron cambios positivos, que resultaron en ambos casos estadísticamente significativos, en ambos indicadores

Propuesta de evaluación del Trabajo Fin de Grado de Biología basada en competencias

La formación del profesorado para las tareas de evaluación y tutorización de los Trabajos Fin de Grado (TFG) constituye uno de los factores importantes a tener en cuenta para su exitosa implantación. Así, el objetivo de este trabajo es presentar las experiencias de formación que se están desarrollando en la Universidad de Málaga para apoyar al profesorado en estas tareas, mostrando su diseño y los resultados obtenidos. Se han impartido tres ediciones de un curso sobre evaluación y tutorización de los TFG, con la participación de 127 profesores de dieciséis Facultades diferentes, que imparten TFG en más de 20 Titulaciones, habiéndose realizado 23 trabajos diferentes relacionados con la temática de los cursos. Abstract Teacher training for the tasks of assessment and tutoring is one of the key factors to consider for a successful implementation of the Final Year Proyect (FYP). The aim of this paper is to present the Universidad de Málaga teacher training experiences to support the teachers for these tasks, showing its design and results obtained with them. Three courses have been held on evaluation and tutoring of FYP. One hundred and twenty seven teachers from 16 different Faculties, who teach FYP in more than 20 official Degrees, have participated. Twenty-three reports, related with the aim of the course, have been developed by the participants.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Highly sensitive marker panel for guidance in lung cancer rapid diagnostic units

While evidence for lung cancer screening implementation in Europe is awaited, Rapid Diagnostic Units have been established in many hospitals to accelerate the early diagnosis of lung cancer. We seek to develop an algorithm to detect lung cancer in a symptomatic population attending such unit, based on a sensitive serum marker panel. Serum concentrations of Epidermal Growth Factor, sCD26, Calprotectin, Matrix Metalloproteinases −1, −7, −9, CEA and CYFRA 21.1 were determined in 140 patients with respiratory symptoms (lung cancer and controls with/without benign pathology). Logistic Lasso regression was performed to derive a lung cancer prediction model, and the resulting algorithm was tested in a validation set. A classification rule based on EGF, sCD26, Calprotectin and CEA was established, able to reasonably discriminate lung cancer with 97% sensitivity and 43% specificity in the training set, and 91.7% sensitivity and 45.4% specificity in the validation set. Overall, the panel identified with high sensitivity stage I non-small cell lung cancer (94.7%) and 100% small-cell lung cancers. Our study provides a sensitive 4-marker classification algorithm for lung cancer detection to aid in the management of suspicious lung cancer patients in the context of Rapid Diagnostic Units.Ministerio de Ciencia e Innovación | Ref. PS09-00405Xunta de Galicia | Ref. INBIOMED 2012-273Xunta de Galicia | Ref. GRC2014/019Ministerio de Ciencia e Innovación | Ref. MTM2011-2320

Testing the efficacy of INtegral Cognitive REMediation (INCREM) in major depressive disorder : study protocol for a randomized clinical trial

Given the limitation of pharmacological treatments to treat cognitive symptoms in patients with Major Depressive Disorder (MDD), cognitive remediation programs has been proposed as a possible procognitive intervention but findings are not conclusive. This study investigates the efficacy of an INtegral Cognitive REMediation (INCREM) that includes a combination of a Functional Remediation (FR) strategy plus a Computerized Cognitive Training (CCT) in order to improve not only cognitive performance but also the psychosocial functioning and the quality of life. A single blind randomized controlled clinical trial in 81 patients with a diagnosis of MDD in clinical remission or in partial remission. Participants will be randomized to one of three conditions: INCREM (FR + CCT), Psychoeducation plus online games and Treatment As Usual (TAU). Intervention will consist in 12 group sessions, of approximately 110 min once a week. The primary outcome measure will be % of change in psychosocial functioning after treatment measured by the Functional Assessment Short Test (FAST); additionally, number of sick leaves and daily activities will also be recorded as pragmatic outcomes. To our knowledge, this is the first randomized controlled clinical trial using a combination of two different approaches (FR + CCT) to treat the present cognitive deficits and to promote their improvements into a better psychosocial functioning. Clinical Trials . Date registered 10th of August 2018 and last updated 24th August 2018

Reduced humoral response 3 months following BNT162b2 vaccination in SARS-CoV-2 uninfected residents of long-term care facilities

SARS-CoV-2 vaccination is the most effective strategy to protect older residents of long-term care facilities (LTCF) against severe COVID-19, but primary vaccine responses are less effective in older adults. Here, we characterised the humoral responses of institutionalised seniors 3 months after they had received the mRNA/BNT162b2 vaccine. plasma levels of SARS-CoV-2-specific total IgG, IgM and IgA antibodies were measured before and 3 months after vaccination in older residents of LTCF. Neutralisation capacity was assessed in a pseudovirus neutralisation assay against the original WH1 and later B.1.617.2/Delta variants. A group of younger adults was used as a reference group. three months after vaccination, uninfected older adults presented reduced SARS-CoV-2-specific IgG levels and a significantly lower neutralisation capacity against the WH1 and Delta variants compared with vaccinated uninfected younger individuals. In contrast, COVID-19-recovered older adults showed significantly higher SARS-CoV-2-specific IgG levels after vaccination than their younger counterparts, whereas showing similar neutralisation activity against the WH1 virus and an increased neutralisation capacity against the Delta variant. Although, similarly to younger individuals, previously infected older adults elicit potent cross-reactive immune responses, higher quantities of SARS-CoV-2-specific IgG antibodies are required to reach the same neutralisation levels. although hybrid immunity seems to be active in previously infected older adults 3 months after mRNA/BNT162b2 vaccination, humoral immune responses are diminished in COVID-19 uninfected but vaccinated older residents of LTCF. These results suggest that a vaccine booster dose should be prioritised for this particularly vulnerable population

Innovative Health and Social Integrated Care Model Effectiveness to Improve Quality Care for Chronic Patients: A Single Group Assignment Clinical Trial

Background: Patients with chronic disease have become one of the major challenges for health and social protection systems in developed countries. Integrated care models (ICM) have demonstrably improved the quality of care of chronic patients. However, new models of integration need further evaluation of its effectiveness and outcomes. Methods: The ICM studied promoted coordination between the health and social sectors during a 6-month period, through an ad hoc developed application (app) that enabled a constant flow of communication between professionals from both sectors. Patients’ quality of life, treatment adherence, chronic patient experience and caregiver overload were assessed by questionnaires at baseline, at the end of the intervention and 6 months post-intervention. Results: The implementation of the new health and social ICM permitted new case detection and medical and social services offered to chronic patients. Furthermore, the quality of life and treatment adherence of patients and caregiver overload were significantly improved. These positive effects lasted at least 6 months after the intervention. Conclusions: Integrated care may facilitate access to care services, increase perceived patient quality of life and treatment adherence. Enhanced access to medical and social services from complex chronic patients may have important implications for caregivers and the care systems who are struggling to adapt to an expanding demand.   Resum Antecedents: Els pacients amb malalties cròniques representen un dels grans reptes per als sistemes de salut i protecció social als països desenvolupats. S’ha demostrat que l’atenció integrada millora la qualitat assistencial dels pacients crònics. Tanmateix, els resultats i l’efectivitat de nous models d’integració requereixen ser avaluats. Metodologia: El model d’atenció integrada d’estudi va promoure la coordinació entre els sectors sanitari i social durant un període de 6 mesos mitjançant una aplicació (app) desenvolupada ad hoc que permetia un flux constant de comunicació entre professionals d’ambdós sectors. La qualitat de vida dels pacients, l’adherència al tractament, l’experiència del pacient i la sobrecàrrega del cuidador es van avaluar mitjançant qüestionaris a l’inici, al final de la intervenció i 6 mesos després de la intervenció. Resultats: La implantació de l’atenció integrada social i sanitària va permetre la detecció de nous casos i un major accés dels pacients crònics als serveis mèdics i socials. A més, va millorar significativament la qualitat de vida i l’adherència al tractament dels pacients i la sobrecàrrega dels cuidadors. Aquests efectes positius van perdurar almenys 6 mesos després de la intervenció. Conclusions: L’atenció integrada pot facilitar l’accés als serveis assistencials, augmentar la qualitat de vida percebuda dels pacients i l’adherència al tractament. L’accés millorat als serveis mèdics i socials dels pacients crònics complexos pot tenir implicacions importants per als cuidadors i els sistemes assistencials que lluiten per adaptar-se a una demanda creixent.   Paraules Clau: Sistemes sanitaris integrats; malaltia crònica; qualitat de vida; implementació de programes; tecnologies de la informació i la comunicació (TIC

LipoDDx: a mobile application for identification of rare lipodystrophy syndromes

BACKGROUND: Lipodystrophy syndromes are a group of disorders characterized by a loss of adipose tissue once other situations of nutritional deprivation or exacerbated catabolism have been ruled out. With the exception of the HIV-associated lipodystrophy, they have a very low prevalence, which together with their large phenotypic heterogeneity makes their identification difficult, even for endocrinologists and pediatricians. This leads to significant delays in diagnosis or even to misdiagnosis. Our group has developed an algorithm that identifies the more than 40 rare lipodystrophy subtypes described to date. This algorithm has been implemented in a free mobile application, LipoDDx(R). Our aim was to establish the effectiveness of LipoDDx(R). Forty clinical records of patients with a diagnosis of certainty of most lipodystrophy subtypes were analyzed, including subjects without lipodystrophy. The medical records, blinded for diagnosis, were evaluated by 13 physicians, 1 biochemist and 1 dentist. Each evaluator first gave his/her results based on his/her own criteria. Then, a second diagnosis was given using LipoDDx(R). The results were analysed based on a score table according to the complexity of each case and the prevalence of the disease. RESULTS: LipoDDx(R) provides a user-friendly environment, based on usually dichotomous questions or choice of clinical signs from drop-down menus. The final result provided by this app for a particular case can be a low/high probability of suffering a particular lipodystrophy subtype. Without using LipoDDx(R) the success rate was 17 +/- 20%, while with LipoDDx(R) the success rate was 79 +/- 20% (p < 0.01). CONCLUSIONS: LipoDDx(R) is a free app that enables the identification of subtypes of rare lipodystrophies, which in this small cohort has around 80% effectiveness, which will be of help to doctors who are not experts in this field. However, it will be necessary to analyze more cases in order to obtain a more accurate efficiency value

Factors associated with the humoral response after three doses of COVID-19 vaccination in kidney transplant recipients

[Introduction] Kidney transplant recipients showed a weak humoral response to the mRNA COVID-19 vaccine despite receiving three cumulative doses of the vaccine. New approaches are still needed to raise protective immunity conferred by the vaccine administration within this group of high-risk patients.[Methods] To analyze the humoral response and identify any predictive factors within these patients, we designed a prospective monocentric longitudinal study of Kidney transplant recipients (KTR) who received three doses of mRNA-1273 COVID-19 vaccine. Specific antibody levels were measured by chemiluminescence. Parameters related to clinical status such as kidney function, immunosuppressive therapy, inflammatory status and thymic function were analyzed as potential predictors of the humoral response.[Results] Seventy-four KTR and sixteen healthy controls were included. One month after the administration of the third dose of the COVID-19 vaccine, 64.8% of KTR showed a positive humoral response. As predictive factors of seroconversion and specific antibody titer, we found that immunosuppressive therapy, worse kidney function, higher inflammatory status and age were related to a lower response in KTR while immune cell counts, thymosin-a1 plasma concentration and thymic output were related to a higher humoral response. Furthermore, baseline thymosin-a1 concentration was independently associated with the seroconversion after three vaccine doses.[Discussion] In addition to the immunosuppression therapy, condition of kidney function and age before vaccination, specific immune factors could also be relevant in light of optimization of the COVID-19 vaccination protocol in KTR. Therefore, thymosin-a1, an immunomodulatory hormone, deserves further research as a potential adjuvant for the next vaccine boosters.This study was supported by a grant from the Fondo de Investigación Sanitaria (FIS/PI21/00357), which is co-founded by Fondos Europeos para el Desarrollo Regional (FEDER) “Una manera de hacer Europa”. VG-R, IO-M and AB-R were supported by Instituto de Salud Carlos III (CD19/00143, FI19/00298 and CM19/00051, respectively). MP-B was supported by the Consejería de Transformación Económica, Industria, Conocimiento y Universidades [DOC_01646 to MP-B] and YP was supported by the Consejería de Salud y Familias of Junta de Andalucía through the “Nicolás Monardes” [RC-0006-2021].Peer reviewe

Estudos Artísticos

Os quinze artigos que aqui se reúnem, nesta edição da Revista Croma, são também as propostas para uma nova política, esclarecida, crítica, e mais exigente. Podem observar-se padrões de intervenção, que partem de algumas dimensões comuns: a interpelação do observador, a criação de novos públicos, a proposta de contribuir para uma mudança alargada, partindo de questões a que não são alheias as problemáticas contemporâneas. As questões de género, a emancipação pós-colonial, a sustentabilidade, as migrações, a massificação, a globalização, o fim das ideologias e a ascensão do populismo, entre outras, constituem os contextos da atualidadeinfo:eu-repo/semantics/publishedVersio

Strategies to reengage patients lost to follow up in HIV care in high income countries, a scoping review

Background: Despite remarkable achievements in antiretroviral therapy (ART), losses to follow-up (LTFU) might prevent the long-term success of HIV treatment and might delay the achievement of the 90-90-90 objectives. This scoping review is aimed at the description and analysis of the strategies used in high-income countries to reengage LTFU in HIV care, their implementation and impact. Methods: A scoping review was done following Arksey & O'Malley's methodological framework and recommendations from Joanna Briggs Institute. Peer reviewed articles were searched for in Pubmed, Scopus and Web of Science; and grey literature was searched for in Google and other sources of information. Documents were charted according to the information presented on LTFU, the reengagement procedures used in HIV units in high-income countries, published during the last 15 years. In addition, bibliographies of chosen articles were reviewed for additional articles. Results: Twenty-eight documents were finally included, over 80% of them published in the United States later than 2015. Database searches, phone calls and/or mail contacts were the most common strategies used to locate and track LTFU, while motivational interviews and strengths-based techniques were used most often during reengagement visits. Outcomes like tracing activities efficacy, rates of reengagement and viral load reduction were reported as outcome measures. Conclusions: This review shows a recent and growing trend in developing and implementing patient reengagement strategies in HIV care. However, most of these strategies have been implemented in the United States and little information is available for other high-income countries. The procedures used to trace and contact LTFU are similar across reviewed studies, but their impact and sustainability are widely different depending on the country studied