Estrés parental y desarrollo infantil en niños prematuros

El presente trabajo trata de analizar si los niveles de estrés experimentados por los progenitores inciden sobre el desarrollo mental y motor de un grupo de niños nacidos demasiado pequeños o demasiado pronto. Participaron 19 niños y niñas nacidos, con menos de 36 semanas de gestación (media 29,84) y menos de 1500 gramos (media 1099,89), en el Hospital 12 de octubre de Madrid cuyos padres y madres consintieron participar en este trabajo. Los instrumentos utilizados fueron la Escala BSID-II para obtener los índices del desarrollo mental y psicomotor en los niños cuando alcanzaron la edad 2 años y la PSI de Abidin, para valorar el estrés total de los padres y madres participantes, así como su percepción de Malestar Paterno, Interacción Disfuncional y Niño Difícil. Los datos fueron sometidos a análisis de comparaciones de medias para muestras independientes. Los resultados indican que existen diferencias significativas entre los altos y los bajos niveles de estrés en cuanto a su incidencia en el desarrollo. En general, tanto en las madres como en los padres, cuando se obtiene una puntuación baja de estrés, existe un mejor desarrollo mental y psicomotor en los niños. Estos resultados se discuten a la luz de las investigaciones sobre el tema y se analizan las implicaciones para la elaboración de programas de atención temprana.The current document analyze if the parent’s stress levels influence the mental and motor development of a children’s group being born too young or too small. The participants were 19 preterm children born at the “Hospital 12 de Octubre” of Madrid with less than 36 gestation weeks (mean 29,84) and 1500 grammes (mean 1099,89), whose parents were agree to take part in this study. The employed instruments were the Bayley Scales of Infant Development (BSID-II) to obtain the mental and psychomotor index scores of the toddlers at 2 years old; and the Parenting Stress Index Short Form (PSI) of Abidin. to assess the Total Stress of the parents, and their perception of Parental Distress, Dysfunctional Parent-Child Interactions and Difficult Child also. The obtained data were analyzed comparing the means of two independent samples. The results show that there are significant differences in the children’s development depending of the high or low parental stress levels. In general terms, when parents have low levels of stress, a better mental and psychomotor development is observed in their children. These results are discussed in the light of other researches about the issue, being considered as well, their implications for the implementation of early intervention programs.peerReviewe

Estrés parental y desarrollo infantil en niños prematuros

El presente trabajo trata de analizar si los niveles de estrés experimentados por los progenitores inciden sobre el desarrollo mental y motor de un grupo de niños nacidos demasiado pequeños o demasiado pronto. Participaron 19 niños y niñas nacidos, con menos de 36 semanas de gestación (media 29,84) y menos de 1500 gramos (media 1099,89), en el Hospital 12 de octubre de Madrid cuyos padres y madres consintieron participar en este trabajo. Los instrumentos utilizados fueron la Escala BSID-II para obtener los índices del desarrollo mental y psicomotor en los niños cuando alcanzaron la edad 2 años y la PSI de Abidin, para valorar el estrés total de los padres y madres participantes, así como su percepción de Malestar Paterno, Interacción Disfuncional y Niño Difícil. Los datos fueron sometidos a análisis de comparaciones de medias para muestras independientes. Los resultados indican que existen diferencias significativas entre los altos y los bajos niveles de estrés en cuanto a su incidencia en el desarrollo. En general, tanto en las madres como en los padres, cuando se obtiene una puntuación baja de estrés, existe un mejor desarrollo mental y psicomotor en los niños. Estos resultados se discuten a la luz de las investigaciones sobre el tema y se analizan las implicaciones para la elaboración de programas de atención temprana.The current document analyze if the parent’s stress levels influence the mental and motor development of a children’s group being born too young or too small. The participants were 19 preterm children born at the “Hospital 12 de Octubre” of Madrid with less than 36 gestation weeks (mean 29,84) and 1500 grammes (mean 1099,89), whose parents were agree to take part in this study. The employed instruments were the Bayley Scales of Infant Development (BSID-II) to obtain the mental and psychomotor index scores of the toddlers at 2 years old; and the Parenting Stress Index Short Form (PSI) of Abidin. to assess the Total Stress of the parents, and their perception of Parental Distress, Dysfunctional Parent-Child Interactions and Difficult Child also. The obtained data were analyzed comparing the means of two independent samples. The results show that there are significant differences in the children’s development depending of the high or low parental stress levels. In general terms, when parents have low levels of stress, a better mental and psychomotor development is observed in their children. These results are discussed in the light of other researches about the issue, being considered as well, their implications for the implementation of early intervention programs.peerReviewe

Do Religious Factors Influence the Attitude Toward Organ Donation Among Medical Students? A Spanish Multicenter Study

Introduction Religious factors have conditioned the attitude toward organ donation and transplantation (ODT) since the beginning of transplantation, despite the fact that most religions are in favor of transplantation. Objective To assess the impact of religious beliefs of medical students on their attitude toward ODT. Method Population under study: Medical students in Spanish universities. Study sample: Stratified by geographical area and academic course. Assessment instrument: Attitude ODT questionnaire PCID-DTO-Ríos, anonymous and self-administered. Results Of all students, 42% (n = 3907) declare themselves atheists or agnostics. The remaining 58% (n = 5368) declare themselves to be religious, the majority being Catholic (55%, n = 5102). Of the rest, 0.2% are Muslims (n = 8), 0.1% Protestants (n = 1), and the remaining 2.7% (n = 257) indicate other religious doctrines but do not want to specify it. Regarding their attitude toward ODT, those who consider themselves atheists or agnostics have a more favorable attitude than those who consider themselves religious (84% versus 76%; P < .001). Among those who follow some kind of religion, Catholics are more in favor of ODT than non-Catholics (77% vs 64%, P < .001). Note that among the religious, only 57% (n = 3050) know which religion is in favor of transplantation, while 22% (n = 1,152) consider that it has not been pronounced on the matter, 13% (n = 723) think the religion is against donation, and the remaining 8% (n = 443) do not know. Conclusion The religion professed by medical students conditions their attitude toward donation, with the atheists and agnostics being more in favor of donation.Sin financiación0.784 JCR (2019) Q4, 155/158 Immunology, 191/210 Surgery, 24/24 Transplantation0.363 SJR (2019) Q3, 254/451 Surgery, 27/41 TransplantationNo data IDR 2019UE

Use of interactive response devices for the improvement of teaching in the degrees of the Faculty of Sciences

La implantación de los nuevos Grados dentro del EEES supone un nuevo enfoque metodológico, pero sobre todo evaluador. El profesor debe esforzarse en ser capaz de valorar no sólo el nivel de conocimientos del alumnado sobre los contenidos, ya que la sociedad actual demanda un perfil de los egresados más completo basado en la formación por competencias. La adquisición de ambas facetas por parte del alumnado se basa principalmente en actividades presenciales y metodologías docentes aplicadas en el desarrollo de las asignaturas, tanto en grupo reducido como en grupo completo. Por tanto, cualquier herramienta adicional que ayude al docente a facilitar esta doble tarea es bien recibida, pues permitirá evaluar el rendimiento académico global del alumnado. Recientemente la Facultad de Ciencias ha puesto en marcha una experiencia piloto mediante la cual un nutrido grupo de profesores ha incorporado en su docencia un sistema de mandos inalámbricos de respuesta. Actualmente, la Facultad de Ciencias dispone de un total de 82 mandos inalámbricos de respuesta y tres antenas receptoras. Esta nueva tecnología ha permitido al docente realizar, de forma interactiva, preguntas colectivas al alumnado y recoger las respuestas individuales de forma inmediata. Los resultados obtenidos en este proyecto nos permiten ser muy optimistas con el uso de esta herramienta y nos animan a continuar en la misma línea. El profesorado participante se ha mostrado dispuesto a continuar empleando esta TIC en su docencia, tratando de abarcar más asignaturas, diversificar el tipo de pruebas, y emplear los mandos de respuesta en grupo completo, cuando el número de alumnos lo permita. La puesta en común de los resultados revela que, de forma general, este tipo de sistemas de respuesta incrementa el nivel de atención del alumnado, ya que se les demanda de forma continuada su participación activa durante la sesión. Se potencia la retención de conceptos, al suministrar en el acto la respuesta correcta a cada pregunta realizada. Permite también al profesorado conocer el nivel previo de conocimientos sobre la materia a impartir, ya que se puede realizar este tipo de preguntas al comienzo de la sesión y enfocar entonces su atención en las debilidades manifestadas. Asimismo se puede testar el grado de adquisición de dichos conocimientos, realizando este tipo de cuestionarios después de la sesión. Además, el tratamiento posterior de los resultados, de forma individualizada, permite gestionar de forma ágil el nivel de conocimientos y adquisición de competencias en lo que es un sistema de evaluación continua, tan necesario en los nuevos enfoques metodológicos nacidos de la implantación del EEES. Por último destacar que el profesorado participante ha considerado que se trata de una herramienta de gran utilidad para la consecución del objetivo de excelencia en la docencia, que además es eficaz y de fácil manejo, y entiende que no debe ser una actividad puntual, sino un proceso transformador en la actividad docente e interacción alumno-profesor, configurándose como una herramienta habitual en los sistemas de enseñanza-aprendizaje.Implementation of the new degrees in the EHEA involve a new methodological approach, but above all evaluation. The teacher should strive to be able to assess not only the level of knowledge of the students on the content, as the current society demands a profile of the most complete graduates based on training by competencies. The acquisition of both facets by students is based mainly on face-to-face activities and teaching methodologies applied in the development of the subjects, both in small group and in whole group. Therefore, any additional tool that helps the teacher to facilitate this double task is well received, since it will allow to evaluate the overall academic performance of the students. Recently the Faculty of Sciences has launched a pilot experience through which a large group of teachers has incorporated into their teaching a system of interactive response devices. Currently, the Faculty of Sciences has a total of 82 wireless response controllers and three receiving antennas. This new technology has enabled the teacher to interact interactively with the students and collect the individual answers immediately. The results obtained in this project allow us to be very optimistic with the use of this tool and encourage us to continue in the same line. The participating teachers have been willing to continue using this ICT in their teaching, trying to cover more subjects, diversify the type of tests, and use the full group response commands, when the number of students allows. The sharing of results reveals that, in a general way, this type of response systems increases the level of attention of the students, since they are continuously demanded their active participation during the session. The retention of concepts is strengthened by providing the correct answer to every question asked. It also allows the faculty to know the previous level of knowledge about the subject to be taught, since this type of questions can be asked at the beginning of the session and then focus their attention on the weaknesses manifested. It is also possible to test the degree of acquisition of this knowledge, performing this type of questionnaire after the session. In addition, the subsequent treatment of the results, in an individualized way, allows to manage in an agile way the level of knowledge and acquisition of competences in what is a system of continuous evaluation, so necessary in the new methodological approaches born from the implantation of the EHEA. Finally, it should be pointed out that the participating teachers have considered that this is a very useful tool for achieving the objective of excellence in teaching, which is also efficient and easy to use and understands that it should not be a specific activity, but a transforming process in the teaching activity and student-teacher interaction, being configured as a habitual tool in the teaching-learning systems

Effects on short term outcome of non-invasive ventilation use in the emergency department to treat patients with acute heart failure: A propensity score-based analysis of the EAHFE Registry

Objective: To assess the effects of non-invasive ventilation (NIV) in emergency department (ED) patients with acute heart failure (AHF) on short term outcomes. Methods: Patients from the EAHFE Registry (a multicenter, observational, multipurpose, cohort-designed database including consecutive AHF patients in 41 Spanish EDs) were grouped based on NIV treatment (NIV+ and NIV–groups). Using propensity score (PS) methodology, we identified two subgroups of patients matched by 38 covariates and compared regarding 30-day survival (primary outcome). Interaction was investigated for age, sex, ischemic cardiomyopathy, chronic obstructive pulmonary disease, AHF precipitated by an acute coronary syndrome (ACS), AHF classified as hypertensive or acute pulmonary edema (APE), and systolic blood pressure (SBP). Secondary outcomes were intensive care unit (ICU) admission; mechanical ventilation; in-hospital, 3-day and 7-day mortality; and prolonged hospitalization (>7 days). Results: Of 11, 152 patients from the EAHFE (age (SD): 80 (10) years; 55.5% women), 718 (6.4%) were NIV+ and had a higher 30-day mortality (HR = 2.229; 95%CI = 1.861–2.670) (p 85 years, p < 0.001), AHF associated with ACS (p = 0.045), and SBP < 100 mmHg (p < 0.001). No significant differences were found in the secondary endpoints except for more prolonged hospitalizations in NIV+ patients (OR = 1.445; 95%CI = 1.122–1.862) (p = 0.004). Conclusion: The use of NIV to treat AHF in ED is not associated with improved mortality outcomes and should be cautious in old patients and those with ACS and hypotension

Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo

Objetivo Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma (GEMA 2009 y 2015) y su repercusión en el control de la enfermedad. Material y métodos Estudio observacional y ambispectivo realizado entre septiembre del 2015 y abril del 2016, en el que participaron 314 médicos de atención primaria y 2.864 pacientes. Resultados Utilizando datos retrospectivos, 81 de los 314 médicos (25, 8% [IC del 95%, 21, 3 a 30, 9]) comunicaron seguir las recomendaciones de la GEMA 2009. Al inicio del estudio, 88 de los 314 médicos (28, 0% [IC del 95%, 23, 4 a 33, 2]) seguían las recomendaciones de la GEMA 2015. El tener un asma mal controlada (OR 0, 19, IC del 95%, 0, 13 a 0, 28) y presentar un asma persistente grave al inicio del estudio (OR 0, 20, IC del 95%, 0, 12 a 0, 34) se asociaron negativamente con tener un asma bien controlada al final del seguimiento. Por el contrario, el seguimiento de las recomendaciones de la GEMA 2015 se asoció de manera positiva con una mayor posibilidad de que el paciente tuviera un asma bien controlada al final del periodo de seguimiento (OR 1, 70, IC del 95%, 1, 40 a 2, 06). Conclusiones El escaso seguimiento de las guías clínicas para el manejo del asma constituye un problema común entre los médicos de atención primaria. Un seguimiento de estas guías se asocia con un control mejor del asma. Existe la necesidad de actuaciones que puedan mejorar el seguimiento por parte de los médicos de atención primaria de las guías para el manejo del asma. Objective: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. Material and methods: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. Results: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3–30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4–33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13–0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12–0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40–2.06). Conclusions: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines