RESUMO
Global Longitudinal Strain (GLS) is a useful tool to follow-up heart transplant (HT) recipients. Important inter-vendor variability of GLS measurements has been reported in healthy subjects and different conditions, but there is still limited evidence among HT patients. We assessed the reliability and validity of GLS using two vendors (General Electric and Philips) in a group of consecutive and stable adult HT recipients. Patients underwent two concurrent GLS analyses during their echocardiographic follow-up. We evaluated GLS inter-vendor reliability using Bland-Altman's limits of agreement (LOA) plots, computing its coverage probability (CP) and the intraclass correlation coefficient (ICC). Validity was assessed though receiver operating characteristics (ROC) curves, predictive values, sensitivity and specificity of GLS for each vendor to detect a normal left ventricle function. 78 pairs of GLS studies in 53 stable HT patients were analyzed. We observed a modest inter-vendor reliability with a broad LOA (less than 50% of values falling out our CP of 2% and an ICC of 0.49). ROC analyses (areas under the curve of 0.824 Vs. 0.631, p < 0.05) and diagnosis test indices (Sensitivity of 0.73 Vs. 0.64; and Specificity of 0.79 Vs. 0.50) favored GE over Philips. Inter-vendor variability for GLS analysis exceeded clinically acceptable limits in HT recipients. GLS from GE software seemed to show higher validity as compared to Philips'. The present study provides evidence to consider caution for the interpretation of GLS for clinical management in the follow-up of HT patients, especially when GLS is measured by different vendors.
Assuntos
Transplante de Coração , Função Ventricular Esquerda , Adulto , Colômbia , Transplante de Coração/efeitos adversos , Ventrículos do Coração , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Centros de Atenção TerciáriaRESUMO
Classrooms in Peace (Aulas en Paz) is an elementary school-based multicomponent program for prevention of aggression and promotion of peaceful relationships. Inspired by international programs and socio-emotional research, it includes (1) a classroom universal curriculum, (2) parent workshops and home visits to parents of the 10% most aggressive children, and (3) extracurricular peer groups of two aggressive and four prosocial children. Activities seek to promote socio-emotional competencies such as empathy, anger management, creative generation of alternatives, and assertiveness. A 2-year quasi-experimental evaluation was conducted with 1154 students from 55 classrooms of seven public schools located in neighborhoods with the presence of youth gangs, drug cartels, and high levels of community violence in two Colombian cities. Despite several implementation (e.g., about half of the activities were not implemented) and evaluation (e.g., randomization problems, large number of missing data, and changes between treatment and control groups) challenges, positive results were found in prosocial behavior and in reduction of aggressive behavior, according to teacher reports, and in assertiveness and reduction of verbal victimization, according to student reports. Furthermore, implementation cost (25 US dollars per student per year) was very low compared to other programs in developed countries. This study shows that the Classrooms in Peace program has an important potential to generate positive results and highlights the challenges of implementing and evaluating prevention programs in highly violent environments.
Assuntos
Instituições Acadêmicas , Violência , Criança , Colômbia , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Grupo AssociadoRESUMO
Recientemente se han desarrollado intervenciones escolares breves basadas en teorías motivacionales y de psicología social. Estas intervenciones, algunas de solamente 15 minutos, han obtenido resultados positivos a largo plazo sobre dominios como el desempeño académico y la convivencia escolar. Este artículo hace una revisión de sus objetivos, características, fundamentos teóricos, evaluaciones y condiciones necesarias para su diseño e implementación. En general, el objetivo de estas intervenciones breves es transformar creencias, pensamientos o sentimientos de un segmento particular de la población estudiantil, considerado en riesgo. Además, buscan romper círculos viciosos al intervenir en momentos específicos de procesos recursivos. Finalmente, esta revisión analiza sus alcances, implicaciones y limitaciones, y sugiere futuras investigaciones.
Recently, brief school interventions based on motivational theories and social psychology have been developed. These interventions, some 15 minutes in length, have demonstrated positive results in the long term in areas such as academic achievement and a positive school environment. This article reviews the objectives, characteristics, theoretical foundations, evaluations, and necessary conditions for their design and implementation. In general, the objective of these brief interventions is to transform beliefs, thoughts, or feelings concerning a particular segment of the student population that is considered to be at risk. Furthermore, these interventions seek to interrupt vicious circles by intervening at specific moments in recursive processes. Finally, this review analyzes their scope, implications, and limitations and suggests future research.
Recentemente foram desenvolvidas intervenções escolares breves baseadas em teorias motivacionais e de psicologia social. Essas intervenções, algumas de somente 15 minutos, obtiveram resultados positivos em longo prazo sobre domínios como o desempenho acadêmico e a convivência escolar. Este artigo faz uma revisão de seus objetivos, características, fundamentos teóricos, avaliações e condições necessárias para sua elaboração e implementação. Em geral, o objetivo dessas intervenções breves é transformar crenças, pensamentos ou sentimentos de um segmento particular da população estudantil, considerado em risco. Além disso, procuram quebrar círculos viciosos ao intervir em momentos específicos de processos recursivos. Finalmente, esta revisão analisa seus alcances, implicações e limitações, além de sugerir futuras pesquisas.
