Análisis de las Intervenciones de Bebés de 9 Meses durante la Lectura Compartida / Analysis of the Interventions of 9 Month-old Babies during Shared Storybook Reading

Resumen La lectura compartida es frecuente en la infancia. Sin embargo, la participación de infantes menores de un año en esta actividad ha sido poco explorada. Este trabajo describe y analiza las intervenciones de bebés de 9 meses en la lectura conjunta materno-infantil en hogares argentinos. Transcribimos y analizamos filmaciones realizadas por 10 madres. Clasificamos las intervenciones en: acción responsiva o espontánea; vocalización responsiva o espontánea; acción responsiva + vocalización; acción espontánea + vocalización. Los bebés realizaron mayoritariamente acciones espontáneas (con o sin vocalizaciones). Luego, clasificamos las acciones (con o sin vocalizaciones) en: convencionales (pasar la página, señalar) o manipulativas (morder, sacudir los libros); otras no orientadas (tomar otro objeto, mirar fuera del escenario). Encontramos que las acciones fueron principalmente manipulativas. Finalmente, clasificamos las acciones en: inespecíficas (morder el libro, sacudirlo) u orientadas (intentar agarrar los objetos representados). Predominaron las acciones inespecíficas. Los hallazgos muestran bebés sensoriomotores en exploración. Sin embargo, algunas intervenciones revelaron también un incipiente desarrollo simbólico al usar los libros convencionalmente y reconocer las imágenes como objetos simbólicos. La lectura compartida es un escenario en el que se accede a diversos sistemas de representación (imágenes, números, letras), permitiendo desarrollar tempranamente un potencial simbólico en contextos sociales relevantes.

Abstract Shared reading is a significant and frequent activity in early childhood. However, the interventions in this kind of activities by babies and infants under one-year have been little explored. The main objective of this work was to describe 9-month-old babies' interventions in reading situations with their mothers at Argentinian homes. The focus of the analysis was babies' actions during reading with their mothers. Ten mothers filmed shared reading sessions with their babies. Then we transcribed and analyzed babies' interventions in three levels. First, we classified the interventions in: responsive action, spontaneous action, responsive vocalization, spontaneous vocalization, responsive action + vocalization, spontaneous action + vocalization. Isolated vocalizations were rare. The babies performed mostly spontaneous actions (with or without vocalizations). Responsive actions were less frequent (with or without vocalizations). Second, we classified babies' actions (with or without vocalizations) in 1-conventional, like turn the page, point to the book, put the book in reading position, 2-manipulative, like bite, shake, put the book in the mouth, open and close the book, try to grab/suck/ touch objects represented in pictures, 3- other actions- actions not oriented to books, like shake another object present in the interaction or looking to some object or person outside the scene. We found that babies' actions were mainly manipulative. Finally, we categorized manipulative actions in 1- unspecific actions, like bite, shake, put the book in the mouth, open and close the book, and 2- pictures-oriented ones, like try to grab, suck, touch objects present in pictures. Unspecific actions predominated. Findings show sensory motor babies in exploration. Nevertheless, the presence of conventional actions and picture-oriented actions are signs of an incipient symbolic development. That is, babies use books conventionally and recognize pictures as symbolic objects. In sum, shared reading is one of the richest scenarios for early symbolic development. In this context babies and children access to diverse representational systems (words, pictures, numbers, letters). This activity allows children to development their symbolic potential in relevant social contexts.

Niños y adultos armando un rompecabezas digital e interactivo en el hogar / Children and Adults Assemblig a Digital and Interactive Puzzle at Home / Crianças e adultos montando um quebra-cabeça digital e interativo em casa

Esta investigación se propuso explorar y analizar las características que presenta la interacción entre niños y adultos con un juego digital e interactivo que implica la solución de un problema, el armado de rompecabezas en una tablet. Se realizaron observaciones seminaturalísticas en los hogares y se indagó mediante un cuestionario la tenencia y hábitos de uso de tecnologías. Las interacciones se analizaron con un sistema de categorías construido inductivamente. Adultos y niños participaron de manera activa en la tarea. Los adultos ayudaron a los niños en su mayo-ría por medio de preguntas, guías e informaciones, acompañadas con frecuencia de acciones no verba-les como señalamientos y arrastre de las piezas. Las intervenciones infantiles fueron en su mayoría no verbales. A pesar de encontrar una fuerte presencia de tecnologías en los hogares, se diferenciaron dos grupos respecto a hábitos de uso: un grupo reportó un bajo uso y los niños no accedían a tablets, otro expresó mayor uso y los niños las utilizabancon frecuencia. Las intervenciones en el armado del rompecabezas se diferenciaron en función de la experiencia infantil con tecnologías. Los resultados se discuten a la luz de investigaciones previas sobre la interacción adulto-niño con herramientas analógicas y digitales.

This study aimed to explore and analyze the charac-teristics of the interaction between children and adults with a digital and interactive game that involves solv-ing a problem, that is, assembling puzzles on a tablet. Semi-naturalistic observations of the interactions in the homes were carried out, and the possession and the habits of the use of were investigated through a survey. The interactions were analyzed with an induc-tively constructed category system. Adults and chil-dren actively participated in the task. Adults helped the children mainly through questions, guidance, and information, accompanied frequently by nonverbal actions, such as pointing at and sliding the pieces. Most of the children's interventions were nonverbal. Despite finding a significant technology presence in the homes, two groups were differentiated regard-ing their habits of use. One group reported little use of technology and no access to tablets for children. Another one expressed that the children used tablets frequently. The interventions in the task differed ac-cording to the children's experience with technologies. The results were discussed considering previous research on adult-child interaction with analogical and digital tools.

Esta pesquisa teve como objetivo explorar e analisar as características da interação entre crianças e adultos com um jogo digital e interativo que envolve a resolução de um problema, a montagem de quebra-cabeças em um tablet. Observações seminaturalísticas foram feitas nas residências e a posse e hábitos de uso de tecnologia foram indagados por meio de um questio-nário. As interações foram analisadas com um sistema de categorias construído indutivamente. Adultos e crianças participaram ativamente da tarefa. Os adul-tos ajudavam seus filhos principalmente por meio de perguntas, orientações e informações, muitas vezes acompanhadas de ações não verbais, como apontar e arrastar as peças. As intervenções das crianças foram em sua maioria não verbais. Apesar de constatar uma forte presença de tecnologias nas residências, dois grupos se diferenciaram quanto aos hábitos de uso. Um grupo relatou baixo uso e as crianças não acessavam tablets, outro grupo expressou maior uso e as crianças os utilizavam com frequência. As intervenções na montagem do quebra-cabeça foram diferenciadas de acordo com a experiência da criança com as tecnologias. Os resultados são discutidos à luz de pesquisas anteriores sobre a interação adulto-criança com ferramentas analógicas e digitais.

La construcción de producciones orales en la infancia a partir de imágenes realistas y no realistas / The construction of oral productions in childhood from realistic and unrealistic images

Resumen El objetivo de este trabajo fue examinar la construcción de narrativas de ficción por parte de niños/as de 5 y 6 años de edad a partir de imágenes con distinto nivel de realismo. Analizamos 49 relatos, 24 realizados a partir de imágenes realistas y 25 a partir de imágenes no realistas. Primero clasificamos las producciones en narraciones, descripciones y otras producciones, y analizamos el ordenamiento de las imágenes. La mayoría de los niños/ as que participaron en la condición no-realista construyeron narraciones e identificaron una imagen para el comienzo y otra para el cierre; mientras que los que observaron imágenes realistas construyeron mayormente descripciones y no las organizaron en secuencias. Luego realizamos un análisis de datos textuales consignando: recuento de palabras y segmentos, y recuento de tipos de palabras y segmentos; glosario de palabras y segmentos ordenados según su frecuencia; y respuesta característica (la más significativa de cada grupo). No se encontraron diferencias en el número de palabras y la cantidad de tipos de palabras utilizadas en cada producción, pero sí en las palabras características y en las respuestas que caracterizaron a cada grupo. En las descripciones se utilizaron más sustantivos, mientras que en las narraciones se utilizaron verbos y conectores causales. La respuesta característica de la descripción consistió en una exposición acerca de cada una de las imágenes por separado. La narración presentó un conflicto o estado emocional, una resolución y un cierre. Los resultados muestran que los niños/ as construyeron distintas producciones (narraciones o descripciones) según el tipo de imágenes presentadas.

Abstract The aim of this paper was to examine the creation of fictional narratives by 5 and 6 year-old children from images with different levels of realism. We analyzed 49 stories, 24 from realistic images and 25 from unrealistic images. First, the productions were classified into narratives, descriptions and other productions, and analyzed the arrangement of the images. Most of the children who participated in the unrealistic condition created narratives and identified one image for the beginning and another for the ending; while those who observed realistic images mostly made descriptions and did not arrange them into sequences. It was analyzed: number of words and segments and number of kinds of words; glossaries and segments of words sorted by frequency; characteristic responses (the most significant of each group). No differences were found neither in the number of words nor in the number of different word types used in each production. However, differences were found in the characteristic words and in the complete responses that characterized each group. More nouns were used in the descriptions, while verbs and causal connectors were used in the narratives. The characteristic response of the description consisted in a presentation of the images separately. The narrative introduced a conflict or emotional state, a resolution and a closure. The results showed that the children developed different productions (narrations or descriptions) according to the type of images they were exposed.

Adjective Learning by Spanish-Speakers Children and Adults. The Impact of Morphology and Semantic Information.

The purpose of this research was to explore the kind of information Spanish-speaking 3-year-old children and adults use when learning adjectives in a joint picturebook reading situation. The impact of two linguistic clues was studied; a morphological clue (adjective suffix) and a semantic clue (descriptive information concerning the property). Results show that for children the description was decisive to map the new adjective with the property; for adults, instead, the presence of the suffix was crucial. These results illustrate a developmental shift in the sort of clues that shapes adjective learning.

Conceptos y justificaciones brindadas por niños de 3 y 4 años antes y después de ser instruidos acerca de camuflaje animal / Which prey is the bird not going to eat? An analysis of the concepts and arguments provided by 3 and 4-year-old children to support their points of view

Las verbalizaciones que brindan los niños permiten que los adultos conozcamos sus aprendizajes y pensamientos. En esta investigación confluyen dos líneas de investigación: una centrada en el impacto de los libros de imágenes en el aprendizaje de conceptos y otra referida a las justificaciones en la infancia. Se presentan dos estudios cuasi-experimentales con diseño de preprueba y posprueba. En el marco de la lectura conjunta de un libro de imágenes se presentó a niños de 3 y 4 años de edad el concepto de camuflaje, con y sin la instrucción del adulto. Primero se analizaron las justificaciones que brindaron los niños para fundamentar sus respuestas, tanto antes como después de la lectura y luego, las categorías conceptuales a las que apelaron. Se observó que con instrucción los niños de 4 años, pero no los de 3, aprendieron el concepto, recurrieron al él para sustentar sus respuestas y complejizaron sus justificaciones con respecto a las que brindaron antes de la lectura. Por otro lado, los niños de 4 años que no recibieron instrucción, no aprendieron el concepto, ni apelaron a él para sustentar sus respuestas; además, no modificaron las justificaciones brindadas después de la lectura. Los resultados aportan sustento empírico respecto al entrelazamiento entre instrucción, aprendizaje de conceptos y justificaciones en la infancia.

Children's verbalizations provide a glimpse into their thoughts and learning processes. This research arises in the intersection of two fields: the impact of picture-books in conceptual and justification learning. Dialogic picture-book reading is a widespread practice between children and adults. The main goal of this research was to analyze the verbalizations children gave before and after the exposition to the concept of camouflage using a picture-book. We designed two studies using a quasi-experimental pre-test post-test approach. In Study 1 we compared two age group-children: 3- and 4-years-olds. Both groups were exposed to the concept of camouflage guided by the instruction of an adult using a picture-book. We considered camouflage as the ability of some animals to blend with the environment to avoid being seen by predators. By instruction, we meant the information given by the adult using examples of animals. The animals were shown in camouflaged and non-camouflaged settings and the adult explained which prey the predator could not eat based on the color of the animal and the background. The picture-book used was specially constructed for this research. It consisted of 10 pages; the first two showed a photograph of a predator (an eagle). The next eight pages showed four different preys depicted in camouflaged and no-camoulaged settings. In the pre-test and the post-test children were asked to choose which prey the depredator will not eat. Children also had to support their answers by explaining why the bird will not eat the chosen prey. We analyzed children's answers and the explanation that they gave before and after the exposition to the concept of camouflage with the picture-book. Additionally, we analyzed the justifications and the conceptual categories that children used to support their choices. The justifications were inspired in Migdalek's work (e.g. Migdalek, Rosemberg & Santibáñez, 2014). The conceptual categories were created inductively from the transcription of children's verbalizations. We found that the 4-years-olds learned the concept and support their choices appealing to the camouflage category; also, they provided complex justifications. As far as 3-years-olds, even though they received the same instruction, they did not learn the concept, neither improved their justifications. Given these results, we concluded that the observed differences in the performance are due to the children's age, since the instruction provided was the same for the two age groups. To specifically explore the impact of the instruction we designed a Study 2 in which we compared children's answers and their verbalizations in two groups of 4-year-old children. Four-years-old were exposed to the same picture-book with and without instruction. The procedure followed was the one described in Study 1. In the condition with out instruction, the experimenter presented the children the picture-book indicating which prey the depredator would not eat, but without explaining the reasons. We found out that the children that did not receive any instruction did not learn the conceptor used it to support their choices. Besides, this group did not improve their justifications. In contrast, the children that received instruction learned the concept and supported their choices using the camouflage category; in addition, they provided complex justifications. Overall, the results presented provided empirical data to highlight the close relationship between instruction, conceptual learning and justifying in children.

Two-Year-Olds' Symbolic Use of Images Provided by a Tablet: A Transfer Study.

Touch screen devices are nowadays part of everyday life and parents and educators assume that young children use their images in a symbolic way. This research aims at replicating and expanding a previous one that reported that, contrary to expectations and to studies with printed or video images, 2-year-old children used the images on a touch screen tablet to retrieve a hidden object (Search), but not to communicate the location of an object they have observed being hidden (Point). In this research, we carried out a transfer study comparing the performance of an Experimental (Search-Point) and a Control group (Point-Point). First, we found that the Experimental group outperformed the Control group. Second, we found that the successful symbolic previous experience gained in the Search tasks was transferred to the Point task, task which 2-year-olds otherwise fail.

Estudio de intervención no aleatorizado sobre evolución postquirúrgica en pacientes tratadas con terapia neural tras mamoplastia de aumento vía axilar / Non-randomized intervention study on postoperative evolution in patients who underwent neural therapy after transaxillary breast augmentation

Antecedentes y objetivo: Durante nuestra práctica clínica nos hemos encontrado algo limitados por el pensamiento y tratamiento de la medicina convencional. Por circunstancias personales hemos entrado en contacto con terapias complementarias ampliamente aplicadas en muchos países a la población general en contextos de medicina general, fisioterapia, medicina interna, y hemos pensado introducir estas técnicas en nuestra práctica diaria y estudiar cómo impactan en nuestros pacientes. Se conoce por terapia neural a la técnica que emplea un anestésico local en muy bajas concentraciones con la finalidad de restaurar el potencial transmembrana de la neurona que se ha perdido por inflamación, cicatriz, infección, etc. La ausencia patológica de potencial transmembrana de la neurona ocasiona que, al no poderse transmitir el impulso nervioso fisiológico, la inflamación o patología a tratar perduren en el tiempo. Por así decirlo, el anestésico local logra un reinicio del normal funcionamiento del sistema nervioso, que afecta a todo el organismo. El presente trabajo estudia la evolución postquirúrgica de las pacientes tras mamoplastia de aumento vía axilar en función de si se les realizó o no terapia neural como tratamiento coadyuvante. Material y Método: Realizamos un estudio de intervención no aleatorizado midiendo la presencia o no de dolor y la presencia o no y grado de encapsulamiento periprotésico según la clasificación de Baker durante los 12 meses siguientes a una mamoplastia de aumento vía axilar, y el consumo de fármacos (Nervobión(R), Accolate(R)) para dichas dolencias según si se les realizó o no terapia neural después de dicha intervención quirúrgica. La muestra estuvo compuesta por 178 mujeres con un rango de edad entre 17 y 52 años (media de 28.34 años) El grupo de tratamiento recibió procaína al 0.33% en la cicatriz cutánea axilar y trayecto por el que pasó la prótesis durante la cirugía. Este tratamiento se inició desde la primera cura y en las visitas sucesivas si la paciente lo requirió, con una media de 4 sesiones de terapia neural por paciente. Utilizamos el paquete estadístico Statistica versión 8.0 para el análisis de tablas de contingencia 2 por 2 mediante X2. Resultados: De las 178 pacientes incluidas en el estudio (con 8 pérdidas), llevamos a cabo tratamiento convencional en 101 y terapia neural coadyuvante en 69, comprobando una mejoría significativa de la evolución postquirúrgica en las pacientes tratadas con terapia neural, mientas que las no tratadas requirieron más medicación postquirúrgica. Conclusiones: A pesar de que la limitación principal de nuestro estudio es el tipo de diseño: estudio de intervención sin aleatorización, en nuestra experiencia, el uso de la terapia neural puede recomendarse como tratamiento coadyuvante para disminuir la contractura capsular y el dolor postquirúrgico en pacientes sometidas a mamoplastia de aumento vía axilar

Background and Objective: During our clinical practice we have found some limitations by the thoughts and treatments of conventional medicine. Due to personal circumstances we got in contact with complementary therapies widely applied in many countries to the general population in contexts of general medicine, physiotherapy, internal medicine, so we thought to introduce these techniques to our daily practice and study how it affected our patients. Neural therapy is a technique that uses local anesthetic in very low concentrations in order to restore the membrane potential of the neuron, lost by inflammation, scar, infection, etc. This pathological membrane potential of the neuron causes an absence of transmission of physiological nervous impulse, so that inflammation or pathology to be treated lasts over time. Somehow, the local anesthetic achieves a reset in the nervous system to restart physiological function of the entire organism. The present study observes the postoperative evolution of the patients after an axillary augmentation mammoplasty, depending on if they were treated with neural therapy as adjuvant treatment or not. Methods: We performed a non-randomized intervention study in which the presence or absence of pain and the presence or not and degree of periprosthetic encapsulation following Baker's scale, was measured after transaxillary breast augmentation, and the use of drugs (Nervobión(R) and Accolate(R)) depending on if they received or not neural therapy as coadjuvant. The sample consisted of 178 women with an age range between 17 and 52 years (average of 28.34 years). The treatment group received 0.33% procaine in the axillary skin scar and the path through which the prosthesis passed during surgery. This treatment was started from the first cure and in the successive visits if the patient required it, with an average of 4 sessions of neural therapy per patient. We used the statistical package Statistica version 8.0 for the analysis of contingency tables 2 by 2 through X2. Results: Of the 178 patients included in the study (with 8 losses), we carried out conventional treatment in 101 and coadjuvant neural therapy in 69, verifying a significant improvement in postoperative evolution in patients treated with neural therapy, while the untreated ones required more postsurgical medication. Conclusions: Although the main limitation of our study is the type of design: intervention study without randomization, in our experience, the use of neural therapy can be recommended as a coadjuvant treatment to reduce capsular contracture and postoperative pain in patients undergoing axillary augmentation mammoplasty

Cambio conceptual: una mirada desde las teorías de Piaget y Vygotsky / Conceptual change: a glance from the theories of Piaget and Vygotsky

Un tema central en la psicología contemporánea consiste en conocer cómo los sujetos desarrollamos nuevas estructuras cognitivas y cómo las modificamos. El presente artículo se propone abordar nexos entre nociones provenientes del campo del cambio conceptual y algunos aspectos de las teorías de Piaget y Vygotsky. A tal fin, se discuten las nociones de teoría implícita y concepto científico desde las teorías del cambio conceptual, así como las nociones de error y pseudoconcepto desde las teorías de Piaget y Vygotsky. Primero se realiza un recorrido por autores representativos del cambio conceptual con la finalidad de comprender el lugar que otorgan a las nociones de teoría implícita y concepto científico. Luego, se consideran algunos aspectos de las teorías de Piaget y Vygotsky reflexionando sobre el lugar que en ellas ocupan los conceptos de error y pseudoconcepto. Finalmente, se analizan y discuten puntos de encuentro entre teorías del cambio conceptual de Piaget y Vygotsky.

A central issue in contemporary psychology consists in understanding how we develop new cognitive structures and how we modify them. This article aims to address the links between the notions from conceptual change and some aspects from the theories of Piaget and Vygotsky. For that purpose, the notions of implicit theory and scientific concept were analyzed from the theory of conceptual change, and the notions of error and pseudo- concept from the theories of Piaget and Vygotsky. First, we examined the work of representative authors of conceptual change to understand the place granted to the notions of implicit theory and scientific concept. Then, some aspects from the theories of Piaget and Vygotsky were considered to reflect on the place that the notions of error and pseudo-concept have in those theories. Finally, we analyzed and discussed the similarities between the theories of conceptual change, Piaget and Vygotsky

Cognición en desarrollo: aprendiendo palabras por medio de imágenes / Cognition in development: learning words through images / Cognição em desenvolvimento: aprender palavras através de imagens

En esta investigación estudiamos el aprendizaje de palabras a través de imágenes. Presentamos tres estudios cuasi-experimentales. En los Estudios 1 y 2, comparamos la ejecución de niños y niñas de tres años y de adultos. Primero enseñamos un seudo-sustantivo (pompe) aplicado a un objeto novedoso. Luego, enseñamos la palabra utilizándola como adjetivo referido a una propiedad no-convencional. En el Estudio 3, contrastamos el aprendizaje de adjetivos por personas adultas, con o sin el sufijo adjetivador ado (pompe-pompeado). Los resultados muestran que los niños y las niñas utilizaron información contextual para aprender las palabras, mientras que los adultos le dieron más relevancia a la lingüística, resultándoles difícil aprender el adjetivo sin sufijo. Concluimos que, bajo algunas circunstancias, los niños y las niñas son aprendices más eficaces que los adultos. Estos hallazgos señalan la importancia de incluir personas adultas en estudios de desarrollo.

This study investigates children’s and adults’ learning of words in apicture learning context. Three quasi-experimental studies are presented. Studies 1 and 2 comparethe performance of three-year-old children with that of adults. First, we teach teaches a new nounapplied to an unknown object (pompe). Then, we teach the same word, but instead using it as anadjective that refers to a non-conventional property. Study 3 contrasted adults’ learning of twoadjectives with or without the spanish suffix ado (pompe-pompeado). Taken together these results show that children use contextual information to learn words, while adults place more relevance onlinguistic information. As a result, the absence of a suffix made learning the adjective more difficult.We conclude that, under some conditions, children are more efficient than adults. These findings showthe importance of ensuring that adults’ inclusion is part of development studies.

Esta investigação estuda a aprendizagem de palavras mediante imagens.Três estudos quase-experimentais são apresentados. Os Estudos 1 e 2 comparam a execução decrianças de três anos e adultos. Primeiro, ensinamos um substantivo desconhecido (pompe) aplicado a um objeto inovador. Depois, nós ensinamos a palavra, mas usada como adjetivo que se refere a uma propriedade não-convencional. O Estudo 3, contrasta a aprendizagem por parte de adultos de adjetivos, com ou sem o sufixo adjetivador “ado” (pompe-pompeado). Os resultados mostram que as crianças usaram informação contextual para aprender as palavras, enquanto os adultos deram mais importância às linguísticas, para o qual a ausência do sufixo dificultou a aprendizagem do adjetivo.Concluímos que, dado algumas circunstâncias, as crianças são mais efetivas que os adultos. Esses resultados mostram a importância de incluir adultos em estudos de desenvolvimento.

La comprensión simbólica temprana de una imagen digital como medio de comunicación y fuente de información / Early symbolic comprehension of a digital image as a source of information and as a mean of communication

Gráficos, fotografías, imágenes digitales, están muy presentes en la vida de los niños desde muy temprano cumpliendo una diversidad de funciones. En esta investigación exploramos la comprensión simbólica de una imagen digital provista por una Tablet como medio de comunicación y como fuente de información por parte de niños de 24 meses. Utilizamos dos tareas, en la primera los niños debían indicar en la imagen el lugar donde habían visto al experimentador esconder un objeto en una habitación pequeña. En la segunda, los niños debían buscar un objeto en la habitación guiados por una imagen en la que se les señalaba el escondite. Encontramos que los niños utilizaron la imagen como fuente de información para guiar la búsqueda, pero no como medio de comunicación para indicar a otro el escondite. Sin embargo, tras una experiencia breve en la utilización de la imagen como fuente de información, lograron utilizarla como medio de comunicación. Los resultados muestran que para los niños pequeños el empleo de la imagen de una Tablet como fuente de información no solo es más sencillo, sino que tiene efectos facilitadores en su empleo como medio de comunicación

Graphs, photographs, digital images, are very much present in children´s lives from very early, accomplishing a variety of functions. In this research we explore the symbolic comprehension of a digital image provided by a Tablet as a mean of communication and as a source of information by 24-month-old children. We used two tasks. In the first, children had to indicate in the image the localization where they have observed the experimenter hid the toy in a small room. In the second, children had to search for an object in the room guided by the image in which the experimenter indicated the location where the object was hidden. We found that children utilized the image as a source of information to guide their search, but not as a mean of communication to inform the localization to someone else. However, after a brief experience in the utilization of the image as a source of information, children successfully used it as a mean of communication. The results show that for young children using the image of the Tablet as a source of information not only is simpler but also has facilitating effects in its use as a mean of communication

Enseñando palabras mediante libros ilustrados: El aprendizaje temprano de sustantivos y adjetivos / Teaching words through picture-books: Early learning of nouns and adjectives

El objetivo del trabajo que se informa fue investigar el aprendizaje de adjetivos y sustantivos mediante libros ilustrados en niños de tres años de edad. Se diseñaron dos estudios con una metodología cuasi-experimental en los que se enseñó a los niños un sustantivo o un adjetivo. Luego los participantes debían extender la palabra aprendida primero al objeto representado por la imagen, y luego a un nuevo ejemplar de la misma categoría de objeto (sustantivo) o propiedad de objeto (adjetivo). El Estudio 1 comparó el aprendizaje de sustantivos y adjetivos. Se encontró que los niños aprendieron el sustantivo pero no el adjetivo, lo que indicaría que para ellos aprender adjetivos a través de libros con imágenes es más difícil que aprender sustantivos. El Estudio 2 exploró el impacto de la información descriptiva sobre el aprendizaje de un adjetivo que refería a una propiedad visual (estampado). Esta información destacaba, por un lado, el núcleo del concepto, el estampado, y por otro la intención comunicativa del interlocutor. Se contrastó la ejecución de los niños en función de la información provista por la experimentadora. Los datos obtenidos muestran que si los niños reciben información descriptiva sobre el aspecto de la imagen que debe conectarse con la palabra, logran relacionarlo con la propiedad a la que refiere, aprendiendo el adjetivo. Los resultados de esta investigación aportan información relevante acerca de la relación entre el aprendizaje del léxico y el desarrollo conceptual y subrayan la relevancia del contexto sociopragmático en el aprendizaje de palabras.(AU)

Picture-books reading are a very common practice between children and adults. In these interactions parents assume that their children learn lots of things, especially words. But, is this interaction effective as a word learning device? Is it the same to teach different kind of words? The main question of this research arises in the intersection of two fields: symbolic comprehension of pictures and word learning. Three main ideas guided this research. Symbolic understanding of pictures is a very complex process that involves cognitive and social skills. The socio-pragmatic context has an impact in the cognitive processes involved in word learning. There is a strong relationship between word learning and conceptual development. The aim of this research was to explore 3-year-old children´s learning of nouns and adjectives in a picture-book reading situation. We designed two studies using a cuasi-experimental approach. In Study 1 we compared two groups of children: one learned a noun (category condition) and the other an adjective (property condition).The noun was pompe, a word that does not exist but has a Spanish morphologic structure. The adjective, pompeado, was built based on the word pompe, adding the suffix-ado; suffix marks that the word is an adjective. Toddlers were exposed to the new words during a picture-book reading interaction with the experimenter, then, they had to solve two successive tests. In the first test of the category condition participants had to apply the new noun learned via pictures to the real object. In the second test they had to extend the new noun to a new exemplar, an object with the same shape but different color. In the first test of the property condition, participants had to apply the new adjective learned via pictures to the real object with the property. In the second test they had to extend the adjective to a new exemplar, a new object with the same target-property. The second tests were taken as strong indicators of word learning as they involved some kind of generalization. In the first test both groups, category and property, applied the word to the real object. In the second test, while children in the category condition extended the noun to another exemplar, children in the property condition did not extend the adjective to another exemplar with the same property. In a second study we explored if children need more cues to extend the adjective to another exemplar with the same property, and truly learn the adjective. Study 2 investigated the impact of descriptive information in word learning. We set two groups on the basis of the information provided by the experimenter. One group received descriptive information highlighting the specific aspect of the picture that had to be mapped with the property. The other group did not receive this additional information. We found that only the participants that received descriptive information extended the word pompeado to a new exemplar with the target property. We propose that the descriptive information worked highlighting the communicative intention of the experimenter as well as the core of the concept. Underscoring the perceptual feature allowed much more than making a superficial association, as the descriptive information pointed directly to the heart of the concept. Overall, the results of this research are consistent with previous studies that found that it is more difficult for young children to learn adjectives than nouns. The results also highlight the strong relationship between word learning and conceptual development. This research provides strong evidence concerning the importance of socio the pragmatic context on referential understanding and word learning.(AU)

Enseñando palabras mediante libros ilustrados: El aprendizaje temprano de sustantivos y adjetivos / Teaching words through picture-books: Early learning of nouns and adjectives

El objetivo del trabajo que se informa fue investigar el aprendizaje de adjetivos y sustantivos mediante libros ilustrados en niños de tres años de edad. Se diseñaron dos estudios con una metodología cuasi-experimental en los que se enseñó a los niños un sustantivo o un adjetivo. Luego los participantes debían extender la palabra aprendida primero al objeto representado por la imagen, y luego a un nuevo ejemplar de la misma categoría de objeto (sustantivo) o propiedad de objeto (adjetivo). El Estudio 1 comparó el aprendizaje de sustantivos y adjetivos. Se encontró que los niños aprendieron el sustantivo pero no el adjetivo, lo que indicaría que para ellos aprender adjetivos a través de libros con imágenes es más difícil que aprender sustantivos. El Estudio 2 exploró el impacto de la información descriptiva sobre el aprendizaje de un adjetivo que refería a una propiedad visual (estampado). Esta información destacaba, por un lado, el núcleo del concepto, el estampado, y por otro la intención comunicativa del interlocutor. Se contrastó la ejecución de los niños en función de la información provista por la experimentadora. Los datos obtenidos muestran que si los niños reciben información descriptiva sobre el aspecto de la imagen que debe conectarse con la palabra, logran relacionarlo con la propiedad a la que refiere, aprendiendo el adjetivo. Los resultados de esta investigación aportan información relevante acerca de la relación entre el aprendizaje del léxico y el desarrollo conceptual y subrayan la relevancia del contexto sociopragmático en el aprendizaje de palabras.

Picture-books reading are a very common practice between children and adults. In these interactions parents assume that their children learn lots of things, especially words. But, is this interaction effective as a word learning device? Is it the same to teach different kind of words? The main question of this research arises in the intersection of two fields: symbolic comprehension of pictures and word learning. Three main ideas guided this research. Symbolic understanding of pictures is a very complex process that involves cognitive and social skills. The socio-pragmatic context has an impact in the cognitive processes involved in word learning. There is a strong relationship between word learning and conceptual development. The aim of this research was to explore 3-year-old children´s learning of nouns and adjectives in a picture-book reading situation. We designed two studies using a cuasi-experimental approach. In Study 1 we compared two groups of children: one learned a noun (category condition) and the other an adjective (property condition).The noun was pompe, a word that does not exist but has a Spanish morphologic structure. The adjective, pompeado, was built based on the word pompe, adding the suffix-ado; suffix marks that the word is an adjective. Toddlers were exposed to the new words during a picture-book reading interaction with the experimenter, then, they had to solve two successive tests. In the first test of the category condition participants had to apply the new noun learned via pictures to the real object. In the second test they had to extend the new noun to a new exemplar, an object with the same shape but different color. In the first test of the property condition, participants had to apply the new adjective learned via pictures to the real object with the property. In the second test they had to extend the adjective to a new exemplar, a new object with the same target-property. The second tests were taken as strong indicators of word learning as they involved some kind of generalization. In the first test both groups, category and property, applied the word to the real object. In the second test, while children in the category condition extended the noun to another exemplar, children in the property condition did not extend the adjective to another exemplar with the same property. In a second study we explored if children need more cues to extend the adjective to another exemplar with the same property, and truly learn the adjective. Study 2 investigated the impact of descriptive information in word learning. We set two groups on the basis of the information provided by the experimenter. One group received descriptive information highlighting the specific aspect of the picture that had to be mapped with the property. The other group did not receive this additional information. We found that only the participants that received descriptive information extended the word pompeado to a new exemplar with the target property. We propose that the descriptive information worked highlighting the communicative intention of the experimenter as well as the core of the concept. Underscoring the perceptual feature allowed much more than making a superficial association, as the descriptive information pointed directly to the heart of the concept. Overall, the results of this research are consistent with previous studies that found that it is more difficult for young children to learn adjectives than nouns. The results also highlight the strong relationship between word learning and conceptual development. This research provides strong evidence concerning the importance of socio the pragmatic context on referential understanding and word learning.

Perfil de ciudad: C.S. Santa Luzmila II, Comas, Lima República del Perú / City profile: C.S. Santa Luzmila II, Comas, Lima Republic of Peru

Describe el plan operativo institucional del distrito de Comas que involucra a la población a que tomen con conciencia de una salud preventiva y promocional, promoviendo una vigilancia sanitaria con participación de la comunidad, su s objetivos por la salud

Intentional teaching facilitates young children's comprehension and use of a symbolic object.

Children are exposed to symbolic objects that they have to learn to use very early in life. The authors' aim was to examine whether it is possible to intentionally teach young children the symbolic function of an object. They employed a search task in which children had to use a map to find a toy. Experiment 1 revealed that with no instruction 3-year-, 10-month-old children were quite successful; 3-year-, 6-month-olds showed a divided performance; and 3-year-, 0-month-olds failed. With this baseline, Experiment 2 compared the performance of 3-year-, 0-month-olds in three different conditions: no-instruction, complete instruction (before the task begins), and teaching (complete instruction plus corrective feedback); only children in the teaching condition succeeded. However, children 6 months younger, 2-year-, 6-month-olds, failed despite teaching that was provided (Study 3). This research shows that at some points in development instruction is not enough; intentional teaching in communicative contexts is the mechanism that boosts symbolic understanding in early childhood.

Estudio de intervención sobre el dolor subagudo y crónico en atención primaria: una aproximación a la efectividad de la terapia neural / Intervention study on subacute and chronic pain in Primary Care: an approach to the effectiveness of neural therapy

ObjetivoEvaluar la efectividad de la TN para disminuir el dolor y el consumo de fármacos.DiseñoEstudio de intervención antes-después.EmplazamientoCAP de Llefià en Badalona (Barcelona).Participantes82 pacientes con edades entre 25 y 85 años que presentaban dolor que no remitió después de al menos un mes de evolución.Mediciones principalesSe recogieron datos para la valoración de las variaciones del dolor y sobre el consumo de fármacos antes de la intervención y después a las 2 semanas, 3 meses y 6 meses mediante entrevista personal y para el dolor mediante la escala visual analógica (EVA).ResultadosEVA media preintervención: 7,94 (DE: 1,68), EVA media a las 2 semanas 4,63 (DE: 2,79), a los 3 meses 3,74 (DE: 3,17) y a los 6 meses 3,48 (DE: 3,27) (p<0,001 en las 3 comparaciones, mediante test de Wilcoxon). En cuanto al consumo de fármacos después de la intervención, un 74,4% de los pacientes lo redujeron a las 2 semanas, un 76,8% lo redujeron a los 3 meses y un 80% a los 6 meses.ConclusionesLa TN puede ser eficaz en disminuir el dolor así como el consumo de fármacos. Faltarían ensayos clínicos que lo confirmaran(AU)

ObjectiveTo evaluate the effectiveness of NT in reducing pain and minimising use of analgesics in patients.DesignBefore and after intervention study.SettingLlefià Primary Health Care centre in Badalona (Barcelona).ParticipantsEighty-two patients between the ages of 25 and 85 years old, who suffered pain that did not disappear after a month.Main measurementsData was collected to evaluate any change in pain and the use of analgesics in patients before intervention and then afterwards, at 2 weeks, 3 months and 6 months. This was conducted by means of interviews and use of the Visual Analogue Pain Scale (VAS).ResultsMean VAS pre-treatment: 7.94 (SD: 1.68), mean VAS after two weeks 4.63 (SD: 2.79), after 3 months 3.73 (SD: 3.17), and after 6 months 3.48 (SD: 3,27) (P<.001 in the 3 comparisons, using the Wilcoxon-test for matched data). As regards analgesic use after treatment, 74.4% of patients reduced it after 2 weeks, 76.8% after 3 months and 80% after 6 months.ConclusionsNeural therapy can be effective in reducing pain, as well as the use of analgesics. Further clinical trials would be needed to confirm this assertion(AU)

Instrucción y desarrollo en la comprensión temprana de fotografías como objetos simbólicos / Instruction and development in early comprehension of photographs as symbolic objects

El propósito de esta investigación fue estudiar el impacto de la instrucción en el desarrollo de la comprensión simbólica de fotografías como fuente de información por parte de niños pequeños. Se llevaron a cabo 3 experimentos utilizando una tarea de búsqueda. Se varió la edad de los niños (24, 30 y 36 meses de edad), la cantidad (completa, sin instrucción) y el tipo (correspondencia, intencionalidad) de instrucción suministrada. Los resultados en su conjunto muestran que a los 24 meses de edad los niños no comprendieron la función simbólica de las fotografías a pesar de las instrucciones completas recibidas. A los 30 meses, la información que privilegió la función intencional resultó ser crítica; mientras que la que enfatizó la correspondencia, sin bien no fue suficiente en sí misma, provocó que los niños comprendieran la función simbólica de las fotografías durante la prueba, probablemente debido a un proceso de comparación. Finalmente, a los 36 meses, los niños captaron la naturaleza simbólica del objeto sin instrucción alguna. Los resultados se discuten en cuanto a las complejas relaciones entre desarrollo e instrucción en la simbolización temprana (AU)

The purpose of this research consisted of studying the impact of instruction in the development of the symbolic comprehension of photographs as sources of information by young children. Three experiments were conducted using a search task. In these experiments the age of the children (24, 30 and 36-months-of-age), the amount (complete, no instruction) and the type (correspondence, intentionality) of the information provided were varied. Results show that at 24 months-of-age children do not comprehend the symbolic function of the photographs in spite of the instructions received. At 30 months-of-age, the information that stressed intentionality turned out to be critical; while the information that stressed correspondences, despite not being enough in itself, provoked that children came to appreciate the symbolic function of pictures during the task, probably as a consequence of a comparison process. Finally, at 36 months-of-age, children captured the symbolic nature of the object with no instruction at all. The results are discussed with regard to the complex relations between development and instruction in early symbolization (AU)

[Intervention study on subacute and chronic pain in primary care: an approach to the effectiveness of neural therapy]. / Estudio de intervención sobre el dolor subagudo y crónico en atención primaria: una aproximación a la efectividad de la terapia neural.

OBJECTIVE: To evaluate the effectiveness of NT in reducing pain and minimising use of analgesics in patients. DESIGN: Before and after intervention study. SETTING: Llefià Primary Health Care centre in Badalona (Barcelona). PARTICIPANTS: Eighty-two patients between the ages of 25 and 85 years old, who suffered pain that did not disappear after a month. MAIN MEASUREMENTS: Data was collected to evaluate any change in pain and the use of analgesics in patients before intervention and then afterwards, at 2 weeks, 3 months and 6 months. This was conducted by means of interviews and use of the Visual Analogue Pain Scale (VAS). RESULTS: Mean VAS pre-treatment: 7.94 (SD: 1.68), mean VAS after two weeks 4.63 (SD: 2.79), after 3 months 3.73 (SD: 3.17), and after 6 months 3.48 (SD: 3,27) (P<.001 in the 3 comparisons, using the Wilcoxon-test for matched data). As regards analgesic use after treatment, 74.4% of patients reduced it after 2 weeks, 76.8% after 3 months and 80% after 6 months. CONCLUSIONS: Neural therapy can be effective in reducing pain, as well as the use of analgesics. Further clinical trials would be needed to confirm this assertion.

El rol de la instrucción en la comprensión simbólica temprana de mapas / The role of instruction in early comprehension of maps

Se informan los resultados del estudio del desarrollo de la comprensión simbólica de mapas por parte de niños pequeños. El propósito fundamental consistió en investigar el rol de la instrucción del adulto en el desarrollo temprano de dicha competencia. Se presentan dos estudios en los cuales se realizó una tarea de búsqueda en la que los niños debían utilizar un mapa para encontrar un juguete en una habitación pequeña. En el primer estudio se comparó la ejecución de dos grupos de niños de 30 y 36 meses, brindándoles instrucciones explícitas acerca de la relación mapa-habitación. Se pretendía conocer si dicha relación era susceptible de ser enseñada a los pequeños. Los resultados indicaron que a los 30 meses los niños no lograron el insight representacional, o sea comprender que el mapa y la habitación se hallan relacionados simbólicamente. A los 36 meses, los niños en su mayoría no resolvieron correctamente la primera subprueba, pero luego de recibir instrucción explícita, alcanzaron el insight representacional. En el segundo estudio se examinó a partir de qué edad los niños son capaces de comprender y utilizar la función simbólica de un mapa sin la instrucción del adulto. Se encontró que mientras a los 42 meses algunos niños fueron capaces de resolver la prueba, a los 46 meses la mayoría alcanzó el insight representacional. Esta investigación muestra claramente que la comprensión temprana de mapas no sólo depende de la edad; el andamiaje que proporciona el adulto, bajo la forma de instrucción, es también crucial en algunos puntos del desarrollo.

Very early in life children must learn to master a wide variety of symbolic systems and objects for a full participation in the culture, like letters, numbers, and pictures. The symbolic systems, like numbers or letters are elements that do not have significance on their own, but provide information when combined in systematic ways. Symbolic objects, on their own, are objects that represent, with different degrees of iconicism or similarity, real entities and provide and transmit specific information. Symbolic objetcs, then, have a dual reality, they are physical objects and, at the same time, they are symbols of the entity they represent. This double nature of symbolic objects is very hard to comprehend by very young children. Symbolic objects can be tridimensional, like scale-models, or bidimensional, as photographs or graphs. This research is focused in the study of the development of early symbolic comprehension of a particular bidimensional symbolic object: a map; specifically we study the role of instruction in this process. Maps can be found among the symbolic objects of a given culture. Like other symbolic objects, they amplify aspects of our perception, attention and cognition; their specific role consists in representing and making comprehensible spatial information. The purpose of this research is to explore if, when and how instruction could affect young children's understanding and use of maps. Specifically, we wanted to know if it is possible to teach very young children the symbolic function of a map, and, if so, when is this possible. An important factor in children's symbolic functioning is the nature and extent of adult informational support. Although we know a great deal about the relation between adult scaffolding and the understanding and production of language and symbolic play, we still know relatively little about the influence of this factor in other symbolic domains such as external representations. So far, no study has investigated the impact of direct instruction or teaching on the detection and use of objects as symbols. In this research a novel manipulation of instruction is proposed: explicit instruction. Explicit instruction implies that the experimenter not only provides complete and detailed information about the symbol-referent relation before the task begins, but also, if necessary, during the task the experimenter corrects and directly teaches the child how to employ the map in order to find the hidden object. The two studies presented in this paper employ a search task in which children have to use a map in order to find a hidden toy in a small room. The first study compares the performance of two age group children (30 months and 36-month-olds) with explicit instructions about the map-room relation. The aim of this study is to find out if it is possible to teach little children the symbolic function of a map. The results show that while 30-month-old children are not able to recognize the map-room relation at all, the majority of 36-month-olds children achieved representational insight after failing the first search and being explicitly taught how to use the map. The second study examines at what age children are capable of recognizing and using the symbolic function of a map without adult's instruction. It was found that while at 42 months old some children are able to solve the task with no instructions at all, at 46 months the majority of children achieve representational insight. This research clearly shows that the early comprehension of maps is not solely dependent of age and maturation, the scaffolding that adult instruction provides is also crucial at some points of development.

[Detection of LADA-type diabetes in overweight diabetic patients. Is treatment with metformin suitable?]. / Detección de diabetes tipo LADA en pacientes diabéticos con exceso ponderal. 'Es adecuado el tratamiento con metformina?

OBJECTIVES: To detect type-1 LADA (latent auto-immune diabetes in adults) in adults with overweight. To describe the metabolic variations in these patients after metformin treatment. DESIGN: Observational, multi-centre study based on a series of cases. SETTING: Health centres in Barcelona province, Spain. PARTICIPANTS: Diabetic patients with overweight or obesity, diagnosed with diabetes for <2 years, aged between 35 and 65, and without clinical micro-macrovascular complications and without initial glycaemia-lowering drug treatment. INTERVENTION: Metformin administration (1700 mg/day). MEASUREMENTS: The metabolic control variable was HbA1c. Other variables measured were: body mass index (BMI), glucose in fast, insulinaemia, C-peptide, and insulin resistance (HOMA-IR). We determined ICA, GADAb and IA2Ab antibodies to diagnose LADA-type diabetes. RESULTS: In our sample of diabetics (N=103), we detected 3 type-1 LADA cases. These patients had higher levels of HbA1c, insulin and, especially, HOMA-IR. Metformin treatment for one year improved HbA1c in both groups (with and without type-1 LADA). However, the decrease in insulin one year afterwards was greater in type-1 LADA patients. CONCLUSIONS: The percentage of type-1 LADA in our sample made us wonder whether we should search for pancreatic antibodies more often in primary care. More studies on the prevalence of type-1 LADA in our country are needed, especially in diabetic patients with overweight. Type-1 LADA patients improved their metabolic control after metformin treatment and showed a drastic decrease in insulin levels. Further studies are needed to evaluate whether metformin improves metabolic control, even though it may not protect insulin reserves, and to contrast metformin with other drugs.

Detección de diabetes tipo LADA en pacientes diabéticos con exceso ponderal. ¿Es adecuado el tratamiento con metformina? / Detection of LADA-type diabetes in overweight diabetic patients. Is treatment with metformin suitable?

Objetivos. Detectar pacientes con diabetes tipo LADA (latent autoinmune diabetes of adult) tipo 1 en diabéticos adultos con sobrepeso y describir las variaciones metabólicas tras administrar metformina. Diseño. Estudio observacional, multicéntrico, basado en una serie de casos. Emplazamiento. Atención primaria, provincia de Barcelona. Participantes. Diabéticos con sobrepeso u obesidad, con diagnóstico de diabetes < 2 años, entre 35 y 65 años de edad, sin complicaciones microvasculares o macrovasculares ni tratamiento farmacológico inicial antidiabético. Intervención. Administración de metformina, 1.700 mg/día. Mediciones. La variable de control metabólico fue la hemoglobina glucosilada (HbA1c); otras variables fueron el índice de masa corporal (IMC), la glucemia en ayunas, la insulinemia, el péptido C y la valoración de la insulinorresistencia (HOMA-IR). Para el diagnóstico de diabetes tipo LADA se determinaron los anticuerpos ICA, anti-GAD y anti-IA2. Resultados. En la muestra de diabéticos estudiada (n = 103) se detectaron 3 casos de LADA tipo 1 (prevalencia del 2,9%; intervalo de confianza del 95%, 0,6-8,3%). Estos pacientes presentaron valores basales más elevados de HbA1c, insulina y sobre todo de HOMA-IR. El tratamiento con metformina mejoró la HbA1c en ambos grupos de pacientes (con o sin LADA de tipo 1). El descenso de la insulinemia al cabo de un año en los pacientes con LADA de tipo 1 fue más marcado que en el resto de diabéticos. Conclusiones. Dada su frecuencia, hay que reflexionar sobre si deberían buscarse con más frecuencia anticuerpos frente a células β pancreáticas en atención primaria. Los pacientes con LADA de tipo 1 presentaron buen control de la HbA1c en tratamiento con metformina y un drástico descenso de la insulina. Faltan estudios que evalúen si la metformina mejora el control glucémico, aunque tal vez no proteja la reserva insulínica, y confrontarla con otros fármacos

Objectives. To detect type-1 LADA (latent auto-immune diabetes in adults) in adults with overweight. To describe the metabolic variations in these patients after metformin treatment. Design. Observational, multi-centre study based on a series of cases. Setting. Health centres in Barcelona province, Spain. Participants. Diabetic patients with overweight or obesity, diagnosed with diabetes for <2 years, aged between 35 and 65, and without clinical micro-macrovascular complications and without initial glycaemia-lowering drug treatment. Intervention. Metformin administration (1700 mg/day). Measurements. The metabolic control variable was HbA1c. Other variables measured were: body mass index (BMI), glucose in fast, insulinaemia, C-peptide, and insulin resistance (HOMA-IR). We determined ICA, GADAb and IA2Ab antibodies to diagnose LADA-type diabetes. Results. In our sample of diabetics (N=103), we detected 3 type-1 LADA cases. These patients had higher levels of HbA1c, insulin and, especially, HOMA-IR. Metformin treatment for one year improved HbA1c in both groups (with and without type-1 LADA). However, the decrease in insulin one year afterwards was greater in type-1 LADA patients. Conclusions. The percentage of type-1 LADA in our sample made us wonder whether we should search for pancreatic antibodies more often in primary care. More studies on the prevalence of type-1 LADA in our country are needed, especially in diabetic patients with overweight. Type-1 LADA patients improved their metabolic control after metformin treatment and showed a drastic decrease in insulin levels. Further studies are needed to evaluate whether metformin improves metabolic control, even though it may not protect insulin reserves, and to contrast metformin with other drugs