Evaluating a Relationship Education Program with Incarcerated Adults

Research indicates healthy family relationships can reduce recidivism. More effort has been placed towards providing family life programming in prisons to promote healthy individual and relational functioning, yet only a handful of studies have evaluated and provided insight on relationship education (RE) for incarcerated adults. This study contributes to this emerging effort and examines changes following participation in a RE program, using a sample of 461 incarcerated men and women. Findings indicate significant improvements in anxiety and depressive symptoms and conflict resolution skills. Additional tests of moderation of change by gender, relationship status, and child age revealed a greater change in individual functioning for those in a relationship compared to those who were not. Indications are that RE programs hold promise for contributing to better individual well-being and healthy relationships during incarceration and the potential for reducing recidivism incidence after re-entry

Effectiveness of a pharmacogenetic tool at Improving treatment efficacy in major depressive disorder: A meta-analysis of three clinical studies

Several pharmacogenetic tests to support drug selection in psychiatric patients have recently become available. The current meta-analysis aimed to assess the clinical utility of a commercial pharmacogenetic-based tool for psychiatry (Neuropharmagen®) in the treatment management of depressive patients. Random-effects meta-analysis of clinical studies that had examined the effect of this tool on the improvement of depressive patients was performed. Effects were summarized as standardized differences between treatment groups. A total of 450 eligible subjects from three clinical studies were examined. The random effects model estimated a statistically significant effect size for the pharmacogenetic-guided prescription (d = 0.34, 95% CI = 0.11-0.56, p-value = 0.004), which corresponded to approximately a 1.8-fold increase in the odds of clinical response for pharmacogenetic-guided vs. unguided drug selection. After exclusion of patients with mild depression, the pooled estimated effect size increased to 0.42 (95% CI = 0.19-0.65, p-value = 0.004, n = 287), corresponding to an OR = 2.14 (95% CI = 1.40-3.27). These results support the clinical utility of this pharmacogenetic-based tool in the improvement of health outcomes in patients with depression, especially those with moderate-severe depression. Additional pragmatic RCTs are warranted to consolidate these findings in other patient populations

Comprensión del proceso meiótico en estudiantes del profesorado en Ciencias Biológicas

Este estudio se centró en las dificultades vinculadas a la comprensión del proceso meiótico en estudiantes del profesorado en Ciencias Biológicas, con el objeto de realizar aportes fundamentados para la enseñanza del tema. Se trató de una investigación de tipo exploratoria en la que se planteó una situación hipotética (cuestionario abierto) a una muestra de 65 alumnos. La misma permitió identificar dificultades en la comprensión de estos contenidos, que en algunos casos, persisten en alumnos próximos a egresar. Fundamentados en esta indagación, se definieron algunos criterios que deberían orientar el tratamiento de los temas mencionados hacia el desarrollo de estrategias de trabajo que colaboren en el logro de aprendizajes más duraderos por parte del alumnado.Facultad de Humanidades y Ciencias de la Educació

HPV distribution in cervical cancer in Portugal. A retrospective study from 1928 to 2005

Objectives: To determine human papillomavirus (HPV) types in invasive cervical cancer in Portugal. Methods: Cases diagnosed at the Institute Portugues de Oncologia de Lisboa de Francisco Gentil from the year 1928 to 2005 were selected for HPV DNA detection and genotyping using SPF10/DEIA/LiPA25 system. Results: Of the 1214 samples that were considered appropriate for HPV detection, 714 (58.8%; 95% CI: 56.0-61.6%) were positive for HPV DNA. This detection rate varied being lower in the first 3 decades (31.3%; 50.1%; 46.5%) and higher in the last decades (77.4-95.1%). This difference was due probably to the fixative used in the first three decades. The five most common types identified among HPV positive cases were HPV16 (58.2%), HPV18 (9.2%), HPV33 (6.2%), HPV45 (4.7%) and HPV31 (4.4%). Multiple infections were detected in 2.8% of the cases. HPV16 and 18 accounted for 67.4% of infections. There were no statistically significant changes of these types over the studied period. An increase at patient's age at diagnosis was observed in the last decades (p < 0.001). Conclusion: HPV16 and 18 accounts for almost 70% of cervical cancers in all 9 decades studied and support data that effective vaccination against these 2 types will reduce the cervical burden in Portuguese women

Estimation of the overall burden of cancers, precancerous lesions, and genital warts attributable to 9-valent HPV vaccine types in women and men in Europe

Background: In addition to cervical cancer, human papillomavirus (HPV) is responsible for a significant proportion of cancers and precancerous lesions of the vulva, vagina, anus, penis, head and neck, as well as genital warts. We estimated the annual number of new cases of these diseases attributable to 9-valent HPV vaccine types in women and men in Europe. Methods: The annual number of new cancers of the cervix, vulva, vagina, anus, penis, and selected head and neck sites in the population of the European Medicines Agency territory was estimated based on age-specific incidence rates extracted from Cancer Incidence in 5 Continents, Volume X and Eurostat population data for 2015. The annual number of new cancers attributable to 9-valent HPV vaccine types was estimated by applying the HPV attributable fraction from reference publications based on a large European multicenter study. For non-cervical cancers, HPV attributable fractions were based on oncogenically-active HPV infections only (i.e., detection of HPV DNA and either mRNA and/or p16 positivity). For precancerous lesions of the cervix, vulva, vagina, and anus, and for genital warts, previously published estimations were updated for the 2015 population. Results: The annual number of new cancers attributable to 9-valent HPV vaccine types was estimated at 47,992 (95% bound: 39,785-58,511). Cervical cancer showed the highest burden (31,130 cases), followed by head and neck cancer (6,786 cases), anal cancer (6,137 cases), vulvar cancer (1,466 cases), vaginal cancer (1,360 cases), and penile cancer (1,113 cases). About 81% were estimated to occur in women and 19% in men. The annual number of new precancerous lesions (CIN2+, VIN2/3, VaIN2/3, and AIN2/3) and genital warts attributable to 9-valent HPV vaccine types was estimated at 232,103 to 442,347 and 680,344 to 844,391, respectively. Conclusions: The burden of cancers associated with 9-valent HPV vaccine types in Europe is substantial in both sexes. Head and neck cancers constitute a heavy burden, particularly in men. Overall, about 90% of HPV-related cancers, 80% of precancerous lesions, and 90% of genital warts are expected to be attributable to 9-valent HPV vaccine types each year, demonstrating the important preventive potential of the 9-valent HPV vaccine in Europe

Engaging with a Prevention Approach: System Supports Needed in Child Abuse and Neglect Prevention

Public policy has been shifting from child abuse and neglect (CAN) intervention toward prevention, using public health style frameworks, which emphasize shared community and legislative responsibilities to support families (Browne, 2014; CDC, 2014). Analysis of qualitative data from statewide focus groups held in 2019 in Alabama with 99 community-based CAN prevention workers shows strengths in community collaboration, but also, struggles to help families meet basic needs because of lack of community resources, such as transportation and quality child care, and other barriers, including stigma. The results demonstrate confusion between prevention, which is intended to build family resilience to avert crisis, and intervention, meant to reunite families after child protection services involvement. We recommend researchers consistently link CAN research to prevention frameworks so as to build meaningful understanding how to create better prevention programs. Future practitioners should understand prevention, and be prepared to document their work so as to demonstrate need

The impact of p16(ink4a) positivity in invasive vulvar cancer on disease-free and disease-specific survival, a retrospective study

Purpose To evaluate HPV and p16(ink4a) status as prognostic factors in patients with invasive vulvar cancer. Methods Retrospective analysis of disease-free (DFS) and disease-specific survival (DSS) of patients with invasive vulvar cancer at a single tertiary care center. Histology, HPV and p16(ink4a) status were evaluated in the context of a global multicenter trial. Logistic regression models were performed to identify the impact of p16(ink4a) positivity. Results 135 patients were included in the analysis. 32 (23.7%) showed a p16(ink4a) expression of over 25%. Disease-free and disease-specific survival was longer in p16(ink4a) positive patients (23 vs. 10 months, p = 0.004, respectively, 29 vs. 21 months, p = 0.016). In multivariate analysis, p16(ink4a) positivity was an independent parameter for DFS (p = 0.025, HR: 2.120 (1.100-4.085)), but not for DSS (p = 0.926, HR: 1.029 (0.558-1.901), in contrast to age and tumor stage. Conclusions Age and tumor stage negatively affect survival. However, disease-free survival is significantly longer in patients with p16(ink4a) positive invasive vulvar cancer

El impacto del cambio climático en la salud: una aproximación desde el contexto urbano con enfoque One Health

El cambio climático afecta a la salud ambiental, animal y -directa e indirectamente- a la humana. Los escenarios urbanos, como ámbitos críticos a este respecto, requieren abordar la cuestión de forma urgente. Y, para ello, el concepto One Health ofrece una componente diferenciadora. Aplicado a planificación y diseño urbanos, permite poner sobre la mesa problemáticas y perspectivas en materia de calidad de vida y mejora ambiental que, a la luz de los riesgos derivados del calentamiento global, resulta esencial considerar. El presente artículo constata esa realidad partiendo de una revisión crítica de problemáticas y de aplicabilidad del concepto. Más allá de las barreras y ambigüedades que pueden acompañarlo, el potencial del enfoque reside en la atención prioritaria a las relaciones, y muy especialmente a las interdependencias entre salud humana, animal y del medioambiente, en un contexto de complejidad. Se evidencia también, en este sentido, el valor de huir de perspectivas de autocomplacencia y de apoyarse en la interdisciplinariedad y en visiones amplias de los problemas de salud derivados del cambio climático en el medio y largo plazo

Problemas relacionados con la medicación que causan ingresos hospitalarios

ResumenObjetivoLos problemas relacionados con los medicamentos (PRM) están vinculados al tratamiento farmacológico del paciente e interfieren o pueden interferir con los resultados esperados en su salud. El presente estudio tiene como objetivo determinar la prevalencia de los PRM en los pacientes de un centro de salud urbano que son causa de ingreso en su hospital de referencia, y su evitabilidad.DiseñoEs un estudio observacional de tipo descriptivo y retrospectivo.EmplazamientoCENTRO de Salud Les Corts, que es un centro de salud urbano y docente con una población asignada de 32.318 habitantes.ParticipantesUsuarios del CS Les Corts ingresados en el Hospital Clínico de Barcelona desde agosto de 2005 a enero de 2006.Resultados y mediciones principalesUna pareja de un farmacéutico y un médico de familia analizan las historias clínicas y determinan la presencia o no de PRM. El 13,4% de todas las altas presentan PRM, que en su mayoría están implicados en el ingreso hospitalario (12%). Un 57,3% del total de altas con un PRM como causa del ingreso hospitalario se ha considerado evitable. Los ingresos por PRM se concentran en los servicios de medicina interna, cardiología y neumología. Los problemas de salud motivo de ingreso hospitalario por PRM son mayoritariamente circulatorios (38,5%) y respiratorios (11,5%).ConclusionesEl número de ingresos debidos a problemas relacionados con la medicación es elevado y evitable.AbstractObjectiveDrug related problems (DRP) are health problems associated with the pharmacological treatment of patients and interfere or can interfere with the expected results on their health. The aim of this study is to determine the prevalence of DRP in patients from an urban health centre that lead to hospitalisation, and its prevention.DesignIt is a retrospective, observational and descriptive study.SettingLes Corts Health Centre (HC), which is an urban health and teaching centre with a reference population of 32,318 inhabitants.ParticipantsUsers of the les Corts HC admitted to the Barcelona Hospital Clinic from August 2005 to January 2006.Results and main outcome measurementsA pharmacist and a family doctor analysed the clinical histories and determined whether or not there was a DRP. A DRP was present in 13.4% of all hospital discharges, and 12% were implicated in the hospital admission. It was considered that 57.3% of all the discharges with a DRP as the causing factor in the hospital admission were avoidable. Admissions due to DRP were mainly in internal medicine, cardiology and pneumology. The health problems that lead to hospital admission due to DRP are mainly circulatory (38.5%) and respiratory (11.5%).ConclusionsThe number of hospital admissions due to drug related problems is avoidably high

O impacto das alterações climáticas na saúde: uma abordagem do contexto urbano com uma visão One Health

Climate change affects environmental health, animal health, and thus -directly and indirectly-, human health. Urban environments, being critical areas in this respect, make it necessary to address the issue urgently. One Health provides a distinctive approach to this end. In urban planning and design, it brings to light issues and perspectives in terms of quality of life and environmental improvement which, given the risks arising from global warming, need to be considered. This paper examines this reality through a critical review of both the challenges and the applicability of the concept. Beyond the barriers and uncertainties that can be associated with it, the potential of the approach lies in the emphasis it places on relationships and in particular on interdependencies between human, animal and environmental health in a context of complexity. In this respect, it is also key to avoid complacent perspectives and to rely on interdisciplinarity and broad visions of the health problems arising from climate change in the medium and long term.El cambio climático afecta a la salud ambiental, animal y -directa e indirectamente- a la humana. Los escenarios urbanos, como ámbitos críticos a este respecto, requieren abordar la cuestión de forma urgente. Y, para ello, el concepto One Health ofrece una componente diferenciadora. Aplicado a planificación y diseño urbanos, permite poner sobre la mesa problemáticas y perspectivas en materia de calidad de vida y mejora ambiental que, a la luz de los riesgos derivados del calentamiento global, resulta esencial considerar. El presente artículo constata esa realidad partiendo de una revisión crítica de problemáticas y de aplicabilidad del concepto. Más allá de las barreras y ambigüedades que pueden acompañarlo, el potencial del enfoque reside en la atención prioritaria a las relaciones, y muy especialmente a las interdependencias entre salud humana, animal y del medioambiente, en un contexto de complejidad. Se evidencia también, en este sentido, el valor de huir de perspectivas de autocomplacencia y de apoyarse en la interdisciplinariedad y en visiones amplias de los problemas de salud derivados del cambio climático en el medio y largo plazo.As alterações climáticas afetam a saúde ambiental, animal e –direta e indiretamente– a humana. Os contextos urbanos, como áreas críticas nesse sentido, requerem uma urgente abordagem ao problema. E, para isso, o conceito One Health oferece uma componente diferenciadora. Aplicado ao planeamento e desenho urbanos, permite colocar sobre a mesa problemas e perspetivas em termos de qualidade de vida e melhoria ambiental que, face aos riscos derivados do aquecimento global, é essencial considerar. Este artigo confirma essa realidade a partir de uma revisão crítica dos problemas e aplicabilidade do conceito. Para além das barreiras e ambiguidades que podem acompanhá-lo, o potencial da sua abordagem reside em dar atenção prioritária às relações e, sobretudo, às interdependências entre a saúde humana, animal e ambiental, num contexto de complexidade. Também fica evidente, neste sentido, o valor de abandonar perspetivas endogâmicas e apostar em visões mais amplas e interdisciplinares para enfrentar os problemas de saúde derivados das mudanças climáticas no médio e longo prazo