Relationship Between Self-Perceived Health, Vitality, and Posttraumatic Growth in Liver Transplant Recipients

Our objective was to analyze the differences in posttraumatic growth in 240 liver transplant recipients based on two factors. First, self-perceived health: better (Group 1 = G1) and worse (Group 2 = G2). Second, vitality: more (Group 3 = G3) and less (Group 4 = G4). The Posttraumatic Growth Inventory, SF-36 Health Survey (Item 2) and SF-12 Health Survey (vitality dimension) were used. Firstly, analyzing main effects recipients with better (G1) compared to worse (G2) self-perceived health, showed greater posttraumatic growth. Interaction effects were found on essential posttraumatic growth domains such as new possibilities (p = 0.040), personal strength (p = 0.027), and appreciation of life (p = 0.014). Statistically significant differences showed that among transplant recipients with worse self-perceived health (G2), those with more vitality had higher levels on abovementioned posttraumatic growth dimensions. However, in transplant recipients with better self-perceived health (G1) respective dimensions were not significantly influenced by the level of vitality. Among the recipients with less vitality (G4), those with better self-perceived health showed higher scores on abovementioned posttraumatic growth dimensions. We conclude that positive self-perceived health might compensate for a lack of vitality as well as a high level of vitality may compensate for negative self-perceived health regarding the development of crucial aspects of posttraumatic growth after liver transplantation.Ministerio de Economía y Competitividad de España PSI2014-51950-

Spanish adaptation and validation of the Transplant Effects Questionnaire (TxEQ-Spanish) in liver transplant recipients and its relationship to posttraumatic growth and quality of life

The valid assessment of the impact of transplantation on psychological well-being is highly relevant to optimize treatment. However, to date there is no standardized instrument available in Spain. The Transplant Effects Questionnaire (TxEQ) evaluates the specific problems associated with organ transplantation, such as worry about transplant, guilt regarding the donor, disclosure of having undergone transplantation, adherence to medical treatment and responsibility toward the donor, family, friends, or medical staff. Against this backdrop the English original version of the TxEQ was translated into Spanish and validated in a sample of 240 liver transplant recipients. Participants also filled in the Posttraumatic Growth Inventory (PTGI), and the 12-Item Short Form Health Survey (SF-12v.2). Confirmatory factor analysis of the TxEQ-Spanish revealed a five-factor structure equivalent to the English original version, and satisfactory internal consistency (Cronbach's alpha: worry α = 0.82, guilt α = 0.77, disclosure α = 0.91, adherence α = 0.82, responsibility α = 0.83). Results showed that better mental quality of life was associated with higher adherence and disclosure, as well as less worry and guilt. Higher posttraumatic growth was significantly associated with worry, guilt, and responsibility. Interestingly, the most powerful predictor of posttraumatic growth was worry. Analysis of variance showed an interaction effect of PTG and mental quality of life on adherence, with medium PTG being associated with significantly stronger adherence in participants with better mental quality of life. In conclusion our study could successfully adapt and validate the Spanish version of the TxEQ in a large sample of liver transplant recipients. Our findings show a complex relationship between emotional reactions to transplantation, mental quality of life, and posttraumatic growth, which give further insight into inner processes supporting psychological well-being and adherence after liver transplantation.Ministerio de Economía y Competitividad de España PSI2014-51950-

Coping strategies in liver transplant recipients and caregivers according to patient posttraumatic growth

The purpose of this study was to analyze the differences in coping strategies employed by liver transplant recipients and their family members according to patient posttraumatic growth. Two matched groups of 214 liver transplant recipients and 214 family members were selected. The Posttraumatic Growth Inventory and Brief COPE were used. The most relevant results were: (1) Interactive effects in active coping, support (instrumental and emotional) and acceptance strategies, which were all used more by patients with higher growth levels, while their family members showed no differences in use of these strategies by patient growth level. Furthermore, while a low level of patient growth did not mark differences between them and their caregivers, a high level did, patients employing more active coping and support (instrumental and emotional), (2) In both groups a high level of patient growth was associated with more use of positive reframing and denial than a low one, and (3) Self-blame was employed by patients more than by their caregivers. It was concluded that a high level of posttraumatic growth in liver transplant recipients is associated with more use of healthy coping strategies, basically active coping, instrumental support, and emotional support.Ministerio de Economía y Competitividad PSI2014-51950-

Post-traumatic growth and its relationship to quality of life up to 9 years after liver transplantation: a cross-sectional study in Spain

Objective Little is known concerning post-traumatic growth (PTG) after liver transplantation. Against this backdrop the current study analysed the relationship between PTG and time since transplantation on quality of life. Furthermore, it compared PTG between liver transplant recipients and their caregivers. Design Cross-sectional case–control study. Setting University Hospital in Spain. Participants 240 adult liver transplant recipients who had undergone only one transplantation, with no severe mental disease, were the participants of the study. Specific additional analyses were conducted on the subset of 216 participants for whom caregiver data were available. Moreover, results were compared with a previously recruited general population sample. Outcome measures All participants completed the Posttraumatic Growth Inventory, and recipients also filled in the 12-Item Short-Form Health Survey. Relevant sociodemographic and clinical parameters were also assessed. Results In the sample of 240 recipients, longer time since transplantation (>9 years) was associated with more pain symptoms (p=0.026). Regardless of duration, recipients showed lower scores on most quality of life dimensions than the general population. However, high PTG was associated with a significantly higher score on the vitality quality of life dimension (p=0.021). In recipients with high PTG, specific quality of life dimensions, such as bodily pain (p=0.307), vitality (p=0.890) and mental health (p=0.353), even equalled scores in the general population, whereas scores on general health surpassed them (p=0.006). Furthermore, liver transplant recipients (n=216) compared with their caregivers showed higher total PTG (p<0.001) and higher scores on the subscales relating to others (p<0.001), new possibilities (p<0.001) and appreciation of life (p<0.001). Conclusions Our findings highlight the protective role of PTG in the long-term outcome of liver transplant recipients. Future studies should analyse and develop psychosocial interventions to strengthen PTG in transplant recipients and their caregivers.Ministerio de Economía, Industria y Competitividad (España) PSI2014-51950-

Advancing in the Self-Determination of young people with intellectual disability: Design of AUTODDIS

Resumen: La autodeterminación es uno de los constructos de mayor importancia para fomentar el bienestar y la autonomía de las personas con discapacidad intelectual, a quienes tradicionalmente se les ha negado la oportunidad de ser agentes causales de sus propias vidas. A pesar de la importancia de este tema, existe aún una gran escasez de herramientas que permitan evaluar la autodeterminación y que ofrezcan información útil para elaborar planes de intervención específicos. El objetivo de este trabajo consiste en elaborar una escala objetiva de evaluación de la autodeterminación para jóvenes y adultos con discapacidad intelectual. Realizar un estudio Delphi con todos los agentes implicados (profesionales, familiares y personas con discapacidad) permitió crear un amplio pool de ítems que se aplicó a 165 participantes. Los datos ponen de manifiesto que la escala resultante cuenta con evidencias empíricas de validez y fiabilidad que garantizan la importancia de continuar investigando en esta línea.Abstract: Self-determination is one of the most important constructs for the welfare and autonomy of people with intellectual disabilities, who have traditionally had a lack of opportunities to be causal agents of their own lives. Despite the importance of this construct, there is not enough tools available to evaluate self-determination and offer useful information to prepare specific intervention plans. The aim of this work is to develop an objective assessment scale of self-determination for young people and adults with intellectual disabilities. Conducting a Delphi study with all the agents involved (professionals, family members and people with disabilities) allowed us to create a wide pool of items that were then applied to 165 participants. Data show that this scale has empirical evidences of validity and reliability that guarantees the importance of continuing this line of research

Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic

Background: The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities. Methods: This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model. Results: We obtained a model with five patterns (entropy = 0.727): ‘Relative Healthy’, ‘Cardiometabolic’, ‘Musculoskeletal’, ‘Musculoskeletal and Mental’, and ‘Complex Multimorbidity’. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression. Conclusions: We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments17 página

Escala AUTODDIS: Evaluación de la autodeterminación de jóvenes y adultos con discapacidad intelectual. Manual de aplicación y corrección

[ES]La Escala AUTODDIS que se presenta en este manual permite evaluar la autodeterminación de jóvenes y adultos con discapacidad intelectual mediante un heteroinforme; es decir, a través de la información proporcionada por una tercera persona que conoce bien a la persona con discapacidad intelectual evaluada. La utilización de la Escala AUTODDIS permitirá el desarrollo de iniciativas ajustadas orientadas a la promoción de su autodeterminación, fomentando así el aumento necesario de prácticas basadas en evidencias empíricas

Retinal Thickness Changes Over Time in a Murine AD Model APPNL-F/NL-F

Background: Alzheimer’s disease (AD) may present retinal changes before brain pathology, suggesting the retina as an accessible biomarker of AD. The present work is a diachronic study using spectral domain optical coherence tomography (SD-OCT) to determine the total retinal thickness and retinal nerve fiber layer (RNFL) thickness in an APPNL−F/NL−F mouse model of AD at 6, 9, 12, 15, 17, and 20 months old compared to wild type (WT) animals. Methods: Total retinal thickness and RNFL thickness were determined. The mean total retinal thickness was analyzed following the Early Treatment Diabetic Retinopathy Study sectors. RNFL was measured in six sectors of axonal ring scans around the optic nerve. Results: In the APPNL−F/NL−F group compared to WT animals, the total retinal thickness changes observed were the following: (i) At 6-months-old, a significant thinning in the outer temporal sector was observed; (ii) at 15-months-old a significant thinning in the inner temporal and in the inner and outer inferior retinal sectors was noticed; (iii) at 17-months-old, a significant thickening in the inferior and nasal sectors was found in both inner and outer rings; and (iv) at 20-months-old, a significant thinning in the inner ring of nasal, temporal, and inferior retina and in the outer ring of superior and temporal retina was seen. In RNFL thickness, there was significant thinning in the global analysis and in nasal and inner-temporal sectors at 6 months old. Thinning was also found in the supero-temporal and nasal sectors and global value at 20 months old. Conclusions: In the APPNL−F/NL−F AD model, the retinal thickness showed thinning, possibly produced by neurodegeneration alternating with thickening caused by deposits and neuroinflammation in some areas of the retina. These changes over time are similar to those observed in the human retina and could be a biomarker for AD. The APPNL−F/NL−F AD model may help us better understand the different retinal changes during the progression of AD. Keywords: Alzheimer, retina, OCT, mouse model of AD, APPNL-F/NL-

Escuela para madres y padres sobre bilingüismo y aprendizaje del inglés

Memoria del proyecto de Aprendizaje y Servicio titulado Escuela para madres y padres sobre bilingüismo y aprendizaje del inglés, dirigido por el Dr. D. Daniel Martín González y financiado por la Oficina de Aprendizaje y Servicio de la UCM en la Convocatoria de Proyectos de Aprendizaje y Servicio 2021-22