Validación Transcultural de la Entrevista de Apego para Niños (EAN) en Población Infantil Mexicana

El apego es el primer organizador de la personalidad. Un apego seguro se relaciona con un desarrollo adecuado y una buena salud mental, mientras que un apego inseguro puede expresarse como un retraimiento en la relación con los demás, una afectación al desarrollo, emociones confusas y rechazo. El objetivo del presente estudio fue realizar la validación transcultural de la Entrevista de Apego para Niños (EAN) (Sierra, Carrasco y Moya, 2018) en niños mexicanos. La EAN evalúa el modelo de representación de apego en niños de 3 a 12 años mediante la estrategia de completamiento de historias, enmarcada en una aproximación contextualizada y dimensional. La EAN presenta una estructura interna y multidimensional compuesta por 4 factores referidos a la reacción positiva y negativa del niño (Reacción Positiva del Niño, Reacción Confiada del Niño, Reacción Negativa del Niño y Reacción Desconfiada del Niño) y 5 factores relacionados con la interacción entre el niño y su figura de apego (Interacción Empática, Interacción Confiada, Interacción Positiva, Interacción Negativa e Interacción Desconfiada). Participaron en el estudio 124 niños y niñas españoles y 95 mexicanos, todos de entre 3 y 12 años y procedentes de población normativa y de contextos en situación de riesgo psicosocial. El riesgo psicosocial puede definirse como aquellos entornos o contextos de desarrollo en los que, por sus características estructurales o funcionales, son potencialmente capaces de influir negativamente en el desarrollo psicológico del niño. La validación se ha realizado mediante la obtención de evidencias de fiabilidad y validez en las diferentes muestras del estudio.Grupo de Investigación AnálisisIntervención y Terapia Aplicada con Niños y AdolescentesAITANA Universidad Miguel Hernández2022-2

Practice education for university student

Se pretende con el proyecto avanzar en el conocimiento de la naturaleza de la formación práctica de los estudiantes universitarios con la finalidad de hacer propuestas operativas que mejoren la calidad de los programas de prácticum que se desarrollan en las universidades. La sociedad española está cada vez más convencida de que la capacitación de profesionales de nivel superior para un mercado productivo exigente es uno de los objetivos principales de la enseñanza universitaria y que esa capacitación descansa en gran medida en la calidad de la formación práctica que reciben los futuros profesionales. Conscientes de ello, las universidades están otorgando al prácticum un lugar destacado en los planes de estudio de todas las titulaciones que imparten. Ahora bien, la formación profesional práctica de titulados superiores no cuenta aún con un cuerpo de conocimiento fundamentado que permita orientar con eficacia las nuevas actividades de enseñanza que el prácticum requiere. El problema esencial es que no hemos sabido dotarnos aún de modelos de enseñanza suficientemente potentes para facilitar a los estudiantes la construcción de esquemas inteligentes de actuación profesional que les guíen en la comprensión global e intuitiva de los problemas de la práctica y les permitan enfrentarse a ellos mediante procesos de , intervención operativos y flexibles que les garanticen cierta posibilidad de éxito. Está claro que mientras el mercado del empleo demanda jóvenes profesionales que ya hayan aprendido mediante la experiencia los aspectos claves de la cultura profesional específica de cada sector productivo y la aplicación de megacompetencias profesionales de carácter experto como puedan ser la visión a largo plazo o la anticipación a los cambios futuros, la universidad sigue formando titulados que tienen una buena formación teórica y una pequeña experiencia práctica que no satisface esas exigencias.We sought to: a) analyse practicums of university careers, as a gap between theory and practice; b) prove the meaningful association existence between 'career which one has matriculated in', 'course one study', 'choice of career in first option', 'degree of satisfaction with the career', 'to combine study and job', on the one hand, and 'professional practice experience', on the other hand, and c) make improvement proposals. We passed a questionnaire to 1454 students of seven career and we analysed practicums of the six career (Law hasn't program), using eleven descriptors: design, objectives, activities, documentation, materials, evaluation, teaching, agents, collaboration centres, collaboration, and education. We calculated frequencies and percentages of the items of academics data, percentages of each answer possibility, and mean and standard deviation of each item. We made a descriptive analysis for each practicum and other general descriptive analysis, and an contingency analysis established associations between demographic variables and each item of the questionnaire. We took out conclusions and made improvement proposals.Ministerio de Ciencia y Tecnología (España

Best practices on accessible tourism

[EN] The institution Patronato Provincial de Turismo València Terra i Mar de la Diputación de Valencia start last year 2012 the project Plan Provincia Accesible, Turismo para todos (Plan Accessible Province, Tourism for All) in order to encourage the participation of people with disabilities in daily living activities and promote the accessible tourism for all. The first phase of this plan had the aim to train the tourism professionals through the edition of a Best Practice Manual on Accessible Tourism besides two conferences with the purpose of building awareness. Both initiatives were carried out with the cooperation of Biomechanics Institute of Valencia[ES] Con el objetivo de fomentar la participación de las personas con discapacidad en las actividades de la vida diaria y de potenciar el turismo accesible para todos, el Patronato Provincial de Turismo València Terra i Mar de la Diputación de Valencia puso en marcha en el ejercicio 2012 el Plan Provincia Accesible, Turismo para todos. La primera de las fases de este Plan persiguió la capacitación de los profesionales del sector turístico mediante la edición de un Manual de buenas prácticas sobre turismo accesible y la celebración de dos jornadas de sensibilización, todo ello con la colaboración del Instituto de Biomecánica (IBV).Pérez Durbán, V.; Serrano Ortiz, JF.; Ferris Oñate, JM.; Poveda Puente, R.; López Torres, M.; Martínez Gómez, L.; Vera Luna, P.... (2013). Buenas prácticas sobre turismo accesible. Revista de biomecánica. 60:58-60. http://hdl.handle.net/10251/38512S58606

Didactic resources for the localization and identification of mosses and liverworts in the city of Cordoba

Este proyecto trata de utilizar la ciudad de Córdoba como recurso educativo para la enseñanza del mundo vegetal, en concreto musgos y hepáticas. Se trata de acercar al alumnado estos organismos, que aunque pasan desapercibidos por su pequeño tamaño, están presentes en las ciudades. El objetivo ha sido diseñar rutas que se puedan realizar con alumnado en las que sea frecuente encontrar especies de briofitos y aportarles material para realizar de forma autónoma la identificación de las especies. Se han desarrollado itinerarios por la ciudad de Córdoba y por el Campus Universitario de Rabanales en los que se han añadido con una señal las especies que se pueden encontrar en cada uno de los puntos marcados a lo largo de la ruta, para que el alumnado pueda encontrar las especies sin dificultad. Se ha elaborado también una guía didáctica que incluye una pequeña introducción de los briofitos, una clave dicotómica para la identificación de las especies, utilizado caracteres morfológicos fácilmente observables a simple vista y una guía fotográfica con fotos y descripciones detalladas de las especies de hepáticas y musgos que se han encontrado con frecuencia en la ciudad. El material se ha elaborado en español y en inglés.This project tries to use the city of Córdoba as educational resource for teaching plant biology, specifically mosses and liverworts. The aim is to bring these organisms closer to the students since, although they go unnoticed due to their small size, they are present in cities. The objectives have been to design routes to be done with students where it is common to find bryophytes and to provide students with material so they can carry out the identification in an autonomous way. A series of itineraries have been developed in the city of Córdoba and in the University Campus of Rabanales. The species that can be found in each of the marked point along the route have been marked with a label so that the students can find the species without difficulty and at the same time a didactic guide has been elaborated including a small introduction of bryophytes, a dichotomous key for identification of the species using morphological characters observable to the naked eye and a photographic guide with photos and detailed descriptions of the liver and moss species that have been found frequently in the city of Córdoba. This material has been prepared in Spanish and English

Influence of Obesity and Metabolic Disease on Carotid Atherosclerosis in Patients with Coronary Artery Disease (CordioPrev Study)

Background Recent data suggest that the presence of associated metabolic abnormalities may be important modifiers of the association of obesity with a poorer prognosis in coronary heart disease. We determined the influence of isolated overweight and obesity on carotid intima media thickness (IMT-CC), and also assessed whether this influence was determined by the presence of metabolic abnormalities. Methods 1002 participants from the CordioPrev study were studied at entry. We determined their metabolic phenotypes and performed carotid ultrasound assessment. We evaluated the influence of obesity, overweight and metabolic phenotypes on the IMT-CC. Results Metabolically sick participants (defined by the presence of two or more metabolic abnormalities) showed a greater IMT-CC than metabolically healthy individuals (p = 4 * 10−6). Overweight and normal weight patients who were metabolically healthy showed a lower IMT-CC than the metabolically abnormal groups (all p<0.05). When we evaluated only body weight (without considering metabolic phenotypes), overweight or obese patients did not differsignificantly from normal-weight patients in their IMT-CC (p = 0.077). However, obesity was a determinant of IMT-CC when compared to the composite group of normal weight and overweight patients (all not obese). Conclusions In coronary patients, a metabolically abnormal phenotype is associated with a greater IMTCC, and may be linked to a higher risk of suffering new cardiovascular events. The protection conferred in the IMT-CC by the absence of metabolic abnormality may be blunted by the presence of obesit

Practical training of university students and professional deontology

Este artículo presenta una investigación dirigida a: 1) analizar los prácticum de diferentes carreras universitarias, 2) analizar las dimensiones éticas de los códigos deontológicos de profesiones universitarias, 3) comparar estas dimensiones con el entrenamiento práctico de las carreras universitarias y 5) ofrecer propuestas para mejorar los prácticum de estas carreras universitarias de acuerdo con las dimensiones éticas percibidas. Se realizó un análisis de contenido de los códigos deontológicos de siete carreras universitarias y se aplicaron a 1.454 estudiantes universitarios un cuestionario y un inventario de creencias. Los datos resultantes fueron sistemáticamente analizados (un análisis descriptivo general, un análisis descriptivo de cada carrera, análisis factoriales y análisis de contingencias) aplicando el programa SPSS. Se presentan los resultados y las conclusiones inferidas, junto a las propuestas de mejora de acuerdo con las deficiencias observadas.This paper presents a study which aimed to: 1) analyse practicums of different university degrees, 2) analyse the ethical dimensions of the deontological codes of university professions, 3) compare these dimensions with the practical training of university degrees and 4) offer proposals to improve the practicums of these university degrees according to the ethical dimensions perceived. An analysis of the contents of the deontological codes of seven university degrees was carried out, a questionnaire and an inventory of beliefs were drawn up which were presented to 1454 undergraduates. The resulting data were statistically analysed (a general descriptive analysis, an analysis of each respective degree, factor analyses and contingency analyses) by applying the SPSS programme. The results and the inferred conclusions are presented with the proposals for improvement in accordance with the observed deficiencies.Programa Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica del Ministerio de Ciencia y Tecnología (Número de referencia: BSO2001-3083)

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

Evolución de Studium. Despliegue de la plataforma moodle 2.x

Memoria ID-2012.001. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis