Environmental and psychopathological predictors of clinical high-risk of psychosis in adolescence.

OBJECTIVES: Clinical high-risk psychosis (CHRp) samples can be heterogeneous, consisting essentially of people with not only psychotic-like experiences but also nonspecific symptoms that may reflect common mental disorders such as depression, anxiety, or substance abuse pathologies. Few studies have attempted to analyze and understand psychosis risk in relation to both environmental (ER) and psychopathological risk (PsR) factors. This study aimed to determine the clinical risk of psychosis in adolescents. METHODS: A representative sample of 1824 Spanish adolescents from the general population was evaluated using different scales to thoroughly examine the possible interaction of CHRp with various ER and PsR factors. Partial correlations were calculated to assess the relationships between the variables. A series of hierarchical linear regression models were then used to obtain a CHRp predictor model. RESULTS: The CHRp predictor model indicated that PsR was the most significant determining factor, explaining 22% of the total associated variance of CHRp. However, the ER factor also emerged as a significant predictor of high-risk psychosis (accounting for 9% of the variance). CONCLUSIONS: A predictive model for CHRp in adolescents was found, in which common psychological problems were presented as more determinant risk factors than ER disruptors. Furthermore, certain transdiagnostic processes, such as psychological inflexibility, may play a central role in the development of mental health problems, including psychosis. Specifying the mechanisms underlying the emergence of CHRp in adolescence is the key to optimizing the focus of preventive therapeutic interventions in these early stages.

Validating the Modified McGill Thyroid Nodule Score for Assessment of Preoperative Risk of Pediatric Thyroid Malignancy.

OBJECTIVE: The McGill Thyroid Nodule Score (MTNS) is a preoperative tool used to predict the risk for well-differentiated thyroid cancer in adults. It was developed by a multidisciplinary team using established evidence-based risk factors for thyroid cancer. The modified McGill Thyroid Nodule Score (mMTNS) was developed to predict malignancy risk in children. A pilot study suggested the mMTNS was able to assess malignancy risk in children with indeterminate cytology on fine needle aspiration (FNA). This study seeks to validate these findings. METHODS: Retrospective chart review identified subjects who underwent FNA biopsy and subsequent resection. Each patient was assigned a score to compare to final pathology. Statistical analysis was performed with SPSS. All tests were 2-tailed and statistical significance defined p < 0.05. Logistic regression used to determine predictive values of scores. RESULTS: 46 patients ≤21 years of age underwent resection of a thyroid nodule. Female predominance of 85% (n = 39). 78% (n = 36) of patients had palpable nodule. 65% (n = 30) found to have benign pathology and 35% (n = 16) found to have malignancy. Malignant nodules associated with greater mean mMTNS compared to benign [13.63 vs 7.23]. An mMTNS greater >12 had sensitivity of 86.7%, specificity of 90.3%, positive predictive value of 81.3%, and negative predictive value of 93.3%. CONCLUSION: Our data suggests the mMTNS continues to be a useful adjunct in predicting malignancy risk of pediatric thyroid nodules. An mMTNS >12 has a high risk for malignancy, which can aid in counseling and clinical decision making, particularly when there is indeterminate cytology on FNA. LEVEL OF EVIDENCE: IV.

A Proposal for Neurography Referral in Patients with Carpal Tunnel Syndrome Based on Clinical Symptoms and Demographic Variables of 797 Patients.

The clinical manifestation of median nerve entrapment at the carpal tunnel level is known as carpal tunnel syndrome (CTS). Electroneurography (ENG) is considered the gold standard in CTS evaluation. We conducted a retrospective study and analyzed some clinical and demographic variables, relating them to the degree of neuropathy using ENG, to better understand the role of ENG in this very common disease. We studied 816 patients referred to our service for neurographic evaluation. Their symptoms were classified as compatible with CTS (cCTS) (n = 646) and atypical for CTS (aCTS) (n = 170). A blind ENG was performed on 797 patients. Patient characteristics were coded as variables and analyzed to study whether they could predict neuropathy severity (sensory and motor involvement or grade ≥ 3 in our classification). We found a correlation between typical symptomatology, age over 50 years, male gender, positivity of Phalen's maneuver and Tinel's sign, and a neuropathy grade ≥ 3. We also found a correlation with CTS in the contralateral hand if the other hand showed neuropathy, despite the lack of symptoms in this hand. We propose a practical algorithm for ENG referral based on clinical symptoms, demographic factors, and neurophysiological variables.

Professional quality of life and fear of COVID-19 among Spanish nurses: A longitudinal repeated cross-sectional study.

AIM AND OBJECTIVES: To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign. BACKGROUND: The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential. DESIGN: A repeated cross-sectional design was carried out with a time-lapse of 12 months. METHODS: A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies. RESULTS: The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = - .16, p = .001; r = - .22, p ≤ .001). RELEVANCE TO CLINICAL PRACTICE: Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care. PATIENT OR PUBLIC CONTRIBUTION: The nurses collaborated by participating in the present study anonymously and disinterestedly.

Experiences of Self-Stigma in People with Chronic Psychosis: A Qualitative Study.

We present the results of a phenomenological study understanding the personal meaning of self-stigma in people with chronic psychosis. Self-stigma is a frequent phenomenon in the lives of people with psychosis and their families and it functions as a barrier to recovery. Semi-structured in-depth interviews were conducted with fourteen outpatients that suffer from chronic psychosis during January 2020. Data analysis was carried out using an inductive approach as described by Graneheim and Lundman through the MAXQDA 2022 program. The themes observed were: "Contextual Stigma", "Components of Self-Stigma", "Skills Loss" and "Coping with Self-Stigma". The main categories and subcategories were avoidance and escape behaviours from their social environment, labelling, loss of social relationships, negative impact and self-concealment of the diagnosis. Our results revealed influence on each other, forming a looping effect that explains and amplifies the lived experience of self-stigma. These findings highlight the need to implement strategies in nursing practice aimed at training the acceptance and distancing necessary to minimize the impact of self-stigma on people with chronic psychosis. This study adheres to the EQUATOR guidelines for the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Arbuscular mycorrhizae reduce the response of important plant functional traits to drought and salinity. A meta-analysis study.

We aimed at exploring the plant functional traits whose responses to drought or salinity are altered by the presence of arbuscular mycorrhiza (AM). We performed a meta-analysis across 114 articles spanning 110 plant species or cultivars. We quantified the size effect of AM symbiosis on the stress response of several functional traits, using linear mixed model analysis (LMM). Correlation analysis between functional traits and total biomass responses to stresses were also performed through LMM. The literature search and further selection yielded seven functional traits, extracted from 114 laboratory studies, including 888 observations and 110 plant species/cultivars. Evidence for significant effects of predictor variables (type of stress, AM symbiosis and/or their interaction) on functional trait response were found for leaf area ratio (LAR), root mass fraction (RMF) and root-shoot (R:S) ratio. Our results provided evidence to accept the hypothesis that AM fungal inoculation may reduce the stress response of these plant functional traits by decreasing its magnitude. We also found a weak correlation between stress responses of these traits and total biomass variation. Although our literature search and data collection were intensive and our results robust, the scope of our conclusions is limited by the agronomical bias of plant species targeted by the meta-analysis. Further knowledge on non-cultivable plant species and better understanding of the mechanisms ruling resources allocation in plants would allow more generalised conclusions.

The Role of Magnetic Transcranial Stimulation in the Diagnosis and Post-Surgical Follow-Up of Cervical Spondylotic Myelopathy.

Degenerative cervical myelopathy (DCM) consists of spinal cord damage due to its compression through the cervical spine. The leading cause is degenerative. The diagnosis is clinical, and the therapeutic approach is usually surgical. Confirmation of the diagnostic suspicion is done by magnetic resonance imaging (MRI); however, this test lacks functional information of the spinal cord, the abnormality of which may precede involvement in neuroimaging. Neurophysiological examination using somatosensory evoked potentials (SSEPs) and transcranial magnetic stimulation (TMS) allows for an evaluation of spinal cord function, and provides information in the diagnostic process. Its role in the post-surgical follow-up of patients undergoing decompressive surgery is being studied. We present a retrospective study of 24 patients with DCM and surgical decompression who underwent neurophysiological tests (TMS and SSEP) before, 6, and 12 months after surgery. The result of the TMS and the SSEP in the post-operative follow-up did not correlate with the clinical outcome, either subjective or measured by clinical scales at six months. We only found post-surgical improvement of central conduction times (CMCTs) in patients with severe pre-surgical motor impairment on TMS. In patients with normal pre-surgical CMCT, we found a transient worsening with return to baseline at the one-year follow-up. Most patients presented pre-surgical increased P40 latency at diagnosis. CMCT and SSEP were more related to clinical outcomes one year after the surgical procedure and were very useful in diagnosing.

Obesity and Adipose Tissue Dysfunction: From Pediatrics to Adults.

Obesity is a growing health problem that affects both children and adults. The increasing prevalence of childhood obesity is associated with comorbidities such as cardiovascular disease, type 2 diabetes and metabolic syndrome due to chronic low-grade inflammation present at early stages of the disease. In pediatric patients suffering from obesity, the role of epigenetics, the gut microbiome and intrauterine environment have emerged as causative factors Interestingly, pediatric obesity is strongly associated with low birth weight. Accelerated weight gain oftentimes occurs in these individuals during the post-natal period, which can lead to increased risk of adiposity and metabolic disease. The pathophysiology of obesity is complex and involves biological and physiological factors compounded by societal factors such as family and community. On a cellular level, adipocytes contained within adipose tissue become dysregulated and further contribute to development of comorbidities similar to those present in adults with obesity. This review provides an overview of the current understanding of adipose tissue immune, inflammatory and metabolic adaptation of the adipose tissue in obesity. Early cellular changes as well as the role of immune cells and inflammation on the progression of disease in pivotal pediatric clinical trials, adult studies and mouse models are emphasized. Understanding the initial molecular and cellular changes that occur during obesity can facilitate new and improved treatments aimed at early intervention and subsequent prevention of adulthood comorbidities.

A new Algorithm for Detecting Clinical High Risk of Psychosis in Adolescents.

BACKGROUND: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings. METHOD: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit. RESULTS: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm. CONCLUSIONS: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.

Is COVID-19 vaccine inequality undermining the recovery from the COVID-19 pandemic?

Background: The devastating health and economic impact of the COVID-19 pandemic led to a global response in the development of effective vaccines to fight the disease in an extraordinarily short time. Both the development and the production of these vaccines opened a path of hope, but the inequality in vaccine distribution raises great concerns about the possibility of effectively eradicating the virus. Methods: It is particularly important to analyse the extent to which vaccines are equally distributed and investigate the possible effects of vaccine inequalities as well as its major drivers. For this purpose, this paper investigates the extent of equitable vaccine distribution using some well-known inequality measures and disentangles the main drivers of the share of vaccination. In addition, the paper analyses the relationship between the vaccination rate, the GDP growth, and the incidence of the coronavirus disease, with the aim of providing empirical evidence on existing relationships worldwide. Results: Our findings show that the situation is more challenging in less developed countries, especially African countries, due to weak health systems and low rates of vaccination. Moreover, we find a positive relationship between the share of vaccinated individuals and GDP. Consequently, the poorest, least developed countries with a lower rate of vaccine uptake will experience lower GDP growth. Conclusions: Vaccines and the vaccination process reveal the existing inequalities between countries and how they, in turn, impact the well-being of their citizens. People who live in less developed countries have a lower probability of being vaccinated, which translates into a greater probability of dying from COVID. Countries are seeing their economic future compromised by low vaccination levels, given the positive and significant relationship between the vaccination rate and GDP growth. In short, while some countries are trying to get back to some sort of normality, even with some pandemic protocols, the situation in less developed countries is more challenging due to weak health systems and low rates of vaccination. Consequently, the poorest, least developed countries with a lower rate of vaccine penetration will experience lower GDP growth, and the pandemic will have a greater effect on their economy due to low vaccination rates.

The role of nurses' professional values during the COVID-19 crisis.

BACKGROUND: The COVID-19 pandemic has produced high stress in nurses, affecting their professional quality of life. Different variables affect psychological stress response and professional quality of life. In this context, the role of professional values represents an interesting object of research. OBJECTIVES: To analyze the relationship between professional values, perceived stress, and professional quality of life among nurses during the COVID-19 crisis. RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT: Descriptive cross-sectional study. Participants were 439 registered nurses from the public health system. Perceived stress, professional quality of life, and professional values were evaluated by using measuring instruments adapted and validated in the geographic context of research. Data were collected online in December 2020 during the second wave of the COVID-19 pandemic in Spain. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee on Clinical Research of the Principality of Asturias. FINDINGS: Within professional values, ethics obtained higher scores showing the primacy of ethical values among nurses. Moderate correlations between ethics, mastery, expertise, and compassion satisfaction were found. Frontline nurses informed high perceived stress. The correlations between professional values and compassion satisfaction were higher in non-frontline nurses. A moderate negative correlation between perceived stress and compassion satisfaction was found in both groups, which implies that the higher the stress, the lower the satisfaction in the helping relationship. CONCLUSION: Professional values positively influence compassion satisfaction during the COVID-19 pandemic. Compassion satisfaction presents a negative correlation with fatigue compassion and burnout in frontline and non-frontline nurses. Given the functionality of values both to guide clinical practice professionally and ethically, and prevent dissatisfaction with one's professional quality of life by reinforcing compassion satisfaction, it is necessary to reinforce them with an intensive and cross-sectional learning during the university training.

Influencia del patrón de crianza parental sobre el comportamiento del paciente pediátrico en la clínica dental: estudio piloto / Influência do padrão parental no comportamento do paciente pediátrico na clínica odontológica: estudo piloto / Influence of the parental styles on the behavior of the pediatric patient in the dental clinic: pilot study

Objetivos: Estudiar el comportamiento y la ansiedad de pacientes de 4-8 años durante la primera visita dental, relacionando dicho comportamiento con las prácticas parentales. Material y métodos: Se diseñó un estudio clínico transversal observacional. La selección de los pacientes se realizó mediante un muestreo no probabilístico consecutivo de conveniencia. Los padres cumplimentaron un cuestionario antes de la visita, y se realizó la evaluación del niño mediante la observación para determinar su nivel de ansiedad y el tipo de comportamiento. Resultados: 18 niños de edades comprendidas entre 4 y 8 años participaron en el estudio. El 72,2 % de los participantes tuvo un nivel de ansiedad "inquieto" y el 27,8 % "relajado". El 72,2 % tuvo un comportamiento "levemente positivo". El estilo de crianza mayoritario fue el "autoritativo" con un 83,3 %. No se ha visto una diferencia estadísticamente significativa entre el nivel de ansiedad y el comportamiento de los niños en la primera visita dental y el estilo de crianza (p>0,5). Conclusiones: El nivel de ansiedad de los niños no está influenciado con el estilo de crianza. Sin embargo, se ha visto un mejor comportamiento en la primera visita dental en los niños con padres autoritativos.

Objetivos: Estudar o comportamento e a ansiedade de pacientes de 4 a 8 anos durante a primeira consulta odontológica, relacionando esse comportamento às práticas parentais. Material e métodos: Foi elaborado um estudo clínico transversal não experimental. A seleção dos pacientes foi realizada inicialmente por meio de amostragem não probabilística consecutiva por conveniência. Os pais receberam um questionário antes da visita e, posteriormente, a criança foi avaliada por observação para determinar seu nível de ansiedade e tipo de comportamento. Resultados: participaram do estudo 18 crianças com idades entre 4 e 8 anos. 72,2% dos participantes apresentavam nível de ansiedade "inquieto" e 27,8% "relaxado". 72,2% tiveram um comportamento "ligeiramente positivo". O estilo parental majoritário foi "autoritativo" com 83,3%. Não foi observada diferença estatisticamente significativa entre o nível de ansiedade e o comportamento das crianças na primeira consulta ao dentista e o estilo parental (p> 0,5). Conclusões: O nível de ansiedade das crianças não é influenciado pelo estilo parental. No entanto, um melhor comportamento na primeira consulta odontológica foi observado em crianças com pais autoritativos.

Objectives: To study the behavior and anxiety of 4-8 year-old patients during the first dental visit, relating this behavior to parenting practices. Material and methods: A non-experimental cross-sectional clinical study was designed. The selection of patients was initially carried out by means of a non-probabilistic consecutive convenience sampling. A questionnaire was given to the parents before the visit, and subsequently the child's evaluation was carried out through observation to determine the level of anxiety and the type of behavior of the child. Results: 18 children aged between 4 and 8 years participated in the study. 72.2% of the participants had a "restless" anxiety level and 27.8 "relaxed". 72.2% had a "slightly positive" behavior. The majority parenting style was "authoritative" with 83.3%. No statistically significant difference was seen between the children's anxiety level and behavior at the first dental visit and parenting style (p> 0.5). Conclusions: The children's anxiety level is not influenced by the parenting style, however, a better behavior has been seen in the first dental visit in children with authoritative parents

Relaciones entre los estilos de crianza actuales, el empleo de las técnicas de orientación del comportamiento y su enseñanza en Odontopediatría. Revisión bibliográfica. / Relações entre os estilos de criação atuais, a utilização das técnicas de orientação comportamental e seu ensino em Odontopediatria. Revisão bibliográfica. / Relationships between current parenting styles, the use of behavioral guidance techniques and their teaching in Pediatric Dentistry. A bibliographic review.

Introducción: Los cambios en los estilos de crianza de los últimos 25 años han llevado a desestimar en Odontopediatria algunas técnicas de orientación conductual (TODC) clásicas porque los padres las consideran poco apropiadas para sus hijos. Esto ha generado cambios en los programas de formación en Odontopediatría. Objetivo: Revisar las TODC más empleadas actualmente por odontopediatras, las más enseñadas en los programas de Odontología y la influencia de la aceptación parental en ello. Material y método: se realizó una revisión descriptiva de la literatura. Para establecer la base documental, constituida por 42 artículos, se realizó una búsqueda en las bases de datos: Cochrane, SciElo, Medline y Google Academy. Resultados:La familia ha experimentado un proceso de transformación con nuevos modelos de relaciones familiares y de crianza. Aunque los odontopediatras reconocen que la crianza autoritativa es la que favorece un comportamiento más positivo en el consultorio, perciben una tendencia parental hacia la permisividad. Eso ha favorecido que el empleo de algunas TODC clásicas, como control de voz o la estabilización física activa haya disminuido y la formación y entrenamiento al respecto también. Conclusiones:La formación de los odontopediatras está influenciada por el entorno socio-cultural y por aspectos ético-legales cambiantes. Ante la tendencia actual a un patrón de crianza más permisivo las TODC más enseñadas en los programas de Odontopediatría y, las más empleadas por los odontopediatras son las de comunicación. Conocer el patrón de crianza parental puede orientar al profesional para sugerir las TODC más adecuadas a cada entorno familiar

Introdução: As mudanças nos estilos de criação dos últimos 25 anos levaram a rejeitar algumas técnicas de orientação comportamental (TOC) clássicas em Odontopediatria porque os pais as consideravam inapropriadas para seus filhos. Isto gerou mudanças nos programas de formação em Odontopediatria. Objetivo: Revisar as TOC mais utilizadas atualmente pelos odontopediatras, as mais ensinadas nos programas de Odontologia e a influência da aceitação parental em todo isso. Material e método: Foi feita uma revisão descritiva da literatura. Para estabelecer a base documental, composta por 42 artigos, realizou-se uma pesquisa nas bases de datos: Cochrane, SciElo, Medline y Google Academy. Resultados: A família passou por um processo de transformação com novos modelos de relacionamento familiar e parental. Embora os odontopediatras reconheçam que a criação autoritativa é a que favorece um comportamento mais positivo no consultório, percebem também uma tendência dos pais à permissividade. Isso tem favorecido que o emprego de algumas TOC clássicas, como controle de voz ou a estabilização física ativa, tenha diminuído e a formação e treinamento a esse respeito também. Conclusões: A formação dos odontopediatras é influenciada pelo entorno sócio-cultural e por aspetos ético-legais mutáveis. Dada a tendência atual para um modelo de criação mais permissivo as TOC mais ensinadas nos programas de Odontopediatria e, as mais empregadas pelos odontopediatras são as de comunicação. Conhecer o modelo parental pode orientar o profissional para sugerir as TOC mais adequadas a cada ambiente familiar

Introduction: The changes in parenting styles in the last 25 years have led to the dismissal in pediatric dentistry of some classic behavioral guidance techniques (BGT) because parents consider them inappropriate for their children. This has generated changes in the training programs in Pediatric Dentistry. Objective: To review the BTG most currently used by pediatric dentists, the most taught in Dentistry programs and the influence of parental acceptance on it. Material and method: A descriptive review of the literature was carried out. To establish the documentary base, consisting of 42 articles, a search was carried out in the databases: Cochrane, SciElo, Medline and Google Academy. Results: The family has undergone a process of transformation with new models of family and parenting relationships. Although pediatric dentists recognize that authoritative parenting is the one that favors a more positive behavior in the dental office, they perceive a parental tendency towards permissiveness that has favored the decrease in the use of some classic BGT, such as voice control or active physical stabilization, and the learning and training about them as well. Conclusions: The training of pediatric dentists is influenced by the socio-cultural environment and by the changing ethical-legal aspects. Given the current trend towards a more permissive parenting pattern, the most taught and most used BGT in Pediatric Dentistry programs are communication techniques. Knowing the parental upbringing pattern can guide the professional to suggest the most appropriate BGT for each family environment

A new Algorithm for Detecting Clinical High Risk of Psychosis in Adolescents / Un Nuevo Algoritmo para la Detección del Alto Riesgo Clínico de Psicosis en Adolescentes

Background: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings. Method: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit. Results: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm. Conclusions: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.(AU)

Antecedentes: La delimitación del alto riesgo clínico de psicosis (CHRp, por sus siglas en inglés) se caracteriza por la gran variedad de síntomas evaluados desde diferentes enfoques y la dificultad que existe para detectar los estadios clínicos más alejados del inicio de la psicosis. Este estudio tiene como objetivo la creación de un procedimiento sistemático para una detección temprana eficaz y precisa del CHRp en entornos educativos. Método: A partir de una muestra representativa de 1.824 adolescentes (edad, media= 15,79 años; 53,8%, mujeres) se ha desarrollado un sistema de evaluación online y un algoritmo de tres vías y tres niveles de riesgo que combina los síntomas de los principales enfoques de riesgo: ultra-alto riesgo (UHR), síntomas básicos (SB) y anomalías en la autoexperiencia subjetiva (ASE), además del déficit funcional. Resultados: A la luz de los datos obtenidos se han confirmado la aceptabilidad y viabilidad del sistema de cribado online. Del total de participantes, 68 (3,7%) fueron identificados como de alto riesgo y 417 (22,9%) como de riesgo moderado, lo que también avala la funcionalidad del algoritmo propuesto. Conclusiones: El sistema apoya la existencia de un modelo dinámico de progresión de los diferentes síntomas en las primeras etapas de la psicosis, y puede constituir una primera línea de identificación de los trastornos mentales graves en los jóvenes en las etapas más tempranas, de cara a la aplicación de las medidas preventivas iniciales.(AU)

Stress-regulated elements in Lotus spp., as a possible starting point to understand signalling networks and stress adaptation in legumes.

Although legumes are of primary economic importance for human and livestock consumption, the information regarding signalling networks during plant stress response in this group is very scarce. Lotus japonicus is a major experimental model within the Leguminosae family, whereas L. corniculatus and L. tenuis are frequent components of natural and agricultural ecosystems worldwide. These species display differences in their perception and response to diverse stresses, even at the genotype level, whereby they have been used in many studies aimed at achieving a better understanding of the plant stress-response mechanisms. However, we are far from the identification of key components of their stress-response signalling network, a previous step for implementing transgenic and editing tools to develop legume stress-resilient genotypes, with higher crop yield and quality. In this review we scope a body of literature, highlighting what is currently known on the stress-regulated signalling elements so far reported in Lotus spp. Our work includes a comprehensive review of transcription factors chaperones, redox signals and proteins of unknown function. In addition, we revised strigolactones and genes regulating phytochelatins and hormone metabolism, due to their involvement as intermediates in several physiological signalling networks. This work was intended for a broad readership in the fields of physiology, metabolism, plant nutrition, genetics and signal transduction. Our results suggest that Lotus species provide a valuable information platform for the study of specific protein-protein (PPI) interactions, as a starting point to unravel signalling networks underlying plant acclimatation to bacterial and abiotic stressors in legumes. Furthermore, some Lotus species may be a source of genes whose regulation improves stress tolerance and growth when introduced ectopically in other plant species.

Psychological Inflexibility in People with Chronic Psychosis: The Mediating Role of Self-Stigma and Social Functioning.

Psychosis is associated with self-stigmatization and loss of social functioning that increase the severity of the disorder. Psychological inflexibility (PI)-an individual's tendency to suppress undesirable private events-plays a fundamental role in the emergence and worst prognosis of psychosis. The main objective of this study was to analyze whether self-stigma and social functioning mediate the association of PI with the severity of psychosis in adults with chronic schizophrenia. The study was carried out with a sample of 103 outpatients. The Acceptance and Action Questionnaire, the Internalized Stigma of Mental Illness Scale, and the Social Functioning Scale were used for clinical assessments. Data analyses were performed by using the PROCESS macro for SPSS. Results showed that the link between PI and the severity of psychosis is not direct, but is better explained by mediation of the self-stigma and social functioning of those assessed. PI also predicts worse social functioning without the need to take self-stigma into account. Moreover, self-stigma alone does not predict the severity of psychotic symptoms; this relationship has to be mediated by social functioning. These findings suggest that interventions designed to increase psychological flexibility, such as Acceptance and Commitment Therapy (ACT), may offer an alternative to attenuate the negative impact of self-stigma and to improve the social functioning.

Basic behavior guidance techniques: A survey of members of the Spanish Society of Paediatric Dentistry.

BACKGROUND: Over the last 20-30 years social trends, educational and parenting patterns, and the ethical and legal factors guiding them have led to the revaluation and even abandonment of some traditionally used behavior guidance techniques (BGTs). AIMS: To profile the professionals providing specialized pediatric treatments in Spain and understand changes in their preferences and use of basic BGTs, and the evolution of these preferences. SETTINGS AND DESIGN: A cross-sectional, descriptive, and correlational study was designed. METHODS: One hundred and twenty-six dentists completed a previously validated survey. STATISTICAL ANALYSIS: Descriptive statistics and Chi-square tests were performed to analyze the questionnaire data. RESULTS: The most common BGTs were "Tell/Show/Do" (98%) and positive reinforcement (92.1%), and the most abandoned BGT was: "hand-over-mouth" (15%), because it was rejected by parents and because of potential legal problems and psychological consequences for the patients. Of note, 37% of the professionals allowed the patient's parents to be present during the treatment. CONCLUSIONS: There has been a notable decrease in the use of certain BGTs in Spain, especially hand-over-mouth and voice control, because they are becoming less socially acceptable as the way society relates to and educates children changes.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

Long-Term V-EEG in Epilepsy: Chronological Distribution of Recorded Events Focused on the Differential Diagnosis of Epileptic Seizures and Psychogenic Non-Epileptic Seizures.

Differential diagnosis in epilepsy is sometimes challenging. Video-electroencephalography (V-EEG) is an essential tool in the diagnosis and management of epilepsy. The prolonged duration of V-EEG recording increases the diagnostic yield of a conventional V-EEG. The right length of monitoring for different indications is still to be established. We present a retrospective descriptive study with a sample of 50 patients with long-term V-EEG monitoring, with a mean age of 36.1 years, monitored from 2013 to 2019 at the Burgos University Hospital. The mean monitoring time was 3.6 days. Events were obtained in 76% of the patients, corresponding to epileptic seizures (ES) in 57.9% of them, with psychogenic non-epileptic seizures (PNES) in 39.5%, and with episodes of both pathologies in 2.6% of the patients. We found that the first event was highly representative, and it correlated with the rest of the events that would be recorded. Moreover, 92% of the first PNES had been captured at the end of the second day, and 89% of the first ES by the end of the third day. V-EEG for differential diagnosis between ES and PNES can be performed in hospitals without specialized epilepsy surgery units. For this indication, the duration of long-term V-EEG can be adjusted individually depending on the nature of the first event.