67 research outputs found

    Thinking Styles: Analysis of its structural validity using adolescents' responses to the thinking styles inventory

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    En su teoría del autogobierno mental, Sternberg afirma que tan importante como disponer de capacidades intelectuales es el modo en cómo se aplican éstas a las diferentes tareas, situaciones o contextos. A la forma predilecta que cada persona tiene de aplicar sus habilidades intelectuales Sternberg le denomina estilo intelectual. Este autor identifica trece estilos intelectuales que se agruparían en cinco dimensiones: función, forma, nivel, ámbito y tendencia. Algunos de los últimos estudios realizados sobre esta teoría ponen en entredicho la existencia de tales dimensiones. En el presente estudio, se analiza la estructura de los estilos pensamiento en una muestra de estudiantes de ESO significativamente mayor que las utilizadas en los estudios que preceden en el tiempo a éste (n= 1.153) y, además, aplicando el análisis factorial jerárquico confirmatorio. Los resultados obtenidos, en general, coinciden con los obtenidos por otros investigadores y ofrecen una estructura de los estilos intelectuales sustancialmente distinta a la sugerida por Sternberg.In his theory of mental self-government, Sternberg stated that the way individuals apply their intellectual skills to various tasks, situations, or contexts is as important as the skills themselves. This author called the preferred way in which people apply their intellectual skills thinking style. He identified thirteen thinking styles that are grouped into five dimensions: function, form, level, setting, and tendency. Some recent studies of this theory have cast doubt on the existence of these dimensions. In this study, the structure of thinking styles is analyzed by means of confirmatory hierarchical factor analysis in a sample of students (n= 1153) from Obligatory Secondary Education (ESO) who are significantly older than those employed in previous studies. In general, the results coincide with those reported by other researchers, providing a thinking-style structure that is substantially different from the one suggested by Sternberg.Centro de Investigación Educativa CIDE-98-02 -0 111Dirección General de Enseñanza Superior e Investigación Científica del MEC 1FD97-0 11

    Nitrogen fertilization after robusta coffee pruning in Cambisols

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    The objective of this work was to evaluate the influence of nitrogen mineral fertilization, after robusta coffee pruning, on crop yield and some chemical (pH, organic matter) and microbiological (biological gas exchange and nitrification) soil indicators in two Cambisols in Tercer Frente, Santiago de Cuba, and La Alcarraza, Holguín, during the years 2003–2007. The response to increasing doses of N (0 up to 400 kg ha-1), in the presence of fixed amounts of P (50 kg ha-1) and K (160 kg ha-1), was studied in a randomized block design with four replicates. To obtain coffee yields between 0.50 and 0.84 Mg ha-1, 75 kg ha-1 N are sufficient. In both soils, applications of 100 kg ha-1 N allowed for coffee yields between 1.22 and 1.25 Mg ha-1. With a dose of 153 kg ha-1 N, 1.80 Mg ha-1 coffee yields are obtained, whereas for yields higher than 2 Mg ha-1, it is necessary to apply 200 kg ha-1 N. There was a significant coffee yield increment per each kilogram of N applied, which ranged from 2.13 to 7.80. The proposed doses per site did not affect the microbial activity or soil organic matter. There was a soil pH reduction compared to its initial stage.El objetivo de este trabajo fue evaluar la influencia de la fertilización mineral nitrogenada, después de la poda del cafeto robusta, sobre la productividad del cultivo y algunos indicadores químicos (pH, materia orgánica) y microbiológicos (respiración biológica y nitrificación) de dos Cambisoles en Tercer Frente, Santiago de Cuba y La Alcarraza, Holguín, durante los años 2003–2007. Se estudió la respuesta a dosis crecientes de nitrógeno (0 hasta 400 kg ha-1), en presencia de un fondo fijo de P (50 kg ha-1) y K (160 kg ha-1), en un diseño experimental de bloques al azar, con cuatro réplicas. Para productividades entre 0,50 y 0,84 Mg ha-1 de café, son suficientes 75 kg ha-1 de N. Aplicaciones de 100 kg ha-1 de N permitieron productividades de 1,22 a 1,25 Mg ha-1 de café. Con dosis de 153 kg ha-1 de N, se logran producciones de 1,80 Mg ha-1 de café, mientras que para productividades superiores a 2 Mg ha-1 se necesita aplicar 200 kg ha-1 en ambos suelos. Se encontró un incremento importante en las productividades del cafeto por cada quilogramo de N aplicado, que osciló entre 2,13 y 7,80. Las dosis propuestas por sitio no afectaron la actividad microbiana y la materia orgánica de los suelos. Se encontró disminución del pH del suelo respecto a su estado inicial.The objective of this work was to evaluate the influence of nitrogen mineral fertilization, after robusta coffee pruning, on crop yield and some chemical (pH, organic matter) and microbiological (biological gas exchange and nitrification) soil indicators in two Cambisols in Tercer Frente, Santiago de Cuba, and La Alcarraza, Holguín, during the years 2003–2007. The response to increasing doses of N (0 up to 400 kg ha-1), in the presence of fixed amounts of P (50 kg ha-1) and K (160 kg ha-1), was studied in a randomized block design with four replicates. To obtain coffee yields between 0.50 and 0.84 Mg ha-1, 75 kg ha-1 N are sufficient. In both soils, applications of 100 kg ha-1 N allowed for coffee yields between 1.22 and 1.25 Mg ha-1. With a dose of 153 kg ha-1 N, 1.80 Mg ha-1 coffee yields are obtained, whereas for yields higher than 2 Mg ha-1, it is necessary to apply 200 kg ha-1 N. There was a significant coffee yield increment per each kilogram of N applied, which ranged from 2.13 to 7.80. The proposed doses per site did not affect the microbial activity or soil organic matter. There was a soil pH reduction compared to its initial stage

    Adaptabilidad y cohesión familiar, implicación parental en conductas autorregulatorias, autoconcepto del estudiante y rendimiento académico

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    En este estudio se analiza la relación existente entre la adaptabilidad y la cohesión familiar, así como la conducta autorregulatoria de los padres en relación a su comportamiento con los hijos, en general, y en su implicación en el ámbito del estudio, en particular. También se estudia el tipo de relación que tales variables familiares mantienen con diferentes dimensiones del autoconcepto de los hijos y con su rendimiento académico. Los datos se obtienen a partir de una muestra de 163 estudiantes de Educación Secundaria Obligatoria que han cumplinentado tres escalas (Family Adaptability and Cohesion Evaluation Scales, Parental Inducement of Self-Regulation y Self-Description Questionnaire-II). Los resultados muestran que la percepción que los hijos tienen sobre el grado de implicación de los padres en comportamientos característicos autorregulatorios influye significativamente sobre las diferentes dimensiones que el estudiante tiene sobre sí mismo (privada, social, académica), que este tipo de percepción se encuentra escasamente relacionada con las características de adaptabilidad y cohesión familiar y, finalmente, que la dimensión académica del autoconcepto predice positiva y significativamente el rendimiento académico, mientras que la dimensión social lo predice negativamente

    Angioedema Due to Acquired Deficiency of C1-Inhibitor: A Cohort Study in Spain and a Comparison With Other Series

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    [Background] Data on acquired angioedema due to C1-inhibitor deficiency (C1-INH-AAE) from 4 European countries (France, Italy, Germany, and Hungary) were recently published.[Objective] To report data from a group of 50 patients with acquired C1-INH deficiency from Spain, of whom 46 had angioedema, and compare them with other European series.[Methods] We performed a retrospective observational study of 46 patients with C1-INH-AAE and 4 asymptomatic patients. Clinical and biological characteristics and associated diseases were assessed and compared with other European series.[Results] Women accounted for 73.9% of cases. The prevalence of C1-INH-AAE related to hereditary forms was 1/10.1. Overall, 8.7% patients were aged <40 years. Diagnostic delay was 1.1 years. Angioedema mainly affected the face (91.3%), followed by the oropharynx (63%), extremities (50%), and abdomen (37%). Only 1 patient underwent orotracheal intubation. Erythema marginatum was present in 1 patient. A hematologic disorder was recorded in 50% of patients. Angioedema preceded all benign conditions, mostly monoclonal gammopathy of undetermined significance, but appeared very close to or after malignant hematologic diseases (median, 2.2 and 0.29 years). Autoimmune diseases were associated in 50% (autoimmune thyroiditis, 21.5%; systemic lupus erythematosus, 10.9%). Half of them coexisted with hematologic disorders. Anti-C1-INH antibodies were found in 67% of tested patients and were not related to the associated disease. Long-term prophylaxis was necessary in 52.2%, most of whom responded to tranexamic acid.[Conclusions] This study emphasizes the possibility of C1-INH-AAE in patients younger than 40 and in autoimmune diseases other than systemic lupus erythematosus such as autoimmune thyroiditis.Peer reviewe

    Development and validation of a clinical score to estimate progression to severe or critical state in Covid-19 pneumonia hospitalized patients

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    The prognosis of a patient with Covid-19 pneumonia is uncertain. Our objective was to establish a predictive model of disease progression to facilitate early decision-making. A retrospective study was performed of patients admitted with Covid-19 pneumonia, classified as severe (admission to the intensive care unit, mechanic invasive ventilation, or death) or non-severe. A predictive model based on clinical, analytical, and radiological parameters was built. The probability of progression to severe disease was estimated by logistic regression analysis. Calibration and discrimination (receiver operating characteristics curves and AUC) were assessed to determine model performance. During the study period 1,152 patients presented with Covid-19 infection, of whom 229 (19.9%) were admitted for pneumonia. During hospitalization, 51 (22.3%) progressed to severe disease, of whom 26 required ICU care (11.4); 17 (7.4%) underwent invasive mechanical ventilation, and 32 (14%) died of any cause. Five predictors determined within 24 hours of admission were identified: Diabetes, Age, Lymphocyte count, SaO2, and pH (DALSH score). The prediction model showed a good clinical performance, including discrimination (AUC 0.87 CI 0.81, 0.92) and calibration (Brier score = 0.11). In total, 0%, 12%, and 50% of patients with severity risk scores ≤5%, 6-25%, and >25% exhibited disease progression, respectively. A simple risk score based on five factors predicts disease progression and facilitates early decision-making according to prognosis.Carlos III Health Institute, Spain, Ministry of Economy and Competitiveness (SPAIN) and the European Regional Development Fund (FEDER)Instituto de Salud Carlos II

    European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain

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    The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. "Optimized" H. pylori therapies achieve over 90% success in Spain

    Memoria del III Coloquio Internacional sobre Diversidad Cultural y Estudios Regionales

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    Del 05 al 07 de noviembre de 2014 se llevó a cabo en la Sede de Occidente de la Universidad de Costa Rica, el III Coloquio Internacional sobre Diversidad Cultural y Estudios Regionales, dicado a Julieta Dobles Izaguirre, Premio Nacional de Cultura Magón, 2013. Este III Coloquio Internacional fue organizado por el Centro de Investigaciones sobre Diversidad Cultural y Estudios Regionales (CIDICER), primer Centro de Investigaciones de una Sede Regional de la Universidad de Costa Rica. Se contó con personas investigacdoras nacionales e internacionales quienes presentaron sobre temas relacionados con la diversidad cultural y los estudios regionales.Universidad de Costa Rica/[836-B4-702]/UCR/Costa RicaUCR::Sedes Regionales::Sede de Occidente::Recinto San Ramón::Centro de Investigaciones sobre Diversidad Cultural y Estudios Regionales (CIDICER

    Role of age and comorbidities in mortality of patients with infective endocarditis

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    [Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

    Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

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    Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

    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)

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    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
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