La investigación etnográfica en psicología evolutiva : una forma de abordar la relación entre mente y cultura

Este texto se presentó como comunicación al II Congreso Internacional de Etnografía y Educación: Migraciones y Ciudadanías. Universidad Autónoma de Barcelona, Barcelona, 5-8 Septiembre 2008.Buena parte de la psicología evolutiva y de la educación que conocemos en España ha sido elaborada desde paradigmas de investigación de corte positivista. Esto se debe por una parte a la concepción individualista que la psicología experimental ha contribuido a crear del individuo, y por otra, a la adopción de los modelos explicativos provenientes de las ciencias naturales, lo que ha dejado no sólo un elenco concreto de métodos de investigación legitimados, sino también un cierto esencialismo y biologicismo en las explicaciones de las acciones de las personas y en las causas de su desarrollo. No obstante, diversas corrientes filosóficas, teorías e investigaciones vienen adviertiendo que esa visión individualista y esencialista propia de la psicología no es capaz de responder a algunas cuestiones planteadas. Una de las más notables puede expresarse cuando Vygotsky (Wertsch, 1988) afirmaba que el ser humano experimenta dos tipos de desarrollo, el biológico y el cultural, y era necesario comprender ambos para comprender el desarrollo. Si tenemos esto en cuenta, veremos que la psicología del desarrollo, y probablemente la psicología en general, no ha hecho grandes aportaciones para tratar de comprender cómo se interrelacionan la mente y la cultura. Sin embargo, en otros países, los aspectos en relación con la mente y la cultura se han venido abordando desde hace tiempo. Es por ello que en este trabajo queremos hacer una revisión de las distintas aportaciones que se han hecho hasta ahora para comprender la relación entre la mente y la cultura que puedan contribuir al estudio de la psicología evolutiva y de la educación en España. De esta forma, un primer epígrafe del trabajo constará de una revisión teórica breve de las corrientes filosóficas y teorías científicas que han planteado los interrogantes acerca de la relación entre mente y cultura o sociedad. En un segundo epígrafe planteamos las ventajas metodológicas que la investigación etnogràfica de corte interpretativo (Erickson, 1989) tiene para el estudio de algunos de los aspectos destacados en el epígrafe anterior. Así, subrayaremos cómo la etnografía se ha enfrentado a aspectos como: a) el estudio de los procesos sociales en la vida cotidiana y en contexto natural, b) el significado de las acciones desde el punto de vista de los participantes, c) la documentación de las distintas capas de significado (Geertz, 2000) o niveles micro y macro del contexto de las acciones, d) el acceso a prácticas sociales ocultas gracias a la observación participante y a la relación con los participantes, e) la flexibilidad metodológica y la captación de las categorías locales, f) la reflexibidad como respuesta al subjetivismo y al papel del investigador en el campo. Así en las conclusiones, mostraremos qué implicaciones tienen los dos epígrafes anteriores para la respuesta que esta orientación metodológica da a algunas de las tensiones clásicas de la psicología del desarrollo

Long-Term Real-World Effectiveness and Safety of Ustekinumab in Crohn’s Disease Patients: The SUSTAIN Study

Background Large real-world-evidence studies are required to confirm the durability of response, effectiveness, and safety of ustekinumab in Crohn’s disease (CD) patients in real-world clinical practice. Methods A retrospective, multicentre study was conducted in Spain in patients with active CD who had received ≥1 intravenous dose of ustekinumab for ≥6 months. Primary outcome was ustekinumab retention rate; secondary outcomes were to identify predictive factors for drug retention, short-term remission (week 16), loss of response and predictive factors for short-term efficacy and loss of response, and ustekinumab safety. Results A total of 463 patients were included. Mean baseline Harvey-Bradshaw Index was 8.4. A total of 447 (96.5%) patients had received prior biologic therapy, 141 (30.5%) of whom had received ≥3 agents. In addition, 35.2% received concomitant immunosuppressants, and 47.1% had ≥1 abdominal surgery. At week 16, 56% had remission, 70% had response, and 26.1% required dose escalation or intensification; of these, 24.8% did not subsequently reduce dose. After a median follow-up of 15 months, 356 (77%) patients continued treatment. The incidence rate of ustekinumab discontinuation was 18% per patient-year of follow-up. Previous intestinal surgery and concomitant steroid treatment were associated with higher risk of ustekinumab discontinuation, while a maintenance schedule every 12 weeks had a lower risk; neither concomitant immunosuppressants nor the number of previous biologics were associated with ustekinumab discontinuation risk. Fifty adverse events were reported in 39 (8.4%) patients; 4 of them were severe (2 infections, 1 malignancy, and 1 fever). Conclusions Ustekinumab is effective and safe as short- and long-term treatment in a refractory cohort of CD patients in real-world clinical practice

Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

La investigación etnográfica en psicología evolutiva : una forma de abordar la relación entre mente y cultura

Este texto se presentó como comunicación al II Congreso Internacional de Etnografía y Educación: Migraciones y Ciudadanías. Universidad Autónoma de Barcelona, Barcelona, 5-8 Septiembre 2008.Buena parte de la psicología evolutiva y de la educación que conocemos en España ha sido elaborada desde paradigmas de investigación de corte positivista. Esto se debe por una parte a la concepción individualista que la psicología experimental ha contribuido a crear del individuo, y por otra, a la adopción de los modelos explicativos provenientes de las ciencias naturales, lo que ha dejado no sólo un elenco concreto de métodos de investigación legitimados, sino también un cierto esencialismo y biologicismo en las explicaciones de las acciones de las personas y en las causas de su desarrollo. No obstante, diversas corrientes filosóficas, teorías e investigaciones vienen adviertiendo que esa visión individualista y esencialista propia de la psicología no es capaz de responder a algunas cuestiones planteadas. Una de las más notables puede expresarse cuando Vygotsky (Wertsch, 1988) afirmaba que el ser humano experimenta dos tipos de desarrollo, el biológico y el cultural, y era necesario comprender ambos para comprender el desarrollo. Si tenemos esto en cuenta, veremos que la psicología del desarrollo, y probablemente la psicología en general, no ha hecho grandes aportaciones para tratar de comprender cómo se interrelacionan la mente y la cultura. Sin embargo, en otros países, los aspectos en relación con la mente y la cultura se han venido abordando desde hace tiempo. Es por ello que en este trabajo queremos hacer una revisión de las distintas aportaciones que se han hecho hasta ahora para comprender la relación entre la mente y la cultura que puedan contribuir al estudio de la psicología evolutiva y de la educación en España. De esta forma, un primer epígrafe del trabajo constará de una revisión teórica breve de las corrientes filosóficas y teorías científicas que han planteado los interrogantes acerca de la relación entre mente y cultura o sociedad. En un segundo epígrafe planteamos las ventajas metodológicas que la investigación etnogràfica de corte interpretativo (Erickson, 1989) tiene para el estudio de algunos de los aspectos destacados en el epígrafe anterior. Así, subrayaremos cómo la etnografía se ha enfrentado a aspectos como: a) el estudio de los procesos sociales en la vida cotidiana y en contexto natural, b) el significado de las acciones desde el punto de vista de los participantes, c) la documentación de las distintas capas de significado (Geertz, 2000) o niveles micro y macro del contexto de las acciones, d) el acceso a prácticas sociales ocultas gracias a la observación participante y a la relación con los participantes, e) la flexibilidad metodológica y la captación de las categorías locales, f) la reflexibidad como respuesta al subjetivismo y al papel del investigador en el campo. Así en las conclusiones, mostraremos qué implicaciones tienen los dos epígrafes anteriores para la respuesta que esta orientación metodológica da a algunas de las tensiones clásicas de la psicología del desarrollo

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

CMS : the TriDAS Project Technical Design Report; v.1, the Trigger Systems

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