Fostering Resilience in Adolescents at Risk: Study protocol for a cluster randomized controlled trial within the resilience school-based intervention

Adolescents; Resilience, Psychological; Mental health educationAdolescentes; Resiliencia Psicológica; Educación en salud mentalAdolescents; Resiliència Psicològica; Educació en salut mentalIntroduction: Resilience is considered of high relevance when developing interventions to cope with stressful situations. Schools are one of the key settings to promote resilience among adolescents. The purpose of this cluster randomized controlled trial is to assess the effectiveness of an intervention in adolescents at risk, aged 12-to-15 years old, to increase resilience and emotional regulation strategies. Methods: The recruitment period started in January 2022. Schools will be randomly allocated to control and intervention groups by an external researcher using computer-generated random numbers. The minimum sample size was estimated to be 70 participants per group. Primary health care nurses will carry out the intervention during the school period (January to June 2022). Students will follow a specific training consisting of six 55-min sessions, for 6 weeks. Each session will consist of 5 min of mindfulness, followed by 45 min of the corresponding activity: introducing resilience, self-esteem, emotional regulation strategies, social skills, problem-solving, community resources, social and peer support, and 5 min to explain the activity to do at home. Data will be collected at baseline, 6 weeks, and 24 weeks after the intervention. The child youth resilience measure-32 (CYRM-32) scale will be used to assess the effectiveness of the intervention. This study received a grant in June 2021. Discussion: The intervention is intended to improve mental health through resilience. Different factors related to resilience will be promoted, such as self-esteem, emotional regulation, social and communication skills, problem-solving and peer support, among others. As it has been designed as a cluster-randomized school-based intervention, we will directly ameliorate the participation and engagement of the target population. With the present intervention, we expect to improve coping skills in adolescents by enhancing resilience capacities

Perinatal contraceptive counselling: effectiveness of a reinforcement intervention on top of standard clinical practice

Objective: to assess the effectiveness of supplemental perinatal contraceptive counselling in addition to standard Spanish postpartum contraceptive counselling with regard to contraceptive use and use of effective contraception up to 1 year postpartum. Women's satisfaction with counselling and the method chosen was also assessed. Design: community-randomized trial. Setting: 'Reproductive and Sexual Health Care' units of the National Health Care System at twenty public Primary Care facilities in Catalonia. Participants: 1,004 consecutive pregnant women (~week 30) receiving prenatal care between 1st October 2015 and 31st March 2016. Women were considered eligible for analysis if appropriate information was available. Interventions: at half of the centres, midwives provided the standard Spanish postpartum contraceptive counselling (control group, CG). At the other half, supplemental perinatal contraceptive counselling was provided in addition to standard counselling (intervention group, IG) at different time points during pregnancy and postpartum. This consisted of a leaflet and a blog with practical information about all contraceptive options plus a short reminder message in the mobile phone during the third quarter of pregnancy and a face-to-face or a virtual meeting lasting 20 min in the first 15 days postpartum. Midwives used ad hoc questionnaires to collect information at week 30 of pregnancy (recruitment), and week 6, month 6 and month 12 postpartum. Measurements and findings: 975 women were eligible for analysis (482 in the CG and 493 in the IG). ~33% women had resumed sexual intercourse by week 6, and nearly all by months 6 and 12. Use and effectiveness of contraceptives was similar in both groups at week 6 and month 6. At month 12, more women in the IG used more effective contraception and less women used contraceptives considered somewhat effective vs. those of the CG (P = 0.006). When considering the place of origin, this was only true for Spanish women. Women of other origins had a much higher use of very effective contraceptives at month 12 also in the CG, with contraceptive counselling having scarce effect. On multivariate analysis, conducted only in Spanish women, the additional counselling resulted in a higher use of highly effective methods while having a university degree increased 3.6 times the OR for this behaviour. A bias towards fostering use of very effective contraceptives among women with low education was seen in standard clinical practice. Satisfaction with counselling and the type of contraception chosen was higher in the IG. Key conclusions: our study has shown that the supplemental counselling tested has a moderate impact on contraceptive use and use of effective contraception in postpartum women. Results of this effort were seen after 6 months postpartum. A possible bias towards women who were more socially vulnerable was found in standard clinical practice, which reduced the effectiveness of the intervention in women who were otherwise the most needy. Implications for practice: despite the benefits provided by supplemental support in perinatal contraceptive counselling, the existence of a possible bias affecting the effectiveness of these interventions should be investigated and addressed

Understanding factors that influence the decision to be vaccinated against influenza and pertussis in pregnancy : A qualitative study

Acord transformatiu CRUE-CSICAims and Objectives: To identify how pregnant women perceive pertussis and influenza and the factors that influence their decision to be vaccinated. Background: Suffering from influenza during pregnancy increases complications in the pregnant woman, foetus and newborn. Pertussis in children under six months of age causes severe complications. Maternal vaccination against influenza and pertussis is effective and safe. However, vaccination rates are insufficient. Design: We conducted a qualitative descriptive study, using semi-structured interviews. This research adheres to the COREQ guidelines and checklist. Methods: We carried out 18 semi-structured face-to-face interviews with pregnant women, using intentional sampling and thematic analysis. Results: We identified an overarching theme, 'factors that influenced participants' decision to be vaccinated or not', which was composed of four subthemes that were in turn made up of 12 categories. The factors that influenced participants' decision to be vaccinated against influenza and pertussis were related to their knowledge of and their perception of risk for these diseases. Participants perceived the risk of pertussis to be greater, and they focused their concern on the newborn. The recommendations and convictions of nurse-midwives were the most important factors encouraging vaccination. Participants trusted their nurse-midwives and most reported that they would have been vaccinated if their midwife had recommended it. Other factors were linked to lack of information, fear and concerns about economic interests. Conclusions: The convictions and actions of the nurse-midwife in recommending vaccination to pregnant women are decisive. Strategies to improve vaccination rates should be directed to helping health professionals understand how their practice affects the final decision of pregnant women. Relevance to clinical practice: Understanding the factors that limit vaccination rates among pregnant women provides valuable information to nurse-midwives that can help to improve vaccination strategies and practices. Increased maternal vaccination rates would reduce morbidity and mortality among pregnant women and newborns

The proliferation index of specific bone marrow cell compartments from myelodysplastic syndromes is associated with the diagnostic and patient outcome

This is an open-access article distributed under the terms of the Creative Commons Attribution License.-- et al.Myelodysplastic syndromes (MDS) are clonal stem cell disorders which frequently show a hypercellular dysplastic bone marrow (BM) associated with inefficient hematopoiesis and peripheral cytopenias due to increased apoptosis and maturation blockades. Currently, little is known about the role of cell proliferation in compensating for the BM failure syndrome and in determining patient outcome. Here, we analyzed the proliferation index (PI) of different compartments of BM hematopoietic cells in 106 MDS patients compared to both normal/reactive BM (n = 94) and acute myeloid leukemia (AML; n = 30 cases) using multiparameter flow cytometry. Our results show abnormally increased overall BM proliferation profiles in MDS which significantly differ between early/low-risk and advanced/high-risk cases. Early/low-risk patients showed increased proliferation of non-lymphoid CD34 + precursors, maturing neutrophils and nucleated red blood cells (NRBC), while the PI of these compartments of BM precursors progressively fell below normal values towards AML levels in advanced/high-risk MDS. Decreased proliferation of non-lymphoid CD34 + and NRBC precursors was significantly associated with adverse disease features, shorter overall survival (OS) and transformation to AML, both in the whole series and when low- and high-risk MDS patients were separately considered, the PI of NRBC emerging as the most powerful independent predictor for OS and progression to AML. In conclusion, assessment of the PI of NRBC, and potentially also of other compartments of BM precursors (e.g.: myeloid CD34 + HPC), could significantly contribute to a better management of MDS.This work has been partially supported by the following grants: RTICC RD06/0020/0035 - Fondo Europeo de Desarrollo Regional FEDER) - from the Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Madrid, Spain; M.J.-A. was supported by a grant from the Programa Personal Técnico de Apoyo a la Investigación. Ministerio de Ciencia e Innovación - Universidad de Salamanca, Spain.Peer Reviewe

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain : a Study Based on Primary Care Records Registry

The purpose was to determine the coverage of maternal vaccination against influenza and pertussis, and the characteristics associated with being vaccinated, in a health area of Catalonia, Spain. Some 36,032 anonymized and computerized clinical records registries of pregnant women from Primary Care Centres (e-CAP database) were analysed, from between 2015 and 2018. Vaccination coverage and the association with sociodemographic variables and clinical conditions were estimated using a Poisson regression model. Maternal vaccination coverage against influenza ranged between 11.9% in 2015 and 6.8% in 2018, following a decreasing trend (p < 0.001). Coverage with the tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine varied between 49.8% in 2016 and 79.4% in 2018, following an increasing trend (p < 0.001). Having living children and suffering from obesity were factors associated with not being vaccinated against both infections. The predictive variables of vaccination against influenza were diabetes (IRR: 2.17, 95% CI: 1.42-3.30) and asthma (IRR: 2.05, 95% CI: 1.76-2.38); and for pertussis, it was asthma (IRR: 1.10, 95% CI: 1.03-1.17). Different socio-demographic factors and chronic conditions in pregnant women were associated with maternal vaccination, and which will have to be taken into account in clinical practice when implementing strategies to improve the coverage of the programme

Modelos mentais e fontes de informação sobre o sistema solar em alunos de quinto ano

The purpose of this article is to identify the different mental models of fifth-grade students at the Monterrey School about the concept of the solar system, and the main sources of information they use to configure their knowledge about such concept. Through the design and implementation of a didactic unit, the authors intend to examine the relationships between the sources of information that students use the most, and the construction of mental models, due to their great influence on the construction of knowledge. Following a qualitative methodological approach, under an interpretative paradigm, unstructured and structured interviews are carried out with students and class records (videos, audios, field diary). The results are quite significant: the students’ mental models at the beginning of the implementation of the didactic unit, in most cases, contrast notoriously with the final models. The authors found that the most elaborated mental models are the linear one, and the model with an approach to Kepler (presence of orbits). The results show that the source of information most used by students for the construction of their knowledge is the Internet (Wikipedia, web page visited by the entire sample). The authors did not find any direct relation between to the source of information and the construction of mental models. However, information sources such as the students’ own experience and the work of school processes play an important role in the reconfiguration of their mental models.El presente artículo de investigación tiene como objetivo identificar los diferentes modelos mentales que tienen los estudiantes de grado quinto del colegio Monterrey acerca del concepto de sistema solar y las principales fuentes de información a las que recurren para configurar su conocimiento sobre dicho concepto. Se pretende examinar, mediante el diseño y la implementación de una unidad didáctica, las relaciones entre las fuentes de información que los estudiantes consultan con frecuencia y la construcción de modelos mentales, debido a la gran influencia que tienen estos en la construcción de conocimiento. Siguiendo una ruta metodológica cualitativa, bajo un paradigma interpretativo, se realizan entrevistas no estructuradas y estructuradas a los estudiantes, y registros de las clases (videos, audios, diario de campo). Los resultados son muy significativos: los modelos mentales que tienen los estudiantes al inicio de la implementación de la unidad didáctica se contrastan notablemente, en la mayoría de los casos, con los modelos finales. Se encontró que los modelos mentales más elaborados por los estudiantes fueron el modelo lineal y el modelo con aproximación a Kepler (presencia de órbitas). Se identificó que la fuente de información más utilizada por los estudiantes para la construcción de su conocimiento es internet (wikipedia, página web frecuentada por toda la muestra); sin embargo, no se encontró una relación directa entre la fuente de información y la construcción de sus modelos mentales. No obstante, fuentes de información como la propia experiencia de los estudiantes y la labor de los procesos escolares resultan ser de gran importancia en la reconfiguración de sus modelos mentales.O presente artigo de pesquisa tem como objetivo, identificar os diferentes modelos mentais que os alunos de quinto ano da escola de Monterrey possuem sobre o conceito de sistema solar, e as principais fontes de informação que recorrem para configurar seu conhecimento desse conceito. Pretende-se examinar, através da criação e implantação de uma unidade didática, as relações entre as fontes de informação que os alunos consultam frequentemente e a construção de modelos mentais, devido à grande influência que estes têm na construção do conhecimento. Seguindo um percurso metodológico qualitativo, sob um paradigma interpretativo, são realizadas entrevistas não estruturadas e estruturadas aos alunos, e registros das aulas (vídeos, áudios, diário de campo). Os resultados são muito significativos: os modelos mentais que os alunos possuem no início da implementação da unidade didática são notavelmente contrastados, na maioria dos casos, com os modelos finais. Encontrou-se que os modelos mentais mais elaborados pelos alunos foram o modelo linear e o modelo com aproximação de Kepler ( presença de órbitas). Identificou-se que a fonte de informação mais utilizada pelos alunos para a construção do seu conhecimento é a internet ( wikipedia, página web frequentada por toda a mostra); não obstante, nenhuma relação direta foi encontrada entre a fonte de informação e a construção de seus modelos mentais. No entanto, fontes de informação como a própria experiência dos alunos e o trabalho dos processos escolares são de grande importância na reconfiguração de seus modelos mentais

Serum tryptase monitoring in indolent systemic mastocytosis: association with disease features and patient outcome

This is an open-access article distributed under the terms of the Creative Commons Attribution License.-- et al.[Background]: Serum baseline tryptase (sBT) is a minor diagnostic criterion for systemic mastocytosis (SM) of undetermined prognostic impact. We monitored sBT levels in indolent SM (ISM) patients and investigated its utility for predicting disease behaviour and outcome. [Methods]: In total 74 adult ISM patients who were followed for ≥48 months and received no cytoreductive therapy were retrospectively studied. Patients were classified according to the pattern of evolution of sBT observed. [Results]: Overall 16/74 (22%) cases had decreasing sBT levels, 48 (65%) patients showed increasing sBT levels and 10 (13%) patients showed a fluctuating pattern. Patients with significantly increasing sBT (sBT slope ≥0.15) after 48 months of follow-up showed a slightly greater rate of development of diffuse bone sclerosis (13% vs. 2%) and hepatomegaly plus splenomegaly (16% vs. 5%), as well as a significantly greater frequency of multilineage vs. mast cells (MC)-restricted KIT mutation (p = 0.01) together with a greater frequency of cases with progression of ISM to smouldering and aggressive SM (p = 0.03), and a shorter progression-free survival (p = 0.03). [Conclusions]: Monitoring of sBT in ISM patients is closely associated with poor prognosis disease features as well as with disease progression, pointing out the need for a closer follow-up in ISM patients with progressively increasing sBT values.This work was supported by grants from the Fondo de Investigaciones Sanitarias (FIS) of the Ministerio de Ciencia e Innovación of Spain (RETICS RD06/0020/0035-FEDER and PS09/00032); Fundación Sociosanitaria de Castilla-La Mancha (FISCAM 2007/36, FISCAM 2010/008 and G-2010/C-002); Instituto de Salud Carlos III of the Ministerio de Economía y Competitividad of Spain (PI11/02399); Junta de Castilla y León (SAN/103/2011); Fundación Ramón Areces; Fundación Española de Mastocitosis (FEM 2010); Hospital Virgen de la Salud Biobank (BioB-HVS) supported by grant of RETICS RD09/0076/00074, (Toledo, Spain).Peer Reviewe

Assessment of humoral immune response to two mRNA SARS-CoV-2 vaccines (Moderna and Pfizer) in healthcare workers fully vaccinated with and without a history of previous infection

Aims: Presence of anti-S1 region of SARS-CoV-2 spike protein was analysed, at two and eight months, in 477 immunocompetent healthcare workers in Zaragoza, Spain, vaccinated with mRNA-1273 (Moderna) or BNT162b2 (Pfizer). Methods and results: Antibody analysis was performed with Alinity i System (Abbott). At 2 months, 100% of vaccinated had anti-S1 IgG (mean = 13, 285 AU ml-1). This value was significantly higher with Moderna (18, 192 AU ml-1) than with Pfizer (10, 441 AU ml-1). The mean value of anti-S1 IgG after vaccination was significantly higher in patients with than without previous infection (18, 539 vs. 7919 AU ml-1); in both groups was significantly higher with Moderna than with Pfizer (21, 881 vs. 15, 733 AU ml-1 and 11, 949 vs. 6387 AU ml-1), respectively. At 8 months, 100% of patients were IgG positive, with higher levels with Moderna than with Pfizer. Nevertheless, in ensemble of cases, a mean decrease of antibody levels of 11, 025 AU ml-1 was observed. Conclusion: At 2 and 8 months after vaccination, IgG response persists with both vaccines but with important decrease which suggests the need for revaccination. Significance and impact of study: The study contributes to know the immune status after vaccination with two of more used anti-SARS-CoV-2 vaccines. This knowledge is important for establishing the best vaccination strategy. © 2022 The Authors. Journal of Applied Microbiology published by John Wiley & Sons Ltd on behalf of Society for Applied Microbiology

Mast cell-related disorders presenting with Kounis syndrome

Letter to the Editor.-- et al.Peer Reviewe

Reliability of a new test food to assess masticatory function

Objective: This study assessed the reliability and validity of masticatory function assessment using a new test food, Optozeta. Design: Thirty-five adults participated in the cross-sectional clinical part of the study; ten of them performed a retest. They performed two free-style masticatory tests consisting of five trials of 20 cycles each chewing three pieces of Optosil or Optozeta placed in a latex bag. Optozeta was created by mixing 50% Optosil with 50% of Zetalabor. Masticatory performance, masticatory laterality and chewing rate were assessed. Reliability and construct validity were assessed using the intraclass correlation coefficient (ICC) and Spearman correlations, respectively. Results: Higher ICC values were observed for each aspect of masticatory function as assessed using Optozeta compared with Optosil. All the participants showed a lower median particle size value using Optozeta than Optosil. For each masticatory parameter, a high correlation was observed between using Optosil or Optozeta. Conclusions: Optozeta seems to have good construct validity and appears to be more reliable than Optosil as a test food to assess masticatory function