Conducta antisocial en adolescentes: factores de riesgo y de protección

Es bien sabido por todos que la denominada “conducta antisocial” constituye, desafortunadamente, un tema de relevancia social indiscutible en la actualidad, no sólo por las graves consecuencias que a nivel social, familiar, escolar o jurídicamente conlleva, sino también, por los efectos tan devastadores que acarrea al propio adolescente. Teniendo presente la ambigüedad conceptual del constructo “conducta antisocial” y sus complejas manifestaciones conductuales a lo largo de la infancia y la adolescencia, la presente investigación doctoral se ha centrado en: a) Describir las distintas manifestaciones de la conducta antisocial (comportamientos antisociales graves y/o violentos, conductas agresivas y consumo de sustancias) en función tanto de la edad como del sexo de los adolescentes. b) Comparar los diferentes patrones de consumo de sustancias y prevalencias de conductas agresivas en función del nivel de conducta antisocial mostrada por los adolescentes. c) Determinar la forma en la que se asocian las diferentes sustancias de comercio legal e ilegal en los adolescentes (tabaco, alcohol, cannabis, fármacos antirreumáticos y tranquilizantes, derivados morfínicos, estimulantes, cocaína, heroína, inhalantes y drogas de síntesis). d) Determinar la capacidad predictiva de los factores bioevolutivos, escolares, familiares, del grupo de iguales y de personalidad, en el intento de establecer un perfil específico asociado a un mayor riesgo de manifestación de comportamientos antisociales en los adolescentes. e) Presentar distintos modelos de riesgo y protección en función de su valor predictivo, que sirvan como base para la posterior construcción y diseño de distintos modelos explicativos de la conducta antisocial en los adolescentes. f) Contrastar la validez de diferentes modelos explicativos en relación con los diversos factores de riesgo asociados a la conducta antisocial y el consumo de sustancias, que ayuden, por una parte, a la explicación de la conducta antisocial en adolescentes, y, por otra, que contribuyan a diseñar programas de intervención y prevención

Risk prediction and assessment of intervention, re-education and reintegration of juvenile offenders: development and psychometric properties of the PREVI-A

This paper proposes and analyzes the psychometric properties of the PREVI-A scale (Predicción del Riesgo y Valoración de la Intervención en la ARRMI—-Risk Prediction and Intervention Assessment in the ARRMI). It describes the process of item development, the factorial structure of the scale, reliability, evidence of validity and diagnostic performance with regard to recidivism risk in juvenile offenders. The sample was made up of 212 juvenile offenders held at detention centers run by the Madrid Agency for Reeducation and Reintegration of Juvenile Offenders, a regional government body. Statistical analyses were used to corroborate the theoretical factorial structure of the PREVI-A, which consists of six risk/protection dimensions (64 items) based on the Risk- Needs-Responsivity Model, and to obtain empirical support for the reliability and validity of PREVI-A as a tool to assess the risk of recidivism by juvenile offenders in Spai

Broad cognitive complaints but subtle objective working memory impairment in fibromyalgia patients

Background Cognitive dysfunction in fibromyalgia (FM) encompasses objective cognitive difficulties, as measured in neuropsychological tests, and self-reported cognitive complaints. Although it has been suggested that FM patients display problems in working memory, the data are inconsistent, and the overall working memory status of the patients is unclear. It is also not clear whether the working memory problems are related to cognitive complaints or how the dyscognition is affected by the characteristic clinical symptoms of FM. Methods To clarify these aspects, we explored the neuropsychological performance for different components of working memory and the subjective self-perception of cognitive status in a sample of 38 women with FM. They were compared with a matched group of 32 healthy women. Results Our findings suggested that the FM patients do not differ from healthy controls in their overall working memory functioning. Only a poor performance was found in a single task of visuospatial working memory, mediated by the presence of depressive symptoms, fatigue and pain. The FM patients also displayed a higher level of perception of cognitive difficulties than healthy controls, and this difference was mediated by depression and fatigue. Furthermore, cognitive complaints in FM patients were only associated with a lower verbal WM capacity. Discussion FM patients have a subtle specific impairment in their working memory functioning, as well as elevated concern about their cognitive status. These findings suggest a disconnection between neuropsychological performance and subjective complaints. In FM patients, clinical variables such as pain, fatigue, and depression play an important role in dyscognition, as assessed by both objective and subjective measures, and should be taken into account in future researchThis work was supported by funding from the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; axudas para a consolidación e Estruturación de unidades de investigación competitivas do Sistema universitario de Galicia [grant number GPC2014/047] and funding from the Spanish Government (Ministerio de Economía y Competitividad) [Grant Number PSI2013-45818-R]. Alberto González-Villar was supported by a grant from the Fundación Ramón DomínguezS

Estudio evaluativo-comparativo acerca de una intervención grupal a madres con hijos prematuros del Hospital San josé, en relación al vínculo temprano materno-infantil, desde la teoría del apego.

Tesis (Licenciado en Psicología)La presente investigación tuvo por finalidad diseñar e implementar una intervención dirigida a madres de recién nacidos prematuros. El objetivo de la investigación es la contribución a través de la intervención del fortalecimiento del vínculo de la pareja madre-bebé. La población se constituyó con madres -entre 16 y 35 años-que durante el segundo semestre del 2003 dieron a luz a sus hijos de manera prematura. Para fines de nuestra investigación se escogió una muestra de diez madres del Hospital San José, las que en primera instancia atravesaron por un proceso de evaluación que constó de la aplicación de instrumentos de diversa índole entrevista de despistaje (PERI), entrevista de fantasías, Pauta de apego en adultos (P.8.1. Posteriormente, se dividió la muestra en un grupo control y uno experimental. Este último fue escogido para participar en el taller diseñado por las investigadoras, cuyo objetivo principal consistió en entregarles herramientas a las madres para que pudiesen establecer un apego más seguro y confiable con sus hijos, impartiendo contenidos -madre suficientemente buena, bebé imaginario y real, mentalización, sintonía afectiva, reverie, etc. y generando un ambiente de contención donde tuviesen la oportunidad de desplegar sus ansiedades y temores. La metodología empleada para evaluar a ambos grupos una vez terminada la intervención, consistió en la observación de las díadas en su ambiente natural. Dicho procedimiento se llevó a cabo una vez a la semana durante un mes, con una duración de una hora por visita -de acuerdo al modelo propuesto por la clínica Tavistock, Londres-. Posteriormente, se sistematizó lo observado en una pauta de perfil de la observación del vínculo madre-bebé. Esta pauta fue utilizada para poder comparar a ambos grupos después de haber realizado la intervención. Los resultados confirman la efectividad de la realización de una intervención temprana en díadas, generando aportes en el establecimiento de un apego más seguro en la pareja madre-bebé.The objective of this study is to design and implement an intervention aimed at mothers with prematura new-bom babies. Moreover, this intervention will contribute to strengthen the link between the mother and her child. The group studied was constituted by mothers between the ages of 16 and 35 years, who had given birth to a prematura child during the last six months of the year 2003. For the purposes of this study, a test-group of ten mothers from the Hospital San José was chosen. These mothers underwent, in the first instance, a period of evaluation where diverse tools were applied, such as interviews to make sure that there were no pathologies associated (PERI), fantasy interviews and a Parental Bonding lnstrument (PBI). The samples were then divided into two groups, a control group and an experimental group. This latter group was chosen to participate in the workshop designad by the research team. The main objective of this workshop was to provide the mothers with tools to furthen strengthen their relation with the new-bom child. This could be done using the following tools: explaining to the mothers the concepts of sufficiently good mother, imaginad baby and real baby, mentalization, affective syntony, reverie, etc., as well as by generating an atmosphere of contension where the mothers could express their anxieties and fears. The methodology used to evaluate both groups once finalised the intervention was to observe the interaction between mothers and their newbom babies in their natural environment. Such a procedure took place once a week during one month. The duration of the visit was of one hour, using the time-frame proposed by the Tavistock Clinic in London. Further to this, the observations were recordad in a profile guideline of the mother-baby link. These guidelines were used to analyse and compare both groups after the intervention had taken place. The results confirm the effectiveness of carrying out this intervention at an early stage with mothers and their newbom babies in order to contribute to the strengthening and securing of mother-child ties

Fabrication of human myocardium using multidimensional modelling of engineered tissues

Biofabrication of human tissues has seen a meteoric growth triggered by recent technical advancements such as human induced pluripotent stem cells (hiPSCs) and additive manufacturing. However, generation of cardiac tissue is still hampered by lack of adequate mechanical properties and crucially by the often unpredictable post-fabrication evolution of biological components. In this study we employ melt electrowriting (MEW) and hiPSC-derived cardiac cells to generate fibre-reinforced human cardiac minitissues. These are thoroughly characterized in order to build computational models and simulations able to predict their post-fabrication evolution. Our results show that MEW-based human minitissues display advanced maturation 28 post-generation, with a significant increase in the expression of cardiac genes such as MYL2, GJA5, SCN5A and the MYH7/MYH6 and MYL2/MYL7 ratios. Human iPSC-cardiomyocytes are significantly more aligned within the MEW-based 3D tissues, as compared to conventional 2D controls, and also display greater expression of C ×43. These are also correlated with a more mature functionality in the form of faster conduction velocity. We used these data to develop simulations capable of accurately reproducing the experimental performance. In-depth gauging of the structural disposition (cellular alignment) and intercellular connectivity (C ×43) allowed us to develop an improved computational model able to predict the relationship between cardiac cell alignment and functional performance. This study lays down the path for advancing in the development of in silico tools to predict cardiac biofabricated tissue evolution after generation, and maps the route towards more accurate and biomimetic tissue manufacture

Evaluation of a New Monoclonal Chemiluminescent Immunoassay Stool Antigen Test for the Diagnosis of Helicobacter pylori Infection: A Spanish Multicentre Study

The stool antigen test (SAT) represents an attractive alternative for detection of Helicobacter pylori. The aim of this study was to assess the accuracy of a new SAT, the automated LIAISON(R) Meridian H. pylori SA based on monoclonal antibodies, compared to the defined gold standard C-13-urea breath test (UBT). This prospective multicentre study (nine Spanish centres) enrolled patients >= 18 years of age with clinical indication to perform UBT for the initial diagnosis and for confirmation of bacterial eradication. Two UBT methods were used: mass spectrometry (MS) including citric acid (CA) or infrared spectrophotometry (IRS) without CA. Overall, 307 patients (145 naive, 162 with confirmation of eradication) were analysed. Using recommended cut-off values (negative SAT = 1.10) the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 67%, 97%, 86%, 92% and 91%, respectively, obtaining an area under the receiver operating characteristic (ROC) curve (AUC) of 0.85. Twenty-eight patients, including seven false positives and 21 false negatives, presented a discordant result between SAT and UBT. Among the 21 false negatives, four of six tested with MS and 11 of 15 tested with IRS presented a borderline UBT delta value. In 25 discordant samples, PCR targeting H. pylori DNA was performed to re-assess positivity and SAT accuracy was re-analysed: sensitivity, specificity, positive predictive value, negative predictive value, accuracy and AUC were 94%, 97%, 86%, 99%, 97% and 0.96, respectively. The new LIAISON(R) Meridian H. pylori SA SAT showed a good accuracy for diagnosis of H. pylori infection

¿Necesitamos un asistente virtual para apoyo y formación permanente de profesores, alumnos y egresados en nuestra página web?

Se trata de identificar las necesidades no resueltas y otras cuestiones de interés, y proponer la utilización del asistente virtual como herramienta de apoyo en el acceso, la formación presente y futura, con carácter permanente, al alumno y al profesor; ello supone su utilidad en el momento presente y en el futuro, como herramienta de formación y acceso permanente. La originalidad del Proyecto estriba precisamente en el planteamiento de la incorporación de la asistencia virtual e inteligencia artificial para la asistencia y apoyo a los alumnos y profesores. El uso de la tecnología es cada vez más mayor, y puede revertir en beneficio al alumno desde una perspectiva más amplia de la que un profesor individualmente puede ofrecerle; se lograría así el acceso a la información con una intervención humana mínima, en cualquier momento y en cuestiones generales de amplio espectro, al que cada profesor en su especialidad no llega a abarcar, y los programas voluntarios de mentorías tampoco

Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry

BACKGROUND: Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. OBJECTIVE: To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. METHODS: Cross‐sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. RESULTS: Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7‐6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub‐score decreased from a median (IQR) of 2 (1‐2) to 0 (0‐1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively). CONCLUSION: The diagnostic work‐up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay

31 visiones actuales de la transparencia

Treinta y una aportaciones de autores nacionales y extranjeros sobre la transparencia de las instituciones públicas y de los sujetos obligados por la Ley 19/2013 de 9 de diciembre y el derecho de acceso a la información pública