Psychosocial impact of malocclusion in Spanish adolescents

OBJECTIVE: To evaluate the psychosocial impact of malocclusion, determine its relationship with the severity of malocclusion, and assess the influence of gender and social class on this relationship in adolescents. METHODS: A random sample of 627 Spanish adolescents aged 12 - 15 years underwent intraoral examinations by 3 calibrated examiners (intraexaminer and interexaminer kappa > 0.85) at their schools. Psychosocial impact was measured through a self-rated Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The severity of malocclusion was measured by the Index of Orthodontic Treatment Need (IOTN). Gender and social class were also recorded. RESULTS: The total PIDAQ score and those of its 4 subscales, social impact, psychological impact, aesthetic concern, and dental self-confidence, presented significant differences (p ≤ 0.05 by analysis of variance) and linear relationships with the IOTN grades (p ≤ 0.05 by linear regression). Stepwise linear regression models showed that the IOTN dental health component was a predictive variable of the total and subscale PIDAQ scores. Neither gender nor social class was an independent predictive variable of this relationship, except the linear model for psychological impact, where gender was a predictive variable. The occlusal conditions responsible for higher PIDAQ scores were increased overjet, impeded eruption, tooth displacement, and increased overbite. CONCLUSIONS: Malocclusion has a psychological impact in adolescents and this impact increases with the severity of malocclusion. Social class may not influence this association, but the psychological impact seems to be greater among girls

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Estudio a nivel de perfil para la implementación de una planta procesadora y comercializadora de frutas deshidratadas en la ciudad de managua, Nicaragua.

Con este proyecto se agregará valor a los procesos productivos, se estimularía el aumento de la producción de frutas, se calificará la mano de obra con la capacitación de los recursos humanos participantes en los procesos productivos, se aumentará en el país la industrialización y la productividad, con el aprovechamiento de las frutas, ofreciendo nuevas alternativas de nutrición a los consumidores

La Rábida : Revista Colombina Hispanoamericana. Número 225 - Año XXI

16 páginasPérez Nieva, Alfonso: Aguas fuertes Colombinas. Cuarto viaje. Quinta estampa.- Nuestras encuestas. Gustavo Adolfo Otero, escritor boliviano - Barcelona, por el Róbison Literario de Hispanoamérica (pseudónimo de Jesús Lea Navas).- Carrancá Trujillo, Raúl: Desde México. La canción de la muerte.- Pérez Palacio, J.: Para "La Rábida". Horizonte azul (III). La ciudad en el campo. Subjetivismo.- Manzano G., Rafael: Recuerdos.- Manuel Bernabé Flores y Octavio Luis Alba: Labor Hispano-americana en el III Congreso ordinario de la U.F.E.H. (Unión Federal de Estudiantes Hispanos).- Lamina con fotografía del Cristo de la Expiración, Capilla del Patrocinio, Sevilla.- Visitando La Rábida (Mr. H.V. Morton, periodista delegado del Daily Herald).- Del Homenaje al Gobernador Alonso.- El Sr. Deschamps, en la Económica Matritente (conferencia en la Sociedad Económica Matritense de Amigos del País).- Lea Navas, Jesús: Una Procesión del Viernes Santo en Quito (Antaño).- En honor de Daniel Vázquez Díaz.- Lea Navas, Jesús: La Expedición al Amazonas. Crónica del Capitán Iglesias.- Notas americanas (diversas noticas relacionadas con Chile).- Permanyer y Nogués, José: Los niños y la guerra. El brillante éxito de una iniciativa hispanoamericana