Efficacy of an eradication schema in case of Pseudomonas aeruginosa primo-infection in children with cystic fibrosis

Introduction: Patients with Cystic fibrosis (CF) are more susceptible to pathogens like P. aeruginosa (PA). PA primo-infection requires particular attention as failure in eradication is associated with accelerated lung deterioration. The main aim of this study is to assess the rate of PA eradication according to our particular protocol with inhaled tobramycin and oral ciprofloxacin, as there is no consensus in the literature on what eradication protocol is optimal. Methods: Retrospective single centre study with data analysis from June 1st 2007 to June 1st 2011 of patients with PA primo-infection exclusively treated by 3 x 28 days of inhaled tobramycin and oral ciprofloxacin for the first and last 21 days. Success in eradication is defined by ≥ 3 negative bacteriologies for 6 months after the beginning of the protocol. If ≥ 1 bacteriology is positive, we consider the eradication as a failure. Results: Out of 41 patients, 18 followed the eradication protocol and were included in our analysis (7 girls (38.9%) and 11 boys (61.1%)). Boys had 12 primo-infections and girls had 8. Among these 20 primo-infections, 16 (80%) had an overall success in eradication and 4 (20%) a failure. There was no significant statistical differences in age between these groups (t-test = 0.07, p = 0.94), nor for FEV1% (t-test = 0.96, p = 0.41) or BMI (t-test = 1.35, p = 0.27). Rate of success was 100% for girls and 66.6% for boys. Conclusion: Our protocol succeeded in an overall eradication rate of 80%, without statistical significant impact on FEV1 % and BMI values. However, there was a sex difference with eradication rates in girls (100%) and boys (66.6%). A sex difference has not yet been reported in the literature. This should be evaluated in further studies.

Predictors of trabecular bone score in school children.

UNLABELLED: Trabecular bone score (TBS) is a DXA-based tool that assesses bone texture and reflects microarchitecture. It has been shown to independently predict the risk of osteoporotic fracture in the elderly. In this study, we investigated the determinants of TBS in adolescents. INTRODUCTION: TBS is a gray-level textural measurement derived from lumbar spine DXA images. It appears to be an index of bone microarchitecture that provides skeletal information additional to the standard BMD measurement and clinical risk factors. Our objectives were to characterize the relationship between TBS and both age and pubertal stages and identify other predictors in adolescents. METHODS: We assessed TBS by reanalyzing spine DXA scan images obtained from 170 boys and 168 girls, age range 10-17 years, gathered at study entry and at 1 year, using TBS software. The results are from post hoc analyses obtained using data gathered from a prospective randomized vitamin D trial. Predictors of TBS were assessed using t test or Pearson's correlation and adjusted using regression analyses, as applicable. RESULTS: The mean age of the study population was 13.2 ± 2.1 years, similar between boys and girls. Age, height, weight, sun exposure, spine BMC and BMD, body BMC and BMD, and lean and fat mass are all significantly correlated with TBS at baseline (r = 0.20-0.75, p < 0.035). Correlations mostly noted in late-pubertal stages. However, after adjustment for BMC, age remained an independent predictor only in girls. CONCLUSIONS: In univariate exploratory analyses, age and pubertal stages were determinants of TBS in adolescents. Studies to investigate predictors of TBS and to investigate its value as a prognostic tool of bone fragility in the pediatric population are needed.

Differences between genders in coping: different strategies or different stressors?

These study analysed gender specificity in coping behaviours by taking into account the types of problem faced by Spanish adolescents attending school. It was focused on the ten problems most frequently reported by participants (828 adolescents, 355 boys, and 473 girls; Mage = 14.07, SD = 1.34), which were classified using a multi-axial classification system. Coping was examined as a two separate measures of approach and avoidance coping, and as a combined measure indicating the predominant use of coping, and total coping effort. A MANCOVA and subsequent univariate tests were conducted to analyse the specificity of coping according to problem and gender, controlled by age. The results showed that the percentage of types of problems reported by adolescents differed according to gender. The influence of gender on coping was scarcely relevant when the type of problem was controlled for. There were no gender differences when the predominant type of coping was considered, but when a total coping effort measure was analysed girls showed more coping efforts than boys to face interpersonal relationship problems and personal illness. Keywords: adolescence, coping, gender differences, stressors.

Stress, coping and personal strengths and difficulties in internationally adopted children in spain

This study analyses the types of coping strategies used by internationally adopted children, and explores the relation between these strategies and personal strengths and difficulties. The Kidcope checklist (Spirito, Stark, & Williams, 1998) and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) were administered to a sample of 35 Spanish adoptees (25.7% boys and 74.3% girls, aged 8-12 years) and their parents. Self-reported problems were categorised and their relation with coping strategies and psychological adjustment was explored. Results indicated that adopted children report problems of interpersonal nature. The content of the problems mainly refers to relationships and health, illness, or accidents. Parents reported that children were generally well-adjusted and they had no problems outside the normal range. International adoptees used mainly control-oriented coping strategies. Escape-oriented coping was linked to parents' ratings of total difficulties, with self-criticism accounting for the highest percentage of the variance.

Trencant espais fixes: programa de prevenció contra l'homo / trans fòbia a l'escola

“Trencant espais fixes: Programa de prevenció contra l’(homo/trans)fòbia a l’escola” és un programa finançat per l’Ajuntament de Barcelona que pren per objectiu prevenir i suprimir l’opressió que reben gais, lesbianes, transsexuals i bisexuals (LGTB) dins del centre educatiu, així com també d’aquells nens i nenes que transgredeixin les normes socials hegemòniques de gènere (establertes dins d’un sistema catalogat com a sexista, patriarcal i heteronormatiu), a través de la formació i apoderament dels docents dels centres educatius públics i concertats dels diferents districtes de Barcelona –fent ús de la prevenció primària, secundària i terciària-. Es pretén fer incís a l’educació de la diversitat afectivo-sexual, a les manifestacions sexistes, al sistema sexe-gènere-desig, als estereotips i prejudicis establerts en la societat i a les diverses dinàmiques de violència, desigualtat i relacions de poder, a fi de sensibilitzar, conscienciar i proporcionar eines als docents per prevenir i poder fer front a les diferents manifestacions discriminatòries a raó d’orientació sexual o identitat de gènere. S’utilitza una metodologia dinàmica i participativa, estructurada en tres sessions de 2,5h en cadascun dels centres educatius inscrits en el programa (a demanda del centre), el qual pren com a principis rectors la perspectiva integral del gènere, la intervenció preventiva, la transversalitat educativa, el procés participatiu i, finalment, l’interseccionalitat de factors identitaris d’una persona. Es pren consideració al Codi Ètic i Deontològic de la professió de Treball Social, ja que el present programa es caracteritza pel seu caràcter sensible i influent en la vida de les persones. Aquets fet suposa certes limitacions pels dinamitzadors dels tallers/sessions, ja sigui per la pròpia sensibilitat o per la manca de participació o de cohesió del grup destinatari.

La música com a eina d’inclusió i cohesió de grup en els entorns escolars

La música com a eina d’inclusió i cohesió de grup de tots els alumnes d’una mateixa aula constitueix el títol del meu Treball Final de Grau. Amb aquesta recerca he volgut conèixer la importància de la música per l’educació i els beneficis que aporta als nens i nenes d’Educació Infantil. També he aprofundit en la inclusió escolar, ja que la música per si mateixa pot reduir barreres pel que fa a la participació i a l’aprenentatge de tots els alumnes. A partir de tota la recerca bibliogràfica, he realitzat entrevistes a diferents professionals de l’educació per tal de valorar la visió que hi ha avui en dia sobre el tractament de la música a les escoles. Així mateix, s’ha portat a terme una intervenció educativa basada amb pràctiques musicals per tal de corroborar si la música contribueix favorablement a la inclusió i cohesió de grup. Finalment, s’han relacionat conceptes i s’han extret conclusions sobre el paper de la música en relació a la inclusió educativa.

A comparison of injuries among children and adult football (soccer) players

Football is a universal and an affordable game but we need to minimize the incidence of accidents among the increasing number of young football players. Our 11 year retrospective epidemiological study (1990-2000) of football injuries in children (N= 1000) was compared with those of adult players in the 2006 European Championship. This comparative study confirmed that the anatomical, biomechanical and biological conditions differ between adults and children and that they warrant particular attention to protect the latter vulnerable group against bone avulsions, overuse pathologies and fatigue-fractures. Injuries were shown to increase significantly with age up to 16 years (P=0.005). Children suffer mainly from contusions, fractures and sprain injuries. Head injuries were more common in boys (P=0.070), while girls were more prone to sprains. The types of injuries differ between adults and children (sprain versus fractures), the anatomical location of injuries is different (lower limbs in adults, lower and upper limbs in children), the circumstances of the injuries are different (contact in adults versus non-contact in children), and teenage girls have different types of injuries than teenage boys. An increased incidence of injuries is due to changes in the position of the center of gravity and in the morphotype during rapid growth. For these reasons it is mandatory to adapt the training to the age and sex of the players. It is unsafe to train children the same way as adults. The height, the weight and the speed of growth must be taken into account by the multidisciplinary team when organising the training programmes. -- Le football fait partie des sports les plus pratiqués au monde en raison de sa popularité et de son accessibilité économ ique. L'incidence des blessures liées à cette pratique doit être diminuée surtout chez les jeunes joueurs en raison de la croissance exponentielle du nombre de joueurs féminins et masculins. Une étude épidémiologique rétrospective sur 11 ans (1990-2000) a été réalisée chez les enfants victimes de blessures liées au football (N==1000), puis a été comparée aux données recueillies de l'UEFA lors d'un Championnat Européen en 2006 sur les lésions des joueurs adultes. Cette étude comparative confirme que les structures anatomiques, biologiques et les tensions biomécaniques chez l'enfant diffèrent de celles de l'adulte. Les enfants ont un risque plus élevé de souffrir d'avulsion osseuse et de fractures de fatigue que les adultes. Les blessures augmentent significativement avec l'âge jusqu'à 16 ans (P==0,005). Les traumatismes crâniens sont plus fréquents chez les garçons tandis que les entorses sont plus à risque chez les filles. Les adultes font plus souvent des entorses tandis que les enfants font plus de fractures. La localisation anatomique diffère également entre ces deux groupes (les membres inférieurs chez l'adulte et les membres inférieurs et supérieurs chez l'enfant). La circonstance des blessures diffère également (choc avec un autre joueur chez l'adulte et des blessures sans contact chez l'enfant). Chez les adolescents, les blessures des filles diffèrent de celles des garçons. L'augmentation chez les enfants de cette incidence est liée au déplacement lors de la croissance du centre de gravité, avec une maladresse accrue lors des phases de croissance. Pour toutes ces raisons, il est justifié d'adapter les entraînements de football en fonction de l'âge, du sexe et du morphotype. L'entrainement des enfants doit être différent de celui des adultes. Le poids, la taille et la vitesse de croissance doit être prise en compte dans des structures multidisciplinaires afin de permettre une meilleure longévité sportive des jeunes joueurs de football.

Accuracy of computer-aided ultrasound as compared with magnetic resonance imaging in the evaluation of nonalcoholic fatty liver disease in obese and eutrophic adolescents

AbstractObjective:To compare the accuracy of computer-aided ultrasound (US) and magnetic resonance imaging (MRI) by means of hepatorenal gradient analysis in the evaluation of nonalcoholic fatty liver disease (NAFLD) in adolescents.Materials and Methods:This prospective, cross-sectional study evaluated 50 adolescents (aged 11–17 years), including 24 obese and 26 eutrophic individuals. All adolescents underwent computer-aided US, MRI, laboratory tests, and anthropometric evaluation. Sensitivity, specificity, positive and negative predictive values and accuracy were evaluated for both imaging methods, with subsequent generation of the receiver operating characteristic (ROC) curve and calculation of the area under the ROC curve to determine the most appropriate cutoff point for the hepatorenal gradient in order to predict the degree of steatosis, utilizing MRI results as the gold-standard.Results:The obese group included 29.2% girls and 70.8% boys, and the eutrophic group, 69.2% girls and 30.8% boys. The prevalence of NAFLD corresponded to 19.2% for the eutrophic group and 83% for the obese group. The ROC curve generated for the hepatorenal gradient with a cutoff point of 13 presented 100% sensitivity and 100% specificity. As the same cutoff point was considered for the eutrophic group, false-positive results were observed in 9.5% of cases (90.5% specificity) and false-negative results in 0% (100% sensitivity).Conclusion:Computer-aided US with hepatorenal gradient calculation is a simple and noninvasive technique for semiquantitative evaluation of hepatic echogenicity and could be useful in the follow-up of adolescents with NAFLD, population screening for this disease as well as for clinical studies.

Estudio sobre el desarrollo de la identidad en la adolescencia

The aim of this study was to determine how adolescents construct their own identity during this important stage of their lifecycle.We evaluated the identity of a group of 42 adolescents between 11 and 12 years (early adolescence) and between 14 and 15 years (late adolescence), from EOMEIS-II (Extended Version of the Objective Mesure of Ego Identity Estatus created by Adams, Benion and Huh, 1989) which is part of an Ericksonian conceptualization of identity. In the results obtained we can see that students have higher scores on a global level, the most active and mature estatus (identity achieved and moratorium) in the passive and immature estatus (identity foreclosed and diffused). The boys have a higher score than girls in stating the identity moratorium on free time and political identity achieved

Epidemiological studies of childhood and adolescence headache

The main purpose of this study was to examine the changes in the prevalence, incidence, and characteristics of headache in childhood and adolescence. In addition, the predictors of the change in the occurrence of childhood headache and the association between adolescent headache and behavior were studied. The occurrence and characteristics of headache were investigated as part of a prospective follow-up study, where 6-year-old children and their families (n=1132) were followed to the age of 12-years (n=1126). The study design entailed both a cohort and case-control group. The incidence of headache and the association between headache and behavior were studied in another cohort, consisting of 11-year-old twins (n=5393), who were followed to the age of 17 (n=4159). The prevalence rates of headache increased during the follow-up, especially in boys whose mothers suffered from frequent headache. The incidence rates of frequent headache changed the most in girls between ages of 11 and 14. Early-onset migraine and tension-type headache were equal predictors of migraine at age 12. The age-related changes observed in pain localization, concurrent symptoms and triggers were considerable. Headache frequency was significantly associated with externalizing and internalizing problem behaviors and adaptive behaviors as rated by parents, but only with externalizing problem behaviors as rated by teachers. Headache both in children and adolescents is characterized by its changing nature. Its prevention and treatment should take familial, environmental and psychosocial aspects into account.

Occlusal and dentofacial characteristics of the deciduous dentition and treatment effects of the eruption guidance appliance in the early mixed dentition

The aim of this investigation was to analyze the dental occlusion in the deciduous dentition, and the effects of orthodontic treatment carried out in the early mixed dentition with the eruption guidance appliance. The deciduous occlusion and craniofacial morphology of 486 children (244 girls and 242 boys) were investigated at the onset of the mixed dentition period (mean age 5.1 years, range 4.0-7.8 years). Treatment in the treatment group and follow-up in the control group were started when the first deciduous incisor was exfoliated (T1) and ended when all permanent incisors and first molars were fully erupted (T2). The mean age of the children was 5.1 years (SD 0.5) at T1 and 8.4 years (SD 0.5) at T2. Treatment was carried out with the eruption guidance appliance. Occlusal changes that took place in 167 children were compared with those of 104 untreated control children. Pre- and post-treatment cephalometric radiographs were taken, and the craniofacial morphology of 115 consecutively treated children was compared with that of 104 control children. The prevalence of malocclusion in the deciduous dentition was 68% or 93% depending on how the cut-off value between the acceptable and non-acceptable occlusal characteristic was defined. The early dentofacial features of children with distal occlusion, large overjet and deepbite differed from those with normal occlusion. However, the skeletal pattern of these three malocclusions showed considerable similarity each being characterized by a retrusive mandible, small maxillo-mandibular difference, convex profile, retrusive lower incisors, and large interincisal angle. In the treatment group, overjet and overbite decreased significantly from T1 to T2. Following treatment, a tooth-to-tooth contact was found in 99% of the treated children but only in 24% of the controls. A Class I molar relationship was observed in 90% of the children in the treatment group, and in 48% in the control group. Good alignment of the incisors was observed in 98% of the treated children, whereas upper crowding was found in 32% and lower crowding in 47% of the controls. A significant difference between the groups was found in the mandibular length, midfacial length and maxillo-mandibular differential. The occlusal correction, brought about by the eruption guidance appliance, was achieved mainly through changes in the dentoalveolar region of the mandible. In addition, the appliance seemed to enhance the growth of the mandible. Treatment in the early mixed dentition using the eruption guidance appliance is an effective method to normalize occlusion and reduce further need of orthodontic treatment. Only few spontaneous corrective changes can be expected without active intervention.

Talent, expert o les dues coses

De vegades és difícil distingir els conceptes d’individu amb talent i individu expert. Sens dubte, això és degut a que els individus que assoleixen l’èxit en l’esport, la música, el teatre, la literatura, etc. mostren ambdues condicions: una si es vol innata, el talent, i una altra adquirida, la de ser expert. També, de vegades, desitjaríem que els talents treballessin per a ser experts, aspecte que els elevaria a un grau superior d’excel·lència. En el present article es realitza una posada al dia d’ambdós conceptes amb l’objectiu d’establir una base adequada sobre la que sostenir amb més solidesa les decisions i actuacions del formador. També es presenten algunes nocions sobre el seguiment i control dels nois que gaudeixen en les canteres esportives sempre amb l’orientació bàsica de formar individus complerts amb un rendiment òptim.

Tracking of physical activity during adolescence: The 1993 Pelotas Birth Cohort, Brazil

Objective: To analyze physical activity during adolescence in participants of the 1993 Pelotas Birth Cohort Study, Brazil. Methods: Data on leisure time physical activity at 11, 15, and 18 years of age were analyzed. At each visit, a cut-off point of 300 min/week was used to classify adolescents as active or inactive. A total of 3,736 participants provided data on physical activity at each of the three age points. Results: A significant decline in the proportion of active adolescents was observed from 11 to 18 years of age, particularly among girls (from 32.9% to 21.7%). The proportions of girls and boys who were active at all three age points were 28.0% and 55.1%, respectively. After adjustment for sex, economic status, and skin color, participants who were active at 11 and 15 years of age were 58.0% more likely to be active at 18 years of age compared with those who were inactive at 11 and 15 years of age. Conclusions: Physical activity declined during adolescence and inactivity tended to track over time. Our findings reinforce the need to promote physical activity at early stages of life, because active behavior established early tends to be maintained over time.

Danza movimiento terapia y abuso sexual

L'organització mundial de la salut, assenyala que la major part de les agressions sexuals tenen com a víctimes a dones i nenes, i són perpetrades per homes i nens. En alguns països, gairebé una de cada quatre dones ha estat víctima de violència sexual per part de la seva parella i fins a una tercera part de les adolescents han sofert una iniciació sexual forçada. Estudis especialitzats fan referència al percentatge de dones que han sofert alguna forma d'abús sexual abans dels 18 anys. En el mateix sentit, enquestes mundials assenyalen que entre el 10% i el 69% de les dones diuen haver estat agredides físicament per una parella masculina en algun moment de la seva vida. La violència sexual infantil provoca a les seves víctimes una sèrie de repercussions i seqüeles, psicològiques, emocionals, socials; compromet el desenvolupament integral de l'individu, i provoca l'aparició d'una sèrie de patologies a l'edat adulta. La present investigació fa una revisió teòrica de la violència sexual, de la violència de gènere, i de les aportacions del procés de recuperació a través de la dansa moviment teràpia d'aquesta població. També es mostra el recorregut del marc d'actuació dels organismes d'ordre públic de la ciutat de Barcelona per a l'atenció i detecció en casos d'abús sexual

Esport extraescolar i la utilització de les TIC i els jocs electrònics modifiquen la força de prensió de la mà?

L'objectiu del nostre estudi va ser conèixer si l'esport extraescolar i el temps dedicat setmanalment a les tecnologies de la informació i la comunicació (TIC) i jocs electrònics, tenen influència en el desenvolupament de la força de prensió de la mà i avantbraç en nens entre els 14 i 16 anys. Es va realitzar un estudi observacional de disseny transversal. La població objecte d'estudi van ser 39 nens de segon cicle de l'ESO. L'activitat física extraescolar i el temps dedicat setmanalment a les TIC i als jocs electrònics es van recollir mitjançant qüestionaris. Es va utilitzar el test d'handgrip per a la valoració de la força màxima voluntària de la mà i avantbraç del costat dominant. L'edat i la força de la mà dominant estan associades de forma estadísticament significativa, la força màxima voluntària (F=5,86; p=0,006) i el valor mig de la força sostinguda per sobre del 60% (F=4,5; p=0,02). A l'analitzar el grau d'activitat física (Kcal/setmana) respecte a la força màxima voluntària (r= 0,07; p= 0,716) i força sostinguda per sobre del 60% (r= 0,30; p= 0,09) observem una associació feble positiva i no estadísticament significativa. Si analitzem les hores setmanes TIC en relació a la força màxima voluntària observem una associació molt feble i no estadísticament significativa. La força de prensió de la mà en escolars està relacionada de forma positiva i estadísticament significativa amb l'edat i el pes corporal. No es relaciona amb el nivell d'activitat física i les hores dedicades a les TIC.