Bíblia i currículum escolar. Introducció a una problemàtica paradoxal

L'article que es presenta forma part d'una elaboració més àmplia. S'ha seleccionat unes reflexions introductòries que obren interrogants i plategen problemàtiques sobre les quals s'aprofundirà posteriorment. Partim de la importància de la Bíblia com a referent espiritual i cultural, a continuació es descriuen alguns dels possibles atansaments vers els textos bíblics i quines són, o podrien ser, les aproximacions a la Bíblia des de l'escola. Es presenta, també, alguns moments significatius sobre l'estudi i la interpretació de la Bíblia i les conseqüències que poden tenir en l'ensenyament

Acute kidney injury secondary to a combination of renin-angiotensin system inhibitors, diuretics and NSAIDS: “The Triple Whammy”

AbstractBackgroundRenin-angiotensin system inhibitors (ACEI/ARB-II), diuretics and NSAIDs, a combination known as “Triple Whammy”, can result in decreased glomerular filtration rate (GFR) and acute kidney injury (AKI).ObjectivesTo describe the incidence of AKI for each drug type and their combinations. To define the profile of patients admitted for drug-related AKI secondary to Triple Whammy drugs (AKITW), with an assessment of costs and mortality.MethodsA retrospective observational 15-month study developed in three stages:–First: a cross-sectional stage to identify and describe hospitalizations due to AKITW.–Second: a follow-up stage of an outpatient cohort consuming these drugs (15,307 subjects).–Third: a cohort stage to assess costs and mortality, which compared 62 hospitalized patients with AKITW and 62 without AKI, paired by medical specialty, sex, age and comorbidity according to their Clinical Risk Groups.ResultsThere were 85 hospitalization episodes due to AKITW, and 78% of patients were over the age of 70. The incidence of AKITW in the population was 3.40 cases/1000 users/year (95% CI: 2.59–4.45). By categories, these were: NSAIDs + diuretics 8.99 (95% CI: 3.16–25.3);Triple Whammy 8.82 (95% CI: 4.4–17.3); ACEI/ARB-II + diuretics 6.87 (95% CI: 4.81–9.82); and monotherapy with diuretics 3.31 (95% CI: 1.39–7.85). Mean hospital stay was 7.6 days (SD 6.4), and mean avoidable costs were estimated at €214,604/100,000 inhabitants/year. Mortality during hospitalization and at 12 months was 11.3% and 38.7% respectively, and there were no significant differences when compared with the control group.ConclusionsTreatment with ACEI, ARB-II, diuretics and/or NSAIDs shows a high incidence of hospitalization episodes due to AKI; diuretics as monotherapy or dual and triple combination therapy cause the highest incidence. AKITW involves high health care costs and avoidable mortality

La religió catòlica a l'escola: nou context, nou currículum? Uns primers apunts per a la reflexió

La publicació del nou currículum de Religió catòlica derivat de la progressiva aplicació de la LOE hauria de suscitar una reflexió sobre la incidència dels nous contextos en l'àmbit cultural, educatiu i religiós. Tot i que es tracta d'un currículum confessional, alhora, és un rostre públic, educatiu i eclesial de la confessió catòlica, per la qual cosa caldrà desenvolupar una especial èmfasi en el coneixement de les realitats canviants i fugir d'un disseny curricular rígid, excloent i aspre que traeixi la identitat i les exigències de l'ensenyament de la religió

Effectiveness of multimodal treatment for young people with body dysmorphic disorder in two specialist clinics

Body dysmorphic disorder (BDD) typically originates in adolescence and is associated with considerable adversity. Evidence-based treatments exist but research on clinical outcomes in naturalistic settings is extremely scarce. We evaluated the short- and long-term outcomes of a large cohort of adolescents with BDD receiving specialist multimodal treatment and examined predictors of symptom improvement. We followed 140 young people (age range 10-18) with a diagnosis of BDD treated at two national and specialist outpatient clinics in Stockholm, Sweden (n=96) and London, England (n=44), between January 2015 and April 2021. Participants received multimodal treatment consisting of cognitive behaviour therapy and, in 72% of cases, medication (primarily selective serotonin reuptake inhibitors). Data were collected at baseline, post-treatment, and 3, 6, and 12 months after treatment. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD, Adolescent version (BDD-YBOCS-A). Secondary outcomes included self-reported measures of BDD symptoms, depressive symptoms, and global functioning. Mixed-effects regression models showed that BDD-YBOCS-A scores decreased significantly from baseline to post-treatment (coefficient [95% confidence interval]=-16.33 [-17.90 to -14.76], p<0.001; within-group effect size (Cohen’s d)=2.08 (95% confidence interval, 1.81 to 2.35). At the end of the treatment, 79% of the participants were classified as responders and 59% as full or partial remitters. BDD symptoms continued to improve throughout the follow-up. Improvement was also seen on all secondary outcome measures. Linear regression models identified baseline BDD symptom severity as a predictor of treatment outcome at post-treatment, but no consistent predictors were found at the 12-month follow-up. To conclude, multimodal treatment for adolescent BDD is effective in both the short- and long-term when provided flexibly within a specialist setting. Considering the high personal and societal costs of BDD, specialist care should be made more widely available

Forest resilience to global warming is strongly modulated by local-scale topographic, microclimatic and biotic conditions

Resilience of endangered rear edge populations of cold-adapted forests in the Mediterranean basin is increasingly altered by extreme heatwave and drought pressures. It remains unknown, however, whether microclimatic variation in these isolated forests could ultimately result in large intra-population variability in the demographic responses, allowing the coexistence of contrasting declining and resilient trends across small topographic gradients. Multiple key drivers promoting spatial variability in the resilience of rear edge forests remain largely unassessed, including amplified and buffered thermal exposure induced by heatwaves along topographic gradients, and increased herbivory pressure on tree saplings in defaunated areas lacking efficient apex predators. Here we analysed whether indicators of forest resilience to global warming are strongly modulated by local-scale topographic, microclimatic and biotic conditions. We studied a protected rear edge forest of sessile oak Quercus petraea, applying a suite of 20 indicators of resilience of tree secondary growth, including multidecadal and short-term indices. We also analysed sapling recruitment success, recruit/adult ratios and sapling thermal exposure across topographic gradients. We found large within population variation in secondary growth resilience, in recruitment success and in thermal exposure of tree saplings to heatwaves, and this variability was spatially structured along small-scale topographical gradients. Multidecadal resilience indices and curves provide useful descriptors of forest vulnerability to climate warming, complementing assessments based in the analysis of short-term resilience indicators. Species-specific associations of trees with microclimatic variability are reported. Biotic factors are key in determining long-term resilience in climatically stressed rear edge forests, with strong limitation of sapling recruitment by increased roe deer and wild boar herbivory. Our results also support non-stationary effects of climate determining forest growth responses and resilience, showing increased negative effects of warming and drought over the last decades in declining stands. Synthesis. Our findings do not support scenarios predicting spatially homogeneous distributional shifts and limited resilience in rear edge populations, and are more supportive of scenarios including spatially heterogeneous responses, characterised with contrasting intra-population trends of forest resilience. We conclude that forest resilience responses to climate warming are strongly modulated by local-scale microclimatic, topographic and biotic factors. Accurate predictions of forest responses to changes in climate would therefore largely benefit from the integration of local-scale abiotic and biotic factors

Impacts of Global Change on Mediterranean Forests and Their Services

The increase in aridity, mainly by decreases in precipitation but also by higher temperatures, is likely the main threat to the diversity and survival of Mediterranean forests. Changes in land use, including the abandonment of extensive crop activities, mainly in mountains and remote areas, and the increases in human settlements and demand for more resources with the resulting fragmentation of the landscape, hinder the establishment of appropriate management tools to protect Mediterranean forests and their provision of services and biodiversity. Experiments and observations indicate that if changes in climate, land use and other components of global change, such as pollution and overexploitation of resources, continue, the resilience of many forests will likely be exceeded, altering their structure and function and changing, mostly decreasing, their capacity to continue to provide their current services. A consistent assessment of the impacts of the changes, however, remains elusive due to the difficulty of obtaining simultaneous and complete data for all scales of the impacts in the same forests, areas and regions. We review the impacts of climate change and other components of global change and their interactions on the terrestrial forests of Mediterranean regions, with special attention to their impacts on ecosystem services. Management tools for counteracting the negative effects of global change on Mediterranean ecosystem- services are finally discussed

Risk and protective factors for anxiety and obsessive-compulsive disorders: an umbrella review of systematic reviews and meta-analyses

A multitude of risk/protective factors for anxiety and obsessive-compulsive disorders have been proposed. We conducted an umbrella review to summarize the evidence of the associations between risk/protective factors and each of the following disorders: specific phobia, social anxiety disorder, generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, and to assess the strength of this evidence whilst controlling for several biases.Publication databases were searched for systematic reviews and meta-analyses examining associations between potential risk/protective factors and each of the disorders investigated. The evidence of the association between each factor and disorder was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of cases (>1000), random-effects p-values, 95% prediction intervals, confidence interval of the largest study, heterogeneity between studies, study effects, and excess of significance.Nineteen systematic reviews and meta-analyses were included, corresponding to 216 individual studies covering 427 potential risk/protective factors. Only one factor association (early physical trauma as a risk factor for social anxiety disorder, OR 2.59, 95% CI 2.17-3.1) met all the criteria for convincing evidence. When excluding the requirement for more than 1000 cases, five factor associations met the other criteria for convincing evidence and 22 met the remaining criteria for highly suggestive evidence.Although the amount and quality of the evidence for most risk/protective factors for anxiety and obsessive-compulsive disorders is limited, a number of factors significantly increase the risk for these disorders, may have potential prognostic ability and inform prevention

The thalamus and its subnuclei—a gateway to obsessive-compulsive disorder

Larger thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and children with clinical-level symptoms within the general population. Particular thalamic subregions may drive these differences. The ENIGMA-OCD working group conducted mega- and meta-analyses to study thalamic subregional volume in OCD across the lifespan. Structural T-1-weighted brain magnetic resonance imaging (MRI) scans from 2649 OCD patients and 2774 healthy controls across 29 sites (50 datasets) were processed using the FreeSurfer built-in ThalamicNuclei pipeline to extract five thalamic subregions. Volume measures were harmonized for site effects using ComBat before running separate multiple linear regression models for children, adolescents, and adults to estimate volumetric group differences. All analyses were pre-registered (https://osf.io/73dvy) and adjusted for age, sex and intracranial volume. Unmedicated pediatric OCD patients (<12 years) had larger lateral (d = 0.46), pulvinar (d = 0.33), ventral (d = 0.35) and whole thalamus (d = 0.40) volumes at unadjusted p-values <0.05. Adolescent patients showed no volumetric differences. Adult OCD patients compared with controls had smaller volumes across all subregions (anterior, lateral, pulvinar, medial, and ventral) and smaller whole thalamic volume (d = -0.15 to -0.07) after multiple comparisons correction, mostly driven by medicated patients and associated with symptom severity. The anterior thalamus was also significantly smaller in patients after adjusting for thalamus size. Our results suggest that OCD-related thalamic volume differences are global and not driven by particular subregions and that the direction of effects are driven by both age and medication status

Human subcortical brain asymmetries in 15,847 people worldwide reveal effects of age and sex

The two hemispheres of the human brain differ functionally and structurally. Despite over a century of research, the extent to which brain asymmetry is influenced by sex, handedness, age, and genetic factors is still controversial. Here we present the largest ever analysis of subcortical brain asymmetries, in a harmonized multi-site study using meta-analysis methods. Volumetric asymmetry of seven subcortical structures was assessed in 15,847 MRI scans from 52 datasets worldwide. There were sex differences in the asymmetry of the globus pallidus and putamen. Heritability estimates, derived from 1170 subjects belonging to 71 extended pedigrees, revealed that additive genetic factors influenced the asymmetry of these two structures and that of the hippocampus and thalamus. Handedness had no detectable effect on subcortical asymmetries, even in this unprecedented sample size, but the asymmetry of the putamen varied with age. Genetic drivers of asymmetry in the hippocampus, thalamus and basal ganglia may affect variability in human cognition, including susceptibility to psychiatric disorders