RAWS4all project: validation of a new silicone model for robotic TAPP inguinal hernia repair.

BACKGROUND: Trans-abdominal pre-peritoneal (TAPP) hernia repair is a complex procedure that presents several challenges. Even though, due to the high prevalence of inguinal hernia, TAPP technique is increasing in frequency and robotic Abdominal Wall Surgery (rAWS) is emerging as a valuable tool in this regard. Although inguinal TAPP procedure principles have been published and simulation is needed, the availability of validated models remains scarce. METHODS: A new low-cost model was developed to simulate inguinal rTAPP repair. For validity assessment, a new TAPP-specific fidelity questionnaire and assessment scale were developed to compare the performance of novices and experts in the simulated procedure. The models used were assessed at 60 min for execution and quality score. RESULTS: Twenty-five residents and specialists from all over the country participated in this study. Execution, quality, and global performance was higher in the seniors group compared to juniors (8.91 vs 6.36, p = 0.02; 8.09 vs 5.14, p < .001; and 17 vs. 11,5, p < .001, respectively). Overall fidelity was assessed as being very high [4.41 (3.5-5.0), α = .918] as well as face [4.31 (3.0-5.0), α = .867] and content validity [4.44 (3.2-5.0), α = .803]. Participants strongly agreed that the model is adequate to be used with the DaVinci® Robot [4.52 (3.5-5.0), α = .758]. CONCLUSION: This study shows face, content, and construct validity of the model for inguinal TAPP simulation, including for robotic surgery. Therefore, the model can be a valuable tool for learning, understanding, practicing, and mastering the TAPP technique prior to participating in the operating room.

Psychological assessment in school contexts: ethical issues and practical guidelines.

BACKGROUND: Psychological assessment in school settings involves a range of complexities and ethical dilemmas that practitioners must navigate carefully. This paper provides a comprehensive review of common issues faced by school psychologists during assessments, discussing best practices and ethical guidelines based on codes from various professional organizations. METHODS: We examine the entire assessment process, from pre-assessment considerations like informed consent and instrument selection to post-assessment practices involving results communication and confidentiality. Key ethical concerns addressed include fairness in assessment, cultural and linguistic appropriateness of testing materials, and issues surrounding informed consent. RESULTS: Specific challenges discussed include selecting appropriate assessment instruments that reflect the diverse needs and backgrounds of students, ensuring fairness and removing bias in testing, and effectively communicating results to various stakeholders while maintaining confidentiality. We emphasize the importance of multi-source, multi-method assessment approaches and the critical role of ongoing professional development in ethical practice. CONCLUSION: By adhering to established ethical standards and best practices, school psychologists can effectively support the educational and developmental needs of students. This paper outlines actionable recommendations and ethical considerations to help practitioners enhance the accuracy, fairness, and impact of their assessments in educational settings.

The Effect of Oral Simethicone in a Bowel Preparation in a Colorectal Cancer Screening Colonoscopy Setting: A Randomized Controlled Trial.

Introduction: Current guidelines suggest adding oral simethicone to bowel preparation for colonoscopy. However, its effect on key quality indicators for screening colonoscopy remains unclear. The primary aim was to assess the rate of adequate bowel preparation in split-dose high-volume polyethylene glycol (PEG), with or without simethicone. Methods: This is an endoscopist-blinded, randomized controlled trial, including patients scheduled for colonoscopy after a positive faecal immunochemical test. Patients were randomly assigned to 4 L of PEG split dose (PEG) or 4 L of PEG split dose plus 500 mg oral simethicone (PEG + simethicone). The Boston Bowel Preparation Scale (BBPS) score, the preparation quality regarding bubbles using the Colon Endoscopic Bubble Scale (CEBuS), ADR, CIR, and the intraprocedural use of simethicone were recorded. Results: We included 191 and 197 patients in the PEG + simethicone group and the PEG group, respectively. When comparing the PEG + simethicone group versus the PEG group, no significant differences in adequate bowel preparation rates (97% vs. 93%; p = 0.11) were found. However, the bubble scale score was significantly lower in the PEG + simethicone group (0 [0] versus 2 [5], p < 0.01), as well as intraprocedural use of simethicone (7% vs. 37%; p < 0.01). ADR (62% vs. 61%; p = 0.86) and CIR (98% vs. 96%, p = 0.14) did not differ between both groups. Conclusion: Adding oral simethicone to a split-bowel preparation resulted in a lower incidence of bubbles and a lower intraprocedural use of simethicone but no further improvement on the preparation quality or ADR.

Introdução: As normas de orientação atuais sugerem a adição de simeticone oral à preparação intestinal para colonoscopia. Contudo, o seu efeito nos indicadores de qualidade no âmbito da colonoscopia de rastreio não está comprovado. O objetivo principal foi avaliar a taxa de preparação adequada usando polietilenoglicol (PEG) em dose dividida com e sem simeticone oral. Métodos: Estudo randomizado controlado, cego para o endoscopista, incluindo doentes admitidos para colonoscopia após teste fecal imunoquímico positivo. Os doentes foram aleatoriamente alocados para 4 litros de PEG em dose dividida (PEG) ou 4 litros de PEG em dose divida + simeticone oral (PEG + simeticone). Foram avaliados: Boston Bowel Preparation Scale (BBPS), qualidade da preparação relativa às bolhas através da Colon Endoscopic Bubble Scale (CEBuS) scale, ADR, CIR e uso de simeticone durante o procedimento. Resultados: Foram incluídos 191 e 197 doentes nos grupos PEG + simeticone e PEG, respetivamente. Comparando os grupos PEG + simeticone versus PEG, não se registaram diferenças de significado estatístico relativamente à taxa de preparação intestinal adequada (97% vs. 93%; p = 0,01) mas o score da escala de bolhas foi significativamente inferior no grupo PEG + simeticone [0 (0) versus 2 (5), p < 0.01], assim como o uso de simeticone durante o procedimento (7% vs. 37%; p < 0,01). A ADR (62% vs. 61%; p = 0,86) e a CIR (98% vs. 96%, p = 0,14) não diferiram significativamente entre os dois grupos, respetivamente. Discussão/Conclusão: Adicionar simeticone oral à preparação intestinal em dose dividida permitiu menor incidência de bolhas e menor utilização de simeticone durante o procedimento, mas não se associa a melhor preparação intestinal ou melhor ADR.

Phonological Awareness Assessment Test (PACOF) for Pre-school Children: Evidence of Validity and Reliability / El test de evaluación de la conciencia fonológica (PACOF) para niños de preescolar: pruebas de validez y fiabilidad

Phonological awareness problems have been identified as predictors of learning difficulties with reading and writing in alphabetic languages. The objective of this study is to present an analysis of the psychometric properties of the Phonological Awareness Assessment Test (PACOF), a computer-based test for assessing syllable, phoneme, and intra-syllable awareness in pre-schoolers. Two studies were conducted to collect: (1) evidence of concurrent validity and reliability (N = 30) and (2) evidence of predictive validity (N = 52). Significant correlations between the scores in PACOF and a different test of phonological awareness were found. Regarding reliability, test-retest results indicated a high stability in the scores over time. Concerning predictive validity, the results revealed that scores on the PACOF and on each of its three sub-scales obtained at the end of preschool predict future reading and writing performance. These findings suggest that the test is a reliable and valid measure to assess phonological awareness in pre-schoolers.(AU)

Se ha comprobado que los problemas de conciencia fonológica predicen las dificultades de aprendizaje de la lectura y la escritura en lenguas alfabéticas. El objetivo de este estudio es analizar las propiedades psicométricas del Test de Evaluación de la Conciencia Fonológica (PACOF), una prueba informatizada para evaluar la conciencia silábica, fonética e intrasilábica en niños de preescolar. Se realizaron dos estudios para recoger: (1) pruebas de fiabilidad y validez concurrente (N = 30) y (2) de validez predictiva (N = 52). Se encontró correlación significativa entre las puntuaciones en el PACOF y otra prueba estandarizada de conciencia fonológica. En cuanto a la fiabilidad, los resultados del test-retest destacan una gran estabilidad en las puntuaciones a lo largo del tiempo. Por lo que respecta a la validez predictiva, los resultados revelaron que las puntuaciones en el PACOF y en cada una de sus tres subescalas obtenidas al final de preescolar predicen el futuro rendimiento en lectura y escritura. Estos resultados sugieren que la prueba es una medida fiable y válida para evaluar la conciencia fonológica en niños de preescolar.(AU)

The Relationship of Oral Reading Fluency Endurance to Comprehension in an Intermediate Depth Orthography / [La relación entre la resistencia en la fluidez lectora y la comprensión en una ortografía de profundidad intermedia]

One-minute oral reading fluency (ORF) tests are widely used, but concerns have been raised regarding whether readers are able to maintain their performance if asked to read for a larger period. The main goals of this study were to investigate whether students are able to maintain their ORF performance in a three-minute task and whether scores measured at one and at three minutes are equally good predictors of the performance in a standardized reading comprehension measure. The sample was composed of 159 Portuguese primary school students (grades 2-4). The results suggested that the number of words read correctly (WRC) declined across reading time and that three-minute mean score underestimated fluency in all grade levels compared to a one-minute reading score. The WRC measured either at one minute or using a three-minute average score was an equal predictor of reading comprehension in all grades. Implications for theory and practice are discussed.(AU)

Las pruebas de fluidez lectora de un minuto son muy utilizadas, pero se ha planteado la preocupación de si los lectores son capaces de mantener su rendimiento si se les pide que lean durante un período más largo. Los objetivos principales de este estudio han sido investigar si los estudiantes son capaces de mantener su rendimiento de fluidez lectora en una tarea de tres minutos y si las puntuaciones medidas a uno y a tres minutos son igualmente predictoras del rendimiento en una medida estandarizada de comprensión lectora. La muestra estaba compuesta por 159 alumnos portugueses de primaria (2º a 4º curso). Los resultados sugieren que el número de palabras leídas correctamente (PLC) disminuyó a lo largo del tiempo de lectura y que la puntuación media a los tres minutos subestimó la fluidez en todos los cursos en comparación con la puntuación de un minuto de lectura. El PLC medido ya sea en un minuto o utilizando una puntuación media de tres minutos fue un predictor igual de la comprensión lectora en todos los cursos. Se discuten las implicaciones para la teoría y la práctica.(AU)

Protective factors and resilience in adolescents: The mediating role of self-regulation / Factores de protección y resiliencia en adolescentes: la autorregulación como variable mediadora

The main goal of this study was to explore the mediating role of self-regulation in the relationship between protective factors and resilience. The sample was composed of 393 adolescents who attended secondary education. Participants were assessed using the Healthy Kids Resilience Assessment to collect information about four protective factors-school, home, community and peer environment-and resilience. Two dimensions of self-regulation-goal setting and impulse control-were assessed using the Short Self-Regulation Questionnaire. The results indicated that home, community and peer environment predicted significantly the levels of resilience of the students. Home environment was the main resilience predictor. Goal setting and impulse control abilities were also predictors of resilience but no evidence was found for a mediating effect of the self-regulation dimensions on the relationship between protective factors and resilience. Results are discussed and implications for prevention from a developmental perspective are presented

El objetivo principal de este estudio fue explorar el papel mediador de la autorregulación en la relación entre los factores protectores y la resiliencia. La muestra se compone de 393 adolescentes de cursos de bachillerato. Los participantes fueron evaluados mediante el Healthy Kids Resilience Assessment para recoger información sobre cuatro factores protectores–entorno escolar, entorno familiar, entorno de la comunidad y entorno entre pares-y resiliencia. Dos dimensiones de la autorregulación-establecimiento de objetivos y control de los impulsos-se evaluaron utilizando el Short Self-Regulation Questionnaire. Los resultados indicaron que el ambiente familiar, de la comunidad y entre iguales predijo significativamente los niveles de resiliencia de los estudiantes. El entorno familiar fue el principal predictor de la resiliencia. El establecimiento de objetivos y la capacidad de control de impulsos también fueron predictores de la resiliencia, pero no se encontraron pruebas de un efecto mediador de las dimensiones de la autorregulación sobre la relación entre los factores de protección y resiliencia. Se discuten los resultados y se presentan implicaciones para la prevención desde una perspectiva del desarrollo

Homework self-regulation strategies: a gender and educational-level invariance analysis

Abstract This study investigates the measurement invariance as a function of gender and educational level of the Homework Behavior Questionnaire (Ktpc), an instrument developed to assess students' homework self-regulation strategies. A sample of 1400 elementary and middle school students was used. Results of confirmatory factor analysis indicated a good fit of the theoretical model composed of three dimensions: planning, execution and evaluation of the homework completion. The results also provided evidence for the existence of metric invariance and partial scalar measurement invariance across boys and girls and across the elementary school and the middle school students. The reliability of the scores in the three dimensions was high. Girls obtained higher scores than boys in planning, execution and evaluation. Middle school students had lower scores in planning compared to the elementary school students. These findings are discussed, and their implications for practice are highlighted. (AU)

An application of the Rasch model to reading comprehension measurement

An effective reading comprehension measurement demands robust psychometric tools that allow teachers and researchers to evaluate the educational practices and track changes in students' performance. In this study, we illustrate how Rasch model can be used to attend such demands and improve reading comprehension measurement. We discuss the construction of two reading comprehension tests: TRC-n, with narrative texts, and TRC-e, with expository texts. Three vertically scaled forms were generated for each test (TRC-n-2, TRC-n-3, TRC-n-4; TRC-e-2, TRC-e-3 and TRC-e-4), each meant to assess Portuguese students in second, third and fourth grade of elementary school. The tests were constructed according to a nonequivalent groups with anchor test design and data were analyzed using the Rasch model. The results provided evidence for good psychometric qualities for each test form, including unidimensionality and local independence and adequate reliability. A critical view of this study and future researches are discussed. (AU)

Listening Comprehension Assessment: Validity Studies of Two Vertically Scaled Tests for Portuguese Students / Evaluación de la Comprensión del Lenguaje Oral: Estudios de Validez de Dos Tests con Escalamiento Común para Alumnos Portugueses

This study aims to gather construct- and criterion-related validity evidence for the Test of Listening Comprehension of Narrative Texts (TLC-n) and the Test of Listening Comprehension of Expository Texts (TLC-e), each composed of a vertically scaled form for Portuguese students from the first to fourth grades of primary school. A sample of 1342 students and a sample of 1168 students participated in the study of the TLC-n and TLC-e forms' dimensionality, respectively. Two hundred and eighty students participated in the criterion-related validity study of the tests. Confirmatory factorial analyses were performed for the study of the test forms' dimensionality. To collect criterion-related validity evidence, Pearson correlations with measures oflistening and reading related skills were calculated. Results provide evidence of an acceptable fit for the one-factor solution, for all forms, and statistically significant correlations between the test forms and the external criteria measures. There is evidence for the validity of the test forms.

Los objetivos de este trabajo fueron recoger evidencia de validez de constructo y de criterio para dos tests, el Test of Listening Comprehension of Narrative Texts (TLC-n) y el Test of listening Comprehension of Expository Texts (TLC-e), con cuatro versiones escaladas verticalmente para evaluar la comprensión oral de los alumnos portugueses de enseñanza primaria. Una muestra de 1342 alumnos y una muestra de 1168 alumnos participaron en el estudio de la dimensionalidad del TLC-n y TLC-e. Participaron 260 alumnos en el estudio de validez de criterio de los tests. La dimensionalidad de los tests se examinó mediante un procedimiento de análisis factorial confirmatorio. Para recoger datos sobre evidencia de validez de criterio, se calcularon las correlaciones de Pearson con otras pruebas de comprensión oral y de lectura. Los resultados revelaron que el modelo de un factor se ajusta a los datos. Se obtuvieron coeficientes de correlación estadísticamente significativos entre el TLC-n y TLC-e y los otros tests. Los resultados apoyan la validez de las versiones de los tests.

Effect of an intervention program on the reading comprehension processes and strategies in 5th and 6th grade students / Efecto de un programa de intervención en los procesos y estrategias para la comprensión lectora en estudiantes de 5º y 6º grado

BACKGROUND: Various investigations have revealed that the promotion of cognitive and metacognitive strategies can improve reading comprehension and that when readers receive this type of instruction, they can use monitoring processes and regulation strategies adequately. The goal of this work is to analyze the effects of strategic and metacognitive instruction on reading comprehension processes and strategies, using the «Aprender a Comprender» [Learning to Understand] program. METHOD: Instruction was carried out in the classroom by two teachers during six months. Ninety-four students participated, 49 from 5th grade and 45 from 6th grade. A pretest-intervention-posttest-follow-up design was used with a comparison group by grade. RESULTS: The analysis of variance shows an impact of the intervention and its differential maintenance in each grade. The 5th-grade intervention group scored higher than the comparison group in the reading comprehension test, both at posttest and at follow-up. The 6th-grade intervention group scored higher than the comparison group n the Planning scale, both at posttest and at follow-up. CONCLUSIONS: Textual strategy instruction favors reading comprehension and the progressive development of planning, which is necessary for supervision and regulation, and its effects are maintained over time

ANTECEDENTES: diferentes investigaciones han evidenciado que el fomento de estrategias cognitivas y metacognitivas puede mejorar la comprensión lectora y su instrucción favorece la utilización adecuada de los procesos de monitoreo y de las estrategias de regulación. El objetivo del estudio es analizar los efectos de la instrucción estratégica y metacognitiva con el programa "Aprender a Comprender" en los procesos y estrategias para la comprensión lectora. MÉTODO: la instrucción se llevó a cabo durante seis meses, en el aula, a cargo de dos docentes. Participaron 94 escolares, 49 de 5º grado y 45 de 6º grado. Se utilizó un diseño pretest-intervención postest- seguimiento con un grupo de comparación por grado. RESULTADOS: los análisis de varianza muestran un impacto de la intervención y su mantenimiento diferencial en cada grado. Los estudiantes del grupo de intervención de 5º grado puntuaron más alto en la prueba de comprensión lectora en postest y en el seguimiento. Los del grupo de intervención de 6º grado puntuaron más alto en la escala de planificación tanto en postest como en el seguimiento. CONCLUSIONES: la instrucción estratégica textual favorece la comprensión lectora y el progresivo desarrollo de la planificación necesaria para su supervisión y regulación, manteniendo sus efectos en el tiempo

Calibration of a reading comprehension test for Portuguese students / Calibración de un test de comprensión lectora para alumnos Portugueses

Reading comprehension assessments are important for determining which students are performing below the expected levels for their grade's normative group. However, instruments measuring this competency should also be able to assess students' gains in reading comprehension as they move from one grade to the next. In this paper, we present the construction and calibration process of three vertically scaled test forms of an original reading comprehension test to assess second, third and fourth grade students. A sample of 843 students was used. Rasch model analyses were employed during the following three phases of this study: (a) analysis of the items’ pool, (b) item selection for the test forms, and (c) test forms’ calibration. Results suggest that a one dimension structure underlies the data. Mean-square residuals (infit and outfit) indicated that the data fitted the model. Thirty items were assigned to each test form, by selecting the most adequate items for each grade in terms of difficulty. The reliability coefficients for each test form were high. Limitations and potentialities of the developed test forms are discussed

Las evaluaciones de la comprensión lectora son importantes para identificar a los estudiantes que tienen un desempeño inferior a lo esperado para su grupo normativo. Sin embargo, los tests para evaluar la comprensión lectora deben también permitir la medición de su mejora a lo largo de la escolaridad. En este artículo, se presenta el proceso de construcción y calibración en la misma métrica de tres versiones de un test de comprensión lectora con dificultad creciente, construidas para evaluar a alumnos portugueses del segundo, tercero y cuarto curso de primaria. Se utilizó una muestra de 843 estudiantes. Se utilizó el modelo de Rasch para analizar los datos en las tres fases del estudio: (a) análisis inicial de la muestra de ítems, (b) selección de los ítems para las versiones de test, y (c) calibración de las versiones de test. Los resultados sugieren la unidimensionalidad de los datos. Las medias de los residuos (infit y outfit) muestran que los datos se ajustan al modelo. A cada versión se asignaron 30 ítems con niveles de dificultad adecuados a cada curso. Se obtuvieron altos coeficientes de fiabilidad para cada versión. Para concluir se discuten las limitaciones y potencialidades de las versiones del test

Diagnostic accuracy of lugol chromoendoscopy in the oesophagus in patients with head and neck cancer

Background and aim: patients with head and neck squamous cell malignancies have a higher risk of oesophageal squamous cell carcinomas. Lugol chromoendoscopy in oesophagus is a simple technique with a high diagnostic yield in premalignant lesions. The objective was to analyze its diagnostic accuracy in dysplasia and carcinoma of the oesophagus in high-risk patients. Methods: prospective study from April/2008 to January/2012 using lugol chromoendoscopy with biopsies of suspicious lugol voiding areas ≥ 5 mm. Patients with head and neck malignancies were included, except the ones with iodine allergy, oesophageal varices and contra-indications to standard endoscopy. The reference method was histopathology. Results: 89 patients were enrolled (mean age 62.8 ± 13.3 years, 87 % men). Primary tumour was located in oropharynx in 37 (41.6 %), in oral cavity in 29 (32.6 %) and in the larynx in 23 (25.8 %) cases. 40.4 % patients had previous treatments and 87 % reported alcohol or tobacco addition. All exams performed without anaesthesia or complications. Nine suspicious lugol voiding areas were observed and biopsied. Histopathological analysis revealed high-grade dysplasia in 2 (2.2 %) and inflammation or normal findings in the others. The sensitivity and specificity for detecting high-grade dysplasia were 100 % and 92 % (95 % CI: 87-97), respectively. Diagnostic accuracy of the test was 92 % (95 % CI: 86-98). Conclusion: lugol staining of the oesophagus during endoscopy seems to be a feasible, safe and justified procedure in high-risk population as it enhances the detection of premalignant lesions (AU)

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Communicative development of Portuguese infants aged between 8 and 15 months / Desarrollo comunicativo de los niños portugueses con edades comprendidas entre los 8 y los 15 meses

The main aim of this study was to investigate the development of gesture and language acquisition in European Portuguese infants. These were assessed using the European Portuguese MacArthur-Bates Communicative Development Inventory: words and gestures. The parents’ reports of gestures and lexical competence of 1314 children, aged between 8 and 15 months, were collected. As expected, the results indicated that word comprehension, word production, and the use of gestures increased with age. A main gender effect was found for total gestures, with girls obtaining higher scores than boys, but the effect size was small. No differences were found between girls and boys for word comprehension, word production, and phrases understood. All lexical and gesture measurements were positively correlated, even after controlling for age and gender effects. These findings are discussed in terms of their consistency with those obtained for other languages (AU)

El objetivo principal de este estudio fue investigar el desarrollo de gestos y la adquisición del lenguaje en niños hablantes de portugués europeo. Los gestos y los conocimientos lingüísticos de los niños se evaluaron utilizando la versión en Portugués Europeo del Inventario de Desarrollo Comunicativo MacArthur-Bates: palabras y gestos. Se recogieron los informes paternos de los gestos y competencia léxica de 1,314 niños, con edades comprendidas entre los 8 y los 15 meses. Como era esperable, los resultados indican que la comprensión de palabras, la producción de palabras y el uso de gestos aumentan con la edad. Se encontró también un efecto principal del género para el total de gestos, obteniendo las niñas puntuaciones más altas que los niños, pero el tamaño del efecto es pequeño. No se encontraron diferencias entre niños y niñas para la comprensión y producción de palabras y para frases entendidas. Todas las medidas de léxico y gestos están correlacionadas positivamente, incluso después de controlar los efectos de la edad y del género. Estos resultados se discuten en términos de su consistencia con los obtenidos para otros idiomas (AU)

Development of listening comprehension tests with narrative and expository texts for Portuguese students

This investigation aimed to develop and collect psychometric data for two tests assessing listening comprehension of Portuguese students in primary school: the Test of Listening Comprehension of Narrative Texts (TLC-n) and the Test of Listening Comprehension of Expository Texts (TLC-e). Two studies were conducted. The purpose of study 1 was to construct four test forms for each of the two tests to assess first, second, third and fourth grade students of the primary school. The TLC-n was administered to 1042 students, and the TLC-e was administered to 848 students. The purpose of study 2 was to test the psychometric properties of new items for the TLC-n form for fourth graders, given that the results in study 1 indicated a severe lack of difficult items. The participants were 260 fourth graders. The data were analysed using the Rasch model. Thirty items were selected for each test form. The results provided support for the model assumptions: Unidimensionality and local independence of the items. The reliability coefficients were higher than .70 for all test forms. The TLC-n and the TLC-e present good psychometric properties and represent an important contribution to the learning disabilities assessment field (AU)

No disponible

Validity of a reading comprehension test for Portuguese students / Validez de un test de comprensión lectora para alumnos portugueses

Background: The purpose of this work was to collect construct and criterion-related evidence of validity for a reading comprehension test (TCL - Teste de Compreensão da Leitura) with three vertically scaled forms, designed to assess students from second, third and fourth grade. Method: Two studies were conducted. In the first (n = 1,229), a confirmatory factor analysis was performed to analyse the test dimensionality. In the second (n= 402), concurrent and predictive evidence of validity was analysed using correlations between TCL, other reading tests and academic achievement. Results: Confirmatory factor analysis results supported a one-factor structure. Correlation coefficients with other reading tests were low to moderate and statistically significant. The TCL forms were shown to be good predictors of students’ reading comprehension as assessed by teachers and of the National Exams of Portuguese Language results. Conclusions: Present results provide empirical evidence for the validity of the TCL forms(AU)

Antecedentes: el objetivo de este trabajo fue recoger evidencia de validez de constructo y de criterio para un test de comprensión lectora (TCL- Teste de Compreensão da Leitura) con tres versiones escaladas verticalmente para evaluar alumnos portugueses de segundo, tercero y cuarto cursos de Primaria. Método: se efectuaron dos estudios. En el primero (n= 1,229) se analizó la dimensionalidad de la prueba recurriendo al análisis factorial confirmatorio. En el segundo (n= 402) se proporcionan datos sobre evidencia de validez concurrente y predictiva, analizando las correlaciones entre los resultados en TCL, los resultados en otras pruebas de lectura y los resultados académicos. Resultados: los análisis factoriales confirmatorios revelaron que el modelo de un factor se ajusta a los datos. Se obtuvieron coeficientes de correlación bajos a moderados y estadísticamente significativos entre las puntuaciones en el TCL y en otros tests de lectura. Las puntuaciones en TCL predijeron las puntuaciones obtenidas por los alumnos en los exámenes nacionales de lengua portuguesa y en las competencias de comprensión evaluadas por los maestros. Conclusiones: estos resultados proporcionan evidencia empírica para la validez de las versiones de TCL (AU)

Terapéutica en AP. Contracepción en la adolescencia / Therapy in Primary Health Care. Contraception in adolescence

El embarazo no deseado durante la primera etapa de la vida fértil comporta riesgos sanitarios y psicológicos, principalmente para la adolescente y su hijo, además de la implicación de otros factores socioculturales. En nuestro país se observa un aumento gradual de las tasas de interrupción voluntaria del embarazo y del uso de la anticoncepción postcoital en este grupo de edad, por lo que parece adecuado reforzar los sistemas de intervención sexual en jóvenes y adolescentes con el objetivo de prevenir dichos embarazos. Los consejos sobre salud sexual destinados a los adolescentes deben cumplir ciertos requisitos para asegurar su eficacia, principalmente privacidad, confidencialidad y una actitud participativa en la toma de decisiones, que no han de ser impuestas. Para la selección de un método anticonceptivo habrá que tener en cuenta diversos factores (personales y del entorno), mostrando todas las opciones e informando sobre la eficacia y seguridad de cada uno de ellos

Undesired pregnancy during the first stage of the potential childbearing life has health care and psychological risks, mainly for the adolescent and her child, in addition to the implication of other sociocultural factors. In our country, a gradual increase in the rates of voluntary interruption of pregnancy and the use of postcoital contraception in this age group is observed. Thus it seems appropriate to reinforce the sexual intervention systems in young people and adolescents in order to prevent these pregnancies. Advice on sexual health aimed at the adolescent should to fulfill certain requirements to assure its efficacy, mainly privacy, confidentiality and a participatory attitude in decision-making, that should not be imposed. In order to select a contraceptive method, several factors must be taken into account (personal and setting), showing all of the options and informing on the efficacy and safety of each one of them

Hiperplasia gingival por medicamentos / Drug-induced gingival hyperplasia

La hiperplasia gingival asociada a medicamentos es una reacción adversa que aparece tras el uso sistémico de algunos fármacos. Por el momento, no se conoce con precisión su patogénesis y su etiología es desconocida. Causa dolor al masticar, trastornos del habla, hemorragia gingival, alteraciones periodontales, oclusión dentaria y daños estéticos. La hiperplasia gingival puede aparecer hasta en un 50% de pacientes tratados con fenitoína y asimismo se ha asociado (aunque con menor frecuencia) con la administración de otros antiepilépticos, como: ácido valproico, carbamazepina, fenobarbitona y vigabatrina. La incidencia de hiperplasia gingival asociada a ciclosporina oscila ampliamente entre un 7% y un 70%; siendo la presencia de placa dental un factor agravante del cuadro. Asimismo constituye uno de los efectos adversos más frecuentes (incidencia entre 0,5 y 83%) de los antagonistas del calcio, en especial de nifedipino; aunque también se ha asociado a otros agentes: diltiazem, verapamilo, amlodipino, felodipino, manidipino, nicardipino y nitrendipino

Drug-induced gingival hyperplasia is an adverse reaction that appears after the systemic use of some drugs. At present, its pathogenesis is not accurately known and its etiology is unknown. It causes pain on chewing, speech disorders, gingival bleeding, periodontal alterations, dental occlusion and esthetic harm. Gingival hyperplasia may appear in up to 50% of patients treated with fenitoin and has also been associated (although with less frequency) with the administration of other epileptic drugs, such as: valproic acid, carbamazepine, phenobarbitone and vigabatrine. The incidence of gingival hyperplasia associated to cyclosporine ranges widely from 7% to 70%, the presence of dental plaque being an aggravating factor of the picture. In addition, it is one of the most frequent adverse events (incidence between 0.5% 83%) of calcium antagonists, especially niphedipine. However, it has also been associated to other agents: diltiazem, verapamil, amlodipine, felodipine, manidipine, nicardipine and nitrendipine

Terapéutica en AP. Tratamiento de la rinitis alérgica / Therapy in Primary Health Care. Treatment of allergic rhinitis

La rinitis alérgica es una de las enfermedadades crónicas más prevalentes, distinguiéndose dos formas clínicas: estacional y perenne. Como en todo proceso alérgico, después de la sensibilización ­en la que se generan anticuerpos específicos contra el alergeno causal­ se distinguen las fases de respuesta inmediata y tardía, que debido a la liberación de histamina y otros mediadores de la inflamación originan los síntomas característicos: estornudos, picor, rinorrea y congestión nasal. Una vez realizado el diagnóstico diferencial frente a otros tipos de rinitis, y si no se puede evitar el contacto con el alergeno, habría que instaurar un tratamiento, según la gravedad y persistencia de los síntomas. Existen numerosas medidas terapéuticas que pueden emplearse para tratar la rinitis alérgica, pero la elección ha de ser individualizada teniendo en cuenta el tipo de rinitis a tratar y la relación beneficio/riesgo según la situación del paciente: embarazadas, niños, contraindicaciones, duración del tratamiento, administración concomitante de otros medicamentos, etc

Allergic rhinitis is one of the most prevalent chronic diseases. Two clinical forms are distinguished: seasonal and perennial. As in every allergic condition, after sensitization in which specific antibodies are generated against the causal allergen, immediate and late response phases are distinguished. These, due to the release of histamines and other inflammation mediators cause the characteristic symptoms: sneezing, itching, rhinorrhea and nasal congestion. Once the differential diagnosis is made compared to other types of rhinitis and if it is not possible to avoid contact with the allergen, treatment must be initiated according to the seriousness and persistence of the symptoms. There are many therapeutic measures that may be used to treat allergic rhinitis. However, the choice must be individualized, considering the type of rhinitis to be treated and the risk/benefit ratio according to the patient's situation: pregnancy, children, contraindications, treatment duration, concomitant administration with other drugs, etc

¿Demasiados triptanes para el tratamiento de la migraña? / Too much triptans for the management of migraine?

En los últimos años, se han venido introduciendo progresivamente en el mercado farmacéutico español diversos agentes pertenecientes al grupo de agonistas r de la serotonina (5 HT1) para el tratamiento de la migraña, que constituyen una nueva clase de medicamentos también conocidos como triptanes. Sumatriptan, fue el primero comercializado, incorporándose después almotriptan, eletriptan, naratriptan, rizatriptan y zolmitriptan. El presente artículo tiene como objetivo revisar la información disponible sobre estos nuevos agentes, establecer a la luz de las evidencias disponibles sus potenciales ventajas e inconvenientes; y, de acuerdo con los estudios realizados y de la experiencia disponible, valorar su papel en la terapéutica de la migraña (AU)