Validación del Cuestionario de Evaluación de las Relaciones Familiares Básicas (CERFB)

L’objectiu d’aquesta tesi ha estat validar un nou instrument, el Qüestionari d’Avaluació de les Relacions Familiars Bàsiques (CERFB), i avaluar les seves propietats psicomètriques. El CERFB és capaç d’avaluar per un cantó, les relacions de parella i, per l’altra cantó, les relacions que tenen els pares amb el seu fill/a. Aquest qüestionari està basat en la Teoria bidimensional de les Relacions Familiars Bàsiques de Linares (1996, 2006a, 2006b, 2011, 2012). La mostra total probabilística de conveniència ha estat formada per 930 participants (451 parelles no clíniques i 28 persones amb problemes de relació de parella que sol·liciten tractament en centre privat). L’Anàlisi factorial exploratori va donar lloc a tres components que explicaven el 52,13% de la Variança. Mitjançant l’Anàlisi Factorial Confirmatori es va verificar el model bifactorial format per dos factors, Conjugalitat i Parentalitat. La fiabilitat per total de l’escala i per tots dos factors va ser molt elevada, .91, .93 i .81 respectivament. L’escala de Conjugalitat va mostrar un alt valor discriminatiu entre parelles sense problemes en la relació de parelles amb problemes, amb una Sensibilitat del 96% i Especificitat del 89%. Tan l’escala de Conjugalitat com la de Parentalitat han correlacionat amb constructes teòrics semblants demostrant la seva validesa convergent. En conclusió podem dir que el CERFB format per 25 ítems posseeix les propietats psicomètriques adients, sent un instrument vàlid i fiable per tal d’avaluar el model bidimensional de la teoria de les Relacions familiars Bàsiques. El CERF és un instrument fàcil de pasar i corretgir, sent útil en contextes clínics, socials i educatius.El objetivo de esta tesis ha sido validar un nuevo instrumento, el Cuestionario de Evaluación de las Relaciones Familiares Básicas (CERFB), y evaluar sus propiedades psicométricas. El CERFB es capaz de evaluar por un lado, las relaciones de pareja y, por el otro lado, las relaciones que tienen los padres con sus hijos/as. Este cuestionario está basado en la Teoría bidimensional de las Relaciones Familiares Básicas de Linares (1996, 2006a, 2006b). La muestra total probabilística de conveniencia ha estado formada por 930 participantes (451 parejas no clínicas y 28 personas con problemas de relación de pareja que solicitan tratamiento en centro privado). El Análisis factorial exploratorio arrojó tres componentes que explicaban el 52,13% de la Varianza. Mediante el Análisis Factorial Confirmatorio se verificó el modelo bifactorial formado por dos factores, Conyugalidad y Parentalidad. La fiabilidad para el total de la escala y para los dos factores fue muy elevada, 91, .93 y .81, respectivamente. La escala de Conyugalidad mostró un alto valor discriminante entre parejas sin problemas de relación y parejas con problemas de relación, con una Sensibilidad del 96% y una Especificidad del 89%. Tanto la escala de Conyugalidad como la de Parentalidad han correlacionado con constructos teóricos parecidos, demuestran así su validez convergente. En conclusión podemos decir que el CERFB formado por 25 ítems posee las propiedades psicométricas pertinentes siendo un instrumento válido y fiable para evaluar el modelo bidimensional de la teoría de las Relaciones familiares Básicas. El CERF es un instrumento fácil de pasar y corregir y adecuado para ser utilizado en contextos clínicos, sociales y educativos.The aim of this thesis has been to validate a new instrument, the questionnaire for the Evaluation of Basic Family Relations (CERFB), and evaluates its psychometric properties. The CERFB is able to assess on the one hand, couple relationships and also the relationships that have parents with their children. This questionnaire is based on the theory of dimensional Basic Family Relations of Linares (1996, 2006a, 2006b).The total sample probabilistic of convenience has been formed by 930 participants (451 non clinical couples and 28 people with relationship problems that seek treatment in a private center). The Factorial analysis produced three components that explained 52.13 % of the variance. The use of Confirmatory Factor Analysis verified the bifactor model formed by two factors: Dyadic Adjustment and Parenting. The reliability for the total scale and for the two factors was very high, 91, .93 and .81, respectively. The scale of Dyadic Adjustment showed a high value without discriminating between distressed and non distressed couples, with a sensitivity of 96% and a specificity of 89 %. Both the scales of Dyadic Adjustment and Parenting have been correlated with similar theoretical constructs, thus showing its convergent validity. In conclusion we can say that the CERFB formed by 25 items has the relevant psychometric properties, being a valid and reliable instrument to assess the two-dimensional model of the theory of basic family relations. The CERF is a tool easy to administrate and correct, and suitable for use in clinical social and educational settings

Normalized abundance spectra of fish community reflect hydro-peaking on a Mediterranean large river

The European Water Framework Directive requires the integration of body size characters as an important part of fish-based bioassessment tools for freshwaters ecological status determination. The study of the entire fish community size-structure provides valuable information about food web capacity, food web stability and ecological efficiency of aquatic ecosystems. One of the most used representations of community size structure is the Normalized Abundance Spectra (NAS) that provides an approximation of the total fish abundance and food web capacity (through the parameter y-intercept) and an estimation of food web efficiency (through the slope of the linear regression). In this study we explored NAS of the lower Ebro River fish community by integrating data from monthly electrofishing samplings during a whole year (November 2014- October 2015). We found that the percentage of total alien and alien-prey individuals were directly related with y-intercept and inversely related with slope of NAS. This is because the bulk of the community consists of introduced species of small body length. Furthermore, we detected significant relationships between NAS-related parameters and the hydrological variables describing diel flow oscillations and daily flow variability. Based on this, we suggest that high flow variability conditions and, above all, high hydro-peaking conditions, caused a diminution of the total abundance of fish and a decrease of the proportion of small sized fish (i.e. lower y-intercept and flatter slopes of NAS, respectively). Finally, a significant interaction between hydro-peaking and the percentage of alien-predators suggests that high hydro-peaking conditions benefit predation by facilitating predator-prey encounters. This is reflected by strong linear relationship between NAS parameters and percentage of piscivorous at high hydropeaking conditions that disappears at low hydro-peaking fluctuations. We concluded that the high proportion of alien fishes and the presence of a hydropower generation plant that operates by hydro-peaking are important factors determining fish size structure in the lower Ebro River.info:eu-repo/semantics/acceptedVersio

LTCC microflow analyzers with monolithic integration of thersmal control

Recently, the low temperature co-fired ceramics technology has shown to be an excellent alternative to silicon-based microfabrication techniques for the production of three-dimensional structures using a multi-layer approach. This enables the integration of several unitary operations of a classical analytical process and also the integration of sensors, actuators and electronics in the same substrate. In this work, we show the integration of the actuators and the sensors needed for the control of temperature inside a miniaturized fluidic device. The proposed device presents enough thermal accuracy to be used in chemical systems where temperature control is a crucial factor, such as enzyme reactions or polymerase chain reaction systems.The authors would like to thank the Spanish MEC for its financial support through: Consolider-Ingenio 2010 (CSD2006-00012), TEC2006-13907-C04-04/MIC and CIT-310200-2007-29. CSM is also thankful to the Alban Program (High-level grants from the European Union to Latin America for its financial support (Grant number: E05D053315MX)

An estimation of the social cost of illicit drug consumption in Catalonia

Drogas ilegales; Coste de la enfermedad; Costes sociales; Planes nacionalesDrogues il·legals; Cost de la malaltia; Costos socials; Plans nacionalsIllegal drugs; Cost of illness; Social costs; National plansWorldwide, as well as in Spain, the use of illegal drugs is among the major contributors to the global burden of disease. Quantifying the costs that illegal drugs impose on society is key in terms of decision-making. The objective of this paper is to estimate the social cost of illicit drug consumption in Catalonia for a specific year, and to establish a methodology to be able to replicate such estimations regularly and monitor properly the impact of national plans. To do that, a cost of illness study was performed. For the estimation of mortality and morbidity costs, we relied on the Attributable Fraction approach. Only public sector costs were included: healthcare and non-healthcare costs. The cost of illegal drug consumption in Catalonia in 2011 was estimated at €326.39 million (0.16% of the Catalan GDP in 2011; 0.15% in 2018). Of the total cost, 82% corresponded to direct costs. Among direct costs, 30.32% corresponded to the penal system, 15.99% to hospitalizations, 13.48% to the police force, 17.19% to pharmacy, 8.34% to treatment in specialized centres, and 5.74% to therapeutic communities, among others. Indirect costs represented 18% of total costs, mostly lost income due to drug-related death. This study has been an opportunity to systematically collect data and think about the potential economic returns that could be achieved from effective policies and programs aimed at reducing the consumption of illegal drugs.Mundialmente, así como en España, el consumo de drogas ilegales es uno los principales contribuyentes a la carga mundial de morbilidad. Cuantificar los costes que las drogas ilegales imponen a la sociedad es clave para la toma de decisiones. El objetivo de este trabajo es estimar el coste social del consumo de drogas ilegales en Cataluña para un año específico y establecer una metodología para poder replicar dichas estimaciones regularmente y monitorear el impacto de los planes nacionales. Se ha realizado un estudio de coste de la enfermedad. Para la estimación de los costes de mortalidad y morbilidad se ha utilizado el enfoque de la fracción atribuible. Solo se incluyeron los costes del sector público, sanitarios y no sanitarios. El coste del consumo de drogas ilegales en Cataluña en 2011 se estimó en € 326,39 millones (0,16 % del PIB catalán en 2011; 0,15 % en 2018). El 82 % del coste total correspondió a costes directos; de estos, el 30,32 % correspondió al sistema penal, 15,99 % a hospitalizaciones, 13,48 % a la policía, 17,19 % a farmacia, 8,34 % a tratamiento en centros especializados y 5,74 % a comunidades terapéuticas, entre otros. Los costes indirectos representaron el 18 % de los costes totales, principalmente pérdidas de productividad debidas a muertes por el consumo de drogas. Este estudio ha sido una oportunidad para recopilar datos de forma sistemática y pensar en los posibles rendimientos económicos que podrían obtenerse de políticas y programas efectivos destinados a reducir el consumo de drogas ilegales

Protocol de diagnòstic i tractament del virus de l’hepatitis C per persones drogodependents

Hepatitis C; Drogodependents; Tractament; DiagnòsticHepatitis C; Drogodependientes; Tratamiento; DiagnósticoHepatitis C; Drug addicts; Treatment; DiagnosisProtocol operatiu de coordinació i atenció integrada entre els centres d’atenció i seguiment (CAS) que fan atenció ambulatòria a les drogodependències, i els serveis hospitalaris encarregats del tractament de la infecció i de la patologia hepàtica pel VHC (serveis de patologia digestiva, unitat d’hepatologia, medicina interna i malalties infeccioses)

Protocol de diagnòstic i tractament del virus de l’hepatitis C per persones drogodependents

Hepatitis C; Drogodependents; Tractament; DiagnòsticHepatitis C; Drogodependientes; Tratamiento; DiagnósticoHepatitis C; Drug addicts; Treatment; DiagnosisProtocol operatiu de coordinació i atenció integrada entre els centres d’atenció i seguiment (CAS) que fan atenció ambulatòria a les drogodependències, i els serveis hospitalaris encarregats del tractament de la infecció i de la patologia hepàtica pel VHC (serveis de patologia digestiva, unitat d’hepatologia, medicina interna i malalties infeccioses)

Relaciones familiares básicas en familias con un hijo con trastorno de la conducta alimentaria

The aim of this study is to get to know and describe the Basic Famil yRelations, marital and parental functions, in families with a child with an eating disorder and control group families, as well as determine the discriminative cut-off points of the Basic Family Relations Inventory (BFRI) between them.The BFRI was applied to 688 participants of whom 338 (169 families) formed the clinical group and 350 (175 families) the control group. Results presented statistically significant differences in the scores of marital and parental functions between clinical and control families, being the valuation of both functions lower in the clinical group regarding the control group. In turn, the discriminative cut-off points of 55 for marital functions and 42 for parental functions were obtained between both groups of families. These results suggest that more work is still to be done to improve the BFRI’s empirical evaluative and discriminative capacity of the Basic Family Relations in families with a child with an eating disorder and control families as a relational diagnosis tool are discussed.El objetivo de este estudio es conocer y describir las Relaciones Familiares Básicas, Conyugalidad y Parentalidad, de las familias con un hijo con trastorno de la conducta alimentaria (TCA) y familias grupo control, así como determinar los puntos de corte del Cuestionario de Evaluación de las Relaciones Familiares Básicas (CERFB) discriminativos entre ellas. Se administró el CERFB a 688 participantes de los cuales 338 (169 familias) formaron el grupo clínico y 350 (175 familias) el grupo control. Los resultados presentaron diferencias estadísticamente significativas en las puntuaciones de Conyugalidad y Parentalidad entre las familias clínicas y control, siendo la valoración de ambas funciones menor por parte del grupo clínico en relación al grupo control. A su vez, se obtuvieron los puntos de corte discriminativos de 55 para Conyugalidad y de 42 para Parentalidad entre los dos grupos de familias. Se discuten estos resultados que apuntan que hay que seguir trabajando para mejorar la capacidad empírica del CERFB de evaluación y discriminación de las Relaciones Familiares Básicas de las familias con un hijo con TCA y familias control como instrumento de diagnóstico relacional

Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

Introduction The effectiveness of colorectal cancer (CRC) screening programs is directly related to participation and the number of interval CRCs. The objective was to analyse specific-mortality in a cohort of individuals invited to a CRC screening program according to type of CRC diagnosis (screen-detected cancers, interval cancers, and cancers among the non-uptake group). Material and methods Retrospective cohort that included invitees aged 50-69 years of a CRC screening program (target population of 85,000 people) in Catalonia (Spain) from 2000-2015 with mortality follow-up until 2020. A screen-detected CRC was a cancer diagnosed after a positive faecal occult blood test (guaiac or immunochemical); an interval cancer was a cancer diagnosed after a negative test result and before the next invitation to the program (<= 24 months); a non-uptake cancer was a cancer in subjects who declined screening. Results A total of 624 people were diagnosed with CRC (n = 265 screen-detected, n = 103 interval cancers, n = 256 non-uptake). In the multivariate analysis, we observed a 74% increase in mortality rate in the group with interval CRC compared to screen-detected CRC adjusted for age, sex, location and stage (HR: 1.74%, 95% CI:1.08-2.82, P = 0.02). These differences were found even when we restricted for advanced-cancers participants. In the stratified analysis for type of faecal occult blood test, a lower mortality rate was only observed among FIT screen-detected CRCs. Conclusion CRC screening with the FIT was associated with a significant reduction in CRC mortality

Diagnostic Performance of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program According to Ambient Temperature and Humidity

Hemoglobin degradation can be affected by ambient temperature and humidity. How this modifies the advanced neoplasia detection rate and interval cancer rate remains understudied. We conducted a retrospective study and analyzed the impact of ambient temperature and humidity on the fecal immunochemical test (FIT) positivity rate, detection rate for advanced neoplasia, and interval colorectal cancer (CRC). The results of our study indicated that at >24 degrees C, the positivity rate was lower, whereas the detection rate of the FIT for advanced neoplasia and the interval cancer detection rate were not affected, probably because we have adopted measures to minimize the impact of ambient temperature on FIT sensitivity. Humidity did not affect FIT sensitivity. The results emphasize the importance of organizational efforts on the procedures along the screening process (such as the cold chain) to minimize the effect of seasonal variations in temperature on the positivity rate. Exposure of the fecal immunochemical test (FIT) to different ambient temperatures and humidity is unavoidable in population-based screening programs in Southern European countries, and it could lead to a decrease in target colorectal lesions. The objective was to evaluate the effect of ambient temperature and humidity on the FIT sensitivity in a population-based screening program for colorectal cancer (CRC) using an ecological design. The retrospective cohort included individuals aged 50-69 years who participated in CRC screening (Barcelona) from 2010-2015, and were followed until 2017 to identify interval CRCs. The positivity rate, and detection rates for advanced polyps and CRC were compared according to ambient temperature, humidity, and quarters of the year. A positive FIT was defined as the detection of >= 20 mu g Hb/g in feces. The monthly ambient temperature and humidity were recorded on the day that the FIT was performed. In total, 92,273 FIT results from 53,860 participants were analyzed. The FIT positivity rate was lower at >24 degrees C than at <= 24 degrees C (p = 0.005) but was not affected by humidity. The temperature's impact on positivity did not lead to a decrease in the FIT detection rate for advanced neoplasia or the interval cancer detection rate in a program where the samples were refrigerated until the analysis and screening invitations were discontinued in July and August

Protocol de la prova de detecció ràpida del VHC per a HSH i persones trans

Virus de l’hepatitis C; HSH; Persones trans; Cribatge comunitariVirus de la hepatitis C; HSH; Personas trans; Cribado comunitarioHepatitis C virus; MSM; Trans people; Community screeningL'objectiu d'aquest protocol és crear un programa de cribratge comunitari del VHC per a HSH i persones trans no infectats pel VIH que tenen pràctiques de risc i/o utilitzen la PrEP