¿Qué hacer si a mi hijo le derivan a Educación Especial?

Durante el proceso de escolarización de su hijo con síndrome de Down, la mayoría de las familias escucha que “tiene necesidades educativas especiales”. Son muchas las dudas que asaltan a los padres con relación a este término: ¿A qué se refiere exactamente? ¿Cuándo se puede decir que un alumno tiene necesidades educativas especiales? ¿Qué debemos hacer y cómo actuar si le derivan a un Centro de Educación Especial? La asesora en educación de Down España, Ana Belén Rodríguez Plaza, ofrece en este texto las claves y la orientación para que los padres sepan qué deben hacer frente a esta situación

Lasso Estimation of an Interval-Valued Multiple Regression Model

A multiple interval-valued linear regression model considering all the cross-relationships between the mids and spreads of the intervals has been introduced recently. A least-squares estimation of the regression parameters has been carried out by transforming a quadratic optimization problem with inequality constraints into a linear complementary problem and using Lemke's algorithm to solve it. Due to the irrelevance of certain cross-relationships, an alternative estimation process, the LASSO (Least Absolut Shrinkage and Selection Operator), is developed. A comparative study showing the differences between the proposed estimators is provided

El proceso de planificación del alta en centros de rehabilitación: sistemas de información para la evaluación de pacientes

IV Congreso Nacional de Informática de la Salud; 2001 Mar 28-30; Madrid; organizado por la Sociedad Española de Informática de la Salud[Resumen] La planificación del alta es un proceso que debe comenzar desde el mismo momento del ingreso. Debe ser sistemático, interdisciplinario y coordinado por un especialista sanitario. Debe involucrar al paciente y a su familia e incluir la valoración de su entorno de vida, soporte familiar, valoración de la discapacidad y posibilidades de llevar a cabo una rehabilitación vocacional. Todas las decisiones que se tomen en el proceso del alta deben implicar y reflejar el consenso de la familia y el propio paciente con el equipo médico (1). Por lo tanto, surge la necesidad de utilizar algún sistema de medición de incapacidad, dada la gran variedad de patologías que abarca la Medicina Física y Rehabilitación y la existencia de cuadros nosológicos muy diferentes en cuanto a su etiología, gravedad y pronóstico. En este contexto, se hace necesaria la utilización de escalas de valoración funcional, que simplifiquen este trabajo y posibiliten un mayor control de todo el proceso desde su inicio. Existen múltiples escalas de valoración, tanto específicas como de propósito general, siendo la más utilizada la Functional Independence Measure (FIM) de la Uniform Data System for Medical Rehabilitation. A partir de estas escalas se han desarrollado diferentes sistemas de datos: el Union Data System (UDS) y el TBI Model Systems National Database del National Institute on Disability and Rehabilitation Research entre los más destacados. En este artículo, además de exponer las distintas fases del proceso de planificación del alta, se hará un estudio de los distintos sistemas de información desarrollados, así como de las escalas de valoración utilizadas

Model biopsychicalsocial in the syndromes of vertebral pain: implications for the protocolize

[Resumen] De forma tradicional el modelo biomédico ha predominado en la práctica asistencial. A diferencia de éste, el modelo biopsicosocial considera a la persona como un todo y hace énfasis sobre la función en lugar de centrarse exclusivamente en el alivio del dolor. En este sentido, la Fisioterapia para el tratamiento de los problemas de espalda, y en concreto para la cervicalgia, tiene que considerar, además del alivio del dolor, la cronicidad y la recurrencia como elementos a considerar en el diseño de actividades protocolizadas.[Abstract] In a traditional way the biomedical model has prevailed in the health care. Against it the biopsychicalsocial pattern considers to the person as a whole and it makes emphasis on the function instead of being centered exclusively in the relief of the pain. In this sense, Physiotheraphy for the treatment of the back problems and in this case for the neck pain, it has to consider besides the relief of the pain, the chronic and the new episodies like elements to consider in the design of protocolized activities

Impact of reducing sitting time in women with fibromyalgia and obesity: a randomized controlled trial

Background: Sitting time has negative effects on health, increasing the risk of obesity, osteoporosis, diabetes, and cancer. Thus, primary health care education interventions aimed to reduce sitting time and sedentary behavior could have beneficial effects on people’s health and wellbeing. The purpose of this study was to assess the effectiveness of an intervention based on reducing sitting time to decrease cardiometabolic risk on a sample of women diagnosed with fibromyalgia and moderate obesity. Methods: Randomized controlled trial to evaluate the effectiveness of an intervention to decrease cardiometabolic risk in 84 participants. Sedentary behavior was monitored using an accelerometer before and at 3-month follow-up. Results: Compared with the control group, body mass index decreased, and the number of steps taken increased, in the intervention group 3 months after the intervention. No significant differences were found in the rest of the variables measured. Conclusion: The intervention group decreased sitting time after the intervention. Group activities and support from primary care may be useful to improve treatment adherence

Physical fitness reference standards for preschool children: the PREFIT project

Objectives: Reference values are necessary for classifying children, for health screening, and for early prevention as many non-communicable diseases aggravate during growth and development. While physical fitness reference standards are available in children aged 6 and older, such information is lacking in preschool children. Therefore, the purposes of this study were (1) to provide sex-and age-specific physical fitness reference standards for Spanish preschool children; and (2) to study sex differences across this age period and to characterise fitness performance throughout the preschool period. Design: Cross-sectional. Methods: A total of 3179 preschool children (1678 boys) aged 2.8–6.4 years old from Spain were included in the present study. Physical fitness was measured using the PREFIT battery. Results: Age- and sex-specific percentiles for the physical fitness components are provided. Boys performed better than girls in the cardiorespiratory fitness, muscular strength, and speed-agility tests over the whole preschool period studied and for the different percentiles. In contrast, girls performed slightly better than boys in the balance test. Older children had better performance in all fitness tests than their younger counterparts. Conclusions: Our study provides age- and sex-specific physical fitness reference standards in preschool children allowing interpretation of fitness assessment. Sexual dimorphism in fitness tests exists already at preschool age, and these differences become larger with age. These findings will help health, sport, and school professionals to identify preschool children with a high/very low fitness level, to examine changes in fitness over time, and to analyse those changes obtained due to intervention effects.The PREFIT project takes place thanks to the funding linked to the Ramón y Cajal grant held by FBO (RYC-2011-09011). CC-S is supported by a grant from the Spanish Ministry of Economy and Competitiveness (BES-2014-068829). JRR and FBO are supported by grants from the Spanish Ministry of Science and Innovation (RYC-2010-05957 and RYC-2011-09011, respectively). In addition, this study was further supported by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). Additional funding from the SAMID III network, RETICS, funded by the PNI+D+I 2017-2021 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (ERDF) (Ref. RD16/0022), the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI), the University of the Basque Country (GIU14/21), and the University of Zaragoza (JIUZ-2014-BIO-08)

Respiratory Immunization With a Whole Cell Inactivated Vaccine Induces Functional Mucosal Immunoglobulins Against Tuberculosis in Mice and Non-human Primates

Vaccination through the natural route of infection represents an attractive immunization strategy in vaccinology. In the case of tuberculosis, vaccine delivery by the respiratory route has regained interest in recent years, showing efficacy in different animal models. In this context, respiratory vaccination triggers lung immunological mechanisms which are omitted when vaccines are administered by parenteral route. However, contribution of mucosal antibodies to vaccine- induced protection has been poorly studied. In the present study, we evaluated in mice and non-human primates (NHP) a novel whole cell inactivated vaccine (MTBVAC HK), by mucosal administration. MTBVAC HK given by intranasal route to BCG-primed mice substantially improved the protective efficacy conferred by subcutaneous BCG only. Interestingly, this improved protection was absent in mice lacking polymeric Ig receptor (pIgR), suggesting a crucial role of mucosal secretory immunoglobulins in protective immunity. Our study in NHP confirmed the ability of MTBVAC HK to trigger mucosal immunoglobulins. Importantly, in vitro assays demonstrated the functionality of these immunoglobulins to induce M. tuberculosis opsonization in the presence of human macrophages. Altogether, our results suggest that mucosal immunoglobulins can be induced by vaccination to improve protection against tuberculosis and therefore, they represent a promising target for next generation tuberculosis vaccines

Lymphocytic choriomeningitis arenavirus requires cellular COPI and AP-4 complexes for efficient virion production

Lymphocytic choriomeningitis virus (LCMV) is a bisegmented negative-sense RNA virus classified within the Arenaviridae family of the Bunyavirales order. LCMV is associated with fatal disease in immunocompromized populations, and as the prototypical arenavirus, acts as a model for the many serious human pathogens within this group. Here, we examined the dependence of LCMV multiplication on cellular trafficking components using a recombinant LCMV expressing enhanced green fluorescent protein in conjunction with a curated siRNA library. The screen revealed a requirement for subunits of both the coat protein 1 (COPI) coatomer and adapter protein 4 (AP-4) complexes. By rescuing a recombinant LCMV harboring a FLAG-tagged glycoprotein (GP-1) envelope spike (rLCMV-GP1-FLAG), we showed infection resulted in marked co-localization of individual COPI and AP-4 components with both LCMV nucleoprotein (NP) and GP-1, consistent with their involvement in viral processes. To further investigate the role of both COPI and AP-4 complexes during LCMV infection, we utilized the ARF-I inhibitor brefeldin A (BFA) that prevents complex formation. Within a single 12-h cycle of virus multiplication, BFA pre-treatment caused no significant change in LCMV-specific RNA synthesis, alongside no significant change in LCMV NP expression, as measured by BFA time-of-addition experiments. In contrast, BFA addition resulted in a significant drop in released virus titers, approaching 50-fold over the same 12-h period, rising to over 600-fold over 24 h. Taken together, these findings suggest COPI and AP-4 complexes are important host cell factors required for the formation and release of infectious LCMV

Prevención secundaria tras un síndrome coronario agudo. Resultados a medio plazo de un programa de rehabilitación cardiaca

Introducción Los Programas de Rehabilitación Cardiaca han adquirido gran relevancia como herramienta para mejorar el pronóstico y la calidad de vida de pacientes que han presentado un síndrome coronario agudo. Objetivo Evaluar los resultados de un programa de rehabilitación cardiaca a medio plazo. Materiales y métodos Estudio descriptivo retrospectivo de 121 pacientes que presentaron un síndrome coronario agudo y fueron incluidos en el programa de rehabilitación cardiaca. Se analizaron las características demográficas, antropométricas, analíticas y de capacidad funcional a la inclusión, tras finalizar el programa presencial y a los 12 meses. Resultados La edad media fue 54 ± 7 años. El factor de riesgo cardiovascular más prevalente fue el sobrepeso/obesidad (88, 4%). Tras la finalización del programa de rehabilitación cardiaca disminuyeron significativamente los valores de colesterol LDL (81, 1 ± 28, 7 vs. 76, 5 ± 31, 5 mg/dl; p 0, 03). Un porcentaje significativo de diabéticos alcanzaron objetivos de Hb A1c < 7% (50% vs. 68, 5%; p 0, 01). El perímetro abdominal mostró una disminución estadísticamente significativa (100, 8 ± 12, 8 vs. 99, 5 ± 12, 3 cm; p 0, 004). El 89, 3% de los pacientes mejoraron su capacidad funcional. En la revisión anual la mayoría de los parámetros estudiados mostraron una discreta tendencia negativa. Un 47, 36% de los fumadores a la inclusión mantenían el hábito tabáquico al año. Conclusiones Los programas de rehabilitación cardiaca mejoran el control de los factores de riesgo cardiovascular, cambios de estilo de vida y capacidad funcional en los pacientes que han sufrido un síndrome coronario agudo. Es preciso reforzar las estrategias de control para mantener estos beneficios a medio-largo plazo. Introduction: Cardiac rehabilitation programmes have become a very important tool for improving the prognosis and quality of life of patients that have suffered an acute coronary syndrome. Objective: To evaluate the medium-term results of a cardiac rehabilitation programme. Materials and methods: A descriptive study of 121 patients that presented with an acute coronary syndrome and were included in a cardiac rehabilitation programme. An analysis was performed on the demographic and anthropometric characteristics, as well as laboratory tests and functional capacity on inclusion, after finishing the programme, and at 12 months. Results: The mean age of the patients was 54 ± 7 years. The most prevalent cardiovascular risk factor was overweight / obesity (88.4%). After finishing the cardiac rehabilitation programmes, the LDL Cholesterol values significantly decreased (81.1 ± 28.7 vs. 76.5 ± 31.5 mg/dl; P =.03). A significant percentage of diabetics reached objectives of an Hb A1c < 7% (50% vs. 68.5%; P =.01). The abdominal circumference showed a statistically significant decrease (100.8 ± 12.8 vs. 99.5 ± 12.3 cm; P =.004). An improvement in functional capacity was observed in 89.3% of the patients. In the annual review, the majority of the parameters studied showed a slight negative trend. Just under half (47.36%) of smokers at inclusion maintained the tobacco habit at one year. Conclusions: Cardiac rehabilitation programmes improve the control of cardiovascular risk factors, changes in life style and functional capacity in patients that had suffered an acute coronary syndrome. Control strategies need to be enforced in order to maintain these benefits in the medium-long term

The relative age effect on physical fitness in preschool children

The aim of the present study was to investigate the existence of a relative age effect (RAE) on physical fitness of preschoolers. Anthropometry and physical fitness were assessed in 3147 children (3–5 years old) using the PREFIT battery. Based on the birth year, participants were divided into 3year groups (3-, 4- and 5-years). Within each year group, 4quarter groups were created: quarter 1, preschoolers born from January to March; quarter 2, from April to June; quarter 3, from July to September; quarter 4, from October to December. The MANCOVA analysis revealed a main effect of year group (Wilks’ ¿ = 0.383; F10, 5996 = 369.64; p &lt; 0.001, ¿p 2 = 0.381) and of quarter (Wilks’ ¿ = 0.874; F15, 8276.6 = 27.67; p &lt; 0.001; ¿p 2 = 0.044) over the whole battery of tests. To the best of our knowledge, this is the first study to report the existence of RAE at the preschool stage. In general, performance improved as the relative age increased (i.e., those born in quarter 1 performed better than those in the other quarters). Individualization strategies should be addressed within the same academic year not only in elementary or secondary years but also in preschoolers