Applying a positive behaviour support plan in school context

El Plan de Apoyo Conductual Positivo es una práctica basada en la evidencia que tras mostrar su eficacia para tratar conductas desafiantes en el ámbito de la discapacidad se está empezando a aplicar con éxito en los colegios de educación regular para responder a las necesidades asociadas a la conducta. El objetivo de este estudio es describir el proceso por el que se empieza a implantar este tipo de intervención proactiva en un Colegio de Educación Infantil y Primaria (CEIP) mediante un programa de formación de carácter teórico-práctico dirigido a once profesores de ese CEIP, y analizar los efectos que el programa tiene sobre la conducta y el clima social de sus aulas. Se encontraron diferencias estadísticamente significativas entre las puntuaciones obtenidas antes y después del programa en el Test de Alteración de la Conducta en la Escuela (Arias, Ayuso, Gil y González, 2006), la adaptación del Inventario de conductas en clase (Curwin y Mendler, 1983) realizada por Fernández (1998), y una adaptación de la escala para evaluar el clima social del aula (Pérez, Ramos y López, 2009). Se contrastan los resultados con los obtenidos con métodos cualitativos y se describe el proceso por el que el profesorado va transformando sus creencias y comienza a aplicar en su aula las estrategias que conducen a la creación de una escuela positiva.Positive Behavior Support Planning is an evidence based practice which, after showing its efficiency to deal with challenging behaviors in the disability world, is beginning to be applied with success in regular schools to respond to the needs associated with behaviour. The aim of this study is to describe the process through which this kind of proactive intervention is applied in an Infant and Primary Education School (IPES) with a theoretical and practical training directed to eleven teachers of that IPES, and to analyze the effects that the program has on behaviour and classroom social climate. Significant statistical differences were found between the scores obtained before and after applying the program in the Test of Challenging Behaviors in the School (Arias, Ayuso, Gil y González, 2006), the adaptation of the Inventory of behaviors in the Classroom (Curwin y Mendler, 1983) made by Fernández (1998), and an adaptation of a Scate to Evaluate Social Climate in the Classroom (Pérez, Ramos y López, 2009). Results are contrasted with those obtained with qualitative methods, and the process by which teachers keep on changing their beliefs and begin to apply in their classrooms the strategies leading to create a positive school is described

Cross-phenotype analysis of Immunochip data identifies KDM4C as a relevant locus for the development of systemic vasculitis.

OBJETIVE: Systemic vasculitides represent a heterogeneous group of rare complex diseases of the blood vessels with a poorly understood aetiology. To investigate the shared genetic component underlying their predisposition, we performed the first cross-phenotype meta-analysis of genetic data from different clinically distinct patterns of vasculitis. METHODS: Immunochip genotyping data from 2465 patients diagnosed with giant cell arteritis, Takayasu's arteritis, antineutrophil cytoplasmic antibody-associated vasculitis or IgA vasculitis as well as 4632 unaffected controls were analysed to identify common susceptibility loci for vasculitis development. The possible functional consequences of the associated variants were interrogated using publicly available annotation data. RESULTS: The strongest association signal corresponded with an intergenic polymorphism located between HLA-DQB1 and HLA-DQA2 (rs6932517, P=4.16E-14, OR=0.74). This single nucleotide polymorphism is in moderate linkage disequilibrium with the disease-specific human leucocyte antigen (HLA) class II associations of each type of vasculitis and could mark them. Outside the HLA region, we identified the KDM4C gene as a common risk locus for vasculitides (highest peak rs16925200, P=6.23E-07, OR=1.75). This gene encodes a histone demethylase involved in the epigenetic control of gene expression. CONCLUSIONS: Through a combined analysis of Immunochip data, we have identified KDM4C as a new risk gene shared between systemic vasculitides, consistent with the increasing evidences of the crucial role that the epigenetic mechanisms have in the development of complex immune-mediated conditions

Effect of Influenza Vaccination Inducing Antibody Mediated Rejection in Solid Organ Transplant Recipients

Introduction: Our goal was to study whether influenza vaccination induced antibody mediated rejection in a large cohort of solid organ transplant recipients (SOTR). Methods: Serum anti-Human Leukocyte Antigen (HLA) antibodies were determined using class I and class II antibody-coated latex beads (FlowPRATM Screening Test) by flow cytometry. Anti-HLA antibody specificity was determined using the single-antigen bead flow cytometry (SAFC) assay and assignation of donor specific antibodies (DSA) was performed by virtual-crossmatch. Results: We studied a cohort of 490 SOTR that received an influenza vaccination from 2009 to 2013: 110 (22.4%) received the pandemic adjuvanted vaccine, 59 (12%) within the first 6 months post-transplantation, 185 (37.7%) more than 6 months after transplantation and 136 (27.7%) received two vaccination doses. Overall, no differences of anti-HLA antibodies were found after immunization in patients that received the adjuvanted vaccine, within the first 6 months post-transplantation, or based on the type of organ transplanted. However, the second immunization dose increased the percentage of patients positive for anti-HLA class I significantly compared with patients with one dose (14.6% vs. 3.8%; P = 0.003). Patients with pre-existing antibodies before vaccination (15.7% for anti-HLA class I and 15.9% for class II) did not increase reactivity after immunization. A group of 75 (14.4%) patients developed de novo anti-HLA antibodies, however, only 5 (1.02%) of them were DSA, and none experienced allograft rejection. Only two (0.4%) patients were diagnosed with graft rejection with favorable outcomes and neither of them developed DSA. Conclusion: Our results suggest that influenza vaccination is not associated with graft rejection in this cohort of SOTR.This study was funded by the Consejería de Salud (Grant Number: PI-0119-2012), Ministerio de Economía y Competitividad, Instituto de Salud Carlos III (Grant Numbers: GR09/0041, PI14-00165, and MPY110/18) and co-financed by European Development Regional Fund “A way to achieve Europe” ERDF, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015/0001)

Diseño e implantación de estrategias docentes activas para facilitar la adquisisción de competencias en la enseñanza presencial y virtual

Memoria ID-2013. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2013-2014

Association of HLA-B*41:02 with Henoch-Schönlein Purpura (IgA Vasculitis) in Spanish individuals irrespective of the HLA-DRB1 status

INTRODUCTION: A study was conducted to determine whether the human leukocyte antigen (HLA) B alleles are implicated in the susceptibility to Henoch-Schönlein purpura (HSP) in the largest series of Caucasian HSP patients ever assessed for genetic studies. METHODS: The study population was composed of 349 Spanish patients diagnosed with HSP fulfilling the American College of Rheumatology and the Michel et al. classification criteria, and 335 sex and ethnically matched controls. HLA-B phenotypes were determined by sequencing-based typing (SBT) and analyzed by chi-square or Fisher exact test. RESULTS: A statistically significant increase of HLA-B*41:02 allele in HSP patients when compared with controls was found (8.3% versus 1.5% respectively; P = 0.0001; OR (odds ratio) =5.76 [2.15-19.3]). These results remained statistically significant after adjusting for Bonferroni correction (P = 0.0028). An internal validation also confirmed the susceptibility effect on HSP associated with HLA-B*41:02 (OR = 5.70 [1.98-16.44]). Since a former study described an association between HLA-DRB1*01:03 and HSP susceptibility, we also evaluated the implication of HLA-B*41:02 independently of HLA-DRB1*01:03. Interestingly, the association remained statistically significant (P = 0.0004, OR = 4.97 [1.8-16.9]). No HLA-B association with specific HSP clinical features was found. CONCLUSIONS: Our study indicates that HLA-B*41:02 is associated with the susceptibility to HSP in Spanish patients irrespective of HLA-DRB1 status.This study was supported by a grant from ‘Fondo de Investigaciones Sanitarias’ PI12/00193 (Spain). RLM is a recipient of a Sara Borrell postdoctoral fellowship from the Instituto de Salud Carlos III at the Spanish Ministry of Health (Spain) (CD12/00425). FG and BU are supported by funds from the RETICS Program (RIER) (RD12/0009/0013).Ye

Factors associated with the humoral response after three doses of COVID-19 vaccination in kidney transplant recipients

[Introduction] Kidney transplant recipients showed a weak humoral response to the mRNA COVID-19 vaccine despite receiving three cumulative doses of the vaccine. New approaches are still needed to raise protective immunity conferred by the vaccine administration within this group of high-risk patients.[Methods] To analyze the humoral response and identify any predictive factors within these patients, we designed a prospective monocentric longitudinal study of Kidney transplant recipients (KTR) who received three doses of mRNA-1273 COVID-19 vaccine. Specific antibody levels were measured by chemiluminescence. Parameters related to clinical status such as kidney function, immunosuppressive therapy, inflammatory status and thymic function were analyzed as potential predictors of the humoral response.[Results] Seventy-four KTR and sixteen healthy controls were included. One month after the administration of the third dose of the COVID-19 vaccine, 64.8% of KTR showed a positive humoral response. As predictive factors of seroconversion and specific antibody titer, we found that immunosuppressive therapy, worse kidney function, higher inflammatory status and age were related to a lower response in KTR while immune cell counts, thymosin-a1 plasma concentration and thymic output were related to a higher humoral response. Furthermore, baseline thymosin-a1 concentration was independently associated with the seroconversion after three vaccine doses.[Discussion] In addition to the immunosuppression therapy, condition of kidney function and age before vaccination, specific immune factors could also be relevant in light of optimization of the COVID-19 vaccination protocol in KTR. Therefore, thymosin-a1, an immunomodulatory hormone, deserves further research as a potential adjuvant for the next vaccine boosters.This study was supported by a grant from the Fondo de Investigación Sanitaria (FIS/PI21/00357), which is co-founded by Fondos Europeos para el Desarrollo Regional (FEDER) “Una manera de hacer Europa”. VG-R, IO-M and AB-R were supported by Instituto de Salud Carlos III (CD19/00143, FI19/00298 and CM19/00051, respectively). MP-B was supported by the Consejería de Transformación Económica, Industria, Conocimiento y Universidades [DOC_01646 to MP-B] and YP was supported by the Consejería de Salud y Familias of Junta de Andalucía through the “Nicolás Monardes” [RC-0006-2021].Peer reviewe

La aplicación de un plan de apoyo conductual positivo en el contexto escolar

ABSTRACTPositive Behavior Support Planning is an evidence based practice which, after showing its efficiency to deal with challenging behaviors in the disability world, is beginning to be applied with success in regular schools to respond to the needs associated with behaviour. The aim of this study is to describe the process through which this kind of proactive intervention is applied in an Infant and Primary Education School (IPES) with a theoretical and practical training directed to eleven teachers of that IPES, and to analyze the effects that the program has on behaviour and classroom social climate. Significant statistical differences were found between the scores obtained before and after applying the program in the Test of Challenging Behaviors in the School (Arias, Ayuso, Gil y González, 2006), the adaptation of the Inventory of behaviors in the Classroom (Curwin y Mendler, 1983) made by Fernández (1998), and an adaptation of a Scate to Evaluate Social Climate in the Classroom (Pérez, Ramos y López, 2009). Results are contrasted with those obtained with qualitative methods, and the process by which teachers keep on changing their beliefs and begin to apply in their classrooms the strategies leading to create a positive school is described.RESUMENEl Plan de Apoyo Conductual Positivo es una práctica basada en la evidencia que tras mostrar su eficacia para tratar conductas desafiantes en el ámbito de la discapacidad se está empezando a aplicar con éxito en los colegios de educación regular para responder a las necesidades asociadas a la conducta. El objetivo de este estudio es describir el proceso por el que se empieza a implantar este tipo de intervención proactiva en un Colegio de Educación Infantil y Primaria (CEIP) mediante un programa de formación de carácter teórico-práctico dirigido a once profesores de ese CEIP, y analizar los efectos que el programa tiene sobre la conducta y el clima social de sus aulas. Se encontraron diferencias estadísticamente significativas entre las puntuaciones obtenidas antes y después del programa en el Test de Alteración de la Conducta en la Escuela (Arias, Ayuso, Gil y González, 2006), la adaptación del Inventario de conductas en clase (Curwin y Mendler, 1983) realizada por Fernández (1998), y una adaptación de la escala para evaluar el clima social del aula (Pérez, Ramos y López, 2009). Se contrastan los resultados con los obtenidos con métodos cualitativos y se describe el proceso por el que el profesorado va transformando sus creencias y comienza a aplicar en su aula las estrategias que conducen a la creación de una escuela positiva.ABSTRACTPositive Behavior Support Planning is an evidence based practice which, after showing its efficiency to deal with challenging behaviors in the disability world, is beginning to be applied with success in regular schools to respond to the needs associated with behaviour. The aim of this study is to describe the process through which this kind of proactive intervention is applied in an Infant and Primary Education School (IPES) with a theoretical and practical training directed to eleven teachers of that IPES, and to analyze the effects that the program has on behaviour and classroom social climate. Significant statistical differences were found between the scores obtained before and after applying the program in the Test of Challenging Behaviors in the School (Arias, Ayuso, Gil y González, 2006), the adaptation of the Inventory of behaviors in the Classroom (Curwin y Mendler, 1983) made by Fernández (1998), and an adaptation of a Scate to Evaluate Social Climate in the Classroom (Pérez, Ramos y López, 2009). Results are contrasted with those obtained with qualitative methods, and the process by which teachers keep on changing their beliefs and begin to apply in their classrooms the strategies leading to create a positive school is described

Association of Functional Polymorphisms of KIR3DL1/DS1 With Behçet's Disease

Behçet's disease (BD) is an immune-mediated vasculitis related to imbalances between the innate and adaptive immune response. Infectious agents or environmental factors may trigger the disease in genetically predisposed individuals. HLA-B51 is the genetic factor stronger associated with the disease, although the bases of this association remain elusive. NK cells have also been implicated in the etiopathogenesis of BD. A family of NK receptors, Killer-cell Immunoglobulin-like Receptor (KIR), with a very complex organization, is very important in the education and control of the NK cells by the union to their ligands, most of them, HLA class I molecules. This study aimed to investigate the contribution of certain KIR functional polymorphisms to the susceptibility to BD. A total of 466 BD patients and 444 healthy individuals were genotyped in HLA class I (A, B, and C). The set of KIR genes and the functional variants of KIR3DL1/DS1 and KIR2DS4 were also determined. Frequency of KIR3DL1004 was lower in patients than in controls (0.15 vs. 0.20, P = 0.005, Pc = 0.015; OR = 0.70; 95% CI 0.54-0.90) in both B51 positive and negative individuals. KIR3DL1004, which encodes a misfolded protein, is included in a common telomeric haplotype with only one functional KIR gene, KIR3DL2. Both, KIR3DL1 and KIR3DL2 sense pathogen-associated molecular patterns but they have different capacities to eliminate them. The education of the NK cells depending on the HLA, the balance of KIR3DL1/KIR3DL2 licensed NK cells and the different capacities of these receptors to eliminate pathogens could be involved in the etiopathogenesis of BD