INTRODUCCIÓN. El modelo de sexualidad integral, que abarca
aspectos biológicos, sociales, psicológicos y culturales, define un
modelo de educación sexual que propone una formación graduada, a lo
...largo de toda la vida, abordada desde diferentes servicios. La
escuela, caracterizada por ser uno de los espacios primarios de
socialización, es clave para el desarrollo de capacidades
relacionadas con la sexualidad y la afectividad. MÉTODO. Se propuso
un estudio exploratorio que permitiera analizar cómo es percibida la
implementación la educación sexual en tres escuelas públicas de la
ciudad de Barcelona. Para llevar a cabo la recogida de datos se
realizaron entrevistas a estudiantes y docentes de 3.º y 4.º curso
de Educación Secundaria Obligatoria de los tres centros estudiados.
RESULTADOS. Los resultados se recogieron en cuatro bloques, según la
información obtenida: a) conceptualización de la Educación Sexual y
Afectiva, b) acciones en la escuela, c) necesidades de los
estudiantes y d) propuestas de mejora. DISCUSIÓN. Finalmente se
contrastaron los resultados obtenidos con estudios que trabajan
sobre la necesidad de una educación sexual integral y transversal
que garantice el ejercicio de la juventud.
Objective
To understand how the COVID‐19 pandemic has impacted sexual and reproductive health (SRH) visits.
Design
An ecological study comparing SRH services volume in different countries before and ...after the onset of the COVID‐19 pandemic.
Setting
Seven countries from the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID) across four continents.
Population
Over 3.8 million SRH visits to primary care physicians in Australia, China, Canada, Norway, Singapore, Sweden and the USA.
Methods
Difference in average SRH monthly visits before and during the pandemic, with negative binomial regression modelling to compare predicted and observed number of visits during the pandemic for SRH visits.
Main outcome measures
Monthly number of visits to primary care physicians from 2018 to 2021.
Results
During the pandemic, the average volume of monthly SRH visits increased in Canada (15.6%, 99% CI 8.1–23.0%) where virtual care was pronounced. China, Singapore, Sweden and the USA experienced a decline (−56.5%, 99% CI −74.5 to −38.5%; −22.7%, 99% CI −38.8 to −6.5%; −19.4%, 99% CI −28.3 to −10.6%; and −22.7%, 99% CI −38.8 to −6.5%, respectively); while Australia and Norway showed insignificant changes (6.5%, 99% CI −0.7 to –13.8% and 1.7%, 99% CI −6.4 to –9.8%). The countries that maintained (Australia, Norway) or surpassed (Canada) pre‐pandemic visit rates had the greatest use of virtual care.
Conclusions
In‐person SRH visits to primary care decreased during the pandemic. Virtual care seemed to counterbalance that decline. Although cervical cancer screening appeared insensitive to virtual care, strategies such as incorporating self‐collected samples for HPV testing may provide a solution in a future pandemic.
The majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data ...Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses.ObjectivesThe majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses.Definitions for respiratory illness types were agreed on collectively. Monthly visit counts with diagnosis were shared centrally for analysis.DesignDefinitions for respiratory illness types were agreed on collectively. Monthly visit counts with diagnosis were shared centrally for analysis.Primary care settings in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden and the United States.SettingPrimary care settings in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden and the United States.Over 38 million patients seen in primary care settings in INTRePID countries before and during the pandemic, from January 1st, 2018, to December 31st, 2021.ParticipantsOver 38 million patients seen in primary care settings in INTRePID countries before and during the pandemic, from January 1st, 2018, to December 31st, 2021.Relative change in the monthly mean number of visits before and after the onset of the pandemic for acute infectious respiratory disease visits including influenza, upper and lower respiratory tract infections and chronic respiratory disease visits including asthma, chronic obstructive pulmonary disease, respiratory allergies, and other respiratory diseases.Main outcome measuresRelative change in the monthly mean number of visits before and after the onset of the pandemic for acute infectious respiratory disease visits including influenza, upper and lower respiratory tract infections and chronic respiratory disease visits including asthma, chronic obstructive pulmonary disease, respiratory allergies, and other respiratory diseases.INTRePID countries reported a marked decrease in the average monthly visits for respiratory illness. Changes in visits varied from -10.9% 95% confidence interval (CI): -33.1 to +11.3% in Norway to -79.9% (95% CI: -86.4% to -73.4%) in China for acute infectious respiratory disease visits and - 2.1% (95% CI: -12.1 to +7.8%) in Peru to -59.9% (95% CI: -68.6% to -51.3%) in China for chronic respiratory illness visits. While seasonal variation in allergic respiratory illness continued during the pandemic, there was essentially no spike in influenza illness during the first 2 years of the pandemic.ResultsINTRePID countries reported a marked decrease in the average monthly visits for respiratory illness. Changes in visits varied from -10.9% 95% confidence interval (CI): -33.1 to +11.3% in Norway to -79.9% (95% CI: -86.4% to -73.4%) in China for acute infectious respiratory disease visits and - 2.1% (95% CI: -12.1 to +7.8%) in Peru to -59.9% (95% CI: -68.6% to -51.3%) in China for chronic respiratory illness visits. While seasonal variation in allergic respiratory illness continued during the pandemic, there was essentially no spike in influenza illness during the first 2 years of the pandemic.The COVID-19 pandemic had a major impact on primary care visits for respiratory presentations. Primary care continued to provide services for respiratory illness, although there was a decrease in infectious illness during the COVID pandemic. Understanding the role of primary care may provide valuable information for COVID-19 recovery efforts and planning for future global emergencies.ConclusionThe COVID-19 pandemic had a major impact on primary care visits for respiratory presentations. Primary care continued to provide services for respiratory illness, although there was a decrease in infectious illness during the COVID pandemic. Understanding the role of primary care may provide valuable information for COVID-19 recovery efforts and planning for future global emergencies.
This study aims to assess the efficacy of a psychoeducational family intervention (PFI) to reduce the severity of depressive symptoms and to improve psychosocial functioning and to increase social ...contacts in a sample of patients with major depressive disorder (MDD). The degree to which PFI will reduce patients’ relapses, hospitalizations, and self-stigmatization and will improve their quality of life will also be assessed. Other secondary outcomes include the improvement of relatives’ coping strategies, family burden, expressed emotions and quality of life. This non-profit, unfunded, national, multicentric randomized controlled trial with blinded outcome assessments will be carried out in 24 Italian university outpatient units. Families will be assessed at baseline and at 6, 12, and 24 months post-randomization. Our working hypothesis is that the PFIs will reduce the patients’ severity of depressive symptoms, their relapses, and their hospitalizations, and that they will improve their psychosocial functioning and quality of life. We expect these results to be maintained after 12 and 24 months, albeit with a reduction in magnitude. The sample will consist of 384 patients randomized at a 1:1 ratio and stratified according to center, age, gender, and educational level.
During the COVID-19 pandemic, telemedicine plays a critical role in providing safe, effective healthcare services, while reinforcing social distancing and optimizing the use of personal protective ...equipment. In this context, the Oklahoma Children's Hospital implemented virtual neonatology prenatal visits for pregnant women with a diagnosis of fetal anomalies. While tele-consultations have been broadly used with a high degree of acceptance in rural and remote areas, satisfaction has not been assessed in this particular scenario, where patients and physicians discussing sensitive healthcare information had to rapidly adjust to this new modality.
To evaluate patients' and neonatologists' satisfaction with virtual prenatal consultations in the context of the COVID-19 pandemic and to compare satisfaction levels of patients receiving virtual consultation with those receiving in-person consults.
This cross-sectional study evaluated patients' and neonatologists' satisfaction with virtual consultations. Participants included pregnant women with diagnosis of fetal anomalies who received neonatology prenatal consultations at Oklahoma Children's Hospital, either in-person or through telemedicine, from May to mid-November 2020, and neonatologists providing virtual prenatal consultations in the same period. Virtual visits were delivered via Zoom Pro™. Patients and physicians who agreed to participate rated acceptability completing an anonymous 5-point Likert scale survey. Item frequencies and means for categories of items were computed by group (video-consult patients, in-person patients, physicians) and analyzed, using Welch's
for unequal sample size.
Overall consultation quality was rated good or excellent by 35 (100%) video-consult patients and 12 (100%) in-person patients. Patient group means computed on six 5-point Likert items about patient-physician communication did not differ significantly, video-consult:
= 28.71 (2.22); in-person consult:
= 28.92 (1.78) (
= 0.753263). All eight physicians (100%) agreed or strongly agreed that telemedicine was effective, using a 5-point Likert scale, and their combined consultation quality score computed on 10 survey questions was high:
= 46.4 (3.11).
Despite patient inexperience with tele-consultations, the quick implementation of telemedicine, and the sensitive reason for the visit, patients and physicians were highly satisfied with virtual visits. Telemedicine is a safe, effective alternative for providing neonatology prenatal consultations for pregnant women with diagnosis of fetal anomalies during the pandemic.
El presente artículo presenta los resultados de una investigación evaluativa participativa en el marco del proyecto AVENIR, cuyo propósito fue la elaboración de un enfoque global e inclusivo entre ...Francia y Cataluña destinado a mejorar el acceso al empleo y la integración de los/as jóvenes menores migrantes no acompañados. El análisis, centrado en Cataluña, elucida las potencialidades de la evaluación participativa, como herramienta de cambio y emancipación. Esta posición metodológica entrelaza la investigación evaluativa con la orientación y el acompañamiento de los agentes implicados, considerando sus inquietudes y posicionamientos. Se concluye mostrando la pertinencia de mantener un diálogo permanente con los agentes que permita no solo fomentar su implicación en el proyecto, sino reorientar el proceso hacia su fin último: la integración de los jóvenes en el territorio.
Introduction
Many patients fail to respond to multiple antidepressant interventions, being defined as “treatment-resistant depression” (TRD) patients. TRD is usually associated with increased ...severity and chronicity of symptoms, increased risk of comorbidity, and higher suicide rates, which make the clinical management challenging. Efforts to distinguish between TRD patients and those who will respond to treatment have been unfruitful so far. Several studies have tried to identify the biological, psychopathological, and psychosocial correlates of depression, with particular attention to the inflammatory system. In this paper we aim to review available studies assessing the full range of biomarkers in TRD patients in order to reshape TRD definition and improve its diagnosis, treatment, and prognosis.
Methods
We searched the most relevant medical databases and included studies reporting original data on possible biomarkers of TRD. The keywords “treatment resistant depression” or “TRD” matched with “biomarker,” “inflammation,” “hormone,” “cytokine” or “biological marker” were entered in PubMed, ISI Web of Knowledge and SCOPUS databases. Articles were included if they included a comparison with healthy controls (HC).
Results
Of the 1878 papers identified, 35 were included in the present study. Higher plasma levels of IL-6 and TNF-α were detected in TRD patients compared to HC. While only a few studies on cortisol have been found, four papers showed elevated levels of C-reactive protein among these patients and four articles focused on immunological cells. Altered kynurenine metabolism in TRD patients was reported in two studies, while contrasting results were found with regard to BDNF.
Conclusion
Only a few biological alterations correlate with TRD. TNF-α seems to be the most relevant biomarker to discriminate TRD patients from both HC and treatment-responsive MDD patients. Moreover, several discrepancies among studies have been found, due to methodological differences and the lack of a standardized diagnostic definition of TRD.
Brain-derived neurotrophic factor (BDNF) plays a key role in brain development, contributing to neuronal survival and neuroplasticity. Previous works have found that BDNF is involved in several ...neurological or psychiatric diseases. In this review, we aimed to collect all available data on BDNF and bipolar disorder (BD) and assess if BDNF could be considered a biomarker for BD. We searched the most relevant medical databases and included studies reporting original data on BDNF circulating levels or Val66Met polymorphism. Only articles including a direct comparison with healthy controls (HC) and patients diagnosed with BD according to international classification systems were included. Of the 2430 identified articles, 29 were included in the present review. Results of the present review show a reduction in BDNF circulating levels during acute phases of BD compared to HC, which increase after effective therapy of the disorders. The Val66Met polymorphism was related to features usually associated with worse outcomes. High heterogeneity has been observed regarding sample size, clinical differences of included patients, and data analysis approaches, reducing comparisons among studies. Although more studies are needed, BDNF seems to be a promising biomarker for BD.
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