Utilidad de las escalas de evaluación de la depresión en Atención Primaria

El diagnóstico de trastornos mentales en Atención Primaria es complejo, siendo la depresión una de las enfermedades más comunes, relevantes e incapacitantes entre la población. El principal problema que se presenta es el infradiagnóstico de los trastornos depresivos, dando lugar a falsos negativos. El procedimiento esencial para el diagnóstico del episodio depresivo es la entrevista clínica. A pesar de que se ha demostrado la utilidad de las escalas de evaluación de la depresión, y de que hay un creciente consenso sobre su incorporación en la práctica clínica, estos instrumentos no se emplean de forma sistemática en las consultas de Atención Primaria. Con este estudio se pretende conocer si el uso sistemático de escalas de evaluación de la depresión por los médicos de familia como complemento a la entrevista clínica, puede mejorar la capacidad de diagnóstico de los trastornos depresivos en Atención Primaria. Se trata de un estudio de evaluación de dos pruebas diagnósticas para la detección de los trastornos depresivos realizado mediante un diseño transversal: la entrevista clínica por parte del médico de familia de forma única, y ésta complementada con el inventario de depresión de Beck-II (BDI-II), utilizando como gold standard la valoración posterior por parte de un psiquiatra. Se evaluará la sensibilidad y la especificidad de cada uno de los métodos diagnósticos. Posteriormente, se construirán las curvas de rendimiento diagnóstico (curvas ROC) y la estimación del área bajo la curva (AUC) con su error estándar (EE) para los diferentes puntos de corte del inventario de Beck, con un intervalo de confianza del 95%, y se compararán estas curvas. Por último, se analizará la concordancia entre la entrevista clínica y la escala de evaluación, mediante el índice kappa de Cohen (K) con un intervalo de confianza 95%. The diagnosis of mental disorders in Primary Care is complex, with depression being one of the most common, relevant and disabling diseases among the population. The main problem that arises is the underdiagnosis of depressive disorders, giving rise to false negatives. The essential procedure for diagnosing a depressive episode is the clinical interview. Although the usefulness of depression assessment scales has been demonstrated, and there is a growing consensus on their incorporation into clinical practice, these instruments are not used systematically in Primary Care consultations. This study aims to find out if the systematic use of depression assessment scales by family doctors as a complement to the clinical interview can improve the ability to diagnose depressive disorders in Primary Care. This is an evaluation study of two diagnostic tests for the detection of depressive disorders carried out using a cross-sectional design: the clinical interview by the family doctor in a unique way, and this complemented with the Beck Depression Inventory II (BDI-II), using the subsequent assessment by a psychiatrist as the gold standard. The sensitivity and specificity of each of the diagnostic methods will be evaluated. Subsequently, the diagnostic performance curves (ROC curves) and the estimation of the area under the curve (AUC) with its standard error (SE) will be constructed for the different cut-off points of Beck's inventory, with a 95% confidence interval, and they will be compared these curves. Finally, the concordance between the clinical interview and the evaluation scale, will be analyzed by means of Cohen's kappa index (K) with a 95% confidence interval

Data cloning estimation of GARCH and COGARCH models

GARCH models include most of the stylized facts of financial time series and they have been largely used to analyze discrete financial time series. In the last years, continuous time models based on discrete GARCH models have been also proposed to deal with non-equally spaced observations, as COGARCH model based on Lévy processes. In this paper, we propose to use the data cloning methodology in order to obtain estimators of GARCH and COGARCH model parameters. Data cloning methodology uses a Bayesian approach to obtain approximate maximum likelihood estimators avoiding numerically maximization of the pseudo-likelihood function. After a simulation study for both GARCH and COGARCH models using data cloning, we apply this technique to model the behavior of some NASDAQ time serie

Creativity, art and laterality as tools for learning the language in children

The first years of life are fundamental because is the time where the bases are laid for the acquisition of cognitive skills, such as psychomotor, emotional and social abilities necessary for the proper learning. However, each day it is more common to find children in primary schools who suffer school failure. Behind this fact we find difficulties that have not been perceived in the first years of schooling, such as a poor integration of the body scheme and spatio-temporal orientation and a lack of definition in laterality. Different studies have shown that good laterality settlement can improve the literacy learning. Creativity, helps learning to be attached by a sense of pleasure which allows the development of cognitive, psychomotor, affective and social abilities in students. This study tests the influence of creativity, art and laterality in the learning of the language subject of 2nd grade children. 60 children have been gathered between the ages of 7 and 8 years old from Barcelona. The results of the investigation have shown that the defined laterality (right and left handed) favors the learning of the language subject to a greater extent than when it is crossed; meaning that academic performance is significantly higher when we have a defined laterality. In order to improve learning, an intervention is proposed to develop creativity and laterality, which is why this research has a preventive function of school failure

Controversias del uso de la hormona de crecimiento en niños con talla baja idiopática y perspectivas de futuras indicaciones

[ES] La talla baja idiopática (TBI) se diagnostica tras haber descartado otras causas de hipocrecimiento. Tras aprobarse el uso de la hormona de crecimiento para su tratamiento en algunos países ha surgido la controversia de si este uso está justificado

Aproximación metodológica al diagnóstico el estado de aptitud de un edificio: aplicaciones para el análisis de riesgo, vulnerabilidad y durabilidad en la Archidiócesis de Sevilla

Es sabido que, la durabilidad en el tiempo de un edifico viene dada por su vulnerabilidad y por cualquier tipo de riesgo al que se encuentra sometido. En el presente trabajo, se expone un procedimiento que nos permite medir los posibles factores dominantes que inciden sobre la vulnerabilidad y el riesgo. De este modo, se puede determinar de forma comparada con otros inmuebles la durabilidad siempre incierta del edificio. Para tratar sistemática y racionalmente la aptitud de un edificio consideramos oportuno determinar y agrupar los factores que de una u otra forma van a influir en la determinación de la vulnerabilidad y el riesgo, y por tanto en la necesidad o no de actuación en la mejora de la conservación del inmueble. Se presenta una primera aproximación metodológica al tratamiento de los datos de dichos factores. Se propone una formula matemática que mide el grado conservación del inmueble en el momento de su análisi

The collapse of marine forests: drastic reduction in populations of the family Sargassaceae in Madeira Island (NE Atlantic)

Species of the genera Cystoseira, Ericaria, Gongolaria, and Sargassum (family Sargassaceae) are key components of the Mediterranean-Atlantic marine forests, essential for biodiversity and ecosystem functioning. Populations of these foundational species are particularly vulnerable to anthropogenic impacts, likely to be intensified under future scenarios of climate change. The decline and even disappearance of these species have been reported in different areas of the world. At Madeira Island (NE Atlantic), populations of Gongolaria abies-marina, Ericaria selaginoides, Sargassum vulgare, and Sargassum filipendula, the most ecologically relevant species in Macaronesian marine forests, have been suffering a drastic decline during the last decades, especially on the southern coast of the island, where anthropogenic pressure is higher than on the north coast. The lack of sufficient temporal coverage on qualitative and quantitative studies of Sargassaceae communities in Madeira poses a challenge to establish a specific period for this decline. Consulting qualitative studies and historical records, we have set for the first time a timeline that shows an evident decrease in Sargassaceae populations in the last 20 years on Madeira Island. Following this timeline, we pinpoint the start of this decline in the first decade of the 2000s. This can be particularly confirmed for places like Funchal and Reis Magos, with significantly higher historical records. Currently, most benthic communities on shallow subtidal rocky reefs along the south coast are dominated by sea urchins and crustose coralline algae, the so-called sea urchin barrens. However, in some cases, they are entirely covered by a layer of sediment. We discuss the possible factors contributing to these drastic changes, bringing Madeira’s marine forests to a dramatic decline. As many animal species rely on marine forests, the decline of Sargassaceae populations represents an invaluable ecological loss for the coastal ecosystem of the island.M1420-09-5369-FSE-000002, CEECINST/00098/2018, MAC2/1.1a/347, MAC2/4.6d/249, UIDB/04292/2020info:eu-repo/semantics/publishedVersio

Los archivos fotográficos online como instrumento de aprendizaje para la asignatura de Historia Económica. Una propuesta de innovación docente a través de las TICs.

Desde hace algunos años numerosas instituciones han puesto al alcance de los usuarios de Internet archivos fotográficos digitalizados. Estos archivos constituyen un recurso docente de la máxima utilidad para la enseñanza y el aprendizaje de la Historia Económica, dado que permiten a los estudiantes visualizar hechos, procesos y conceptos básicos para la comprensión de la asignatura. Al mismo tiempo, pueden ser utilizados como punto de partida para la realización de actividades prácticas que potencien el desarrollo de estrategias de aprendizaje basado en la investigación, así como contribuir a la normalización de metodologías de trabajo basadas en las TICs que incorporen estrategias de selección de la información fundamentadas en criterios académicos. En esta comunicación ponemos de relieve el potencial de los archivos fotográficos online como recurso docente y realizamos una propuesta de actividad práctica basada en los mismos

Dietary intake in pregnant women in a Spanish Mediterranean area: as good as it is supposed to be?

Objective To assess food and nutrient intakes and compliance with nutritional recommendations in pregnant women according to selected sociodemographic characteristics. Design Cross-sectional study based on data from the INMA-Valencia cohort (Spain), which recruited pregnant women between 2004 and 2005. Information on maternal sociodemographics and anthropometry was collected. Dietary intake was assessed through an FFQ. Intakes of foods were compared with Spanish food-based dietary guidelines. Intake inadequacy for nutrients was assessed using the Dietary Reference Intakes of the US Institute of Medicine. Setting Valencia, Spain. Subjects We studied 822 pregnant women who had information on dietary intake during their first trimester of pregnancy. Results More than 50 % of pregnant women did not meet the guidelines for cereals and legumes; reported intakes of carbohydrates, n-3 and n-6 fatty acids were below recommendations and exceeded the total fat intake according to dietary references. Dietary inadequacy for folate, Fe and vitamin E ranged from 99 % to 68 %. Vegetable intake was related to age only. Younger and less educated women showed lower intakes of protein and n-3 fatty acids and higher intakes of trans-fatty acids as well as greater inadequacy for micronutrients. Spanish women reported lower intakes of fruit and carbohydrates and higher intakes of protein, total fat, SFA, MUFA and n-3 fatty acids compared with their foreign-born counterparts. Conclusions Women in the studied area have inadequate intakes of several nutrients relevant during pregnancy. Age, education and country of origin are factors significantly related to dietary intake and adequacy

El currículum y la enseñanza, ¿qué se enseña y cómo al alumnado en situación de riesgo de exclusión?

En el presente artículo se analiza el currículo y la enseñanza de dos programas o medidas que se desarrollan en la Región de Murcia y en la Comunidad de Andalucía –Programa de Diversificación Curricular y Programa de Iniciación Profesional y/o Programa de Garantía Social- ambos destinados al alumnado con serias dificultades para continuar la enseñanza en las aulas regulares. Tras presentar diversos datos recogidos a través de cuestionarios y entrevistas con diferentes sujetos implicados, se analizan y valoran los resultados de la investigación realizada, procurando responder a la cuestión de en que grado el currículo diseñado en tales programas y la formación y aprendizajes logrados han contribuido a responder a las necesidades de este alumnado