Performance, academic context and self-reported health in psychology students before and after of the EHEA

[EN] The European Higher Education Area (EHEA) has involved a number of structural and methodological changes whose results on academic performance and student health have not been sufficiently studied. The purpose of this paper is to evaluate the performance, perceived context and self-reported health of a sample of undergraduate and graduate Psychology students to see how these variables relate to and influence their academic achievement and welfare. Methodology. The sample consisted of 811 students (487 pre-Bologna system and 324 bacherlor ́s degree). For the evaluation of the indicated variables, the following instruments were used: the Academic Context questionnaire, to evaluate the educational environment; the GHQ-28 questionnaire to evaluate the self-reported health; and the CHAS (Cuestionario de Hábitos de Sueño, in Spanish, Sleeping Habits Questionnaire), in addition, the academic performance was collected. Results. EHEA students perform better than students pre-Bologna, although the difference is not very high. They are also more dissatisfied with the results obtained, they have worse psychological health, worse quality of sleep, greater anxiety and insomnia, greater social dysfunction, in addition, they need more medical leave due to stress and anxiety. Conclusions. Adaptation to the EHEA does not seem to achieve its objectives of improving the quality of education and having a negative impact on the health and physical and psychological well-being of students.[ES] El Espacio Europeo de Educación Superior (EEES) ha implicado una serie de modificaciones a nivel estructural y metodológico cuyos resultados sobre el rendimiento académico y la salud de los estudiantes no se han estudiado suficientemente. El objetivo de este trabajo es evaluar el rendimiento, el contexto percibido y la salud auto informada de una muestra de estudiantes de Psicología de licenciatura y grado, para ver cómo se relacionan estas variables e influyen en sus resultados académicos y bienestar. Metodología. La muestra estuvo compuesta por 811 estudiantes (487 de licenciatura y 324 de grado). Para la evaluación de las variables indicadas se utilizaron los siguientes instrumentos: cuestionario de Contexto Académico, el cuestionario GHQ-28 para evaluar la salud percibida, y el Cuestionario de hábitos de sueño CHAS, además se recabó el rendimiento académico. Resultados. Los estudiantes del EEES obtienen un mejor rendimiento que los de licenciatura, aunque la diferencia no es muy elevada. Así mismo muestran estar más insatisfechos con los resultados obtenidos, tienen peor salud psicológica, peor calidad de sueño, mayor ansiedad e insomnio, mayor disfunción social y más bajas médicas por estrés y ansiedad. Conclusiones. La adaptación al EEES parece que no cumple con sus objetivos de mejora de la calidad de la enseñanza además de tener un impacto negativo en la salud y bienestar físico y psicológico de los estudiantes.López-Núñez, M.; Rubio-Valdehita, S.; Díaz Ramiro, E. (2018). Rendimiento, contexto académico y salud percibida en estudiantes de psicología antes y después del EEES. 211-226. doi:10.4995/redu.2018.8961SWORD21122

Comprehensive analysis and insights gained from long-term experience of the Spanish DILI Registry

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER); Agencia Española del Medicamento; Consejería de Salud de Andalucía.Background & Aims: Prospective drug-induced liver injury (DILI) registries are important sources of information on idiosyncratic DILI. We aimed to present a comprehensive analysis of 843 patients with DILI enrolled into the Spanish DILI Registry over a 20-year time period. Methods: Cases were identified, diagnosed and followed prospectively. Clinical features, drug information and outcome data were collected. Results: A total of 843 patients, with a mean age of 54 years (48% females), were enrolled up to 2018. Hepatocellular injury was associated with younger age (adjusted odds ratio [aOR] per year 0.983; 95% CI 0.974-0.991) and lower platelet count (aOR per unit 0.996; 95% CI 0.994-0.998). Anti-infectives were the most common causative drug class (40%). Liver-related mortality was more frequent in patients with hepatocellular damage aged ≥65 years (p = 0.0083) and in patients with underlying liver disease (p = 0.0221). Independent predictors of liver-related death/transplantation included nR-based hepatocellular injury, female sex, higher onset aspartate aminotransferase (AST) and bilirubin values. nR-based hepatocellular injury was not associated with 6-month overall mortality, for which comorbidity burden played a more important role. The prognostic capacity of Hy's law varied between causative agents. Empirical therapy (corticosteroids, ursodeoxycholic acid and MARS) was prescribed to 20% of patients. Drug-induced autoimmune hepatitis patients (26 cases) were mainly females (62%) with hepatocellular damage (92%), who more frequently received immunosuppressive therapy (58%). Conclusions: AST elevation at onset is a strong predictor of poor outcome and should be routinely assessed in DILI evaluation. Mortality is higher in older patients with hepatocellular damage and patients with underlying hepatic conditions. The Spanish DILI Registry is a valuable tool in the identification of causative drugs, clinical signatures and prognostic risk factors in DILI and can aid physicians in DILI characterisation and management. Lay summary: Clinical information on drug-induced liver injury (DILI) collected from enrolled patients in the Spanish DILI Registry can guide physicians in the decision-making process. We have found that older patients with hepatocellular type liver injury and patients with additional liver conditions are at a higher risk of mortality. The type of liver injury, patient sex and analytical values of aspartate aminotransferase and total bilirubin can also help predict clinical outcomes