Adaptation of practical classes of clinical subjects in the COVID-19 era

Abstract Pharmaceutical Care is a subject within the Pharmacy Degree that is taught using theoretical and practical classes. When COVID-19 appeared, Faculty of Pharmacy had to change its way of teaching and learning to online classes. Our aim is to assess the impact of COVID-19 situation on practical classes in Pharmaceutical Care. A prospective study was performed by undergraduate students from Pharmaceutical Care subject. Students attended to 2-day practical classes and were assessed through an evaluative workbook. Undergraduate students (n=390) obtained a score of 8.4±0.8 in practical classes, being higher in face-to-face sessions than online sessions, but not significant differences among both methodologies. The higher score was for the session of minor ailment services (9.3±1.3) and the lower for Personalized Medication Dosage (7.0±1.6) and similar in both scenarios. 59% of students obtained more than 8 score in the global punctuation, being higher in in-face-to-face practical classes. This study showed that learning in health care can be guided and evaluated through an online method. Adapt to new technologies, prevent vulnerable students from being left behind, as well as working on cross-cutting skills at a distance, are some of the challenges of higher education in times of COVID-19.

Estado emocional de pacientes oncológicos: evaluación de la ansiedad y la depresión en función de variables clínicas y sociodemográficas / Frequency of depression and anxiety in a group of 623 patients with cancer

Background: Patients with life threatening diseases may experience anxiety and depression. Aim: To analyze anxiety and depression in Chilean patients with cancer. Material and Methods: The Hospital Anxiety and Depression Scale (HADS) was applied to 623 ambulatory and hospitalized patients with cancer (70% women). Results: A low frequency of clinical anxiety (11,7%) and depression (5,3%) was observed. Depression was more common in women, in patients with mid-level education, in unemployed patients and in older people. Anxiety was more common in young and unemployed patients. Conclusions: The frequency of depression and anxiety was low in this group of cancer patients. Women, educated, uneomployed, and older subjects are risk groups for depression. Young and unemployed subjects experience more anxiety.

Assessment of the Hospital Anxiety and Depression Scale for cancer patients / Adaptación y validación de la Escala de Ansiedad y Depresión Hospitalaria en pacientes chilenos con cáncer

Background: Depression and anxiety are common in patients with cancer. Aim: To adapt and validate the Hospital Anxiety and Depression Scale (HADS) for adult Chilean cancer patients, and to provide information about their prevalence of anxiety and depression. Material and Methods: Two hundred fifteen patients with cancer answered an adapted version of HADS for Chilean population. The language adjustment of the scale was carried out with the opinions of 10 expert linguists and with a pilot study on 17 cancer patients. The Depression and Anxiety subscales of the DASS-21 were also applied to verify the convergent validity of HADS: Results: The confirmatory factor analysis indicated that the data fits the model of two correlated factors (anxiety and depression), χ2 = 98.608; df = 76;p < 0.05; χ2/df= 1.23, RMSEA = 0.037; CFI = 0.99; TLI = .98. Reliability analysis showed an adequate internal consistency of both subscales (.76 for anxiety and .84 for depression) and the general scale (.87). Correlations between HADS and DASS-21 scores were significant for both anxiety (r =.514, p < 0.001) and depression (r = 0.600, p < 0.001). Prevalence rates were approximately 30% for depression (actual = 12%, possible = 22.8%) and approximately 20% for anxiety (actual = 7%, possible = 8.4%). Conclusions: We conclude that HADS is a reliable and valid instrument for screening clinically relevant anxiety and depression symptoms in Chilean cancer patients.

Objetivo: Adaptar y validar la Escala Hospitalaria de Ansiedad y Depresión (HAD) a población adulta oncológica chilena y aportar información sobre la prevalencia de ansiedad y depresión en la muestra. Método: Participantes: 215 pacientes oncológicos. Instrumentos: Protocolo de datos sociodemográficos y clínicos; HAD y el DASS-21, utilizada como Gold Standar para comprobar la validez de convergencia de la escala. Procedimiento: adaptación lingüística de la escala mediante juicio de expertos lingüistas (n = 10) y pilotaje con 17 pacientes oncológicos. Resultados: El análisis factorial confirmatorio indica que la escala se ajusta al modelo de dos factores correlacionados (ansiedad y depresión) (χ2 = 98,608; gl = 76; p < 0,05; χ2/gl = 1.23; RMSEA = 0,037; CFI = 0,99; TLI = 0,98). Los análisis de confiabilidad ponen de manifiesto una adecuada consistencia interna tanto de las subescalas que la componen (0,76 para ansiedad y 0,84 para depresión) como de la escala general (0,87). Las correlaciones entre las puntuaciones del HAD y el DASS-21 fueron positivas y significativas tanto para ansiedad (r = 0,514, p < 0,001) como para depresión (r = 0,600, p < 0,001). Se señalan cifras de prevalencia en torno al 30% para depresión (caso = 12%; posible = 22,8%) y al 20% para ansiedad (caso = 7%; posible = 8,4%). Conclusiones: El HADS es un instrumento válido y confiable para el screnning de síntomas de ansiedad y depresión de relevancia clínica en pacientes oncológicos chilenos.

Ethnic identities of immigrant and native adolescents: development and relationship to life satisfaction

Abstract Ethnic identity becomes an important issue during adolescence, especially for ethnic minority groups. This study examines ethnic identities of immigrant and native adolescents who live in Spain, focusing on the ethnic labels they use, their development, and the relation with life satisfaction. Questionnaires were administered to first-generation immigrants (n= 501; mean age 14.6 years) as well as to their native host classmates (n= 501, mean age 14.3 years). Results show that ethnic identification was mainly determined by country of birth; however, in the case of immigrants, having immigrated at an early age favored the use of identity labels of the majority group. Immigrants were more likely to be in the achieved ethnic identity category than non-immigrants, although it was positively related to life satisfaction in both groups. Finally, older adolescents were not more likely to be in the achieved category than younger ones.

Adolescentes latinoamericanos en España: Aculturación, autonomía conductual, conflictos familiares y bienestar subjetivo / Latin American adolescents in Spain: Acculturation, behavioral autonomy, family conflicts and subjective well-being

Resumen En este estudio se analizan los perfiles de aculturación de 331 adolescentes latinoamericanos residentes en España y su relación con sus niveles de autonomía conductual, los conflictos que mantienen con sus progenitores y su bienestar subjetivo. Los resultados de los análisis de conglomerados confirman la existencia de cuatro perfiles de aculturación: integración (n=113), separación (n=100), marginación (n=63) y asimilación (n=55). Respecto a las diferencias entre perfiles en las variables estudiadas, los resultados de los análisis de la varianza mostraron que no existieron diferencias estadísticamente significativas en la autonomía conductual ni en la frecuencia de conflictos; pero sí en el bienestar subjetivo, siendo el perfil de marginación fue el que presentó una menor satisfacción vital.

Abstract In this study, we analyze the acculturation profiles of 331 Latin-American adolescents living in Spain, and their relation with their levels of behavioral autonomy, conflicts with their parents, and their subjective well-being. Results confirm the existence of four acculturation strategies: integration (n=113), separation (n=100), marginalization (n=63), and assimilation (n=55). Regarding differences between profiles, results from analyses of variance showed there were not statistical differences in adolescents' behavioral autonomy, nor in the frequency of parent-adolescent conflict; there was in subjective well-being, being the marginalization profile the one that presenting less life satisfaction.

Validación de la Escala de Identidad étnica Multigrupo- Revisada en adolescentes inmigrantes y autóctonos residentes en España / Validation of the Multigroup Ethnic Identity Measure-Revised for use with immigrant and native adolescents in Spain / Validação da Escala de Identidade étnica Multigrupo Revisada em adolescentes imigrantes e autóctones residentes na Espanha

En este estudio analizamos las propiedades psicométricas y la estructura factorial de la adaptación al español de la Escala de Identidad étnica Multigrupo Revisada (Eiem-R). Participaron 1002 adolescentes residentes en España, la mitad inmigrantes de primera generación (67.7% nacidos en Latinoamérica, 13.6% en Europa del Este, 13.2% en áfrica, 3.6% en Asia y 2% en el resto de Europa, así como sus padres y madres) y la otra mitad autóctonos (nacidos en España, así como sus padres y madres). Los análisis factoriales exploratorios y confirmatorios apoyan que la escala mide los dos componentes de la identidad étnica propuestos -exploración y compromiso- por los autores originales, y que estos se encuentran correlacionados. Los análisis también mostraron casi completos niveles de invarianza de esta estructura factorial al comparar entre sexos, etapas de adolescencia y autóctonos e inmigrantes.

This study examined the psychometric properties and factorial structure of the Spanish version of the Multigroup Ethnic Identity Measure Revised (Meim-R). Participants for this study were 1002 adolescents living in Spain, half of them first-generation migrants (67.7% born in Latin America, 13.6% in Eastern Europe, 13.2% in Africa, 3.6% in Asia and 2% in the rest of Europe, as well as their parents). Confirmatory and exploratory factor analysis supports that the scale measures the two dimensions of ethnic identity (exploration and commitment) proposed by the original authors, and that these dimensions are correlated. High Measurement Invariance levels of this structure are proved across gender, periods of adolescence and native and immigrant adolescents.

O presente estudo analisa as propriedades psicométricas e a estrutura de fatores da adaptação ao espanhol da Escala de Identidade étnica Multigrupo Revisada (Eiem-R). Participaram 1002 adolescentes que moram na Espanha, sendo a metade deles de imigrantes de primeira geração (67,7% nascidos na América Latina, 13,6% na Europa do Leste, 13,2% na áfrica, 3,6% na ásia e 2% no resto da Europa, assim como os seus pais e as suas mães) e a outra metade de autóctones (nascidos na Espanha, assim como os seus pais e suas mães). As análises fatoriais exploratórias e confirmatórias sustentam que a escala mede os dois componentes da identidade étnica (exploração e compromisso) que já foram propostos pelos autores originais, e que ambos estão correlacionados. Além disso, a análise também mostrou níveis quase completos dessa invariância fatorial ao comparar, entre os sexos, as etapas da adolescência e autóctones e imigrantes.

Evaluación del efecto terapéutico del quelbén en pacientes con queloides / Evaluation of the therapeutical effect of quelben in patients with keloids

Se realizó un estudio con 80 pacientes en edades comprendidas entre 15 y 25 años, de cualquier raza y sexo que presentan queloides en cualquier parte del cuerpo, dividiéndose en 2 grupos, según tabla aleatoria confeccionada para este fin. Se le aplicó a un grupo un producto denominado quelbén, elaborado a base de lodo termal, y al otro grupo una crema esteroidea al 2 por ciento en un período de 6 meses de tratamiento. La respuesta clínica al tratamiento se midió a través de 3 parámetros: el tamaño de la lesión y el grosor, la consistencia de la lesión, así como los síntomas subjetivos (prurito, dolor, hiperestesias y tirantez) acompañantes de la lesión. La respuesta al tratamiento con el quelbén fue favorable ya sea en pacientes limpios (11) o respondedores (21), lo que representa un 91,43 por ciento en lo referente al grupo A, con una ostensible superioridad en cuanto a la eficacia del tratamiento en comparación con el grupo B (68,57 por ciento), en el que se utilizó la crema esteroidea al 2 por ciento

Quiste de coledoco en niños: a propósito de un caso / Cyst of choledochal in children: apropos of case

El quiste de colédoco es una patología poco común del arbol biliar. Clínicamente se caracteriza por la presencia de ictericia, dolor abdominal y masa palpable. El tratamiento definitivo es quirúrgico, pues el manejo conservador conlleva a complicaciones fatales. Presentamos el caso de un preescolar con quiste de colédoco tipo I. El estudio ecosonográfico y la TAC fueron de gran valor para establecer el diagnóstico. A este paciente le fue practicada la extirpación total del quiste, realización de una hepaticoyeyunostomía en Y de Roux y biopsia hepática. El diagnóstico histológico concluyó en quiste de colédoco y cirrosis hepática. La evolución postoperatoria fue satisfactoria