Executive functions profile in extreme eating/weight conditions: from anorexia nervosa to obesity.

BACKGROUND Extreme weight conditions (EWC) groups along a continuum may share some biological risk factors and intermediate neurocognitive phenotypes. A core cognitive trait in EWC appears to be executive dysfunction, with a focus on decision making, response inhibition and cognitive flexibility. Differences between individuals in these areas are likely to contribute to the differences in vulnerability to EWC. The aim of the study was to investigate whether there is a common pattern of executive dysfunction in EWC while comparing anorexia nervosa patients (AN), obese subjects (OB) and healthy eating/weight controls (HC). METHODS Thirty five AN patients, fifty two OB and one hundred thirty seven HC were compared using the Wisconsin Card Sorting Test (WCST); Stroop Color and Word Test (SCWT); and Iowa Gambling Task (IGT). All participants were female, aged between 18 and 60 years. RESULTS There was a significant difference in IGT score (F(1.79); p<.001), with AN and OB groups showing the poorest performance compared to HC. On the WCST, AN and OB made significantly more errors than controls (F(25.73); p<.001), and had significantly fewer correct responses (F(2.71); p<.001). Post hoc analysis revealed that the two clinical groups were not significantly different from each other. Finally, OB showed a significant reduced performance in the inhibition response measured with the Stroop test (F(5.11); p<.001) compared with both AN and HC. CONCLUSIONS These findings suggest that EWC subjects (namely AN and OB) have similar dysfunctional executive profile that may play a role in the development and maintenance of such disorders.

Modulation of the Endocannabinoids N-Arachidonoylethanolamine (AEA) and 2-Arachidonoylglycerol (2-AG) on Executive Functions in Humans.

Animal studies point to an implication of the endocannabinoid system on executive functions. In humans, several studies have suggested an association between acute or chronic use of exogenous cannabinoids (Δ9-tetrahydrocannabinol) and executive impairments. However, to date, no published reports establish the relationship between endocannabinoids, as biomarkers of the cannabinoid neurotransmission system, and executive functioning in humans. The aim of the present study was to explore the association between circulating levels of plasma endocannabinoids N-arachidonoylethanolamine (AEA) and 2-Arachidonoylglycerol (2-AG) and executive functions (decision making, response inhibition and cognitive flexibility) in healthy subjects. One hundred and fifty seven subjects were included and assessed with the Wisconsin Card Sorting Test; Stroop Color and Word Test; and Iowa Gambling Task. All participants were female, aged between 18 and 60 years and spoke Spanish as their first language. Results showed a negative correlation between 2-AG and cognitive flexibility performance (r = -.37; p<.05). A positive correlation was found between AEA concentrations and both cognitive flexibility (r = .59; p<.05) and decision making performance (r = .23; P<.05). There was no significant correlation between either 2-AG (r = -.17) or AEA (r = -.08) concentrations and inhibition response. These results show, in humans, a relevant modulation of the endocannabinoid system on prefrontal-dependent cognitive functioning. The present study might have significant implications for the underlying executive alterations described in some psychiatric disorders currently associated with endocannabinoids deregulation (namely drug abuse/dependence, depression, obesity and eating disorders). Understanding the neurobiology of their dysexecutive profile might certainly contribute to the development of new treatments and pharmacological approaches.

Expectations, experiences and attitudes of patients and primary care health professionals regarding online psychotherapeutic interventions for depression: protocol for a qualitative study.

BACKGROUND In the year 2020, depression will cause the second highest amount of disability worldwide. One quarter of the population will suffer from depression symptoms at some point in their lives. Mental health services in Western countries are overburdened. Therefore, cost-effective interventions that do not involve mental health services, such as online psychotherapy programs, have been proposed. These programs demonstrate satisfactory outcomes, but the completion rate for patients is low. Health professionals' attitudes towards this type of psychotherapy are more negative than the attitudes of depressed patients themselves. The aim of this study is to describe the profile of depressed patients who would benefit most from online psychotherapy and to identify expectations, experiences, and attitudes about online psychotherapy among both patients and health professionals that can facilitate or hinder its effects. METHODS A parallel qualitative design will be used in a randomised controlled trial on the efficiency of online psychotherapeutic treatment for depression. Through interviews and focus groups, the experiences of treated patients, their reasons for abandoning the program, the expectations of untreated patients, and the attitudes of health professionals will be examined. Questions will be asked about training in new technologies, opinions of online psychotherapy, adjustment to therapy within the daily routine, the virtual and anonymous relationship with the therapist, the process of online communication, information necessary to make progress in therapy, process of working with the program, motivations and attitudes about treatment, expected consequences, normalisation of this type of therapy in primary care, changes in the physician-patient relationship, and resources and risks. A thematic content analysis from the grounded theory for interviews and an analysis of the discursive positions of participants based on the sociological model for focus groups will be performed. DISCUSSION Knowledge of the expectations, experiences, and attitudes of both patients and medical personnel regarding online interventions for depression can facilitate the implementation of this new psychotherapeutic tool. This qualitative investigation will provide thorough knowledge of the perceptions, beliefs, and values of patients and clinicians, which will be very useful for understanding how to implement this intervention method for depression.

Low intensity vs. self-guided internet-delivered psychotherapy for major depression: a multicenter, controlled, randomized study.

BACKGROUND Major depression will become the second most important cause of disability in 2020. Computerized cognitive-behaviour therapy could be an efficacious and cost-effective option for its treatment. No studies on cost-effectiveness of low intensity vs self-guided psychotherapy has been carried out. The aim of this study is to assess the efficacy of low intensity vs self-guided psychotherapy for major depression in the Spanish health system. METHODS The study is made up of 3 phases: 1.- Development of a computerized cognitive-behaviour therapy for depression tailored to Spanish health system. 2.- Multicenter controlled, randomized study: A sample (N=450 patients) with mild/moderate depression recruited in primary care. They should have internet availability at home, not receive any previous psychological treatment, and not suffer from any other severe somatic or psychological disorder. They will be allocated to one of 3 treatments: a) Low intensity Internet-delivered psychotherapy + improved treatment as usual (ITAU) by GP, b) Self-guided Internet-delivered psychotherapy + ITAU or c) ITAU. Patients will be diagnosed with MINI psychiatric interview. Main outcome variable will be Beck Depression Inventory. It will be also administered EuroQol 5D (quality of life) and Client Service Receipt Inventory (consume of health and social services). Patients will be assessed at baseline, 3 and 12 months. An intention to treat and a per protocol analysis will be performed. DISCUSSION The comparisons between low intensity and self-guided are infrequent, and also a comparative economic evaluation between them and compared with usual treatment in primary. The strength of the study is that it is a multicenter, randomized, controlled trial of low intensity and self-guided Internet-delivered psychotherapy for depression in primary care, being the treatment completely integrated in primary care setting. TRIAL REGISTRATION Clinical Trials NCT01611818.

La dona a Roma (del segle IV aC al segle III dC)

Estudi interdisciplinari de la dona romana entre els segles IV aC i III dC. El treball s'ha basat en estudis monogràfics, justificats i comprovats mitjançant la lectura i l'examen de fonts de l'època.

Moderate-Vigorous Physical Activity across Body Mass Index in Females: Moderating Effect of Endocannabinoids and Temperament.

BACKGROUND Endocannabinoids and temperament traits have been linked to both physical activity and body mass index (BMI) however no study has explored how these factors interact in females. The aims of this cross-sectional study were to 1) examine differences among distinct BMI groups on daytime physical activity and time spent in moderate-vigorous physical activity (MVPA), temperament traits and plasma endocannabinoid concentrations; and 2) explore the association and interaction between MVPA, temperament, endocannabinoids and BMI. METHODS Physical activity was measured with the wrist-worn accelerometer Actiwatch AW7, in a sample of 189 female participants (43 morbid obese, 30 obese, and 116 healthy-weight controls). The Temperament and Character Inventory-Revised questionnaire was used to assess personality traits. BMI was calculated by bioelectrical impedance analysis via the TANITA digital scale. Blood analyses were conducted to measure levels of endocannabinoids and endocannabinoid-related compounds. Path-analysis was performed to examine the association between predictive variables and MVPA. RESULTS Obese groups showed lower MVPA and dysfunctional temperament traits compared to healthy-weight controls. Plasma concentrations of 2-arachidonoylglyceryl (2-AG) were greater in obese groups. Path-analysis identified a direct effect between greater MVPA and low BMI (b = -0.13, p = .039) and high MVPA levels were associated with elevated anandamide (AEA) levels (b = 0.16, p = .049) and N-oleylethanolamide (OEA) levels (b = 0.22, p = .004), as well as high Novelty seeking (b = 0.18, p<.001) and low Harm avoidance (b = -0.16, p<.001). CONCLUSIONS Obese individuals showed a distinct temperament profile and circulating endocannabinoids compared to controls. Temperament and endocannabinoids may act as moderators of the low MVPA in obesity.

Association of irisin with fat mass, resting energy expenditure, and daily activity in conditions of extreme body mass index.

FNDC5/irisin has been recently postulated as beneficial in the treatment of obesity and diabetes because it is induced in muscle by exercise, increasing energy expenditure. However, recent reports have shown that WAT also secretes irisin and that circulating irisin is elevated in obese subjects. The aim of this study was to evaluate irisin levels in conditions of extreme BMI and its correlation with basal metabolism and daily activity. The study involved 145 female patients, including 96 with extreme BMIs (30 anorexic (AN) and 66 obese (OB)) and 49 healthy normal weight (NW). The plasma irisin levels were significantly elevated in the OB patients compared with the AN and NW patients. Irisin also correlated positively with body weight, BMI, and fat mass. The OB patients exhibited the highest REE and higher daily physical activity compared with the AN patients but lower activity compared with the NW patients. The irisin levels were inversely correlated with daily physical activity and directly correlated with REE. Fat mass contributed to most of the variability of the irisin plasma levels independently of the other studied parameters. Conclusion. Irisin levels are influenced by energy expenditure independently of daily physical activity but fat mass is the main contributing factor.

Modulation of Higher-Order Olfaction Components on Executive Functions in Humans.

The prefrontal (PFC) and orbitofrontal cortex (OFC) appear to be associated with both executive functions and olfaction. However, there is little data relating olfactory processing and executive functions in humans. The present study aimed at exploring the role of olfaction on executive functioning, making a distinction between primary and more cognitive aspects of olfaction. Three executive tasks of similar difficulty were used. One was used to assess hot executive functions (Iowa Gambling Task-IGT), and two as a measure of cold executive functioning (Stroop Colour and Word Test-SCWT and Wisconsin Card Sorting Test-WCST). Sixty two healthy participants were included: 31 with normosmia and 31 with hyposmia. Olfactory abilities were assessed using the ''Sniffin' Sticks'' test and the olfactory threshold, odour discrimination and odour identification measures were obtained. All participants were female, aged between 18 and 60. Results showed that participants with hyposmia displayed worse performance in decision making (IGT; Cohen's-d = 0.91) and cognitive flexibility (WCST; Cohen's-d between 0.54 and 0.68) compared to those with normosmia. Multiple regression adjusted by the covariates participants' age and education level showed a positive association between odour identification and the cognitive inhibition response (SCWT-interference; Beta = 0.29; p = .034). The odour discrimination capacity was not a predictor of the cognitive executive performance. Our results suggest that both hot and cold executive functions seem to be associated with higher-order olfactory functioning in humans. These results robustly support the hypothesis that olfaction and executive measures have a common neural substrate in PFC and OFC, and suggest that olfaction might be a reliable cognitive marker in psychiatric and neurologic disorders.

Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome.

The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of pre-post changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome.

Diagnòstic en profunditat sobre la integració dels i les joves de 14 i 18 anys migrats a Catalunya

La finalitat d'aquest projecte és aprofundir en el procés d'integració socioeducativa de la joventut migrada a Catalunya, específicament, dels i les joves entre 14 i 18 anys. Entre els resultats destaquem que els ioves tenen un concepte força tancat i excloent del concepte de ciutadania com a estatus , i un baix grau, de coneixement de la diversitat cultural, especialment els joves autòctons, tot i que tenen una actitud de reconeixement i acceptació, favorable a la convivència intercultural, tant al centre educatiu com al seu barri. No obstant, tenen una visió de la diversitat cultural i del fet migratori en clau de coexistència, sense el reconeixement que suposaria un pas més cap a la convivència. La immigració és vista com un col•lectiu vulnerable, amb un baix nivell econòmic i cultural i que també és percebut com un problema i, fins i tot, com a causant de les dificultutats que actualment pateix i travessa el conjunt de la societat. Els joves tendeixen a relacionar-se amb el seu grup cultural, i responen de forma passiva en la comprensió i actuació davant dels problemes i assumptes públics. Entre els elements que valoren per sentir-se ciutadà té una especial importància la llengua. Eis joves que fa més de 10 anys que viuen a Catalunya són els que tendeixen a tenir un sentiment de pertinença cívica amb el lloc de residència. De fet, com mes temps porten els joves estrangers vivint al lloc d’acollida, perden importància elements d’identificació cultural del país d’origen, però la religió, les celebracions populars, l’art i la tendència a formar parella són elements identitaris del lloc d’origen, més estables. Es demana una intervenció urgent en diversos nivells i destinades a diferents agents. Destaquem: la importància d’una acollida afectiva i efectiva; potenciar espais de trobada; treballar els prejudicis; transversalitzar l’educació intercultural; potenciació de l’aprenentatge de la llengua catalana; formació del professorat en competències interculturals.

Projecte d’intervenció Compartim i participem per créixer junts.

El projecte d’intervenció objecte d’aquest treball es desenvoluparà al municipi de Palau-solità i Plegamans, concretament amb el col•lectiu d’infants de 3 a 6 anys i els seus pares i mares. L’Ajuntament del municipi va fer l’encàrrec per a que es desenvolupés aquest projecte. Una de les temàtiques que aquesta administració vol incloure arreld’aquesta intervenció és la participació infantil, que serà la prioritat principal del projecte. Tot i això, s’inclouran altres temàtiques després de conèixer i analitzar lesopinions i demandes dels pares i mares d’infants de 3 a 6 anys a través d’una enquesta, creada específicament per aquesta intervenció, i les característiques i necessitats del desenvolupament vital d’aquests infants. La intervenció que es realitzarà amb aquest col•lectiu es dividirà en dos grups: per una banda, els infants i, per l’altra, els pares i mares d’aquests. Les temàtiques es dividiran en vuit sessions, en les que gran part d’aquestes es treballaran amb cada grup per separat però a gairebé totes les sessions es destinarà la part final a unir els dos grups per treballar de manera conjunta.

Diagnòstic en profunditat sobre la integració dels i les joves de 14 a 18 anys migrats a Catalunya

La present recerca s’emmarca doncs, a l’eix 3 definit pel Pacte Nacional per a la Immigració (PNI), sobre la integració de la nova població catalana i de la societat d’acollida en una cultura pública comuna, mantenint la cohesió social. Entenem la integració com un procés dinàmic d’apropament i empatia recíprocs entre la persona migrada i la societat d’acollida, fet que suposa el reconeixement dels valors de cada grup en la seva diferència i en la seva igualtat per tal d’ enriquir al conjunt social. Apostem per la integració des d’un enfocament intercultural de diàleg i intercanvi, on el reconeixement de la condició de ciutadania, és indispensable i, ha de permetre tenir presents totes les dimensions de la integració: estructural, cognitiva i cultural, social i de la identitat (Martínez, 2006). Aquest repte es tradueix en la construcció de la ciutadania des de la diversitat ètnica i cultural avançant així cap a una autèntica interculturalitat. Es parteix d’un concepte d’integració bidireccional, dinàmic i continu, entre els joves migrats i la resta, coincideix totalment amb el que reconeix el PNI. La finalitat d’aquesta recerca és identificar els elements clau de l’estat actual de la integració dels joves migrats a Catalunya, per això cal definir tant els elements constitutius com els entramats del procés de la integració d’aquesta joventut al context català. La metodologia serà un estudi per enquesta, amb una mostra de 3000 joves de Catalunya. L’estudi descriptiu es complementarà amb grups de discussió de joves i entrevistes a agents socials i educatius implicats en l’acompanyament a aquests joves. Plantegem, per tant, un estudi descriptiu-comprensiu, que combina el treball sobre dades quantitatives i dades qualitatives en funció de l’objecte a valorar, sota una lògica de complementarietat (Bericat, 1998). En l’estudi per enquesta, s’aplicarà el “Qüestionari de cohesió social entre joves” elaborat per Palou (2009). Per l’aproximació qualitativa, es faran grups de discussió amb joves per analitzar en profunditat la seva realitat; i finalment, es faran entrevistes en profunditat a agents socials i educatius. El rigor metodològic permetrà que aquesta anàlisi en profunditat tingui per fruit línies clares per a elaborar propostes afavoridores per la convivència i la cohesió social.La integració a una cultura pública comuna (objectiu clau del PNI i el Pla de ciutadania i immigració 2009-2012) passa per l'Administració més propera a les persones (en aquest cas, els joves migrats i migrades del municipi), a través de les polítiques de ciutadania per a la joventut. Els resultats del present projecte pretenen orientar propostes d’actuació en aquest nivell, bé sigui en clau d’acollida i coneixement de la llengua i l’entorn com d’integració al teixit social i associatiu del barri o municipi.Més enllà de la política pública local, l’aplicabilitat del projecte que es presenta també troba un altre encaix en les polítiques educatives de Catalunya i, més concretament, en el Pla per a la llengua i la cohesió social. Educació i convivència intercultural (Departament d’Educació, 2007), Dins de les seves línies estratègiques, aquest Pla contempla el reforç de la xarxa estable de l’entorn escolar amb la col•laboració dels diferents serveis i recursos municipals (entitats d'àmbit social, cultural o esportiu), a través d’iniciatives com els Plans Educatius d’Entorn (PEE).

Qüestionari de percepció de recolzament social. Context comunitari, educatiu i familiar

Projecte de recerca (EDU2011-25960) Ministerio de Ciencia e Innovación.

Antibiotics shaping bacterial genome: deletion of an IS91 flanked virulence determinant upon exposure to suinhibitory antibiotic concentrations

The nucleoid-associated proteins Hha and YdgT repress the expression of the toxin α-hemolysin. An Escherichia coli mutant lacking these proteins overexpresses the toxin α-hemolysin encoded in the multicopy recombinant plasmid pANN202-312R. Unexpectedly, we could observe that this mutant generated clones that no further produced hemolysin (Hly-). Generation of Hly- clones was dependent upon the presence in the culture medium of the antibiotic kanamycin (km), a marker of the hha allele (hha::Tn5). Detailed analysis of different Hly- clones evidenced that recombination between partial IS91 sequences that flank the hly operon had occurred. A fluctuation test evidenced that the presence of km in the culture medium was underlying the generation of these clones. A decrease of the km concentration from 25 mg/l to 12.5 mg/l abolished the appearance of Hly- derivatives. We considered as a working hypothesis that, when producing high levels of the toxin (combination of the hha ydgT mutations with the presence of the multicopy hemolytic plasmid pANN202-312R), the concentration of km of 25 mg/l resulted subinhibitory and stimulated the recombination between adjacent IS91 flanking sequences. To further test this hypothesis, we analyzed the effect of subinhibitory km concentrations in the wild type E. coli strain MG1655 harboring the parental low copy number plasmid pHly152. At a km concentration of 5 mg/l, subinhibitory for strain MG1655 (pHly152), generation of Hly- clones could be readily detected. Similar results were also obtained when, instead of km, ampicillin was used. IS91 is flanking several virulence determinants in different enteric bacterial pathogenic strains from E. coli and Shigella. The results presented here evidence that stress generated by exposure to subinhibitory antibiotic concentrations may result in rearrangements of the bacterial genome. Whereas some of these rearrangements may be deleterious, others may generate genotypes with increased virulence, which may resume infection.

Contribucion al conocimiento de la flora del Sistema Iberico Septentrional

Se aporta un catálogo florístico de 313 táxones seleccionados procedentes de algunas de las sierras septentrionales del Sistema Ibérico aragonés: Sierras de Villarroya, Vicort, Cucalón y Retuerta, Monte de Herrera, la Modorra de Bádenas y Baños de Segura. La visita a algunas de las localidades clásicas de ASSO, ha permitido confirmar numerosas citas de las que aparecen en su Synopsis stirpium indigenarum Aragoniae (1779), así como establecer algunas sinonimias. En el aspecto nomenclatural se propone una nueva combinación: Androsace elongata L. subsp. breistrofferi (Charpin & Greuter) J . Molero & JM. Montserrat, comb. nova. En el aspecto corológico, una lista, que no pretende ser exahustiva, sobre novedades para la Flora aragonesa y otras especies escasamente citadas que incluye: Paronychia rouyana, Suene scabriflora, Sisymbrium macroloma, Hutera hispida, Saxifraga losae var. camarae, Rosa arvensis, Aphanes cornucopioides, Lathyrus cirrhosus, Trifolium retusum, Trifolium gemellum, Seseli cantabricum, Daucus durieua, Anthemis alpestris fma. ligulata , Hieracium castellanum, Festuca capillifolia , Avenula pubescens, Carex tomentosa, etc.