Using transient elastography to detect chronic liver diseases in a primary care nurse consultancy

Background: Chronic liver diseases (CLDs) are significant causes of death in adults in many countries and are usually diagnosed at late stages. Early detection may allow time for treatment to prevent disease progression. Objectives: The aim of this study was to assess the feasibility of screening for unrecognized CLDs in a primary care nurse consultancy and report findings from screening. Methods: Two experienced nurses in a primary care nurse consultancy were trained to perform transient elastography (TE). Subjects aged from 18 to 70 years were identified randomly from the health registry and invited to participate in a feasibility pilot study. Exclusion criteria were past or current history of liver diseases. Nurses collected demographic and clinical data and performed TE tests using Fibroscan tomeasure liver stiffness; a cutoff score of 6.8 kPa or greater was used as an indicator of the presence of CLD with fibrosis. Results: Accurate measurements were obtained in 495 of 502 participants (98.6%). Prevalence of elevated liver stiffness was observed in 28 of 495 subjects (5.7%). Compared to patients with normal liver stiffness, patients with increased liver stiffness were older, were more frequently male, and had higher frequency of metabolic syndrome. Nonalcoholic fatty liver was the most common cause of CLD. Discussion: Following training in procedures for conducting TE, nurses in a primary care clinic were able to detect unrecognized CLDs in presumably healthy subjects. Early detection of CLDs is feasible in primary care clinics and may facilitate identification of undiagnosed CLD in adults.

Semantic domain and grammatical class effects in the picture-word interference paradigm

The role of grammatical class in lexical access and representation is still not well understood. Grammatical effects obtained in picture-word interference experiments have been argued to show the operation of grammatical constraints during lexicalization when syntactic integration is required by the task. Alternative views hold that the ostensibly grammatical effects actually derive from the coincidence of semantic and grammatical differences between lexical candidates. We present three picture-word interference experiments conducted in Spanish. In the first two, the semantic relatedness (related or unrelated) and the grammatical class (nouns or verbs) of the target and the distracter were manipulated in an infinitive form action naming task in order to disentangle their contributions to verb lexical access. In the third experiment, a possible confound between grammatical class and semantic domain (objects or actions) was eliminated by using action-nouns as distracters. A condition in which participants were asked to name the action pictures using an inflected form of the verb was also included to explore whether the need of syntactic integration modulated the appearance of grammatical effects. Whereas action-words (nouns or verbs), but not object-nouns, produced longer reaction times irrespective of their grammatical class in the infinitive condition, only verbs slowed latencies in the inflected form condition. Our results suggest that speech production relies on the exclusion of candidate responses that do not fulfil task-pertinent criteria like membership in the appropriate semantic domain or grammatical class. Taken together, these findings are explained by a response-exclusion account of speech output. This and alternative hypotheses are discussed.

La diversitat funcional al treball

L’accés al mercat laboral per part de les persones amb diversitat funcional no està exempt de dificultats. Encara avui persisteixen barreres que societat i empresa han de superar com són els estereotips o prejudicis cap a les persones amb capacitats diferents. Perquè les persones en risc d’exclusió social puguin augmentar les seves opcions de trobar una feina plantegem, a la primera part de l’article, un pla d’acompanyament personalitzat a la inserció laboral que permeti al candidat augmentar els seus nivells d’ocupabilitat. A la segona meitat, canviem el focus d’atenció cap a l’empresa i proposem com la presència de persones amb diversitat funcional pot generar valor dins d’una organització.

Sistema educativo e igualdad de oportunidades entre los jóvenes tutelados: estudios recientes en el Reino Unido

Educational system and equal opportunities for young people in care: Recent studies in the UK. Publications on research about formal educational itineraries of people who were cared for by the social protection public systems when they were children are scarce, and restricted to a few countries. In recent years, statistics from some European countries have been published, showing that the young people who were cared for are overrepresented in practically all the clusters of people that accumulate indicators of social disadvantage, and it has therefore been argued that they can be considered one of the groups of population with the highest risk for social exclusion. In the present review, the emergence of new data and research results in some European countries —particularly in the United Kingdom, where the fact that less than 5% of this population reaches university studies has been underlined— is tentatively contextualised. Although the extent to which current available data can be extrapolated to other contexts and countries is yet unclear, such results raise important challenges for social intervention and social policies, as well as for psychosocial research, in all countries of the European space