Features of birth families with foster children in Andalusia

The aim of the presentation is to describe the personal features of biological families whose children are in non-kinship foster care and with whom they have face-to-face contact in Málaga, Granada and Jaén (provinces of Andalusia, Spain). This study was funded by the research project Application of a psychoeducational intervention program to improve visits between foster children and their biological families (Reference EDU2016 77094-P). SPSS v.21.0 was used to carry out the descriptive and frequency analysis of socio-demographic information collected by the Child File Summary Form designed for this study. The results show the difficulties experienced by birth families to deal with the responsibility of parenthood. There is a high percentage of unemployment (54.5% mothers, 46.4% fathers), and a low level of education (61.7% uneducated mothers, 68.8% uneducated fathers). Furthermore, it is necessary to consider their diverse personal problems which undermine their competences to bring up and educate their children: substance abuse, mental health issues, mental disability and prison. Finally, the lack of relation between Social Services and birth families is highlighted. Knowing the circumstances of families at psychosocial risk permits to develop social policies that match with their specific necessities, by providing them the support and resources required, in line with Recommendation Rec(2006)19 of the Committee of Ministers to member states. Moreover, children and families’ rights have to be respected, such as their right to have contact to maintain and strengthen their affective bonds as part of their identity. These findings will contribute to design: (a) family intervention programs which allow parents to acquire the necessary parental skills; (b) support and educational tools for the social workers; and (c) projects to contribute to children’s well-being.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Programa de preparación de las familias biológicas y acogedoras para mejorar la calidad de las visitas

Tras la trayectoria del grupo de investigación en acogimiento familiar, se pone de manifiesto la necesidad de mejorar la calidad de las visitas entre los niños en acogimiento con familia ajena y su familia biológica. En concreto, se pretende diseñar y aplicar un programa de intervención psicoeducativa de preparación y apoyo dirigido a las familias biológicas y las familias acogedoras. Este trabajo forma parte de un Proyecto de Excelencia I+D (EDU2016 77094-P), financiado por el Ministerio de Economía y Competitividad, titulado "Aplicación de un programa de intervención psicoeducativa para mejorar las visitas entre los niños acogidos y sus familias biológicas". Los participantes en el estudio son: a) las familias biológicas que mantienen contactos con los niños que se encuentran en acogimiento con familia ajena; b) las familias acogedoras de dichos menores, y c) los técnicos responsables de la supervisión de las visitas. Se realizará un diseño pretest-intervención-postest y la intervención se desarrollará en 7 sesiones de forma consecutiva, con la periodicidad que establezca el régimen de contactos de cada familia. Esta intervención consiste en una propuesta sistemática y organizada que establece de forma secuencial los principales contenidos a tratar en la preparación de las visitas. Algunas de las temáticas a abordar con las familias biológicas son aprender a transmitir mensajes adecuados a los niños, proponer los tipos de regalos y juguetes que pueden llevar a las visitas, entrenarles en habilidades específicas de comunicación, entre otras. En el caso de las familias acogedoras se pretende mostrar la importancia de preparar al niño acogido para las visitas con su familia biológica, comprender y ayudar a los niños acogidos a expresar las emociones que les producen los contactos con sus familiares, analizar las posibles dificultades que puedan provocar las visitas en el desarrollo de la vida familiar de los acogedores, etc

Casos clínicos estructurados, basados en la integración de imágenes, para la docencia de medicina

[SPA] La observación y descripción de posibles patologías es parte fundamental de la enseñanza y aprendizaje de medicina. Las técnicas de imagen están experimentando un notable incremento en la práctica de la medicina y su conocimiento resulta cada vez más importante en la docencia de las ciencias biomedicas. Se hace necesario encontrar metodologías de aprendizaje que permitan estructurar las imágenes, junto con otros datos de diagnóstico, de tal forma que el alumno integre los signos y síntomas de la enfermedad. Describimos un sistema de integración de imágenes médicas que hemos elaborado utilizando recursos de tecnologías de la información y comunicación (TIC). El objetivo es que el alumno adquiera competencias destinadas al diagnóstico de la enfermedad. El sistema se basa en una plataforma digital que permite la elaboración y presentación de casos clínicos concretos y estructurados para que aparezcan sin reseñas de filiación ni datos clínicos de los pacientes, y que conduzcan a la realización de un diagnóstico clínico. A estos casos clínicos se les asocian imágenes que habitualmente utilizan distintas disciplinas médicas, con especial referencia a los hallazgos histopatológicos. [ENG] Observation and description of human pathologies is an essential and fundamental part in teaching and learning medicine. The expansion of Imaging Techniques in the field of medicine makes it necessary to introduce new learning methodology. Thus, correct knowledge of these techniques is an important area to cover in the medicine studies. It is necessary to find teaching methodologies that permit learning of clinical diagnosis integrating images provided by image based techniques with symptoms and other signs of the illness. We describe a system that we have elaborated, and that permit the integration of medical images using information and communication technical resources. The system is directed toward the acquisition of diagnostic skills by the medical student. Using a digital platform, the system permits the presentation of a clinical history without affiliation data, and that induce the performance of a clinical differential diagnosis. Medical images used in diverse medical specialties, with special reference to histopathology, are linked to the main menu to permit the student making a correct diagnosis

Sleep-disordered breathing, circulating exosomes, and insulin sensitivity in adipocytes

Background: Sleep-disordered-breathing (SDB), which is characterized by chronic intermittent hypoxia (IH) and sleep fragmentation (SF), is a prevalent condition that promotes metabolic dysfunction, particularly among patients suffering from obstructive hypoventilation syndrome (OHS). Exosomes are generated ubiquitously, are readily present in the circulation, and their cargo may exert substantial functional cellular alterations in both physiological and pathological conditions. However, the effects of plasma exosomes on adipocyte metabolism in patients with OHS or in mice subjected to IH or SF mimicking SDB are unclear. Methods: Exosomes from fasting morning plasma samples from obese adults with polysomnographically-confirmed OSA before and after 3 months of adherent CPAP therapy were assayed. In addition, C57BL/6 mice were randomly assigned to (1) sleep control (SC), (2) sleep fragmentation (SF), and (3) intermittent hypoxia (HI) for 6 weeks, and plasma exosomes were isolated. Equivalent exosome amounts were added to differentiated adipocytes in culture, after which insulin sensitivity was assessed using 0 nM and 5 nM insulin-induced pAKT/AKT expression changes by western blotting. Results: When plasma exosomes were co-cultured and internalized by human naive adipocytes, significant reductions emerged in Akt phosphorylation responses to insulin when compared to exosomes obtained after 24 months of adherent CPAP treatment (n = 24; p < 0.001), while no such changes occur in untreated patients (n = 8). In addition, OHS exosomes induced significant increases in adipocyte lipolysis that were attenuated after CPAP, but did not alter pre-adipocyte differentiation. Similarly, exosomes from SF- and IH-exposed mice induced attenuated p-AKT/total AKT responses to exogenous insulin and increased glycerol content in naive murine adipocytes, without altering pre-adipocyte differentiation. Conclusions: Using in vitro adipocyte-based functional reporter assays, alterations in plasma exosomal cargo occur in SDB, and appear to contribute to adipocyte metabolic dysfunction. Further exploration of exosomal miRNA signatures in either human subjects or animal models and their putative organ and cell targets appears warranted

Correlation of fatigue with other disease related and psychosocial factors in patients with rheumatoid arthritis treated with tocilizumab: ACT-AXIS study

To assess the hypothesis if tocilizumab (TCZ) is effective on disease activity, and also its effect in fatigue and other clinical and psychological disease-related factors in patients with rheumatoid arthritis (RA) treated with TCZ.A 24-week, multicenter, prospective, observational study in patients with moderate to severe RA receiving TCZ after failure or intolerance to disease-modifying antirheumatic drugs or tumor necrosis factor-alpha was conducted.Of the 122 patients included, 85 were evaluable for effectiveness (85% female, 51.9 ± 12.5 years, disease duration 8.7 ± 7.4 years). Mean change in C-reactive protein level from baseline to week 12 was -11.2 ± 4.0 (P < .001). Mean Disease Activity Index score (DAS28) decreased from 5.5 ± 1.0 at baseline to 2.7 ± 1.3 (P < .001) at week 24. Mean change in Functional Assessment of Chronic Illness Therapy score was -5.4 ± 11.2 points at week 24. Multiple regression analysis showed that the improvement in DAS28, sleep, and depression explained 56% and 47% of fatigue variance at week 12 and 24, respectively.Tocilizumab is effective in reducing disease activity and results in a clinically significant improvement in fatigue, pain, swollen joint count, morning stiffness, sleepiness, depression, and DAS28; the last 3 were specifically identified as factors explaining fatigue variance with the use of TCZ in RA patients

An international cross-sectional investigation on social media, fitspiration content exposure, and related risks during the COVID-19 self-isolation period.

With the global COVID-19 pandemic, governments from many countries in the world implemented various restrictions to prevent the SARS-Cov-2 virus's spread, including social distancing measures, quarantine, in-home lockdown, and the closure of services and public spaces. This led to an in-creased use of social media platforms to make people feel more connected, but also to maintain physical activity while self-isolating. Concerns about physical appearance and the desire to keep or reach a muscular and toned ideal body, might have further reinforced the engagement in fitness-related social media activities, like sharing progresses in training achievements or following more fitness contents on popular profiles. To better understand the underlying relation among these factors, the present study investigates 729 responses to the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), the Self-Compassion Scale (SCS) and their association to social media usage and compares the results cross-culturally in five countries (Spain, Lithuania, United Kingdom, Japan, and Hungary). Findings highlight significant differences between males and females, espe-cially in regard to the time spent online (U = 477.5, p = 0.036). Greater levels of appearance anxiety were associated with the exposure to fitness-related contents on social media. These results strongly confirm the previously highlighted association between fitspiration media and body image anxiety predominantly in females. Clinical implications and future considerations in terms of prevention and treatment in a situation of global emergency are also discussed

Does Consumption of Ultra-Processed Foods Matter for Liver Health? Prospective Analysis among Older Adults with Metabolic Syndrome

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been sufficiently assessed. We aimed to investigate the prospective association between UPF consumption and liver health biomarkers. Methods: We followed for 1 year 5867 older participants with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus trial. A validated 143-item semi-quantitative food frequency questionnaire was used to evaluate consumption of UPF at baseline, 6, and 12 months. The degree of processing for foods and beverages (g/day) was established according to the NOVA classification system. The non-invasive fatty liver index (FLI) and hepatic steatosis index (HSI) were used to evaluate liver health at three points in time. The associations between changes in UPF consumption (percentage of total daily dietary intake (g)) and liver biomarkers were assessed using mixed-effects linear models with repeated measurements. Results: In this cohort, UPF consumption at baseline was 8.19% (SD 6.95%) of total daily dietary intake in grams. In multivariable models, each 10% daily increment in UPF consumption in 1 year was associated with significantly greater FLI (β 1.60 points, 95% CI 1.24;1.96 points) and HSI (0.43, 0.29; 0.57) scores (all p-values < 0.001). These associations persisted statistically significant after adjusting for potential dietary confounders and NAFLD risk factors. Conclusions: A higher UPF consumption was associated with higher levels of NAFLD-related biomarkers in older adults with overweight/obesity and MetS

Associations Between the Modified Food Standard Agency Nutrient Profiling System Dietary Index and Cardiovascular Risk Factors in an Elderly Population

Background: Helping consumers to improve the nutritional quality of their diet is a key public health action to prevent cardiovascular diseases (CVDs). The modified version of the Food Standard Agency Nutrient Profiling System Dietary Index (FSAm-NPS DI) underpinning the Nutri-Score front-of-pack label has been used in public health strategies to address the deleterious consequences of poor diets. This study aimed to assess the association between the FSAm-NPS DI and some CVD risk factors including body mass index (BMI), waist circumference, plasma glucose levels, triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and diastolic and systolic blood pressure. Materials and Methods: Dietary intake was assessed at baseline and after 1 year of follow-up using a 143-item validated semi-quantitative food-frequency questionnaire. Dietary indices based on FSAm-NPS applied at an individual level were computed to characterize the diet quality of 5,921 participants aged 55-75 years with overweight/obesity and metabolic syndrome from the PREDIMED-plus cohort. Associations between the FSAm-NPS DI and CVD risk factors were assessed using linear regression models. Results: Compared to participants with a higher nutritional quality of diet (measured by a lower FSAm-NPS DI at baseline or a decrease in FSAm-NPS DI after 1 year), those participants with a lower nutritional quality of diet (higher FSAm-NPS DI or an increase in score) showed a significant increase in the levels of plasma glucose, triglycerides, diastolic blood pressure, BMI, and waist circumference (beta coefficient [95% confidence interval]; P for trend) (1.67 [0.43, 2.90]; <0.001; 6.27 [2.46, 10.09]; <0.001; 0.56 [0.08, 1.05]; 0.001; 0.51 [0.41, 0.60]; <0.001; 1.19 [0.89, 1.50]; <0.001, respectively). No significant associations in relation to changes in HDL and LDL-cholesterol nor with systolic blood pressure were shown. Conclusion: This prospective cohort study suggests that the consumption of food items with a higher FSAm-NPS DI is associated with increased levels of several major risk factors for CVD including adiposity, fasting plasma glucose, triglycerides, and diastolic blood pressure. However, results must be cautiously interpreted because no significant prospective associations were identified for critical CVD risk factors, such as HDL and LDL-cholesterol, and systolic blood pressure