Estudio sobre la integración en aula específica, de un IES, de alumnado diagnosticado como negativista desafiante y su posible inclusión en aula ordinaria

It is known that, nowadays, with the arrival of the inclusive school, in our classrooms we find a greater functional diversity in the students than in the past, diversity that is not always known and accepted within normality. The present investigation, based on the real experience, has as objective the integration in an IES of specific classroom of students affected by serious behavior disorders, such as the defiant negativist disorder, for its later inclusion in the ordinary classroom, in principle, under supervision. The sample consists of 5 subjects whose ages range between 13 and 15 years, who, due to serious alterations in their behavior, can not have full-time schooling in the ordinary classroom. Three of these students are enrolled in 1st of Compulsory Secondary Education (ESO) and 2 of them in 2nd. The serious behavioral problems led to the application of a behavior modification program and a cognitive restructuring and a self-control training.Es sabido que, en la actualidad, con la llegada de la escuela inclusiva, en nuestras aulas nosencontramos con una mayor diversidad funcional en el alumnado que en tiempos pasados, diversidad que no siempre es conocida y aceptada dentro de la normalidad. La presente investigación, basada en la experiencia real, tiene como objetivo la integración en un IES de un aula específica de alumnado afectado de trastornos graves de conducta, como es el trastorno negativista desafiante, para su posterior inclusión en el aula ordinaria, en principio, bajo supervisión. La muestra consta de 5 sujetos cuyas edades oscilan entre los 13 y 15 años, que por presentar graves alteraciones en su conducta no pueden tener una escolarización a tiempo completo en el aula ordinaria. Tres de estos alumnos, estan matriculados en 1º de la Educación Secundaria Obligatoria (ESO) y 2 de ellos en 2º. Los graves problemas de conducta llevaron a la aplicación de un programa de modificación de conducta cognitivo conductual, a una reestructuración cognitiva y a un entrenamiento en autocontrol

The impact of the COVID-19 pandemic on the mental health of healthcare workers:study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study

BACKGROUND: Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. METHODS: Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country’s income level. RESULTS: As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. CONCLUSIONS: This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-021-02211-9

La Ingeniería Automotriz clave para el desarrollo sostenible de Ecuador

El presente texto es una contribución al desarrollo de la sostenibilidad ecuatoriana y mantiene el debate sobre temas del estudio de la Ingeniería Automotriz. El mérito del libro radica en una triple condición: alimenta la investigación académica ecuatoriana, contribuye a llenar el vacío de producción científica automotriz direccionada a las necesidades del Ecuador y reconoce el esfuerzo de los investigadores que se dedican a la producción académica técnica. La Universidad Politécnica Salesiana —en su sede Guayaquil— realizó en 2018, las Segundas Jornadas Científicas de Ingeniería Automotriz; este texto es el producto final de ese evento académico, cuyas memorias técnicas son constituidas por ocho resultados de investigaciones en Ingeniería Automotriz que aportarán desarrollo sostenible al Ecuador en áreas como: el diseño, el control de contaminación, la eficiencia energética y la movilidad. Este recorrido por varias ramas de la Ingeniería Automotriz muestra al lector múltiples aplicaciones y cambios de paradigmas en la industria; no somos solamente consumidores de tecnología, somos también productores de la misma. Este texto da cuenta del desarrollo de la industria automotriz ecuatoriana. Ing. Renato Fierro J. MSc

The impact of the university upon local economy: three methods to estimate demand-side effects

C67, I2, D1,

Clinical Features of Guillain-Barré Syndrome With vs Without Zika Virus Infection, Puerto Rico, 2016

Importance: The pathophysiologic mechanisms of Guillain-Barré syndrome (GBS) associated with Zika virus (ZIKV) infection may be indicated by differences in clinical features. Objective: To identify specific clinical features of GBS associated with ZIKV infection. Design, Setting, and Participants: During the ZIKV epidemic in Puerto Rico, prospective and retrospective strategies were used to identify patients with GBS who had neurologic illness onset in 2016 and were hospitalized at all 57 nonspecialized hospitals and 2 rehabilitation centers in Puerto Rico. Guillain-Barré syndrome diagnosis was confirmed via medical record review using the Brighton Collaboration criteria. Specimens (serum, urine, cerebrospinal fluid, and saliva) from patients with GBS were tested for evidence of ZIKV infection by real-time reverse transcriptase-polymerase chain reaction; serum and cerebrospinal fluid were also tested by IgM enzyme-linked immunosorbent assay. In this analysis of public health surveillance data, a total of 123 confirmed GBS cases were identified, of which 107 had specimens submitted for testing; there were 71 patients with and 36 patients without evidence of ZIKV infection. Follow-up telephone interviews with patients were conducted 6 months after neurologic illness onset; 60 patients with and 27 patients without evidence of ZIKV infection participated. Main Outcomes and Measures: Acute and long-term clinical characteristics of GBS associated with ZIKV infection. Results: Of 123 patients with confirmed GBS, the median age was 54 years (age range, 4-88 years), and 68 patients (55.3%) were male. The following clinical features were more frequent among patients with GBS and evidence of ZIKV infection compared with patients with GBS without evidence of ZIKV infection: facial weakness (44 [62.0%] vs 10 [27.8%]; P \u3c .001), dysphagia (38 [53.5%] vs 9 [25.0%]; P = .005), shortness of breath (33 [46.5%] vs 9 [25.0%]; P = .03), facial paresthesia (13 [18.3%] vs 1 [2.8%]; P = .03), elevated levels of protein in cerebrospinal fluid (49 [94.2%] vs 23 [71.9%]; P = .008), admission to the intensive care unit (47 [66.2%] vs 16 [44.4%]; P = .03), and required mechanical ventilation (22 [31.0%] vs 4 [11.1%]; P = .02). Six months after neurologic illness onset, patients with GBS and evidence of ZIKV infection more frequently reported having excessive or inadequate tearing (30 [53.6%] vs 6 [26.1%]; P = .03), difficulty drinking from a cup (10 [17.9%] vs 0; P = .03), and self-reported substantial pain (15 [27.3%] vs 1 [4.3%]; P = .03). Conclusions and Relevance: In this study, GBS associated with ZIKV infection was found to have higher morbidity during the acute phase and more frequent cranial neuropathy during acute neuropathy and 6 months afterward. Results indicate GBS pathophysiologic mechanisms that may be more common after ZIKV infection

Implementation and Evaluation of Guillain-Barré Syndrome Surveillance in Puerto Rico during the 2016 Zika Virus Epidemic

OBJECTIVE: Guillain-Barré syndrome (GBS) is an uncommon autoimmune disorder that follows infection or vaccination, and increased incidence has been reported during Zika virus (ZIKV) transmission. During the 2016 ZIKV epidemic, the Puerto Rico Department of Health (PRDH) implemented the Enhanced GBS Surveillance System (EGBSSS). Here, we describe EGBSSS implementation and evaluate completeness, validity, and timeliness. METHODS: GBS cases were identified using passive surveillance and discharge diagnostic code for GBS. Completeness was evaluated by capture-recapture methods. Sensitivity and positive predictive value (PPV) for confirmed GBS cases were calculated for both case identification methods. Median time to completion of key time steps were compared by quarter (Q1-4) and hospital size. RESULTS: A total of 122 confirmed GBS cases with onset of neurologic illness in 2016 were identified. Capture-recapture methodology estimated that four confirmed GBS cases were missed by both identification methods. Identification of cases by diagnostic code had a higher sensitivity than passive surveillance (89% vs. 80%), but a lower PPV (60% vs. 72%). There was a significant decrease from Q1 to Q3 in median time from hospital admission to case reporting (11 days vs. 2 days, p = 0.032) and from Q2 to Q3 in median time from specimen receipt to arbovirus laboratory test reporting (35 days vs. 26 days, p = 0.004). CONCLUSION: EGBSSS provided complete, valid, and increasingly timely surveillance data, which guided public health action and supported healthcare providers during the ZIKV epidemic. This evaluation provides programmatic lessons for GBS surveillance and emergency response surveillance

The STARMEN trial indicates that alternating treatment with corticosteroids and cyclophosphamide is superior to sequential treatment with tacrolimus and rituximab in primary membranous nephropathy

International audienc