The cost of colorectal cancer according to the TNM stage. / Valoración del coste económico del cáncer colorrectal según estadio tumoral.

INTRODUCTION: The aim of this study was to measure the cost of treatment of colorectal cancer in the Basque public health system according to the clinical stage. METHODS: We retrospectively collected demographic data, clinical data and resource use of a sample of 529 patients. For stagesi toiii the initial and follow-up costs were measured. The calculation of cost for stageiv combined generalized linear models to relate the cost to the duration of follow-up based on parametric survival analysis. Unit costs were obtained from the analytical accounting system of the Basque Health Service. RESULTS: The sample included 110 patients with stagei, 171 with stageii, 158 with stageiii and 90 with stageiv colorectal cancer. The initial total cost per patient was 8,644€ for stagei, 12,675€ for stageii and 13,034€ for stageiii. The main component was hospitalization cost. Calculated by extrapolation for stageiv mean survival was 1.27years. Its average annual cost was 22,403€, and 24,509€ to death. The total annual cost for colorectal cancer extrapolated to the whole Spanish health system was 623.9million€. CONCLUSIONS: The economic burden of colorectal cancer is important and should be taken into account in decision-making. The combination of generalized linear models and survival analysis allows estimation of the cost of metastatic stage.

Anorectal melanoma. An update.

Anorectal melanoma is an uncommon and aggressive disease. Because the patients often present with non specific complaints, a high clinical suspicion is important to avoid a delayed diagnosis. Patients undergoing radical surgery have no significant survival difference compared to those undergoing wide local excision. Abdominoperineal resection should be reserved for selected patients in whom local excision is not technically possible or cannot obtain a clear margin. The indiscriminate use of groin dissection is not advisable in anorectal melanoma and should be use in selected cases. Systemic chemotherapy is generally a non effective treatment and continues be studied. Radiation therapy can be used as hypofractionated radiation therapy combined with local excision or in a palliative setting. The oncological outcomes in anorectal melanoma are very poor. The aim of the present study is to review clinicopathology features and management of anorectal melanoma.

Dual alcohol and cannabis use in male and female adolescents: Relationships with family variables.

Family dynamics influence adolescents' use of alcohol and other substances, such as cannabis. The aim of this study was to understand the relationship between family variables and alcohol use, dual use of alcohol and cannabis, and non-use in adolescents according to sex. A cross-sectional study was conducted. The sample comprised 879 adolescents (56.4 % boys; M(SD)age = 14.25 (1.88) years). Multinomial regression analysis showed that for boys, the presence of family conflict increased the likelihood of being an alcohol (OR = 1.19) and dual (OR = 1.23) user rather than a non-user. For girls, communication reduced the probability of being an alcohol user (OR = 0.88), and the presence of consequences for breaking rules reduced the probability of being a dual user rather than a non-user (OR = 0.83) or an alcohol user (OR = 0.84). These findings highlight the importance of family prevention of adolescents' substance use, bearing in mind the participants' sex.

Mindfulness improves theory of mind in people experiencing psychosis: A pilot randomized clinical trial.

Impaired Theory of Mind (ToM) ability is a core feature of psychotic disorders that challenges psychosis treatment. We aimed to explore the effect of a Mindfulness-Based Intervention (MBI) on ToM ability in a randomized clinical trial (RCT). A sample of 36 participants diagnosed with psychotic disorder were recruited from a community center and randomly allocated to Integrated Rehabilitation Treatment (IRT) or IRT+MBI. ToM skills were assessed through the Hinting Test and the Reading the Mind in the Eyes Test (RMET). IRT+MBI scored higher in RMET than IRT at posttreatment. MBI is a promising tool for improving ToM ability in psychosis.

A cross-cultural comparison between Spain and the USA: temperament and character distribution by sex and age.

The Unified Biosocial Theory of Personality developed by Cloninger has been applied in different cultures. Distribution by age and sex of the Temperament and Character Inventory (TCI) dimensions were assessed cross-culturally for samples in Spain and the USA. Three non-clinical samples were included: i) 404 participants from Asturias (Spain); ii) 240 participants from Burgos (Spain); and iii) 300 adults from St. Louis (USA). Each participant was assessed by means of the TCI. A significant negative correlation between NS and both HA (r=-0.329; P<0.01) and P (r=-0.217; P<0.01) was found in the study sample, as well as significant effects of age in NS, HA, RD, and C for women and in NS and HA for men, and also of sex in HA and RD. Personality dimensions for the two Spanish samples appear to be similar (differences in HA4 and RD) compared to those for the US sample (differences in NS, HA, RD and P). Findings support Cloninger's theory about differences between men and women, but not regarding the intercorrelations between temperament dimensions.

Differences between individualist and collectivist cultures in emotional Facebook usage: relationship with empathy, self-esteem, and narcissism.

BACKGROUND: Adolescents are one of the groups who most use social networks in an emotional way, to express their own emotions and to empathize with the emotions of others. Although personality factors; namely, empathy, self-esteem, and narcissism appear to play an important role in this usage, the contribution of cultural variables has yet to be examined. The aim of this study is to examine cross-cultural variations in Facebook usage and the relationship of those variations with empathy, self-esteem and narcissistic personality factors. METHOD: Using a sample of 479 Spanish adolescents (220 females) and 405 Thai adolescents (224 females), the Use of Facebook Questionnaire was applied, and empathy, self-esteem and narcissism personality traits were measured. RESULTS: Findings suggested variations between Thai and Spanish samples at the intra- and inter-cultural level. The Thai sample had higher scores in Affective Empathy but lower scores in Cognitive Empathy, used Facebook more, and engaged in more emotional and empathic expression when using Facebook. Also, results also show interesting differences related with the interaction between gender and country. CONCLUSIONS: We discuss the results in relation to Hofstede’s criteria about the differences between Eastern and Western societies. We highlight the need for longitudinal studies about this topic.

Crítica del libro Manual de tratamientos psicológicos. Infancia y adolescencia, de Eduardo Fonseca Pedrero (Coord.). Editorial Pirámide, 864 pp., año 2021 / [Review of the book Manual de tratamientos psicológicos: infancia y adolescencia, by Eduardo Fonseca Pedrero (Coord.). Editorial Pyramid, 864 pages, year 2021]

No disponible

Emotional Uses of Facebook and Twitter: Its Relation With Empathy, Narcissism, and Self-Esteem in Adolescence.

Facebook and Twitter have change interpersonal relationships. Adolescents are the sector of the population who use most these networks. They use them in an emotional way, to express their emotions and to comment on those of others. Empathy, narcissism, and self-esteem may play an important role in the use of these networks. Using a sample of 503 Spanish adolescents (272 males, 231 females), this work studies the relationship between the Basic Empathy Scale, the Narcissistic Personality Inventory, the Rosenberg Self-Esteem Scale, and emotional and empathic use of Facebook and Twitter. The results showed that those who use Facebook and Twitter have higher scores in empathy. It has been observed that certain ways of using these two social networks are associated with narcissism. Greater use of Facebook and Twitter is associated with lower self-esteem.

La psicología ante la disforia de género, más allá de la ideología queer / Psychology and gender dysphoria: Beyond queer ideology

La disforia de género en la infancia y la adolescencia está hoy en día más bajo el domino de la ideología queer que dentro de los conocimientos científicos y profesionales. Este dominio de la ideología se traduce en importantes consecuencias prácticas como la autodeterminación de la identidad de género con base en el sentimiento y la terapia afirmativa de la identidad sentida como la única opción aceptable. Como resultado, quedan fuera de evaluación los aspectos psicológicos y se emprenden transiciones fármaco-quirúrgicas que no resuelven el problema para todos. En particular, surge el nuevo fenómeno de los arrepentidos de haber cambiado de género y destransicionistas que quisieran volver atrás. Las profesiones sanitarias incluida la psicología, así como la psiquiatría y la pediatría, debieran reclamar ante la disforia de género los mismos estándares científicos y profesionales que aplican en los demás problemas, empezando por la exploración, la evaluación, el análisis funcional, el diagnóstico, la prudencia, la espera atenta, en vez de asumir sin más la terapia afirmativa.(AU)

Gender dysphoria in childhood and adolescence is today more under the domain of queer ideology than within scientific and professional knowledge. This dominance of ideology translates into important practical consequences such as self-determination of gender identity based on sentiment and affirmative therapy of felt identity as the only acceptable option. As a result, psychological aspects are left out of evaluation and pharmaco-surgical transitions are undertaken that do not solve the problem for everyone. In particular, there is the new phenomenon of those who regret having changed their gender and detransitionists who would like to reverse the process The health professions, including psychology, as well as psychiatry and paediatrics, should claim the same scientific andprofessional standards for gender dysphoria as they apply to other problems, starting with exploration, evaluation, functional analysis, diagnosis, prudence, attentive waiting, instead of simply assuming affirmative therapy.(AU)

Sedentary versus active leisure activities and their relationship with sleeping habits and body mass index in children of 9 and 10 years of age.

A random sample of 291 9- and 10-year-old schoolchildren from Asturias (Spain) was taken. Using path analysis, a model was tested in which bedtime, the number of hours spent sleeping and leisure activities were the independent variables and the body mass index was the dependent variable. The results show that sedentary and active leisure time and hours spent sleeping are predictors of the body mass index in children. Those children who go to bed late and who use that extra time to watch the television or play with the computer tend to have a greater body mass index, while those children who go to bed earlier and have spent more time reading or playing in the park or at home have a lower body mass index. Encouraging active leisure activities can have an extremely positive effect on their body mass index.

Characteristics of Empathy in young people measured by the Spanish validation of the Basic Empathy Scale.

BACKGROUND: Empathy is a personality feature that can play a major role in predicting the emotional and social functioning of adolescents (Jolliffe & Farrington, 2006). Recent research confirms the existence of two fundamental dimensions embedded within this construct, Affective Empathy (experiencing a congruent emotional response with another person) and Cognitive Empathy (understanding rationally the emotions of another person). The Basic Empathy Scale (Jolliffe & Farrington, 2006) is an up-to-date instrument which has been reported to satisfactorily measure these two dimensions. METHOD: We used a sample of 752 adolescents (339 males, 413 females) aged 14-25 who completed the Spanish adaptation of BES. RESULTS: Confirmatory factor analysis showed that the Spanish adaptation of the scale had the same bi-factorial structure as the original (CFI = .93). This adaptation also showed both satisfactory reliability (Cronbach’s alpha coefficient > .92) and discriminant and convergent validity with regard to measurements of Narcissism, Psychoticism and Agreeableness. Females were found to have higher scores than males both in Affective and Cognitive Empathy. Both subscales show a direct significant correlation with age. CONCLUSIONS: The evidence suggested that this revised scale possessed good psychometric properties for evaluating empathy in Spanish young people.

Differences between individualist and collectivist cultures in emotional Facebook usage: relationship with empathy, self-esteem, and narcissism / Diferencias entre culturas individualistas y colectivas en el uso emocional de Facebook: relación con la empatía, la autoestima y el narcisismo

BACKGROUND: Adolescents are one of the groups who most use social networks in an emotional way, to express their own emotions and to empathize with the emotions of others. Although personality factors; namely, empathy, self-esteem, and narcissism appear to play an important role in this usage, the contribution of cultural variables has yet to be examined. The aim of this study is to examine cross-cultural variations in Facebook usage and the relationship of those variations with empathy, self-esteem and narcissistic personality factors. METHOD: Using a sample of 479 Spanish adolescents (220 females) and 405 Thai adolescents (224 females), the Use of Facebook Questionnaire was applied, and empathy, self-esteem and narcissism personality traits were measured. RESULTS: Findings suggested variations between Thai and Spanish samples at the intra- and inter-cultural level. The Thai sample had higher scores in Affective Empathy but lower scores in Cognitive Empathy, used Facebook more, and engaged in more emotional and empathic expression when using Facebook. Also, results also show interesting differences related with the interaction between gender and country. CONCLUSIONS: We discuss the results in relation to Hofstede's criteria about the differences between Eastern and Western societies. We highlight the need for longitudinal studies about this topic

ANTECEDENTES: los adolescentes son el grupo de población que más usan las redes sociales de forma emocional para expresar sus emociones y para empatizar con las emociones de otros. Mientras que factores de personalidad como empatía, autoestima y narcisismo parecen desempeñar un papel importante en este uso, la contribución de las variables culturales no ha sido examinada. El objetivo de este estudio es examinar variaciones interculturales en el uso de Facebook, y su relación con la empatía, autoestima y narcisismo. MÉTODO: usando una muestra de 479 adolescentes españoles (220 mujeres) y 405 adolescentes tailandeses (224 mujeres), se aplicó el Cuestionario de Uso de Facebook y se midieron los rasgos de empatía, autoestima y narcisismo. RESULTADOS: los resultados sugieren variaciones entre las muestras españolas y tailandesas a nivel intra e intercultural. La muestra tailandesa puntuó más alto en Empatía Afectiva, pero más bajo en Empatía Cognitiva, y usó más Facebook expresando emociones y empatía. También se obtuvieron resultados relacionados con la interacción entre sexo y país. CONCLUSIONES: se discuten estos resultados en relación con los criterios de Hofstede acerca de las diferencias entre las sociedades occidentales y orientales. Se destaca la necesidad de estudios longitudinales

Valoración del coste económico del cancer colorrectal según estadio tumoral / The cost of colorectal cancer according to the TNM stage

INTRODUCCIÓN: El objetivo de este trabajo fue medir el coste del tratamiento del cáncer colorrectal en un hospital del sistema sanitario público vasco según el estadio clínico. MÉTODOS: Se recogieron de forma retrospectiva variables demográficas, clínicas y uso de recursos de una muestra de 529 pacientes. Para los estadios I a III se midieron los costes iniciales y de seguimiento. El coste del estadio IV combinó los modelos lineales generalizados para relacionar el coste con la duración del seguimiento con el análisis de supervivencia de tipo paramétrico. Los costes unitarios se obtuvieron del sistema de contabilidad analítica del Servicio Vasco de Salud. RESULTADOS: La muestra se distribuyó en 110 pacientes en estadio I, 171 en estadio II, 158 en el estadio III y 90 en el estadio IV. El coste total inicial por paciente fue de 8.644 euros (Euros) en el estadio I, 12.675 Euros en el estadio II y 13.034 Euros en el estadio III. El principal componente del coste fue la hospitalización. La supervivencia media calculada por extrapolación para el estadio IV fue de 1,27 años. Su coste anual medio fue de 22.403 Euros, y de 24.509 Euros hasta el fallecimiento. El coste anual total para el tratamiento del cáncer colorrectal extrapolado a toda España fue de 623.900.000 Euros. CONCLUSIONES: La carga económica del cáncer colorrectal es importante y debe ser tenida en cuenta en la toma de decisiones. La combinación de los modelos lineales generalizados y el análisis de supervivencia para relacionar el coste con el seguimiento permite estimar el coste del estadio metastásico

INTRODUCTION: The aim of this study was to measure the cost of treatment of colorectal cancer in the Basque public health system according to the clinical stage. METHODS: We retrospectively collected demographic data, clinical data and resource use of a sample of 529 patients. For stages I to III the initial and follow-up costs were measured. The calculation of cost for stage IV combined generalized linear models to relate the cost to the duration of follow-up based on parametric survival analysis. Unit costs were obtained from the analytical accounting system of the Basque Health Service. RESULTS: The sample included 110 patients with stage I, 171 with stage II, 158 with stage III and 90 with stage IV colorectal cancer. The initial total cost per patient was 8,644 Euros for stage I, 12,675 Euros for stage II and 13,034 Euros for stage III. The main component was hospitalization cost. Calculated by extrapolation for stage IV mean survival was 1.27 years. Its average annual cost was 22,403 Euros, and 24,509 Euros to death. The total annual cost for colorectal cancer extrapolated to the whole Spanish health system was 623.9 million Euros. CONCLUSIONS: The economic burden of colorectal cancer is important and should be taken into account in decision-making. The combination of generalized linear models and survival analysis allows estimation of the cost of metastatic stage

Melanoma anorrectal. Revisión de conjunto / Anorectal melanoma. An update

Melanoma anorrectal es un tumor infrecuente y muy agresivo. Su clínica es muy inespecífica, por lo que se requiere un alto índice de sospecha para evitar un retraso diagnóstico. La cirugía radical no ofrece ninguna mejora en la supervivencia y debe reservarse para aquellos pacientes en los que la escisión local no es factible. La linfadenectomía inguinal no está indicada de forma sistemática y debe valorarse de forma individualizada. La quimioterapia adyuvante no es efectiva. El papel de la radioterapia es controvertido. Puede utilizarse, bien como terapia hipofraccionada tras escisión local o bien como tratamiento paliativo. En cualquier caso, los resultados oncológicos son desalentadores. El objetivo de este artículo es realizar una revisión de la literatura existente sobre las características clinicopatológicas y el manejo del melanoma anorrectal

Anorectal melanoma is an uncommon and aggressive disease. Because the patients often present with non-specific complaints, a high clinical suspicion is important to avoid a delayed diagnosis. Patients undergoing radical surgery have no significant survival difference compared to those undergoing wide local excision. Abdominoperineal resection should be reserved for selected patients in whom local excision is not technically possible or cannot obtain a clear margin. The indiscriminate use of groin dissection is not advisable in anorectal melanoma and should be used in selected cases. Systemic chemotherapy is generally a non-effective treatment and continues be studied. Radiation therapy can be used as hypofractionated radiation therapy combined with local excision or in a palliative setting. The oncological outcomes in anorectal melanoma are very poor. The aim of the present study was to review clinicopathology features and management of anorectal melanoma

A study on MSH2 and MLH1 mutations in hereditary nonpolyposis colorectal cancer families from the Basque Country, describing four new germline mutations.

Hereditary non-polyposis colorectal cancer (HNPCC) or Lynch syndrome underlies between 2 and 5% of all colorectal cancer. It is inherited as an autosomal dominant condition due to mutations in the mismatch repair genes. Fifty-four non-related index cases, 21 of them fulfilling Amsterdam criteria I or II, were studied. Ten (10/21 = 47.6%) different pathological mutations were found in this group, two of which had not previously been reported--one in MLH1 and the other in MSH2-. In the remaining patients, we also found another family with one of these new mutations, and four additional changes, two of which were also new--a pathological change in MSH2 and a second change of uncertain significance in MLH1-, while the other two changes had already been reported. Of all mutations, eight were found in MSH2 (8/15 = 53.3%) and seven in MLH1 (7/15 = 46.6%), suggesting a slightly greater involvement of MSH2 in HNPCC than MLH1 in our population, in contrast to the results reported by other authors.