Nodal involvement evaluation in advanced cervical cancer: a single institutional experience

Purpose: To assess the usefulness of different imaging techniques in the detection of nodal involvement in patients with advanced cervical carcinoma. Moreover, to analyze the correlation between the presurgical (FIGO) and postsurgical (pTNM) staging classifications. Materials and Methods: All patients diagnosed with advanced cervical cancer (FIGO Stages IIB-IV) from 2005 to 2012 were selected. The medical charts of 51 patients that underwent presurgical assessment with posterior surgical staging by means of paraaortic lymphadenectomy, were reviewed. Nodal status assessment by computed tomography scan (CT scan), magnetic resonance imaging (MRI), positron emission tomography (PET), and sonography was compared, as well as the size given in imaging techniques compared to the final pathologic report information. Results: Presurgical analysis by CT scan, MRI, PET, and sonography showed pelvic nodal involvement in 51.3% of patients, and para-aortic involvement in 30.8% of cases. CT scan showed positive pelvic nodes in 35% of cases, but pathologic confirmation was observed in just 17.6% of cases. However, MRI resulted in higher rates of up to 48.8% of cases. Concerning para-aortic nodal involvement, CT scan showed positive nodes in 25% of cases, MRI in 3.2% of cases, and the pathologic report in 15.6% of cases. The authors found significant differences between staging groups among both classifications (FIGO vs. pTNM; p < 0.001). Eight cases (15.7%) were understaged by FIGO classification. Conclusions: Despite all imaging techniques available, none has demonstrated to be efficient enough to avoid the systematic study of para-aortic nodal status by means of surgical evaluatio

Relationships between executive function of children in residential care and caregivers’ discipline style: a pilot study.

Despite legislative efforts to ensure that the Residential Care (RC) guarantees good care for children, there are difficulties inherent to the profile of the foster population. One of the areas affected in this population is executive functions. However, there is a lack of information on how these functions are related to other variables as affective relationships (affection/communication and criticism/rejection) and the discipline styles of caregivers. Therefore, this research aims to study these relationships. Forty-six boys and girls between 10 and 16 years old and thirty-nine caregivers from seven residential centres participated in the study. This work is a pilot study within a larger research that includes all the RC centres in the province of Malaga (Spain). BRIEF-2 Family version was used to assess executive functions, while Warmth Scale (EA) and the Rules-Demands Scale (ENE) were used to asses affection and discipline style of caregivers. The results showed that: (a) about 50% of the sample shows scores classified as high or clinically significant on all scales and indexes of executive functions, while the general Spanish population shows only 16-19% in this same categories, (b) higher scores on perceived criticism/rejection show a postive correlation with difficulties in emotional and cognitive control, and (c) an indulgent/permissive discipline style is positively correlated to cognitive control problems. These results are not conclusive, as they correspond to the pilot study phase, nevertheless they already point to the need of deeper research about the difficulties presented by the population in RC in terms of executive functions.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Control previo y su incidencia en la gestión presupuestaria del Instituto Nacional de Oftalmología de Lima, 2021

A raíz que la herramienta de Control Previo se ha convertido en una herramienta que, al ser implementada correctamente, puede significar una oportunidad de mejora para la gestión presupuestaria del Instituto Nacional de Oftalmología. La presenta investigación se titula “El Control Previo y su incidencia en la Gestión Presupuestal del Instituto Nacional de Oftalmología de Lima, 2021 tiene como objetivo principal determinar de qué manera incide el control previo en la Gestión Presupuestaria del Instituto Nacional de Oftalmología de Lima, 2021. La investigación de tipo básica tuvo un enfoque cuantitativo cuyo diseño no experimental correlacional causal fue de corte transversal ya que los datos para llevar a cabo el estudio fueron recopilados en un momento determinado de la investigación. La población de estudio fueron 70 colaboradores del área administrativa del Instituto Nacional de Oftalmología. El muestreo fue no probabilístico. Se concluye que existe incidencia del Control Previo en la gestión presupuestaria, tal como lo demuestran el estadístico de Wald mayor a 4.00 y el valor de significancia estadística p_valor = 0.000 < 0.05. Mediante el coeficiente de Nagelkerke, la variación del control previo se debe al 58,6% de la gestión presupuestaria

Catálogo de Investigación Joven en Extremadura. Volumen III

El tercer volumen del Catálogo de Investigación Joven en Extremadura se presenta como una amplia recopilación de algunas de las líneas de investigación en las que trabajan actualmente investigadores noveles y/o jóvenes. Cada capítulo corresponde a un autor, por lo que se reúnen en una sola obra estudios pertenecientes a distintas disciplinas científicas y académicas. Pretende ser un referente tanto para investigadores extremeños que se encuentren en fases iniciales de sus carreras, como para cualquier interesado en algunas de las temáticas incluidas.The third volume of the Catalogue of Young Research in Extremadura is presented as a broad compilation of some of the lines of research in which new and/or young researchers are currently working. Each chapter corresponds to an author, so that studies belonging to different scientific and academic disciplines are gathered in a single work. It is intended to be a reference for researchers from Extremadura who are in the initial stages of their careers, as well as for anyone interested in some of the topics included

Development of a stepwise tool to aide primary health care professionals in the process of deprescribing in older persons

Funding: The deprescribing tool was supported by Colciencias contract (110177758303 CT-792-2018) and Doctoral Fellowship Program 647-2015The aim of this study was to develop and validate a stepwise tool to aid primary health care professionals in the process of deprescribing potentially inappropriate medication in older persons. We carried out a systematic review to identify previously published tools. A composite proposal of algorithm was made by following the steps from clinical experience to deprescribe medications. A 2-round electronic Delphi method was conducted to establish consensus. Eighteen experts from different countries (Colombia, Spain and Argentina) accepted to be part of the panel representing geriatricians, internists, endocrinologist, general practitioners, pharmacologists, clinical pharmacists, family physicians and nurses. Panel members were asked to mark a Likert Scale from 1 to 9 points (1= strongly disagree, 9= strongly agree). The content validity ratio, item-level content validity, and Fleiss' Kappa statistics was measured to establish reliability. The same voting method was used for round 2. A 7-question algorithm was proposed. Each question was part of a domain and conduct into a decision. In round 1, a consensus was not reached but statements were grouped and organized. In round 2, the tool met consensus. The inter-rater reliability was between substantial and almost perfect for questions with Kappa=0.77 (95% CI 0.60-0.93), for domains with Kappa= 0.73 (95%CI 0.60-0.86) and for decisions with Kappa= 0.97 (95%CI 0.90-1.00). This is a novel tool that captures and supports healthcare professionals in clinical decision-making for deprescribing potentially inappropriate medication. This includes patient's and caregiver's preferences about medication. This tool will help to standardize care and provide guidance on the prescribing/deprescribing process of older persons' medications. Also, it provides a holistic way to reduce polypharmacy and inappropriate medications in clinical practice

Is contact with birth parents beneficial to children in non-kinship foster care? A scoping review of the evidence

Many children in non-kinship foster care maintain contact with their birth parents, although debate continues about whether or not, or under what circumstances, it is beneficial to the child. In this scoping review we analyze the findings of studies conducted over the past two decades that have specifically examined face-to-face contact with birth parents for children in non-kinship foster care, our aim being to determine more clearly when it may contribute positively to the child’s well-being. The review was conducted in accordance with PRISMA-ScR guidelines and involved a search of nine electronic databases. A total of 21 studies met the criteria for inclu- sion in the review, namely primary studies analyzing one or more aspects of these contact visits, written in English or Spanish, and published during the period 1997–2022. In analyzing these studies we grouped their findings according to four broad areas of interest: characteristics of contact visits, appraisal of visits by families and professionals, relationship between contact and fostering outcomes, and impact of contact on children. The four main conclusions we draw from the review are: a) surprisingly few studies have specifically examined the effects of face-to-face contact with birth parents in non-kinship foster care; b) the findings to date are neither conclusive nor generalizable, although they are not generally encouraging; c) under the right circumstances (e.g., adequate supervision, conducted in a context of emotional security for the child), contact can contribute to the child’s well-being and increase the likelihood of family reunification; and d) more robust research is needed to guide the development of interventions that can improve parent–child relationships and the quality of contact visitsAndalusian Plan for Research, Development and Innovation (PAIDI) Research Group SEJ-466. Funding for open access charge: Universidad de M ́alaga / CBU

Indicators of contact visit quality in non-kinship foster care: An observational checklist

This study explores whether the frequency and diversity of behaviours observed during contact visits may be used as indicators of visit quality. We observed 20 contact visits and quantified the frequency and diversity of behaviours for both parent and child, classified as positive or negative with respect to the child's well-being. Quality of visits was classified based on a list of parent and child behaviours and two indicators (diversity and frequency), to create two observational checklists and calculate an overall quality index. This observational tool will enable identification of areas where birth parents or their child require additional support.Funding for open access charge: Universidad de Málaga / CBUA. This study is part of a I + D Project of Excellence financed by the Government of Spain (EDU2016-77094-P)

Behavioral Observation and Analysis of Participants in Foster Care Visits.

Objective: To identify situations and behaviors occurring during contact visits that are likely to have an impact on a foster child’s well-being. Background: It has been argued that contact visits between foster children and birth parents can help to maintain attachment bonds and sup port the child’s development. However, contact continues to be a subject of controversy, and evidence of both benefits and drawbacks has been reported in the literature. Few studies have examined what actually occurs during such vis its, how parents and children interact, and what role is played by those involved. Method: We conducted an in-depth qualitative observational analysis of the behavior of partic ipants in contact visits (birth parent, child, and social worker), as well as of the characteristics of the venue. Participants were 20 children in nonkinship foster care and their birth parents. Information regarding the characteristics of vis its was provided by the child protection services and the fostering agencies involved. Results: The analysis revealed a large num ber of positive behaviors among parents, chil dren, and social workers, but also the need for improvement in several areas (e.g., family relationships, social/communication skills, and presents). Conclusions: This study highlights the need to improve contact visits by developing inter vention strategies targeting all those involved. Notably, the support and supervision provided by social workers was not always adequate. Implications: The results of this study could be used to develop an instrument for assessing the quality of contact visits and identifying aspects that need to be improved

Association of Mediterranean diet with peripheral artery disease: the PREDIMED randomized trial

Association of Mediterranean Diet With Peripheral Artery Disease: The PREDIMED Randomized Trial The role of nutrition in preventing peripheral artery disease (PAD) remains elusive. 1 Mediterranean diets reduce the risk of myocardial infarction and stroke. 2,3. They also may reduce the risk of PAD, but this hypothesis has never been tested in a randomized trial. We assessed the association of Mediterranean diets with the occurrence of symptomatic PAD in an exploratory, nonprespecified analysis of a randomized trial..

Acogimiento familiar de urgencia: resultados e implicaciones

Emergency foster care is a relatively new measure of protection in our country and one that is scarcely studied. The aim of this study is to perform a descriptive analysis of the status of emergency foster care since being put in place in the Province of Malaga. The sample comprised 89 children, 84 biological families and 38 foster families. The instrument used for data collection was the Data Collection Sheet. The findings are the following: a) 59.6 per cent of the children had suffered mistreatment; b) a socio-demographic profile characterized by addiction and psychopathology was found in the biological families; c) the quality and regularity of the parents’ visits to their children was superior to that found in other modalities of foster care; d) foster families had a high number of fostering and had received several children simultaneously; e) 20.3 per cent of the children had been in other previous foster care; f) the average stay in emergency foster care was 5.7 months; and g) 32.4 per cent of children were successfully reintegrated to their biological families after the emergency foster care terms were concluded.El objetivo de este estudio es conocer la situación de los Acogimientos Familiares de Urgencia desde su implantación en la provincia de Málaga, dado que es una medida de protección relativamente reciente en nuestro país y escasamente estudiada. Participaron 89 niños, 84 familias biológicas y 38 familias acogedoras de urgencia. El instrumento utilizado fue la Ficha de recogida de datos. Los resultados mostraron que: a) el 59,6 por ciento de los niños habían sufrido maltrato; b) en la familia biológica se encontró un perfil caracterizado por la toxicomanía y la psicopatología; c) la calidad y regularidad de las visitas de los padres a sus hijos fueron superiores a las encontradas en otros tipos de acogimiento; d) las familias acogedoras habían realizado un número elevado de acogimientos y habían acogido a varios niños simultáneamente; e) el 20,3 por ciento había estado en otra medida de protección previa al acogimiento de urgencia; f) la duración media de los acogimientos fue de 5.7 meses; y g) el 32,4 por ciento de los acogidos retornó con su familia biológica al finalizar el acogimiento de urgencia.