Atenció a les persones amb trastorn de l'espectre alcohòlic fetal: a l'escola [manual]

TEAF; Escola; ConsellsTEAF; Escuela; ConsejosTEAF; School; TipsAquesta guia s’adreça en concret als professionals de l’àmbit educatiu. El professorat juga un paper clau en l’educació i la modulació de la conducta de tot l’alumnat i cal que també estigui preparat per atendre les necessitats especials dels infants amb TEAF. Esperem que aquesta eina els sigui molt útil per poder identificar els TEAF abans, comprendre millor els comportaments de les persones afectades i ajudar-les en els seus processos d’aprenentatge, en la seva integració amb el grup de classe i en l’adaptació a l’entorn educatiu

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Tratamiento psicológico cognitivo-conductual en adolescentes y adultos con TDAH

Introducción: la TCC es el abordaje psicológico con mayor evidencia empírica para adultos con TDAH. No obstante, no existen estudios previos de psicoeducación en comparación con tratamientos cognitivo-conductuales. Por otro lado, la mayoría de programas de tratamiento psicológico para adolescentes son intervenciones dirigidas a padres e intervenciones escolares. Existe escasa evidencia sobre intervenciones psicológicas directas al adolescente. Método: se han llevado a cabo dos estudios con el objetivo de evaluar la eficacia de la TCC en adultos y adolescentes con TDAH. En el primer estudio, 32 adultos con TDAH fueron asignados aleatoriamente a dos condiciones de tratamiento: psicoeducación (N=17) y grupo TCC (N=15). En el segundo ensayo clínico, 119 adolescentes (15-21 años) fueron asignados aleatoriamente a TCC grupal (n=45) o grupo control en lista de espera (N=44). Resultados: en el estudio de adultos, los dos programas (psicoeducación y TCC) obtuvieron mejoras en los síntomas nucleares de TDAH (ADHD-RS: p<0.001 d=0.12; CAARS-inatención: p<0.001 d=0.15; CAARS hiperactividad: p<0.001 d=0.19, CAARS impulsividad: p<0.05 d=0.32), mejoras en autoestima (CAARS: p<0.05 d=0.12),) así como disminución de sintomatología de ansiedad (STAI: p<0.001 d=0.35), depresión (BDI: p<0.001 d=0.1) y mejoras en calidad de vida (QLESQ: p=0.05 d=0.33) sin observarse diferencias significativas entre grupos. En el estudio de adolescentes, los pacientes del grupo de TCC obtuvieron reducciones significativas en los síntomas de TDAH [ADHD-RS versión adolescentes: magnitud −7.46; (95% intervalo de confianza, −9.56 a −5.36); p<0.001; d=7.5 y ADHD-RS según padres: −9.11 (95% IC, −11.48 a −6.75); p<0.001; d=8.38], menor severidad de los síntomas según el CGI-S [CGI-Self-Report: −0.68; (95% IC, −0.98 a −0.39); p<0.001; d=3.75] y CGI heteroaplicada [−0.79 (95% IC, −0.95 a −0.62); p<0.001; d=7.71]. También se observó menor repercusión funcional de los síntomas de TDAH en comparación con el grupo control en lista de espera según los padres [Weiss Functional Impairment Scale −4.02 (95% IC, −7.76 a −0.29); p < 0.05; d=2.29] y el clínico [EEAG: −7.58 (95% IC, −9.1 a−6.05); p<0.001; d=7.51]. No obstante, no se observaron diferencias significativas en los síntomas asociados (ansiedad, síntomas depresivos y dificultades en el manejo de la rabia). Conclusión: la psicoeducación demostró ser un abordaje eficaz en la reducción de síntomas de TDAH en adultos y la TCC grupal en combinación con tratamiento farmacológico mostró ser una intervención eficaz en la reducción de síntomas de TDAH en adolescentes.Introduction: CBT is the most evidence based psychological treatment for adults with ADHD. However, no previous studies on psychoeducation compared to CBT treatment have been published. Also, the majority of psychological interventions in adolescents with ADHD have focused on parent treatment programs and school interventions. Little is known on psychological interventions which consist of a direct focus on the adolescent. Method: two studies have been carried out in order to assess CBT efficacy in adults and adolescents with ADHD. In the first study, 32 adults with ADHD were randomized to two treatment conditions: psychoeducation group (N=17) and CBT group (N=15). The second study is a randomized controlled trial carried out in a sample of 119 adolescents (15-21 years). Patients were randomly assigned to 12 group manualized CBT sessions (n=59) or a waiting list control group (N=60). Results: In the adult trial, results indicated that both treatments (psychoeducation and CBT) were associated with statistically significant improvements on ADHD core symptoms (ADHD-RS p<0.001 d=0.12; CAARS-inattention p<0.001 d=0.15; CAARS hyperactivity p<0.001 d=0.19, CAARS impulsivity p<0.05 d=0.32), improvements on self-steem (CAARS: p<0.05 d=0.12), decreases in anxiety (STAI: p<0.001 d=0.35), depressive symptomatology (BDI: p<0.001 d=0.1) and improvements on quality of life (QLESQ: p=0.05 d=0.33). Nevertheless, no statistically differences between groups were observed in these measures. In the adolescent trial, patients who were in the CBT group condition reduced significantly ADHD symptoms compared to the control group [ADHD-RS Adolescent: magnitude−7.46; (95% confidence interval, −9.56 to −5.36); p<0.001; d=7.5 and ADHD-RS Parents: −9.11 (95% CI, −11.48 to −6.75); p<0.001; d=8.38], and also less symptoms severity according to CGI-S [CGI-Self-Report: −0.68; (95% CI, −0.98 to −0.39); p<0.001; d=3.75] and CGI-S Clinician [−0.79 (95% CI, −0.95 to −0.62); p<0.001; d=7.71]. Functional impairment decreased significantly more in the CBT group according to parents [Weiss Functional Impairment Scale −4.02 (95% CI, −7.76 to −0.29); p < 0.05; d=2.29] and the blinded evaluator [GAF: −7.58 (95% CI, −9.1 to −6.05); p<0.001; d=7.51]. However, no differences were observed on associated symptoms (anxiety, depressive symptoms or difficulties in anger management). Conclusion: Psychoeducation demonstrated to be an efficacious treatment in reducing ADHD core symptoms for adults with ADHD and CBT group associated with pharmacological treatment proved to be an efficacious intervention for adolescents with ADHD in reducing ADHD symptoms

Abordaje psicológico de adolescentes y jóvenes con TDAH

Introducción: La mayoría de programas de tratamiento psicológico para adolescentes con TDAH son intervenciones dirigidas a padres e intervenciones escolares. Existe escasa evidencia sobre intervenciones psicológicas directas al adolescente. Método: Se realizó una búsqueda bibliográfica en las bases de datos MEDLINE y PsychINFO usando los términos psychological treatment OR psychotherapy OR psychosocial treatment AND ADHD. Se limitó la edad, seleccionando los tratamientos de adolescentes (adolescent: 13-18 years). A raíz de los resultados obtenidos en la revisión sistemática, se desarrolló el primer estudio controlado de terapia cognitivo-conductual en adolescentes y jóvenes con TDAH. Resultados: Se encontraron 11 estudios de tratamiento psicológico publicados en adolescentes con TDAH: 2 estudios no controlados de terapia cognitivo-conductual (TCC), 4 estudios de intervenciones para padres y 5 investigaciones de intervenciones escolares. En el 2015, se desarrolló el primer estudio controlado de TCC grupal. Se aleatorizaron 119 adolescentes entre 15 y 21 años a 12 sesiones manualizadas de TCC junto a tratamiento farmacológico (n=59) o a un grupo en lista de espera de solo tratamiento farmacológico (n=60). Los resultados indicaron mayor eficacia del grupo de tratamiento combinado en la reducción de síntomas de TDAH, disminución de la severidad del trastorno y mejoras en el funcionamiento global del paciente. Conclusión: Las intervenciones para padres han demostrado baja significación clínica en sus resultados y las intervenciones escolares han mostrado eficacia en adolescente jóvenes. La terapia cognitivo-conductual en combinación con tratamiento psicológico ha demostrado ser un abordaje eficaz en adolescentes mayores con TDA

Promotion of Values Education (Factors Involved in Prosocial Behaviors and Volunteering)

(1) Background: Prosocial behavior aligns with the current societal model, where human values hold greater importance considering cultural, social, and personal variables that may influence the opportunity to benefit others. Hence, the objective of this research was established: to understand how diverse factors influence the values of young people, aiming to promote education and enhance prosocial behavior. (2) Methods: This study is quantitative research employing an empirical–analytical, cross-sectional social research method. A validated instrument was used with a sample of 1702 individuals from the city of Melilla, noteworthy for its multicultural context due to its location in North Africa. (3) Results: Inferential analysis was conducted using multiple linear regression to predict future behaviors, focusing on the factors influencing values. Various models were employed, incorporating twelve variables and four scales: sociability, transcendence, culture, and effects. (4) Conclusions: The results and conclusions suggest the need to enhance affect and sociability, primarily among the most prominent factors.PID2020-119194RB-I00, financed by MCIN/AEI/10.13039/501100011033Eur. J. Investig. Health Psychol. Educ

Tratamiento psicológico cognitivo-conductual en adolescentes y adultos con TDAH

Premi Extraordinari de Doctorat concedit pels programes de doctorat de la UAB per curs acadèmic 2017-2018Introducción: la TCC es el abordaje psicológico con mayor evidencia empírica para adultos con TDAH. No obstante, no existen estudios previos de psicoeducación en comparación con tratamientos cognitivo-conductuales. Por otro lado, la mayoría de programas de tratamiento psicológico para adolescentes son intervenciones dirigidas a padres e intervenciones escolares. Existe escasa evidencia sobre intervenciones psicológicas directas al adolescente. Método: se han llevado a cabo dos estudios con el objetivo de evaluar la eficacia de la TCC en adultos y adolescentes con TDAH. En el primer estudio, 32 adultos con TDAH fueron asignados aleatoriamente a dos condiciones de tratamiento: psicoeducación (N=17) y grupo TCC (N=15). En el segundo ensayo clínico, 119 adolescentes (15-21 años) fueron asignados aleatoriamente a TCC grupal (n=45) o grupo control en lista de espera (N=44). Resultados: en el estudio de adultos, los dos programas (psicoeducación y TCC) obtuvieron mejoras en los síntomas nucleares de TDAH (ADHD-RS: p 0.001 d=0.12; CAARS-inatención: p 0.001 d=0.15; CAARS hiperactividad: p 0.001 d=0.19, CAARS impulsividad: p 0.05 d=0.32), mejoras en autoestima (CAARS: p 0.05 d=0.12),) así como disminución de sintomatología de ansiedad (STAI: p 0.001 d=0.35), depresión (BDI: p 0.001 d=0.1) y mejoras en calidad de vida (QLESQ: p=0.05 d=0.33) sin observarse diferencias significativas entre grupos. En el estudio de adolescentes, los pacientes del grupo de TCC obtuvieron reducciones significativas en los síntomas de TDAH [ADHD-RS versión adolescentes: magnitud −7.46; (95% intervalo de confianza, −9.56 a −5.36); p 0.001; d=7.5 y ADHD-RS según padres: −9.11 (95% IC, −11.48 a −6.75); p 0.001; d=8.38], menor severidad de los síntomas según el CGI-S [CGI-Self-Report: −0.68; (95% IC, −0.98 a −0.39); p 0.001; d=3.75] y CGI heteroaplicada [−0.79 (95% IC, −0.95 a −0.62); p 0.001; d=7.71]. También se observó menor repercusión funcional de los síntomas de TDAH en comparación con el grupo control en lista de espera según los padres [Weiss Functional Impairment Scale −4.02 (95% IC, −7.76 a −0.29); p 0.05; d=2.29] y el clínico [EEAG: −7.58 (95% IC, −9.1 a−6.05); p 0.001; d=7.51]. No obstante, no se observaron diferencias significativas en los síntomas asociados (ansiedad, síntomas depresivos y dificultades en el manejo de la rabia). Conclusión: la psicoeducación demostró ser un abordaje eficaz en la reducción de síntomas de TDAH en adultos y la TCC grupal en combinación con tratamiento farmacológico mostró ser una intervención eficaz en la reducción de síntomas de TDAH en adolescentes.Introduction: CBT is the most evidence based psychological treatment for adults with ADHD. However, no previous studies on psychoeducation compared to CBT treatment have been published. Also, the majority of psychological interventions in adolescents with ADHD have focused on parent treatment programs and school interventions. Little is known on psychological interventions which consist of a direct focus on the adolescent. Method: two studies have been carried out in order to assess CBT efficacy in adults and adolescents with ADHD. In the first study, 32 adults with ADHD were randomized to two treatment conditions: psychoeducation group (N=17) and CBT group (N=15). The second study is a randomized controlled trial carried out in a sample of 119 adolescents (15-21 years). Patients were randomly assigned to 12 group manualized CBT sessions (n=59) or a waiting list control group (N=60). Results: In the adult trial, results indicated that both treatments (psychoeducation and CBT) were associated with statistically significant improvements on ADHD core symptoms (ADHD-RS p 0.001 d=0.12; CAARS-inattention p 0.001 d=0.15; CAARS hyperactivity p 0.001 d=0.19, CAARS impulsivity p 0.05 d=0.32), improvements on self-steem (CAARS: p 0.05 d=0.12), decreases in anxiety (STAI: p 0.001 d=0.35), depressive symptomatology (BDI: p 0.001 d=0.1) and improvements on quality of life (QLESQ: p=0.05 d=0.33). Nevertheless, no statistically differences between groups were observed in these measures. In the adolescent trial, patients who were in the CBT group condition reduced significantly ADHD symptoms compared to the control group [ADHD-RS Adolescent: magnitude−7.46; (95% confidence interval, −9.56 to −5.36); p 0.001; d=7.5 and ADHD-RS Parents: −9.11 (95% CI, −11.48 to −6.75); p 0.001; d=8.38], and also less symptoms severity according to CGI-S [CGI-Self-Report: −0.68; (95% CI, −0.98 to −0.39); p 0.001; d=3.75] and CGI-S Clinician [−0.79 (95% CI, −0.95 to −0.62); p 0.001; d=7.71]. Functional impairment decreased significantly more in the CBT group according to parents [Weiss Functional Impairment Scale −4.02 (95% CI, −7.76 to −0.29); p 0.05; d=2.29] and the blinded evaluator [GAF: −7.58 (95% CI, −9.1 to −6.05); p 0.001; d=7.51]. However, no differences were observed on associated symptoms (anxiety, depressive symptoms or difficulties in anger management). Conclusion: Psychoeducation demonstrated to be an efficacious treatment in reducing ADHD core symptoms for adults with ADHD and CBT group associated with pharmacological treatment proved to be an efficacious intervention for adolescents with ADHD in reducing ADHD symptoms

Promotion of Values Education (Factors Involved in Prosocial Behaviors and Volunteering)

(1) Background: Prosocial behavior aligns with the current societal model, where human values hold greater importance considering cultural, social, and personal variables that may influence the opportunity to benefit others. Hence, the objective of this research was established: to understand how diverse factors influence the values of young people, aiming to promote education and enhance prosocial behavior. (2) Methods: This study is quantitative research employing an empirical–analytical, cross-sectional social research method. A validated instrument was used with a sample of 1702 individuals from the city of Melilla, noteworthy for its multicultural context due to its location in North Africa. (3) Results: Inferential analysis was conducted using multiple linear regression to predict future behaviors, focusing on the factors influencing values. Various models were employed, incorporating twelve variables and four scales: sociability, transcendence, culture, and effects. (4) Conclusions: The results and conclusions suggest the need to enhance affect and sociability, primarily among the most prominent factors

Visiones

El trabajo obtuvo un Premio Tomás García Verdejo a las buenas prácticas educativas en la Comunidad Autónoma de Extremadura para el curso 2017/2018. Modalidad BSe presenta un proyecto llevado a cabo en la Escuela Oficial de Idiomas de Plasencia (Cáceres) que tenía como objetivo principal el uso de la lengua a través de actividades eminentemente comunicativas que fomenten las relaciones y la convivencia. Se desarrollaron 4 actividades: 'Visiones de Plasencia, El mercado' que pretendía mostrar la visión que los turistas y vecinos extranjeros tienen de Plasencia; 'Visiones de Europa', que consistió en contactar con un ilustrador gráfico y se le encargaron ilustraciones de 5 ciudades europeas, en torno a las cuales se realizaron distintas tareas; 'Visiones culturales' en la que teniendo como base siete ilustraciones de personajes famosos que destacaban por su labor profesional y contribución cultural se investigó sobre su vida y 'Visiones personales' que se construyó con retratos de la ciudad de Plasencia elaborados por los propios alumnos del centro (selfies)ExtremaduraES