Participative Management And Educational Quality In The Context Of Plan Colombia Institutional Improvement In Schools

The purpose is to understand the meanings that educational actors of the Magdalena - Colombia, assign to the Plan of Institutional Improvement; Instrument where the macro, meso and micro of the educational policy converge, considering Participatory Management and Educational Quality. From a qualitative approach, a sociocritical paradigm, processes of reflection, analysis, understanding and conferring meanings are generated, through the formation of focus groups (managers, teachers, students, parents). The results show gaps between the normative and the operationalization of the plan; we conclude on the need for a strategic culture of participation for decision making as the basis of school management..El propósito es comprender los significados que actores educativos del Magdalena – Colombia, asignan al Plan de Mejoramiento Institucional; instrumento donde confluyen lo macro, meso y micro de la política educativa, considerando la Gestión Participativa y Calidad Educativa. Desde un enfoque cualitativo, paradigma sociocrítico, se generan procesos de reflexión, análisis, comprensión y conferimiento de significados, mediante la conformación de grupos focales (directivos, docentes, estudiantes, padres). Los resultados evidencian brechas entre lo normativo y la operacionalización del plan; se concluye en, la necesidad de una cultura estratégica de participación para la toma de decisiones como fundamento de la gestión escola

Prevalence of Intestinal Coccidia: First Description of Cyclosporidiosis Associated with Diarrhea in Children in Colombia

Background: In Colombia, the studies about the etiology of acute diarrhea disease (ADD) in children by using standard stool culture techniques methods and DNA detection tools for intestinal virus show that viral origin was the most frequent, however still between 16 to 45% of the cases of unknown etiology. Specific staining techniques or high sensitivity molecular methods for the intestinal coccidia Cryptosporidium sp and Cyclospora sp have been not applied in the Colombian studies, for this reason, the current situation of these intestinal coccidia in Colombia as cause of diarrhea is unknown.  Objective: To estimate the frequency of Cryptosporidium sp. and Cyclospora sp. and to analyze the association between infection and clinical manifestations on children with acute diarrhea consulting the pediatrics emergency service of a third level Hospital. Methods:  An observational descriptive study was performed in 150 children that consulted the emergency service at the Hospital San Juan de Dios in Armenia, Colombia, in the period between April 1st and May 31st of 2022. We applied questionnaires and collected primary data from clinical records of children, as well as stool samples of each child after receiving informed consent from the parents and/or legal guardian of the minors. To identify the pathogenic intestinal coccidia (Cryptosporidium sp. and Cyclospora sp.), we used stool fresh preparations with 1% iodine and stained by a modified Ziehl Nielsen coloration protocol (Kinyoun stain). Samples were examined by expert microbiologists on a light microscope with a 40x objective. Prevalence and odds ratios were estimated. For statistical analysis differences in proportions among groups were compared via the X2 test and Fisher exact test. For non-parametric data, differences of means between two groups were analyzed through a Kruskall-Wallis test. Differences of medians were analyzed via Kruskal-Wallis test for non-parametric variables and analysis of variance (ANOVA) for parametric variables; statistical significance was considered when p ≤ 0.05. Statistical calculations were made by using software factors in Epi Info 7.2 Epi-Info version 3.5.1 (CDC, Atlanta).  Results: The prevalence of infection in the children that went to the urgency service was of 19,7% by Cryptosporidium sp. and 10,9% by Cyclospora sp. The 59,2% of children with cryptosporidiosis and 66,6% of children with cyclosporidiosis were hospitalized. There was a statistically significant association between the presence of parasite in stools and fever in cyclosporidiosis (93,3% of children with cyclosporidiosis vs. 56% by other causes, OR 10,7 IC95% 1,3-84; p= 0,004).  Conclusions: The study results indicate the need to use specific diagnostic techniques to identify Cryptosporidium sp and Cyclospora sp in children with diarrhea, because they are frequent and are treatable with specific antiparasitic medication. We recommend that its search should be done systematically

Lifestyle in undergraduate students and demographically matched controls during the covid-19 pandemic in Spain

Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 +- 8.1 vs. 77.2 +- 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles

Predictors of adherence to a Mediterranean-type diet in the PREDIMED trial.

BACKGROUND: Determinants of dietary changes obtained with a nutritional intervention promoting the Mediterranean diet have been rarely evaluated. AIM: To identify predictors of higher success of an intervention aimed to increase adherence to a Mediterranean diet (MeDiet) in individuals at high cardiovascular risk participating in a trial for primary prevention of cardiovascular disease: the PREDIMED (PREvención con DIeta MEDiterránea) trial. Candidate predictors included demographic and socioeconomic characteristics, cardiovascular risk factors, and baseline dietary habits. METHODS: A total of 1,048 asymptomatic subjects aged 55-80 years allocated to the active intervention groups (subjects in the control group were excluded). Participants' characteristics were assessed at baseline among subjects. Dietary changes were evaluated after 12 months. Main outcome measures were: attained changes in five dietary goals: increases in (1) fruit consumption, (2) vegetable consumption, (3) monounsaturated fatty acid (MUFA)/saturated fatty acid (SFA) ratio, and decreases in (4) sweets and pastries consumption, (5) and meat consumption. Univariate and multivariate logistic regression analyses were used to examine associations between the candidate predictors and likelihood of attaining optimum dietary change (improved adherence to a MeDiet). RESULTS: Among men, positive changes toward better compliance with the MeDiet were more frequent among non-diabetics, and among those with worse dietary habits at baseline (higher consumption of meat, higher SFA intake, lower consumption of fruit and vegetables). Among women, marital status (married) and worse baseline dietary habits (high in meats, low in fruits and vegetables) were the strongest predictors of success in improving adherence to the MeDiet. CONCLUSIONS: Some participant characteristics (marital status and baseline dietary habits) could contribute to predicting the likelihood of achieving dietary goals in interventions aimed to improve adherence to a MeDiet, and may be useful for promoting individualized long-term dietary changes and improving the effectiveness of dietary counseling

The adjusted global antiphospholipid syndrome score (aGAPSS) and the risk of recurrent thrombosis: Results from the APS ACTION cohort

Objectives: To assess whether patients with antiphospholipid syndrome (APS) and history of recurrent thrombosis have higher levels of adjusted Global AntiphosPholipid Syndrome Score (aGAPSS) when compared to patients without recurrent thrombosis. Methods: In this cross-sectional study of antiphospholipid antibody (aPL)-positive patients, we identified APS patients with a history of documented thrombosis from the AntiPhospholipid Syndrome Alliance For Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (“Registry”). Data on aPL-related medical history and cardiovascular risk factors were retrospectively collected. The aGAPSS was calculated at Registry entry by adding the points corresponding to the risk factors: three for hyperlipidemia, one for arterial hypertension, five for positive anticardiolipin antibodies, four for positive anti-β2 glycoprotein-I antibodies and four for positive lupus anticoagulant test. Results: The analysis included 379 APS patients who presented with arterial and/or venous thrombosis. Overall, significantly higher aGAPSS were seen in patients with recurrent thrombosis (arterial or venous) compared to those without recurrence (7.8 ± 3.3 vs. 6 ± 3.9, p<0.05). When analyzed based on the site of the recurrence, patients with recurrent arterial, but not venous, thrombosis had higher aGAPSS (8.1 ± SD 2.9 vs. 6 ± 3.9; p<0.05). Conclusions: Based on analysis of our international large-scale Registry of aPL-positive patients, the aGAPSS might help risk stratifying patients based on the likelihood of developing recurrent thrombosis in APS

Gene co-expression architecture in peripheral blood in a cohort of remitted first-episode schizophrenia patients

A better understanding of schizophrenia subtypes is necessary to stratify the patients according to clinical attributes. To explore the genomic architecture of schizophrenia symptomatology, we analyzed blood co-expression modules and their association with clinical data from patients in remission after a first episode of schizophrenia. In total, 91 participants of the 2EPS project were included. Gene expression was assessed using the Clariom S Human Array. Weighted-gene co-expression network analysis (WGCNA) was applied to identify modules of co-expressed genes and to test its correlation with global functioning, clinical symptomatology, and premorbid adjustment. Among the 25 modules identified, six modules were significantly correlated with clinical data. These modules could be clustered in two groups according to their correlation with clinical data. Hub genes in each group showing overlap with risk genes for schizophrenia were enriched in biological processes related to metabolic processes, regulation of gene expression, cellular localization and protein transport, immune processes, and neurotrophin pathways. Our results indicate that modules with significant associations with clinical data showed overlap with gene sets previously identified in differential gene-expression analysis in brain, indicating that peripheral tissues could reveal pathogenic mechanisms. Hub genes involved in these modules revealed multiple signaling pathways previously related to schizophrenia, which may represent the complex interplay in the pathological mechanisms behind the disease. These genes could represent potential targets for the development of peripheral biomarkers underlying illness traits in clinical remission stages after a first episode of schizophrenia

The polygenic basis of relapse after a first episode of schizophrenia

Little is known about genetic predisposition to relapse. Previous studies have linked cognitive and psychopathological (mainly schizophrenia and bipolar disorder) polygenic risk scores (PRS) with clinical manifestations of the disease. This study aims to explore the potential role of PRS from major mental disorders and cognition on schizophrenia relapse. 114 patients recruited in the 2EPs Project were included (56 patients who had not experienced relapse after 3 years of enrollment and 58 patients who relapsed during the 3-year follow-up). PRS for schizophrenia (PRS-SZ), bipolar disorder (PRS-BD), education attainment (PRS-EA) and cognitive performance (PRS-CP) were used to assess the genetic risk of schizophrenia relapse.Patients with higher PRS-EA, showed both a lower risk (OR=0.29, 95% CI [0.11–0.73]) and a later onset of relapse (30.96± 1.74 vs. 23.12± 1.14 months, p=0.007. Our study provides evidence that the genetic burden of neurocognitive function is a potentially predictors of relapse that could be incorporated into future risk prediction models. Moreover, appropriate treatments for cognitive symptoms appear to be important for improving the long-term clinical outcome of relapse

Spanish cohort of VEXAS syndrome : clinical manifestations, outcome of treatments and novel evidences about UBA1 mosaicism

The vacuoles, E1-enzyme, X linked, autoinflammatory and somatic (VEXAS) syndrome is an adult-onset autoinflammatory disease (AID) due to postzygotic UBA1 variants. To investigate the presence of VEXAS syndrome among patients with adult-onset undiagnosed AID. Additional studies evaluated the mosaicism distribution and the circulating cytokines. Gene analyses were performed by both Sanger and amplicon-based deep sequencing. Patients' data were collected from their medical charts. Cytokines were quantified by Luminex. Genetic analyses of enrolled patients (n=42) identified 30 patients carrying UBA1 pathogenic variants, with frequencies compatible for postzygotic variants. All patients were male individuals who presented with a late-onset disease (mean 67.5 years; median 67.0 years) characterised by cutaneous lesions (90%), fever (66.7%), pulmonary manifestations (66.7%) and arthritis (53.3%). Macrocytic anaemia and increased erythrocyte sedimentation rate and ferritin were the most relevant analytical abnormalities. Glucocorticoids ameliorated the inflammatory manifestations, but most patients became glucocorticoid-dependent. Positive responses were obtained when targeting the haematopoietic component of the disease with either decitabine or allogeneic haematopoietic stem cell transplantation. Additional analyses detected the UBA1 variants in both haematopoietic and non-haematopoietic tissues. Finally, analysis of circulating cytokines did not identify inflammatory mediators of the disease. Thirty patients with adult-onset AID were definitively diagnosed with VEXAS syndrome through genetic analyses. Despite minor interindividual differences, their main characteristics were in concordance with previous reports. We detected for the first time the UBA1 mosaicism in non-haematopoietic tissue, which questions the previous concept of myeloid-restricted mosaicism and may have conceptual consequences for the disease mechanisms