Current practices and challenges in the diagnosis and management of pku in Latin America: A multicenter survey

This study aimed to describe the current practices in the diagnosis and dietary management of phenylketonuria (PKU) in Latin America, as well as the main barriers to treatment. We developed a 44-item online survey aimed at health professionals. After a pilot test, the final version was sent to 25 practitioners working with inborn errors of metabolism (IEM) in 14 countries. Our results include 22 centers in 13 countries. Most countries (12/13) screened newborns for PKU. Phenylalanine (Phe) targets at different ages were very heterogeneous among centers, with greater consistency at the 0–1 year age group (14/22 sought 120–240 µmol/L) and the lowest at >12 years (10 targets reported). Most countries had only unflavored powdered amino acid substitutes (10/13) and did not have low-protein foods (8/13). Only 3/13 countries had regional databases of the Phe content of foods, and only 4/22 centers had nutrient analysis software. The perceived obstacles to treatment were: low purchasing power (62%), limited/insufficient availability of low-protein foods (60%), poor adherence, and lack of technical resources to manage the diet (50% each). We observed a heterogeneous scenario in the dietary management of PKU, and most countries experienced a lack of dietary resources for both patients and health professionals.Fil: Poloni, Soraia. Hospital de Clínicas de Porto Alegre; BrasilFil: Dos Santos, Bruna Bento. Universidade Federal do Rio Grande do Sul; Brasil. Hospital de Clínicas de Porto Alegre; BrasilFil: Chiesa, Ana Elena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas "Dr. César Bergada". Gobierno de la Ciudad de Buenos Aires. Centro de Investigaciones Endocrinológicas "Dr. César Bergada". Fundación de Endocrinología Infantil. Centro de Investigaciones Endocrinológicas "Dr. César Bergada"; ArgentinaFil: Specola, Norma. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Pereyra, Marcela. Gobierno de la Provincia de Mendoza. Hospital Pediátrico Humberto Notti; ArgentinaFil: Saborío Rocafort, Manuel. Universidad de Costa Rica; Costa RicaFil: Salazar, María Florencia. Universidad de Chile; ChileFil: Leal-Witt, María Jesús. Universidad de Chile; ChileFil: Castro, Gabriela. Universidad de Chile; ChileFil: Peñaloza, Felipe. Universidad de Chile; ChileFil: Wong, Sunling Palma. Hospital Nacional de Niños; Costa RicaFil: Badilla Porras, Ramsés. Hospital Nacional de Niños; Costa RicaFil: Ortiz Paranza, Lourdes. Ministerio de Salud Pública y Bienestar Social; ParaguayFil: Sanabria, Marta Cristina. Hospital de Clínicas; ParaguayFil: Vela Amieva, Marcela. Instituto Nacional de Pediatría; MéxicoFil: Morales, Marco. No especifíca;Fil: Caro Naranjo, Amanda Rocío. Pontificia Universidad Javeriana; ColombiaFil: Mahfoud, Antonieta. Pontificia Universidad Javeriana; ColombiaFil: Colmenares, Ana Rosa. Hospital Clinica Caracas-Materno Infantil de Caricuao; VenezuelaFil: Lemes, Aida. Instituto de Seguridad Social; UruguayFil: Sotillo Lindo, José Fernando. Hospital de especialidades Pediátricas “Omar Torrijos Herrera"; PanamáFil: Perez, Ceila. Robert Reid Cabral Children’s Hospital; República DominicanaFil: Martínez Rey, Laritza. Centro Nacional de Genética Médica; CubaFil: Zayas Torriente, Georgina María. Centro de Nutrición e Higiene de los Alimentos del Instituto Nacional de Higiene, Epidemiología y Microbiología; CubaFil: Farret Refosco, Lilia. Hospital de Clínicas de Porto Alegre; BrasilFil: Doederlein Schwartz, Ida Vanessa. Universidade Federal do Rio Grande do Sul; Brasil. Hospital de Clínicas de Porto Alegre; BrasilFil: Cornejo, Veronica. Universidad de Chile; Chil

Desarrollo de un banco de ítems para medir conocimiento en estudiantes universitarios

Measurement in the educational field of academic achievement of university students is considered empirical and quantitative. Hence, the main purpose of such assessments is to control educational systems and evaluation based on objective criteria (Long, Wendt, & Dunne, 2011). The aim of this article was to develop an Item Bank for General Knowledge Test composed by 20 specific domains of knowledge. Considering that an effective construction of a test requires organization and systematization of activities, progress in six domains are presented. The sample was composed by 6,794 university students. 1,526 items from different domains were evaluated. To calibrate the items, a nonlinear exploratory factorial analysis was performed. Difficulty and discrimination indices were obtained according to the classical theory of tests and the item response theory, and reliability indices as well. It was observed that 68% of the items have moderate difficulty and 32% of them have high or low difficulty. Internal consistency of the instrument showed high reliability values, up to .70. Further studies are needed in order to expand the item sample, and review items that showed inadequate indexes on discrimination, difficulty and reliability. This instrument allows measuring academic performance on an interval scale level and reducing the misclassification of students.La medición en el ámbito educativo del rendimiento académico de los estudiantes universitarios es considerada empírica y cuantitativa. De allí que el propósito principal de dichas evaluaciones consiste en el control de los sistemas educativos y la evaluación a partir de criterios objetivos (Long, Wendt, & Dunne, 2011). Este trabajo apunta a desarrollar un banco de ítems para el Test de Conocimiento General compuesto de 20 dominios específicos. Se presentan avances realizados en seis dominios (psicología, biología, historia, literatura, economía y leyes). La muestra estuvo compuesta por 6.794 estudiantes. Se evaluaron 1.526 ítems de distintos dominios. Se realizó un análisis factorial exploratorio no lineal, se obtuvieron los índices de dificultad y discriminación según la teoría clásica de los test y la teoría de respuesta al ítem; también se obtuvieron índices de fiabilidad. El 68% presenta dificultad moderada y 32% un índice de dificultad alto o bajo. Sobre los índices de confiabilidad en la mayoría de los dominios se obtuvieron valores satisfactorios superiores a ,70. Se concluye la necesidad de revisar los ítems que no cumplieron estos criterios y ampliar la muestra. Este instrumento permitirá reducir los errores de clasificación de los alumnos y medir el desempeño académico con una escala de intervalo

Development of an Item Bank to Measure Knowledge in University Students

La medición en el ámbito educativo del rendimiento académico de los estudiantes universitarios es considerada empírica y cuantitativa. De allí que el propósito principal de dichas evaluaciones consiste en el control de los sistemas educativos y la evaluación a partir de criterios objetivos (Long, Wendt, & Dunne, 2011). Este trabajo apunta a desarrollar un banco de ítems para el Test de Conocimiento General compuesto de 20 dominios específicos. Se presentan avances realizados en seis dominios (psicología, biología, historia, literatura, economía y leyes). La muestra estuvo compuesta por 6.794 estudiantes. Se evaluaron 1.526 ítems de distintos dominios. Se realizó un análisis factorial exploratorio no lineal, se obtuvieron los índices de dificultad y discriminación según la teoría clásica de los test y la teoría de respuesta al ítem; también se obtuvieron índices de fiabilidad. El 68% presenta dificultad moderada y 32% un índice de dificultad alto o bajo. Sobre los índices de confiabilidad en la mayoría de los dominios se obtuvieron valores satisfactorios superiores a ,70. Se concluye la necesidad de revisar los ítems que no cumplieron estos criterios y ampliar la muestra. Este instrumento permitirá reducir los errores de clasificación de los alumnos y medir el desempeño académico con una escala de intervalo.Fil: Cupani, Marco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudio sobre Cultura y Sociedad. Centro de Investigaciones de la Facultad de Psicología - Grupo Vinculado CIPSI; ArgentinaFil: Ghio, Fernanda Belén. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Leal Denis, Maria Florencia. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Giraudo, Gimena Mariel. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Castro Zamparella, Tatiana. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Piumatti, Gisella. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Casalotti, Antonella Belén. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Ramírez, Juan Claudio. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Andrés Arranz, María. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Farías, Analía Norma. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Padilla, Natalia. Universidad Nacional de Córdoba. Facultad de Psicología; ArgentinaFil: Barrionuevo, Leandro. Universidad Nacional de Córdoba. Facultad de Psicología; Argentin

Adherence to a Supplemented Mediterranean Diet Drives Changes in the Gut Microbiota of HIV-1-Infected Individuals

Objective: The health effects of a supplemented Mediterranean diet (SMD) with extra-virgin olive oil (EVOO) and nuts are well documented in non-HIV-infected individuals. We hypothesised that the benefits of an SMD could be mediated by changes in the gut microbiota, even in those with an altered intestinal microbiota such as people living with HIV. Design: Individuals living with HIV (n = 102) were randomised to receive an SMD with 50 g/day of EVOO and 30 g/day of walnuts (SMD group) or continue with their regular diet (control group) for 12 weeks. Methods: Adherence to the Mediterranean diet was assessed using the validated 14-item MD-Adherence-Screener (MEDAS) from the PREDIMED study. A sub-study classifying the participants according to their MEDAS scores was performed. Results: The lipid profile was improved in the SMD group vs. that in the control group (delta-total cholesterol and delta-B-lipoprotein). The immune activation (CD4+HLADR+CD38+ and CD8+HLADR+CD38+ cells) and IFN-γ-producing T-cells significantly decreased at week 12 compared to the baseline in the SMD group but not in the control group. The gut microbiota in those from the high-adherence group presented significantly high diversity and richness at the end of the intervention. Succinivibrio and Bifidobacterium abundances were influenced by the adherence to the MD and significantly correlated with Treg cells. Conclusion: The Mediterranean diet improved metabolic parameters, immune activation, Treg function, and the gut microbiota composition in HIV-1-infected individuals. Further, Mediterranean diet increased the Bifidobacterium abundances after the intervention, and it was associated to a beneficial profile

Adherence to a Supplemented Mediterranean Diet Drives Changes in the Gut Microbiota of HIV-1-Infected Individuals

Objective: The health effects of a supplemented Mediterranean diet (SMD) with extra-virgin olive oil (EVOO) and nuts are well documented in non-HIV-infected individuals. We hypothesised that the benefits of an SMD could be mediated by changes in the gut microbiota, even in those with an altered intestinal microbiota such as people living with HIV. Design: Individuals living with HIV (n = 102) were randomised to receive an SMD with 50 g/day of EVOO and 30 g/day of walnuts (SMD group) or continue with their regular diet (control group) for 12 weeks. Methods: Adherence to the Mediterranean diet was assessed using the validated 14-item MD-Adherence-Screener (MEDAS) from the PREDIMED study. A sub-study classifying the participants according to their MEDAS scores was performed. Results: The lipid profile was improved in the SMD group vs. that in the control group (delta-total cholesterol and delta-B-lipoprotein). The immune activation (CD4+HLADR+CD38+ and CD8+HLADR+CD38+ cells) and IFN-γ-producing T-cells significantly decreased at week 12 compared to the baseline in the SMD group but not in the control group. The gut microbiota in those from the high-adherence group presented significantly high diversity and richness at the end of the intervention. Succinivibrio and Bifidobacterium abundances were influenced by the adherence to the MD and significantly correlated with Treg cells. Conclusion: The Mediterranean diet improved metabolic parameters, immune activation, Treg function, and the gut microbiota composition in HIV-1-infected individuals. Further, Mediterranean diet increased the Bifidobacterium abundances after the intervention, and it was associated to a beneficial profile