A role and mechanism for redox sensing by SENP1 in ß-cell responses to high fat feeding.

Pancreatic ß-cells respond to metabolic stress by upregulating insulin secretion, however the underlying mechanisms remain unclear. Here we show, in ß-cells from overweight humans without diabetes and mice fed a high-fat diet for 2 days, insulin exocytosis and secretion are enhanced without increased Ca2+ influx. RNA-seq of sorted ß-cells suggests altered metabolic pathways early following high fat diet, where we find increased basal oxygen consumption and proton leak, but a more reduced cytosolic redox state. Increased ß-cell exocytosis after 2-day high fat diet is dependent on this reduced intracellular redox state and requires the sentrin-specific SUMO-protease-1. Mice with either pancreas- or ß-cell-specific deletion of this fail to up-regulate exocytosis and become rapidly glucose intolerant after 2-day high fat diet. Mechanistically, redox-sensing by the SUMO-protease requires a thiol group at C535 which together with Zn+-binding suppresses basal protease activity and unrestrained ß-cell exocytosis, and increases enzyme sensitivity to regulation by redox signals.

Active identification of vertebral fracture in the FLS model of care.

The identification of vertebral fracture is a key point in an FLS. We have analyzed the characteristics of 570 patients according to the route of identification (referral by other doctors, emergency registry or through VFA), concluding that promoting referral by other doctors with a training campaign is effective. PURPOSE: Vertebral fractures (VF) are associated with increased risk of further VFs. Our objective was to analyze the characteristics of patients with VF seen in a Fracture Liaison Service (FLS). METHODS: An observational study was carried out on patients with VF referred to the outpatient metabolic clinic (OMC) after a training campaign, identified in the emergency registry, and captured by VF assessment with bone densitometry (DXA-VFA) in patients with non-VFs. Patients with traumatic VF or VF > 1 year, infiltrative or neoplastic disease were excluded. The number and severity of VFs (Genant) were analyzed. Treatment initiation in the first 6 months after baseline visit was reviewed. RESULTS: Overall, 570 patients were included, mean age 73. The most common route for identifying VF was through referral to OMC (303 cases), followed by the emergency registry (198) and DXA-VFA (69). Osteoporosis by DXA was found in 312 (58%) patients and 259 (45%) had ≥ 2 VFs. The rate of grade 3 VFs was highest among patients on the emergency registry. Those identified through OMC had a higher number of VFs, a higher rate of osteoporosis, more risk factors and greater treatment initiation. Patients with VFs detected by DXA-VFA were mostly women with a single VF and had a lower rate of osteoporosis by DXA. CONCLUSIONS: We present the distribution of VFs by the route of identification in an FLS. Promoting referral by other doctors with a training campaign may help in the quality improvement of the FLS-based model of care.

[Cross-sectional study on sleep habits and new technologies use in high school students.] / Estudio transversal sobre hábitos de sueño y nuevas tecnologías en estudiantes de ciclos formativos.

OBJECTIVE: During lasts years, the use of information and communication technologies (ICTs) have boomed up, as well as their related- harmful behaviours. Parallel, time and quality of sleep has reduced along current society, which implies negatively in health in medium and long-terms. The present study aims to evaluate the association between lifestyle habits and quality of sleep of a subpopulation of young students. METHODS: An observational transversal study has been performed in Certificate of Medium and Higher Education from a High school of Alcázar de San Juan (Ciudad Real, Spain), who filled up a survey related to their lifestyle habits and the use of ICTs. Furthermore, the survey also included several variables related to quality of sleep by using Pittsburgh test. Bivariate comparisons using student test or Mann-Whitney U test, or Chi-square or exact test depending on the variable were performed. Afterwards, logistic regression was also done. RESULTS: The study sample were 286 students (43.4% women) were included being 22.2±7.3 years old on average. 99.7% of them owned mobile phone, using it 42 hours per week. Average total score of Pittsburgh test was 6.4±3.5, being higher in women (7.36±3.8) than in men (5.62±3.1). Moreover, 51.7% of surveyed students suffered from sleep disorders, being associated to several risk factors, such us using mobile phone while lying and without light (OR=2.04; CI95% [1.12-3.73]), using mobile phone in the middle of the night (OR=1.9; CI95% [1.06-3.42]) and drinking and smoking (OR=2.28; CI95% [1.14-4.55]). On the other hand, practising sports was defined as protector factor (OR=0.43; CI95% [0.26-0.72]). CONCLUSIONS: More than half of surveyed suffer from sleep disorders, mainly derived from the inadequate use of ICTs, showing differences between genders.

OBJETIVO: Durante los últimos años se ha incrementado el uso de nuevas tecnologías de la información y comunicación (TIC), así como los comportamientos nocivos en relación a su uso. Paralelamente, se ha descrito un descenso en el tiempo y calidad del sueño, lo cual repercute negativamente en la salud a medio y largo plazo. El objetivo del presente estudio fue evaluar la asociación de los diferentes hábitos con la calidad del sueño de una subpoblación de jóvenes estudiantes. METODOS: Se realizó un estudio observacional transversal de ciclos formativos en un instituto de educación secundaria de Alcázar de San Juan (Ciudad Real), basado en una encuesta sobre hábitos de vida y uso de nuevas tecnologías, además de diferentes variables relacionadas con el sueño, evaluadas mediante el índice de Pittsburgh. Se hicieron comparaciones bivariadas mediante t de student o U de Mann Whitney, o test de Chi-cuadrado (o test exacto) según variables. Posteriormente se realizó regresión logística. RESULTADOS: La muestra estuvo compuesta por 286 estudiantes con una edad media de 22,2±7,3 y siendo mujeres un 43,4%. El 99,7% tenía teléfono móvil, el cual utilizaban de media 42 horas a la semana. La puntuación media del test de Pittsburgh fue de 6,4±3,5, siendo mayor en las mujeres (7,36±3,8) que en los hombres (5,62±3,1). El 51,7% de los encuestados presentaban trastornos de sueño, siendo los factores asociados el uso del móvil acostado y sin luz (OR=2,04; IC95% [1,12-3,73]), el uso del móvil en mitad de la noche (OR=1,9; IC95% [1,06-3,42]), el consumo de tabaco y alcohol (OR=2,28; IC95% [1,14-4,55]) y hacer deporte como factor protector (OR=0,43 IC95% [0,26-0,72]). CONCLUSIONES: Más de la mitad de los encuestados presentan trastornos de sueño, fundamentalmente debido a un uso inadecuado de las TIC, existiendo diferencias claras entre hombres y mujeres.

Changes in Physical Fitness Parameters in a Portuguese Sample of Adolescents during the COVID-19 Pandemic: A One-Year Longitudinal Study.

Due to a worldwide response to the COVID-19 pandemic, many changes were imposed on individuals' daily lives, including those related to the physical activity of children and adolescents. The present study aims to comprehend the impact of early COVID-19 pandemic restrictions on Portuguese adolescents' physical fitness parameters during two school years. A total of 640 students from the 5th to the 12th grades participated in the longitudinal study. Data on body composition, aerobic fitness, speed, agility, lower and upper body strength, and flexibility were collected at three moments: 1. before the COVID-19 pandemic (December 2019); 2. after the COVID-19 lockdown when the schools reopened delivering in-person classes (October 2020), and 3. two months after the in-person classes started (December 2020). To analyze the overall changes between the three moments and between two age groups, we conducted repeated measure ANOVAs. The main findings indicate that participants' body composition (i.e., waist circumference) and aerobic fitness (i.e., maximal oxygen uptake) deteriorated after the first lockdown but improved two months after the in-person classes started. However, the same did not happen to neuromuscular fitness (i.e., horizontal Jumps and Sit and Reach). These findings suggest that the COVID-19 lockdown may have negatively impacted adolescents' physical fitness, particularly older adolescents. Altogether, data reinforce the importance of in-person classes and school context in promoting adolescents' physical health.

Implications of FRAX® adjusted for recent fracture on the indication of treatment in an FLS.

We analyzed the practical consequences of applying an adjusted FRAX® for recent fractures in a FLS. After analyzing 2777 patients, we concluded that the adjusted FRAX® is irrelevant when calculating FRAX® with DXA and is only useful for fractures of the humerus when DXA is not available. PURPOSE: A FRAX® adjusted to fractures less than 2 years old has been proposed. The objective of this work was to analyze the clinical implications of applying the adjusted FRAX® instead of the classic FRAX® in a fracture liaison service (FLS) unit. METHODS: Adults aged 50 years or older with fragility fractures (hip, spine, humerus, and forearm) that occurred in the 12 months prior to the baseline visit were included. We recorded demographic data, type of fracture, DXA, classic FRAX®, and FRAX® adjusted for recent fractures and indications for anti-osteoporotic medication (AOM) following the guidelines of the Spanish Society of Rheumatology. RESULTS: A total of 2777 patients were included, mean age 73 years, 84% women. The type of fracture was as follows: forearm (n = 958; 34.5%), hip (n = 781; 28.1%), humerus (n = 642; 23.1%), and spine (n = 397, 14.3%). DXA was performed in 2134 cases (76.8%). A total of 2522 patients (90.8%) were candidates for AOM (100% involving the hip and spine, 83% forearm, and 85% humerus). FRAX®-hip ≥ 3% increased from 1601 to 1775 cases (57.6 to 64%). The average FRAX®-hip (SD) increased from 5.7 (6) to 7.5 (9) (4.6 to 8.8 in males and 5.9 to 7.3 in females). The percentage of forearm fracture candidates for AOM, with or without DXA, did not change after FRAX®-hip adjustment, while the number of patients with humerus fractures increased from 59 to 80% in those who did not have DXA. In the entire sample, FRAX®-adjusted led to an indication of AOM for 15 additional patients (0.5% of major fractures): 14 with a humerus fracture and 1 with a forearm fracture. CONCLUSIONS: The adjusted FRAX® for recent fractures in an FLS unit in an adjusted FRAX® is irrelevant when calculating FRAX® with DXA; in fact, it is only useful for fractures of the humerus when DXA is not available.

"COVID-19 in Trials and Tribulations" Project: A Self-Regulation-Based Support Response for Confined Families through Social Networks.

The COVID-19 pandemic has placed today's society in an unprecedented scenario. During Portugal's first home confinement period (March-July 2020), the online-based "COVID-19 in Trials and Tribulations" project was implemented to support families with school-aged children. The project was grounded on the self-regulation framework and delivered through Facebook® and Instagram® pages. Being responsive to ongoing developments of the pandemic, activities were conveyed in two phases. Phase 1 occurred during lockdown (school was suspended). Phase 2 occurred while students were enrolled in at-distance (online) school. The present study aimed to examine the reach of the project, while examining the content and format of delivery that generated the most engagement among the users (4500 Facebook® effective followers; 1200 Instagram® effective followers) during the confinement period. Results showed that, at the individual page level, Facebook® had higher reach indicators compared to Instagram®, except for video. At the Facebook® post level, followers and users showed more engagement with the page prior to the at-distance schooling phase; however, videos still generated engagement (p = 0.002). Both the post type (p < 0.01) and frequency (p < 0.001) of publication were suggested to be good predictors of engagement. The information gathered will help design and inform future interventions that may be implemented as new lockdowns are set in place.

Impact of statin treatment on non-invasive tests based predictions of fibrosis in a referral pathway for NAFLD.

OBJECTIVE: In non-alcoholic fatty liver disease (NAFLD), fibrosis determines the risk of liver complications. Non-invasive tests (NITs) such as FIB-4, NAFLD Fibrosis Score (NFS) and Hepamet, have been proposed as a tool to triage NAFLD patients in primary care (PC). These NITs include AST±ALT in their calculations. Many patients with NAFLD take statins, which can affect AST/ALT, but it is unknown if statin affects NITs fibrosis prediction. METHODS: We included 856 patients referred through a standardised pathway from PC with a final diagnosis of NAFLD. 832 had reliable vibration controlled transient elastography (VCTE) measurements. We assessed the effects of statins on the association between NITs and VCTE at different fibrosis thresholds. RESULTS: 129 out of 832 patients were taking a statin and 138 additional patients had indication for a statin. For any given FIB-4 value, patients on a statin had higher probabilities of high VCTE than patients not on a statin. Adjusting for body mass index, diabetes and age almost completely abrogated these differences, suggesting that these were related to patient's profile rather to a specific effect of statins. Negative predictive values (NPVs) of FIB-4 <1.3 for VCTE >8, 10, 12 and 16 were, respectively, 89, 94, 96% and 100% in patients on a statin and 92, 95, 98% and 99% in patients not on a statin. Statins had similar impact on Hepamet predictions but did not modify NFS predictions. CONCLUSION: In patients with NAFLD referred from PC, those on statins had higher chances of a high VCTE for a given FIB-4 value, but this had a negligible impact on the NPV of the commonly used FIB-4 threshold (<1.3).

An Exploratory Study on Sleep Procrastination: Bedtime vs. While-in-Bed Procrastination.

Sleep Procrastination literature has focused on the behaviors individuals engage in before going to bed (Bedtime Procrastination) but not on the behaviors individuals engage in after going to bed (While-in-Bed Procrastination). The main goal of this study is to explore whether this While-in-Bed procrastination is a novel phenomenon that adds to the Sleep Procrastination literature. The study was conducted online with 400 high school students (Mage = 16.56; 139 males) recruited through personal contacts and social media. The Bedtime procrastination scale was adapted and validated for this sample, whereas the While-in-Bed Procrastination scale was developed for this study. Data show a low correlation (r = 0.158 **) between Bedtime and While-in-Bed Procrastination scales, suggesting that Sleep Procrastination may be composed of the two facets. Additionally, results showed that more Bedtime Procrastination was related to later waking time and later dinnertime hours, whereas more While-in-Bed Procrastination was linked to being male, later desired time to sleep, and earlier dinnertime hour. Findings indicate that solely assessing Bedtime Procrastination as representing the procrastination of Sleep is limited and overlooks a significant part of this behavior. This exploratory study adds a new perspective to the literature by stressing the role of While-in-Bed Procrastination, thus opening new research pathways.

The impact of three types of writing intervention on students' writing quality.

Students' writing constitutes a topic of major concern due to its importance in school and in daily life. To mitigate students' writing problems, school-based interventions have been implemented in the past, but there is still a need to examine the effectiveness of different types of writing interventions that use robust design methodologies. Hence, the present study followed a longitudinal cluster-randomized controlled design using a multilevel modeling analysis with 370 fourth-grade students (nested in 20 classes). The classes were randomly assigned to four conditions: one comparison group and three writing types of writing interventions (i.e., week-journals, Self-Regulation Strategy Development (SRSD) instruction and SRSD plus Self-Regulated Learning (SRL) program using a story-tool), with five classes participating in each condition. Data supports our hypothesis by showing differences between the treatment groups in students' writing quality over time. Globally, the improvement of students' writing quality throughout time is related to the level of specialization of the writing interventions implemented. This is an important finding with strong implications for educational practice. Week-journals and writing activities can be easily implemented in classrooms and provides an opportunity to promote students' writing quality. Still, students who participated in the instructional programs (i.e., SRSD and SRSD plus story-tool) exhibited higher writing quality than the students who wrote week-journals. Current data did not find statistical significant differences between results from the two instructional writing tools.

First-Year Students Background and Academic Achievement: The Mediating Role of Student Engagement.

The current study aimed to analyze the relationships between students' background variables (students' academic preparation and sociocultural status), students' cognitive and behavioral engagement, and an outcome variable (academic achievement). One sample of 380 first-year students who were studying in different scientific areas participated in the study. Students answered a questionnaire at the beginning and at the end of their first semester in college. To increase ecological validity, students' cognitive and behavioral engagement and academic achievement were assessed using a specific curricular subject of the course as a reference. Students' grades were collected through academic services. Data from both time points were analyzed with a structural equation model (SEM), and data showed a goodness of fit of SEM in both time points. Findings indicate that cognitive and behavioral engagement mediated the relationship between students' background variables and their academic achievement. The analysis of both SEM allows us to understand that academic achievement at the end of the semester is closely related to what happens at the beginning of the semester (e.g., approach to learning, study time). Thus, promoting students' engagement at the beginning of the semester should be considered a priority, as the first part of the first semester represents a critical period for students and for their integration in college. Thus, universities should consider improving their mechanisms of collecting information to allow for early identification, support, and monitoring of students at risk of dropping out, showing high level of disengagement and low academic achievement.

Práticas intergeracionais e Longevidade / Intergenerational practices and Longevity / Prácticas intergeneracionales y Longevidad

Este artigo objetiva apresentar os resultados de uma pesquisa sobre a importância de práticas intergeracionais junto a pessoas longevas. Jovens em situação de vulnerabilidade social, frequentadores de uma instituição, o Projeto Quixote, são orientados para assumir o papel de agentes socioculturais, quando partilham com idosos, frequentadores do Centro-Dia Pasárgada, de atividades de ocupação do tempo livre. Tendo como meta a reaproximação de membros de ambas as gerações, foi desenvolvida uma pesquisa-ação, de caráter educacional, sendo aplicado o método qualitativo à luz da fundamentação gerontológica, complementado pela observação-participante, com registro em Diário de Pesquisa. A metodologia previu uma série de Oficinas, que foram sendo, no seu decorrer, avaliadas, sofrendo as mudanças necessárias. Os resultados, sob o olhar dos participantes, apontaram as oportunidades intergeracionais como muito bem-sucedidas, além de promissoras porque fundadas na fraternidade, sendo capazes de aproximar jovens e idosos, e especialmente mudar seu cotidiano de vida.

This article aims to present the results of a research about the importance of intergenerational practices with longevity people. Young people in socially vulnerable situations, who go to an institution, the Quixote Project, are oriented to take on the role of socio-cultural agents when they share activities with the elderly in the Pasárgada Day-Care Center. Aiming at the rapprochement of members of both generations, an educational action research was developed, and the qualitative method was applied in light of the gerontological foundation, complemented by the participant observation, registered in the Research Journal. The methodology foresaw a series of workshops, which were evaluated throughout the course, undergoing the necessary changes. The results, in the eyes of the participants, pointed out the intergenerational opportunities as very successful, as well as promising because they are founded on fraternity, being able to bring young and old together and change their daily life.

Este artículo tiene como objetivo presentar los resultados de una investigación sobre la importancia de las prácticas intergeneracionales con personas a largo plazo. Los jóvenes en situaciones de vulnerabilidad social que acuden a una institución, el Proyecto Quijote, están orientados a asumir el papel de agentes socioculturales cuando comparten actividades con los ancianos en la guardería Pasárgada. Con el objetivo del acercamiento de los miembros de ambas generaciones, se desarrolló una investigación de acción educativa, y el método cualitativo se aplicó a la luz de la base gerontológica, complementada por la observación participante, registrada en el Research Journal. La metodología preveía una serie de talleres, que fueron evaluados a lo largo del curso, experimentando los cambios necesarios. Los resultados, a los ojos de los participantes, señalaron las oportunidades intergeneracionales como muy exitosas, además de prometedoras porque se basan en la fraternidad, en la capacidad de unir a jóvenes y mayores y cambiar su vida cotidiana.

Interactions among gibberellins, brassinosteroids and genes regulate stomatal development in the Arabidopsis hypocotyl.

Stomata are pores on the plant surface that enable gas exchange with the atmosphere. In Arabidopsis thaliana, brassinosteroids, which function upstream of the TTG/bHLHs/MYBs/GL2 transcriptional network, positively regulate stomatal formation in the hypocotyl. Gibberellins also promote stomatal development in the embryonic stem. Here, we investigated the hypothetical interactions between the gibberellin and brassinosteroid signaling pathways during stomatal formation. By combining genetics and gene expression studies, we found that gibberellins promote stomatal development, functioning upstream of both brassinosteroids and the TTG/bHLHs/MYBs/GL2 network. Gibberellins also regulate an earlier step in stomatal development than that regulated by the receptor-like membrane protein TOO MANY MOUTHS.

"My Child has Cerebral Palsy": Parental Involvement and Children's School Engagement.

Engaged students tend to show school-committed behaviors (e.g., attend classes, get involved with the learning process), high achievement, and sense of belonging. However, students with disabilities are prone to show a lack of engagement with school due to the specific difficulties they have to handle. In fact, children with disabilities are likely to show poor participation in school when compared with children without disabilities. This poor involvement is related to their low autonomy to participate in the school activities, which, in turn, results in low school engagement. Parents play a crucial role in their children's education. Parental involvement in school activities promotes autonomous behaviors and, consequently, school engagement. In fact, extant literature has shown close relationships between parental involvement, school engagement, and academic performance. Yet, parental involvement in school activities of children with Cerebral Palsy (CP) has received little direct attention from researchers. These children tend to display lower participation due to the motor, or cognitive, impairments that compromise their autonomy, and have a high likelihood to develop learning disabilities, with special incidences in reading and arithmetic. Therefore, our aim is twofold, to understand the parental styles; and how the perceived parental involvement in school activities is related to their children school engagement. Hence, 19 interviews were conducted with one of the parents of 19 children with CP. These interviews explored the school routines of children and the perceived involvement of parents in those routines. Additionally, children filled out a questionnaire on school engagement. Results show that the majority of the parents were clustered in the Autonomy Allowance and Acceptance and Support parental style, and the majority of their children were perceived as autonomous. Moreover, about a half of the children reported a high level of school engagement. Finally, neither children's autonomous behaviors reported by parents, nor parental style, seem to be related with the children's level of school engagement. Rehabilitation centers and schools could consider training parents/caregivers focusing on their educational needs, promotion of reflections on the usefulness of applying autonomy promotion strategies with their child, and foster their involvement.

Development of a validated algorithm for the diagnosis of paediatric asthma in electronic medical records.

An accurate estimation of the prevalence of paediatric asthma in Alberta and elsewhere is hampered by uncertainty regarding disease definition and diagnosis. Electronic medical records (EMRs) provide a rich source of clinical data from primary-care practices that can be used in better understanding the occurrence of the disease. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) database includes cleaned data extracted from the EMRs of primary-care practitioners. The purpose of the study was to develop and validate a case definition of asthma in children 1-17 who consult family physicians, in order to provide primary-care estimates of childhood asthma in Alberta as accurately as possible. The validation involved the comparison of the application of a theoretical algorithm (to identify patients with asthma) to a physician review of records included in the CPCSSN database (to confirm an accurate diagnosis). The comparison yielded 87.4% sensitivity, 98.6% specificity and a positive and negative predictive value of 91.2% and 97.9%, respectively, in the age group 1-17 years. The algorithm was also run for ages 3-17 and 6-17 years, and was found to have comparable statistical values. Overall, the case definition and algorithm yielded strong sensitivity and specificity metrics and was found valid for use in research in CPCSSN primary-care practices. The use of the validated asthma algorithm may improve insight into the prevalence, diagnosis, and management of paediatric asthma in Alberta and Canada.

Ingresos laborales, transferencias y seguridad económica de los adultos mayores de Medellín, Colombia / Labor income, transfers and economic security for the elderly of Medellin, Colombia

Objetivo: Explorar la seguridad económica de los adultos mayores en Medellín, Colombia, así como sus fuentes de ingreso y transferencias económicas, desde una mirada comprensiva. Materiales y métodos: Estudio cualitativo exploratorio de fuente primaria, con selección por bola de nieve por medio del método histórico-hermenéutico. Se entrevistaron quince adultos mayores y cinco especialistas en el tema, a los cuales se les indagó por aspectos relacionados con sus condiciones económicas y se analizó la información, como una teoría fundamentada, donde emergen categorías de los textos. Resultados: Los mayores se sienten inseguros económicamente al no contar con ingresos fijos y suficientes que les permitan vivir de manera autónoma e independiente; menos de una tercera parte cuenta con ingresos provenientes de un empleo, el cual es informal en la mayoría de los casos Por otro lado, las transferencias por pensión y jubilaciones están determinadas por la ocupación y tipo de vinculación en su anterior vida laboral y muchos de ellos deben recurrir a las transferencias económicas de sus familiares. Conclusión: Los adultos mayores entrevistados ven comprometida su seguridad económica por no contar con un ingreso económico para la cobertura de necesidades básicas, ya que una gran mayor parte de ellos carecen de ingresos fijos, que los lleva a la informalidad para vivir el día a día, conscientes de que cada vez se envejecerá más, aumentará la dificultad para seguir laborando y se reducen los espacio para laborar y por ello deben depender del Estado o la familia.

Objective: To explore the economic security of the elderly in Medellin, Colombia as well as their sources of income and economic transfers from a comprehensive perspective. Materials and methods: An exploratory qualitative study of primary source with selection by snowball through historical hermeneutic method was conducted. 15 seniors and 5 specialists in the field selected by snowball were interviewed and asked for aspects related to their economic conditions. The given information was analyzed, as a grounded theory, where categories from the texts emerge. Results: Elderly people feel insecure financially because they do not have fixed and sufficient income to live autonomously and independently. Less than one-third have income from employment, which in most cases is informally. On the other hand, transfers from pension and retirement benefits are determined by the occupation and type of labor relationship in their previous jobs and many of them must rely on financial transfers from their families. Conclusion: Elderly people, who were interviewed, see their economic security compromised by not having an income to cover basic needs, since a large majority of them lack of fixed incomes. This situation leads them to work informally to live day to day knowing that every time they are getting older, it is more difficult to continue working, the job opportunities are reduced and therefore they must rely on the State or their families

Evaluation of SAMe-TT2R2 score and other clinical factors influencing the quality of anticoagulation therapy in non-valvular atrial fibrillation: a nationwide study in Spain.

OBJECTIVE: To assess the major clinical factors affecting the quality of anticoagulation and evaluate the predictive value of the SAMe-TT2R2 score to identify patients who will achieve a high average time in therapeutic range (T.T.R.) with vitamin K antagonist (V.K.A.) treatment. RESEARCH DESIGN AND METHODS: This observational, cross-sectional, retrospective and nationwide multicenter study included 1524 patients from the primary care setting with non-valvular atrial fibrillation receiving V.K.A. (≥12 months). We performed a bivariate analysis to identify factors individually associated with the T.T.R. and a multiple regression analysis to identify the independent predictive factors. For the validation of the SAMe-TT2R2 score, the receiver operating characteristic (R.O.C.) curve was calculated and the Hosmer-Lemeshow test was used to test calibration. RESULTS: A total of 94.8% of patients received acenocumarol (4.8% warfarin). A progressive decrease in mean T.T.R. was found when the SAMe-TT2R2 score increased from 0 points (72.1 ± 17.1%) to 4 points (64.1 ± 23.2%), p < 0.001. Other risk scores (CHADS2 and CHA2DS2-VASc, HAS-BLED) were also associated with the mean T.T.R. We found a significant association between low T.T.R. and the following clinical factors: female sex, three or more comorbidities, amiodarone treatment, dietary habits, bleeding history and the intake of ≥7 tablets per day besides V.K.A. (p < 0.01). Regarding SAMe-TT2R2 score validation, the R.O.C. curve showed significant capability, although not high, of discriminating good anticoagulation control (T.T.R. ≥65%) with an area under the curve of 0.562 (95% C.I. 0.533-0.592, p < 0.001) which increased, remaining modest, to 0.594 (95% C.I. 0.564-0.624, p < 0.001) when the factors not included in SAMe-TT2R2 score were added. CONCLUSION: In this cohort, the SAMe-TT2R2 score had a significant, although modest, ability to assess the likelihood of good international normalized ration (I.N.R.) control, and its predictive value might slightly improve by adding other simple clinical factors. Further research is needed to refine the predictive scales.

The effects of teachers' homework follow-up practices on students' EFL performance: a randomized-group design.

This study analyzed the effects of five types of homework follow-up practices (i.e., checking homework completion; answering questions about homework; checking homework orally; checking homework on the board; and collecting and grading homework) used in class by 26 teachers of English as a Foreign Language (EFL) using a randomized-group design. Once a week, for 6 weeks, the EFL teachers used a particular type of homework follow-up practice they had previously been assigned to. At the end of the 6 weeks students completed an EFL exam as an outcome measure. The results showed that three types of homework follow-up practices (i.e., checking homework orally; checking homework on the board; and collecting and grading homework) had a positive impact on students' performance, thus highlighting the role of EFL teachers in the homework process. The effect of EFL teachers' homework follow-up practices on students' performance was affected by students' prior knowledge, but not by the number of homework follow-up sessions.

Parents' conceptions of their homework involvement in elementary school.

BACKGROUND: Homework is a universal practice used in schools, and is commonly related to academic achievement. According to literature, parental homework involvement has positive and negative aspects, depending on parents’ behaviors. METHOD: Assuming a phenomenographic perspective, this study examined 4th graders’ parents’ conceptions of their involvement in homework. With the purpose of mapping the parents’ various conceptions of homework involvement, 32 semi-structured interviews were conducted and analyzed. RESULTS: The results show that parents’ conceptions of homework involvement have a positive meaning, and focus primarily on the role played in the promotion of academic learning by (a) fostering their children’s autonomy, (b) exerting control over their learning, and (c) providing them with emotional encouragement (when children struggle with difficulties). CONCLUSIONS: Given that parents perceive their involvement in their children’s homework as important, it is necessary to promote parent-teacher collaboration and parent-training workshops to improve the quality of parental homework involvement.

Adult ADHD screening in alcohol-dependent patients using the Wender-Utah Rating Scale and the adult ADHD Self-Report Scale.

OBJECTIVE: The aim was to analyze the psychometric properties of two screening instruments, Wender-Utah Rating Scale (WURS) that evaluates childhood ADHD and Adult ADHD Self-Report Scales (ASRS) that assesses symptoms in adulthood, in alcohol-dependent patients. METHOD: A total of 355 outpatients were included. Conners' adult ADHD diagnostic interview results were used as a gold standard in childhood and adulthood ADHD. RESULTS: The WURS with a 41 cutoff had a sensitivity of 79.6% and a specificity of 60.3%. The ASRS with a 14 cutoff had a sensitivity of 86.7% and specificity of 66.1%. Analyzing both rating scales in combination, it was observed that patients with positive ASRS and WURS presented a sensitivity of 92.3%. Patients with positive ASRS, but negative WURS, presented a specificity of 73.6%. CONCLUSION: WURS and ASRS are useful tools in the diagnosis of adult ADHD in alcohol-dependent patients; with the use of both instruments, the psychometric properties are substantially improved.

A importância da capacitação e formação de pessoas que trabalham com idosos em Centros-Dia / The importance of capacity building and training for those working with older people in Centers-Day

Estas reflexões surgem a partir da experiência de investigação em um Centro-Dia para Idosos, na cidade de São Paulo (SP), Brasil, durante o período de um ano e quatro meses, de setembro de 2011 a fevereiro de 2013, no desenvolvimento de projeto de doutorado intitulado “Geras Vitalis”, que teve como foco a criação de Oficinas adaptadas para a população idosa dessa instituição, com o objetivo não só de viabilizar espaços de expressão e de escuta de idosos, mas especialmente proporcionar-lhes uma melhor interação sociocultural que lhes pudesse trazer melhoria em seu bem-estar, em sua qualidade de vida. Foram diagnosticados problemas como o de lacunas de serviços e de incipiência quanto ao conhecimento gerontológico, por parte de funcionários atuando como cuidadores diretos, e de dirigentes ― duas instâncias fundamentais para a gestão de uma Instituição como a que está em foco neste estudo. Tais insuficiências, a nosso ver, podem exacerbar comportamentos inadequados em tal ambiente, contribuindo para uma baixa qualidade de vida dos utentes, assim como daqueles que com eles lidam no cotidiano. Assim é que, como desdobramento deste estudo, sugere-se a implementação de projetos de capacitação, caracterizados por intervenções gerontológicas orientadas por componentes como o Aconselhamento, a Escuta Psicológica e Educacional e, se necessária, a utilização da estratégia denominada Gestão de Caso.

Reflections discussed here originated from workshops developed to provide a space for elders to express themselves and to be heard as well to provide better socio-cultural interactions and improvement in their wellbeing and quality of life. These workshops were conducted at a Center Day for Elderly in São Paulo, Brazil, from September 2011 to February 2013, as part of a PhD project entitled “Geras Vitalis”. Service gaps and lack of gerontological knowledge by care-takers and directors from the institution where the work was undertaken were observed during the workshops. These shortcomings, in our view, can exacerbate inappropriate behavior, contributing to a lower quality of life of the older people, as well as those who deal with them in everyday life. As a result of this study, we suggest training programs, where gerontological interventions are oriented by components such as counseling, psychological and educational listening and, if necessary, the use of “Case Management”.