Perceived vulnerability and severity predict adherence to COVID-19 protection measures: the mediating role of instrumental coping

[EN] The COVID-19 disease has caused thousands of deaths worldwide and required the rapid and drastic adoption of various protective measures as main resources in the fight to reduce the spread of the disease. In the present study we aimed to identify socio cognitive factors that may influence adherence to protective measures toward COVID-19 in a Spanish sample. This longitudinal study analyzes the predictive value of perceived severity and vulnerability of infection, self-efficacy, direct exposure to the virus, and instrumental focused coping style for adhering to infection protection behaviors during the first months of the COVID-19 pandemic. It also tests sex and age differences in these factors and changes over time. A two-wave longitudinal study (N = 757) was conducted in March and April 2020 starting the day after a strict national lockdown was decreed in Spain. A path analysis was used to test direct and indirect effects between vulnerability and the adherence to protective behaviors. Results suggest that individuals’ perceived severity and vulnerability to COVID-19 and instrumental coping strategies are related to the use of more protective behaviors. This coping strategy mediates the effect of perceived vulnerability on engaging in protective behaviors, and this effect depends on direct exposure to COVID-19 and perceived self-efficacy moderators. Results suggest that recognizing one’s own abilities to engage in instrumental actions may facilitate adherence to protective measures in people who had not been directly exposed to COVID-19. Therefore, adopting instrumental coping strategies to manage an individual’s perceived vulnerability to infection may positively impact the adherence to protective behaviors, especially during the onset of an unexpected threat and when there is no prior direct experience with the situation.This research was supported by funds awarded by the European Regional Development Fund (ERDF) and the Department of Education of the Junta de Castilla y León (Spain) by order of 19 June 2020 to the project Coping Strategies in the Health Emergency Situation created by COVID-19. The University of Burgos awarded funding to the Social Inclusion and Quality of Life (SIQoL) research group

Off- and Online Heterosexual Dating Violence, Perceived Attachment to Parents and Peers and Suicide Risk in Young Women

Dating violence (DV) is a public health problem among young people, especially women. It involves violent acts towards one’s partner and occurs face-to-face (offline) or through the Internet (online). Offline DV is linked to suicidal ideation and attachment to parents and peers. Fewer studies analyze the psychological and social consequences of online DV. This study tests the link between young women’s DV victimization (off- and online), suicide risk (SR), and parent and peer support in a sample of young Spanish females (N = 1227) (Mage=19, SD = 2.82; range = 13–28). Results confirm that compared to non-victims off- and online DV increase suicidal thoughts and attempts. This effect is stronger for victims of both types of DV (thoughts: OR offline DV = 3.11; CI95% 2.06, 4.69; OR online DV = 2.37; CI95% 1.69, 3.32; OR off-online DV = 4.19 CI95% 2.44, 7.17) (attempts: OR offline DV = 4.02; CI95% 1.83, 8.81; OR online DV = 3.69; CI95% 1.96, 7.01; OR off-online DV = 10.55 CI95% 2.56, 44.43). Mediation and moderation models were used to assess the effect of perceived attachment of parents and friends in DV victims and SR. Mediation analyses indicated that perceived attachment and proximity to parents and peers reduces the impact of DV on SR. Moderation analyses showed that a high level of perceived peer attachment reduces the effect of offline DV on SR. Regarding off-online DV, a high level of perceived parent attachment mitigates suicide risk. Loneliness, lack of care from loved ones, and thwarted belongingness increase suicidal thoughts in DV victims. Peers and parents’ proximity may prevent risk behaviors in DV victims.This research was funded by CONICYT 2017/Doctorado en el Extranjero Becas Chile/2017, grant number 72180394 to Marcela Gracia Leiva, and by Basque government Post–Doctoral Scholarship to Alicia Puente Martínez, POS_2019_2_0014; This study was partially funded by grant 2019/00184/001 awarded by the Junta of Castilla y León (Spain) to the Social Inclusion and Quality of Life (SIQoL) research group and by grant Culture, Cognition and Emotion. Ref GIC12/91 IT–666–13 and the University of the Basque Country and Basque Government [grant number: GIC12/91 IT–666–13]

Current Systemic Treatment Options for Metastatic and Unresectable Pancreatic Cancer

Metastatic and local advanced unresectable pancreatic cancers are lethal conditions that always carry a poor prognosis with rare exceptions. Currently, the mainstay of therapy is cytotoxic chemotherapy plus best supportive care. First-line therapy for patients with a good performance status includes FOLFIRINOX or gemcitabine plus nab-paclitaxel regimens. Patients carrying a deleterious germline BRCA mutation can be treated with maintenance olaparib after FOLFIRINOX. Patients with a poor performance status, but still fit enough for chemotherapy, may be treated with single agent gemcitabine. Second-line therapy will depend on previous therapy and current performance status. Options for patients treated with gemcitabine-based regimens are 5-fluorouracil plus leucovorin plus either nanoliposomal irinotecan, irinotecan or oxaliplatin. Patients that were treated with first line FOLFIRINOX may benefit from a gemcitabine-based chemotherapy, but evidence from randomized trials is lacking. Other options like immunotherapy and targeted therapies yield benefit only in very selected cases, and it is still an area of research

Prevalence of EGFR Mutations in Lung Cancer in Uruguayan Population

Background. Incorporation of molecular analysis of the epidermal growth factor receptor (EGFR) gene into routine clinical practice represents a milestone for personalized therapy of the non-small-cell lung cancer (NSCLC). However, the genetic testing of EGFR mutations has not yet become a routine clinical practice in developing countries. In view of different prevalence of such mutations among different ethnicities and geographic regions, as well as the limited existing data from Latin America, our aim was to study the frequency of major types of activating mutations of the EGFR gene in NSCLC patients from Uruguay. Methods. We examined EGFR mutations in exons 18 through 21 in 289 NSCLC Uruguayan patients by PCR-direct sequencing. Results. EGFR mutations were detected in 53 of the 289 (18.3%) patients, more frequently in women (23.4%) than in men (14.5%). The distribution by exon was similar to that generally reported in the literature. Conclusions. This first epidemiological study of EGFR mutations in Uruguay reveals a wide spectrum of mutations and an overall prevalence of 18.3%. The background ethnic structure of the Uruguayan population could play an important role in explaining our findings

Evaluación geriátrica guiada por G8 en la decisión del tratamiento de adultos mayores con cáncer. Un estudio piloto

NOTA DE CONTRIBUCIÓN: Lucia Richter: a,b,c,e,f, Ariana Revollo: a,b,c,e,f, Noelia Silveyra: a, b, c, d, e, f, g, h, Natalia Lladó: b, c, e, g, Ana Kmaid: a, b, e, f, g, Luis Ubillos: a, c, e, f, g a) Concepción y diseño del estudio b) Recolección de los datos o realización de los experimentos c) Análisis e interpretación de los datos o resultados d) Análisis estadísticos de los datos o resultados e) Elaboración de un borrador del manuscrito f) Escritura del manuscrito g) Supervisión del trabajo h) Colección y manejo de las muestras provenientes de los pacientes Lucia Richter: Servicio de Oncología Clínica. Hospital de Clínicas, Facultad de Medicina, Universidad de la República. Montevideo – Uruguay. ORCID: 0000-0001-9755-3098 Ariana Revollo: Departamento de Geriatría y Gerontología. Hospital de Clínicas, Facultad de Medicina, Universidad de la República. Montevideo – Uruguay. ORCID: 0000-0002-8248-5915 Noelia Silveyra: Servicio de Oncología Clínica. Hospital de Clínicas, Facultad de Medicina-Universidad de la República. Montevideo – Uruguay. ORCID: 0000-0002-0021-5760 Natalia Lladó: Departamento de Geriatría y Gerontología. Hospital de Clínicas, Facultad de Medicina, Universidad de la República. Montevideo – Uruguay. ORCID: 0000-0003-3100-5843 Ana Kmaid: Departamento de Geriatría y Gerontología. Hospital de Clínicas, Facultad de Medicina, Universidad de la República. Montevideo – Uruguay. ORCID: 0000-0003-4504-5467 Luis Ubillos: Departamento de Geriatría y Gerontología. Hospital de Clínicas, Facultad de Medicina, Universidad de la República. Montevideo – Uruguay. Correo electrónico: [email protected] ORCID: 0000-0002-9081-7545Introducción: El cáncer es una enfermedad asociada al envejecimiento y tiene una alta prevalencia en los adultos mayores. La valoración geriátrica integral (VGI) mejora los cuidados de los adultos mayores (AM) con cáncer. En contextos sanitarios con recursos limitados, no todos los AM podrán ser evaluados por un geriatra. Un modelo en 2 pasos, incluyendo el test G8, en la consulta habitual del oncólogo, permite seleccionar aquellos pacientes que se beneficiarán de una VGI. Esta puede aportar en la toma de decisiones del tratamiento oncológico específico. Objetivo: Evaluar el beneficio del test G8 y la VGI en ≥ 70 años con cáncer candidatos a recibir quimioterapia. Material y Métodos: Estudio observacional, descriptivo, de corte transversal, de una muestra no probabilística de pacientes ≥ de 70 años con diagnóstico de cáncer y candidatos a recibir quimioterapia. Se aplicó el G8 por el oncólogo y se completó la VGI en los que presentaron alteración en algunas de las áreas evaluadas. Resultados: Se analizaron 32 pacientes. Se realizó G8 a todos, en 21 de ellos se completó la VGI. En estos, en reunión multidisciplinaria con oncólogo y geriatra se discutió el tratamiento. En el 38% de los pacientes se cambió la conducta oncológica tras contar con la valoración geriátrica integral. Conclusión: Creemos que la incorporación del G8 en la práctica clínica del oncólogo aporta una herramienta de cribado útil para identificar los pacientes ≥70 años que se benefician de una VGI previa al inicio de tratamiento oncoespecífico, optimizando de esta manera los recursos.Introduction: Cancer is a disease associated with aging and has a high prevalence in older adults. Comprehensive geriatric assessment (CGA) improves the care of older adults (OA)with cancer. In healthcare settings with limited resources, not all OA may be evaluated by a geriatrician. A 2-step model, including the G8 test, in the usual oncologist consultation, allows selecting those patients who will benefit from CGA. This can contribute to decision-making regarding specific cancer treatment. Aims: To evaluate the benefit of the incorporation of the G8 test and CGA in the ≥ 70 years with cancer candidates for chemotherapy. Methods: Observational, descriptive, crosssectional study of a non-probability sample of patients ≥ 70 years of age with a diagnosis of cancer and candidates for chemotherapy. The G8 was applied by the oncologist and the CGA was completed in those who presented alteration in some of the evaluated areas. Results: 32 patients were analyzed. G8 was performed in all, in 21 of them the CGA was completed. In these, the treatment was discussed in a multidisciplinary meeting with an oncologist and a geriatrician. Oncological behavior was changed in 38% of patients after having a comprehensive geriatric evaluation. Conclusion: We believe that the incorporation of the G8 test in the clinical practice of the oncologist provides a useful screening tool to identify patients ≥70 years who benefit from CGA prior to the start of oncospecific treatment, thus optimizing resources.Introdução: O câncer é uma doença associada ao envelhecimento e tem alta prevalência em idosos. A avaliação geriátrica ampla (AGA) melhora o atendimento a idosos com câncer. Em ambientes de saúde com recursos limitados, nem todos eles podem ser avaliadas por um geriatra. Um modelo de duas etapas, incluindo o teste G8, na consulta oncológica usual, permite selecionar os pacientes que serão beneficiados pela AGA. Isso pode contribuir para a tomada de decisões em relação ao tratamento específico do câncer. Objetivo: Avaliar o benefício da incorporação do teste G8 e AGA nos ≥ 70 anos com câncer, candidatos à quimioterapia. Material e Métodos: Estudo observacional, descritivo e transversal de uma amostra não probabilística de pacientes com idade ≥ 70 anos com diagnóstico de câncer e candidatos à quimioterapia. O G8 foi aplicado pelo oncologista e a AGA foi realizada naqueles que apresentaram alteração em algumas das áreas avaliadas. Resultados: 32 pacientes foram analisados. O G8 foi realizado em todos, em 21 deles a AGA foi aplicada. Nesses, o tratamento foi discutido em reunião multidisciplinar com oncologista e geriatra. O tratamento oncológico foi alterado em 38% dos pacientes após uma avaliação geriátrica amplia. Conclusão: Acreditamos que a incorporação do teste G8 na prática clínica do oncologista fornece uma ferramenta de triagem útil para identificar pacientes com idade ≥70 anos que se beneficiam da AGA antes do início do tratamento oncoespecífico, otimizando recursos

Changing plasma cytokine, chemokine and growth factor profiles upon differing malaria transmission intensities

Background: Malaria epidemiological and immunological data suggest that parasite tolerance wanes in the absence of continuous exposure to the parasite, potentially enhancing pathogenesis. The expansion of control interventions and elimination campaigns raises the necessity to better understand the host factors leading to susceptibility or tolerance that are afected by rapid changes in malaria transmission intensity (MTI). Mediators of cellular immune responses are responsible for the symptoms and pathological alterations during disease and are expected to change rapidly upon malaria exposure or cessation. Methods: The plasma concentrations of 30 cytokine, chemokine and growth factors in individuals of all ages from a malaria endemic area of southern Mozambique were compared between 2 years of diferent MTI: 2010 (lower, n=234) and 2013 (higher, n=143). The efect of the year on the correlations between cytokines, chemokines and growth factors and IgGs to Plasmodium falciparum (markers of exposure) was explored. The efects of age, sex, neighbourhood and parasitaemia on analyte levels and their interactions with year were also assessed. Results: An inverse correlation of several cellular immune mediators with malarial antibodies in 2013, and a lack of correlation or even a positive correlation in 2010 were observed. Most cytokines, chemokines and growth factors, regardless of their immune function, had higher concentrations in 2010 compared with 2013 in P. falciparum-infected and uninfected subjects. Age and neighbourhood showed an efect on analyte concentrations. Conclusions: The results show a diferent regulation of the cellular immune response in 2010 vs 2013 which could be related to a loss of immune-tolerance after a decline in MTI in 2010 and previous years, and a rapid re-establishment of tolerance as a consequence of more continuous exposure as MTI began increasing in 2012. Cellular immune mediators warrant further investigation as possible surrogates of MTI-associated host susceptibility or tolerance

Antibody responses to α-Gal in African children vary with age and site and are associated with malaria protection

Naturally-acquired antibody responses to malaria parasites are not only directed to protein antigens but also to carbohydrates on the surface of Plasmodium protozoa. Immunoglobulin M responses to α-galactose (α-Gal) (Galα1-3Galβ1-4GlcNAc-R)-containing glycoconjugates have been associated with protection from P. falciparum infection and, as a result, these molecules are under consideration as vaccine targets; however there are limited field studies in endemic populations. We assessed a wide breadth of isotype and subclass antibody response to α-Gal in children from Mozambique (South East Africa) and Ghana (West Africa) by quantitative suspension array technology. We showed that anti-α-Gal IgM, IgG and IgG1–4 levels vary mainly depending on the age of the child, and also differ in magnitude in the two sites. At an individual level, the intensity of malaria exposure to P. falciparum and maternally-transferred antibodies affected the magnitude of α-Gal responses. There was evidence for a possible protective role of anti-α-Gal IgG3 and IgG4 antibodies. However, the most consistent findings were that the magnitude of IgM responses to α-Gal was associated with protection against clinical malaria over a one-year follow up period, especially in the first months of life, while IgG levels correlated with malaria risk

Lecciones y practicum de Derecho Constitucional

El presente proyecto de innovación docente persigue un doble objetivo: la actualización de los contenidos de Lecciones de Derecho Constitucional II y la reorganización y difusión de las prácticas de Derecho Constitucional II. Mientras que la primera finalidad ya ha sido satisfecha, la segunda se está desarrollando al tiempo en el que se imparten las lecciones por parte de los distintos profesores.Departamento de Derecho Constitucional, Procesal y Eclesiástico del Estad

El proceso de integración europea y la convergencia de los niveles españoles de gasto en protección social

El presente trabajo resume algunos de los resultados obtenidos de un trabajo empírico orientado a valorar el proceso de convergencia europea en el aspecto concreto de la intensidad con que los países europeos afrontan la protección social de sus ciudadanos. Para el período 1985-97, las técnicas clásicas de análisis de convergencia �convergencia sigma y convergencia beta� no permiten afirmar con garantías que exista convergencia en los valores de intensidad media como gasto en protección social por habitante alcanzados por los once países objeto de estudio. El trabajo incluye la aplicación de una tercera técnica. Ésta consiste en obtener patrones econométricos para la intensidad del gasto social en función del PIB per cápita. Los patrones obtenidos para cada año, representan una norma europea que relaciona el gasto realizado con las capacidades económicas en cada caso, de modo que la evolución temporal de la distancia entre la intensidad real y normal describe, para cada país, su particular proceso de convergencia o divergencia respecto a la norma europea. En el trabajo se exponen los resultados de algunos países en los que se puede observar una evolución divergente frente a la norma comunitaria