Review of interventions to improve pragmatic language skills in children with behaviour and attention problems

Pragmatic language is the socially appropriate use of language in accordance with the context in which interactions take place. In view of this, deficiencies in pragmatic skills have a significant impact on psychosocial adjustment. Recent evidence has shown that children who present behavioural problems usually display these linguistic difficulties as well. The aim of this work is to analyse different interventions intended to improve the pragmatic skills of children with behavioural and/or attention problems and discuss the evidence of the results. After a literature search, nine interventions were found: five aimed at children with behavioural problems and four intended for children with attention and hyperactivity problems. The results showed that, while the characteristics of the interventions varied considerably, they generally achieved positive results, especially when they were implemented using a systemic approach with other educational agents participating (such as the family or peer group). Even so, the lack of available evidence suggests that further research into evidence-based interventions to help children improve their pragmatic, communicative, and social competences is required.El lenguaje pragmático hace referencia al uso socialmente apropiado del lenguaje en función del contexto en que las interacciones tienen lugar. Por tanto, los déficits en las habilidades pragmáticas tienen importantes repercusiones sobre el ajuste psicosocial. Evidencias recientes han puesto de manifiesto que los niños y niñas que presentan problemas de conducta suelen experimentar también estas dificultades lingüísticas. Este trabajo tiene por objeto analizar diferentes intervenciones destinadas a mejorar las habilidades pragmáticas de niños y niñas con problemas de conducta y/o atención y discutir las evidencias de sus resultados. Tras la búsqueda bibliográfica, se localizaron nueve intervenciones, cinco dirigidas a niños y niñas con problemas conductuales y cuatro para menores con problemas de atención e hiperactividad. Los resultados mostraron que, aunque las características de las intervenciones eran muy variadas, en general se lograron con ellas efectos positivos, especialmente cuando se realizaban desde un enfoque sistémico y participaban otros agentes educativos (como la familia o el grupo de iguales). Aun así, la escasez de evidencia al respecto invita a seguir investigando sobre intervenciones basadas en la evidencia que ayuden a los niños y niñas a mejorar sus habilidades pragmáticas, comunicativas y sociales

Validación de modelos alternativos del inventario EA-HOME en adolescentes españoles

Home Observation for Measurement of the Environment (HOME) es un instrumento creado por Bettye Caldwell y Robert Bradley que evalúa, a través de la metodología observacional y de una entrevista semiestructurada, la calidad del apoyo y la estimulación existentes en el hogar durante la infancia y adolescencia. El objetivo del estudio es validar la versión para adolescentes. Para ello, se analizan sus propiedades psicométricas en una muestra de 276 familias, de las cuales 165 son usuarias de los Servicios Sociales. El análisis factorial confirmatorio indica que, tras eliminarse 7 de los 60 ítems originales, el modelo formado por tres factores de primer orden (Entorno y elementos físicos disponibles, Estimulación cognitiva y experiencias de aprendizaje y Apoyo socioafectivo y emocional) y un factor global de segundo orden presenta los mejores indicadores de ajuste y consistencia interna. Se comparan las puntuaciones del modelo alternativo entre las familias en situación de riesgo psicosocial y las normativas para evaluar su validez, encontrándose que las primeras obtienen resultados significativamente peores. Se concluye que esta versión del inventario posee propiedades psicométricas adecuadas y puede emplearse como un instrumento de cribado (screening), aunque se sugiere continuar con los análisis para mejorar su adaptación al contexto cultural español.Home Observation Measurement Environment inventory (HOME) is an instrument created by Bettye Caldwell and Robert Bradley which evaluates, using the observation and a semi-estructured interview, the quality of stimulation and support available during childhood and adolescence in the home environment. The aim of this study is to validate the adolescent version. Its psychometric properties are examined with data from a sample of 276 families, and of which 165 are users of Social Services. Confirmatory factor analyses indicate that the structure formed by three first-order factors (physics elements of environment, cognitive stimulation and learning experiences and socioaffective and emotional support) and one second-order factor presents best indicators of adjustment and internal consistency, after eliminated 7 of the 60 items of the original inventory. Additionally, scores of the alternative model are compared between families at psychosocial risk and normative families to evaluate criterion validity. Families at psychosocial risk get significantly worse scores than the other families. Thus, this version of the inventory shows adequate psychometric properties and it can be used as a valid screening instrument, although continuing with analyses to improve its adaptation to the Spanish cultural context is suggested

Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

BackgroundPrevious studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain. MethodsProspective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients. ResultsWe included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 +/- 12 vs. 54 +/- 16 years, p < 0.001), had been diagnosed younger (31 +/- 12 vs. 36 +/- 15 years, p < 0.001), and had a shorter disease duration (14 +/- 7 vs. 18 +/- 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92-2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0-1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses. ConclusionsCompared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe

Contextualizing the well-being of transgender youth in Spain: indicators of lifestyles, developmental contexts, victimization at school, and mental health

In recent years, the need to consider the gender identity in the theoretical and methodological frameworks of the research, as well as in the intervention, has been manifested. As an evidence of this growing interest in learning about the reality of transgender people, it is observed an exponential increase in publications of scientific research in the last 15 years. Undeniably, transgender people face severe victimization and discrimination episodes in a cis-hetero-patriarchal social system that affects their health and well-being, explained in depth from Ian Meyer's minority stress model and its subsequent updates. This has led research to focus on transgender health from a pathological perspective, in which topics such as risk behaviors or serious mental health problems stand out. Studying this area of health is undeniably crucial, but at the same time there is a lack of research on elements that build resilience or at least offer a more normalizing, positive, and complete view of transgender health. Regarding other methodological limitations, samples used in transgender studies are usually obtained with non-probabilistic sampling (such as snowball sampling or chain sampling). At the same time, few large-scale studies include questions in order to know the gender identity of the participants. It may happen that large studies manage to collect information on transgender people, but within the LGBT community, which allows us to have data, but not in a distinguished and clear way. Moreover, in the case of studies conducted with random and large samples, they come from Western and English-speaking countries, thus there is a tendency to generalize the results of people living in these contexts to countries whose legislation or sensitivity to gender diversity may be different. The purpose of this doctoral dissertation has been to bring to light an overview of the health and well-being of transgender adolescents in Spain. First, the utility of the two-step approach as a measure of gender identity in adolescence was assessed. Second, different dimensions of health were studied, covering lifestyles, mental health, and developmental contexts, considering the characteristics of transgender adolescents. Third, from the minority stress framework, the prevalence of involvement in bullying and cyberbullying episodes was estimated. Finally, an integrative model of the influence of perceived social support on the health-realted quality of life when victimization at school is experienced according to gender identity was explored. This thesis has been developed in the framework of the Health Behaviour in School-aged Children (HBSC) study, an international research collaboration with the World Health Organization (WHO) in which more than 50 countries participate conducting a survey cycle every four years. However, this thesis used only data obtained in Spain. The sample was selected using a random multistage stratified cluster sampling, taking into account the age of the participants, the type of habitat, and the type of school, in order to obtain a nationally representative sample of the Spanish population of adolescents between 11 and 18 years old. In the 2018 edition, 40,495 adolescents participated. For the current dissertation we had data from 17,678 young people between 15 and 18 years of age (those who answered both measures on sex and self-perceived gender identity). Of this group, 303 youth were identified as transgender adolescents. From the remaining 17,375 cisgender participants, resampling based on matching was used to facilitate sample equalization, taking into consideration the variables of age, country of birth, socioeconomic status, type of school, and type of habitat. The final sample comprised 303 transgender adolescents and 909 cisgender adolescents with a comparable profile. Thus, the final sample was 1,212 adolescents. The results obtained in this thesis showed that transgender adolescents reported worse health indicators in all areas assessed than cisgender adolescents, emphasizing poorer mental health, lower perception of social support, and more involvement in bullying and cyberbullying episodes. We hope this new contribution can serve to validate the experiences of transgender adolescents, can encourage scholar to conduct new research lines from a sensitive, positive, and strength-based approach, as well as we hope that this work will serve to detect areas of vulnerability and strength in order to develop evidence-based interventions and policies aimed to enhance their well-being

Asking about sex, gender and youth health: A pilot study

This pilot study will evaluate understandability, acceptability and answerability a set of survey items on birth-registered sex, gender identity and sexual orientation among young people aged 13-18 participating in the Health Behaviour in School-aged Children (HBSC), a World Health Organization collaborative cross-national study of child and adolescent health

Nationwide COVID-19-EII Study : Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry

We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD