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1.
Birth Defects Res ; 116(2): e2317, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38362599

RESUMO

BACKGROUND: The condition of monozygotic, monochorionic triplet fetuses with a pair of conjoined twins is extremely rare (close to one in a million births), presents challenges in its management, and with poor prognosis. CASE REPORT: We report a case of monochorionic diamniotic triplet pregnancy, ultrasound at 14 weeks shows a pair of conjoined thoracopagus fetuses, sharing heart, liver, and umbilical cord, in addition to omphalocele. The third fetus, without malformations, presents signs of early heart failure compatible with twin-to-twin transfusion syndrome. It was decided to carry out expectant management where at 18 weeks, intrauterine death of the three fetuses occurs. An abortion is performed by hysterotomy. CONCLUSIONS: The treatment in these cases is discussed, three management options have been proposed: expectant management, selective reduction of the conjoined fetuses, or termination of the pregnancy. A review of the literature found only 12 cases with this combination of pathologies, in which only 3 normal fetuses (25%) survived and none of the conjoined twins survived. To our knowledge, this case is the first of a monochorionic triplet pregnancy with conjoined fetuses complicated with early twin-to-twin transfusion.


Assuntos
Transfusão Feto-Fetal , Gravidez de Trigêmeos , Gêmeos Unidos , Feminino , Gravidez , Humanos , Transfusão Feto-Fetal/complicações , Morte Fetal/etiologia , Feto/anormalidades
2.
Front Pediatr ; 12: 1302049, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38292212

RESUMO

Background: In refractory respiratory failure (RF), extracorporeal membrane oxygenation (ECMO) is a salvage therapy that seeks to reduce lung injury induced by mechanical ventilation. The parameters of optimal mechanical ventilation in children during ECMO are not known. Pulmonary ventilatory management during this therapy may impact mortality. The objective of this study was to evaluate the association between ventilatory parameters in children during ECMO therapy and in-hospital mortality. Methods: A systematic search of PubMed/MEDLINE, Embase, Cochrane, and Google Scholar from January 2013 until May 2022 (PROSPERO 450744), including studies in children with ECMO-supported RF assessing mechanical ventilation parameters, was conducted. Risk of bias was assessed using the Newcastle-Ottawa scale; heterogeneity, with absence <25% and high >75%, was assessed using I2. Sensitivity and subgroup analyses using the Mantel-Haenszel random-effects model were performed to explore the impact of methodological quality on effect size. Results: Six studies were included. The median age was 3.4 years (IQR: 3.2-4.2). Survival in the 28-day studies was 69%. Mechanical ventilation parameters associated with higher mortality were a very low tidal volume ventilation (<4 ml/kg; OR: 4.70; 95% CI: 2.91-7.59; p < 0.01; I2: 38%), high plateau pressure (mean Dif: -0.70 95% CI: -0.18, -0.22; p < 0.01), and high driving pressure (mean Dif: -0.96 95% CI: -1.83, -0.09: p = 0.03). The inspired fraction of oxygen (p = 0.09) and end-expiratory pressure (p = 0.69) were not associated with higher mortality. Patients who survived had less multiple organ failure (p < 0.01). Conclusion: The mechanical ventilation variables associated with higher mortality in children with ECMO-supported respiratory failure are high plateau pressures, high driving pressure and very low tidal volume ventilation. No association between mortality and other parameters of the mechanical ventilator, such as the inspired fraction of oxygen or end-expiratory pressure, was found. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023450744, PROSPERO 2023 (CRD42023450744).

3.
Behav Sci (Basel) ; 13(10)2023 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-37887478

RESUMO

This work analyses the motivational regulation, achievement goals and sport commitment of Spanish Masters swimmers, being the first study of its kind. A total of 211 (106 women and 105 men) Masters swimmers from the Federation of Castilla-La Mancha (Spain) aged between 20 and 74 participated. Each participant completed the Sport Motivation Scale (motivation regulation), the Achievement Goals Questionnaire for Sport (achievement goals) and the Sport Commitment Questionnaire (sport commitment), all validated for the Spanish population. A mixed rANOVA was performed to analyse the results, using sex and age group as covariates, and the different groupings of the sample (weekly training days, weekly training hours and practice of other sports) as between-participants factors. The results showed that the participants presented a predominantly intrinsic-integrated and identified regulation, rather than introjected and external regulation. Mastery goals were more prevalent than performance-approach and performance-avoidance goals. In addition, current sport commitment was high, being greater than future commitment. Pearson's correlation analysis showed moderate relationships between our variables. We found no influence of either the covariates of sex and age or the grouping variables. These findings serve as the basis for further study of the motivation of Masters swimmers in Spain.

4.
Biochim Biophys Acta Mol Basis Dis ; 1869(4): 166642, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36669578

RESUMO

Cardiac fibroblasts are a cell population that controls the homeostasis of the extracellular matrix and orchestrates a damage response to maintain cardiac architecture and performance. Due to these functions, fibroblasts play a central role in cardiac fibrosis development, and there are large differences in matrix protein secretion profiles between fibroblasts from aged versus young animals. Senescence is a multifactorial and complex process that has been associated with inflammatory and fibrotic responses. After damage, transient cellular senescence is usually beneficial, as these cells promote tissue repair. However, the persistent presence of senescent cells within a tissue is linked with fibrosis development and organ dysfunction, leading to aging-related diseases such as cardiovascular pathologies. In the heart, early cardiac fibroblast senescence after myocardial infarction seems to be protective to avoid excessive fibrosis; however, in non-infarcted models of cardiac fibrosis, cardiac fibroblast senescence has been shown to be deleterious. Today, two new classes of drugs, termed senolytics and senostatics, which eliminate senescent cells or modify senescence-associated secretory phenotype, respectively, arise as novel therapeutical strategies to treat aging-related pathologies. However, further studies will be needed to evaluate the extent of the utility of senotherapeutic drugs in cardiac diseases, in which pathological context and temporality of the intervention must be considered.


Assuntos
Senescência Celular , Coração , Animais , Senescência Celular/fisiologia , Envelhecimento/patologia , Fibrose , Fibroblastos/metabolismo
5.
Sci Total Environ ; 869: 161652, 2023 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-36693573

RESUMO

The La Palma 2021 volcanic eruption was the first subaerial eruption in a 50-year period in the Canary Islands (Spain), emitting ~1.8 Tg of sulphur dioxide (SO2) into the troposphere over nearly 3 months (19 September-13 December 2021), exceeding the total anthropogenic SO2 emitted from the 27 European Union countries in 2019. We conducted a comprehensive evaluation of the impact of the 2021 volcanic eruption on air quality (SO2, PM10 and PM2.5 concentrations) utilising a multidisciplinary approach, combining ground and satellite-based measurements with height-resolved aerosol and meteorological information. High concentrations of SO2, PM10 and PM2.5 were observed in La Palma (hourly mean SO2 up to ~2600 µg m-3 and also sporadically at ~140 km distance on the island of Tenerife (> 7700 µg m-3) in the free troposphere. PM10 and PM2.5 daily mean concentrations in La Palma peaked at ~380 and 60 µg m-3. Volcanic aerosols and desert dust both impacted the lower troposphere in a similar height range (~ 0-6 km) during the eruption, providing a unique opportunity to study the combined effect of both natural phenomena. The impact of the 2021 volcanic eruption on SO2 and PM concentrations was strongly influenced by the magnitude of the volcanic emissions, the injection height, the vertical stratification of the atmosphere and its seasonal dynamics. Mean daily SO2 concentrations increased during the eruption, from 38 µg m-3 (Phase I) to 92 µg m-3 (Phase II), showing an opposite temporal trend to mean daily SO2 emissions, which decreased from 34 kt (Phase I) to 7 kt (Phase II). The results of this study are relevant for emergency preparedness in all international areas at risk of volcanic eruptions; a multidisciplinary approach is key to understand the processes by which volcanic eruptions affect air quality and to mitigate and minimise impacts on the population.

6.
Res Q Exerc Sport ; 94(1): 1-14, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-34860643

RESUMO

Background: Observational studies associate physical activity (PA) with improved perceptions of children and adolescents' physical self-concept (PSC) and global self-concept (GSC). However, only a few PA-based interventions exist for improving PSC and their results have been inconclusive. Objective: To determine the effect of specific PA-based programmes on the PSC (including its sub-dimensions) and GSC of children and adolescents, and to assess possible moderators. Methods: The databases Web of Science, Scopus, SportDiscus, PubMed, CINAHL, and Cochrane Library were reviewed in February 2020. Only studies with pre-post measurements and control groups were included. The impact of PA-based interventions was explored through different meta-analyses and moderator analyses. Results: Altogether, 20 studies were included in the meta-analysis. Positive and significant effects of PA were determined on self-perceived physical appearance (g = 0.13; 95% CI = 0.03, 0.23), self-perceived sport competence (g = 0.30; 95% CI = 0.09, 0.51), self-perceived physical fitness (g = 0.19; 95% CI = 0.05, 0.32), PSC (g = 0.31; 95% CI = 0.10, 0.52), and GSC (g = 0.17; 95% CI = 0.01, 0.33). The existence of additional interventions in PA-based programmes (e.g., interventions focused on psychological factors or healthy habits) moderated the influence of PA on self-perceived sport competence and physical fitness. Moreover, environment and time were distinguished as moderators for self-perceived physical appearance and sport competence. Further, intervention type, gender, and frequency of intervention moderated the effects of PA on PSC. Conclusions: PA-based interventions, especially in school, seem to be beneficial for the development of positive physical self-perceptions.


Assuntos
Exercício Físico , Esportes , Criança , Adolescente , Humanos , Exercício Físico/psicologia , Aptidão Física/psicologia , Autoimagem , Instituições Acadêmicas
7.
An. psicol ; 38(2): 278-294, may. 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-202889

RESUMO

Los estudiantes con altas capacidades, aquellos que presentan una mayor probabilidad de lograr metas extraordinarias en uno o más dominios, generalmente difieren del alumnado general en algunas de las dimensiones del autoconcepto, o la percepción que tiene una persona de sí misma. Sin embargo, la investigación actual sobre altas capacidades ha evolucionado introduciendo nuevos posibles moderadores en estas diferencias por lo que se hace necesaria una actualización sobre el tema. El objetivo del presente metaanálisis (referencia: CRD42018094723) fue sintetizar los estudios desde 2005 sobre las diferencias en el autoconcepto entre estudiantes con altas capacidades y alumnado general. Los resultados mostraron que los alumnos con altas capacidades presentan niveles superiores de autoconcepto global y académico, especialmente el matemático. Sin embargo, no se hallaron diferencias en autoconceptos conductual y emocional, y hubo puntuaciones levemente más bajas en autoconcepto social. En el autoconcepto físico, estos estudiantes puntúan notablemente más bajo que el alumnado general. Las diferencias en esta subdimensión están moderadas por los procedimientos de identificación, la procedencia y la edad, por lo que se sugieren que los estereotipos sociales acerca de las altas capacidades, así como los hábitos de actividad física podrían estar detrás de las dichas diferencias.(AU)


Gifted students (i.e., those who are more likely to achieve ex-traordinary goals in one or more domains) generally differ from the non-gifted students in some of the dimensions of self-concept (i.e., a person's perception of him/herself). However, the current research on giftedness has evolvedto introduce new possible moderators of these differences so it has become necessary to carry out an update on the topic. The aim of the present meta-analysis (reference: CRD42018094723) was to synthesise the studies since 2005 on differences in self-concept between gifted and non-gifted students. The results showed that gifted students have higher levels of general and academic self-concept, especially in math self-concept. However, no differences were found in behavioural and emotion-al self-concepts, andonly slightly lower scores in social self-concept. In physical self-concept they scored significantly lower than non-gifted stu-dents. The differences in this sub-dimension are moderated by identifica-tion procedures, geographical area, and age, so it is suggested that social stereotypes about giftedness as well as physical activity habits may be some of the reasons for these differences.(AU)


Assuntos
Humanos , Ciências da Saúde , Autoimagem , Estudantes , Criança Superdotada , Metanálise em Rede , Individualidade
8.
J Perinat Med ; 50(3): 319-326, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-34881544

RESUMO

OBJECTIVES: To analyze umbilical artery (UA) Doppler velocimetry and its possible role in placenta-mediated fetal growth restriction (FGR) in second- and third-trimester fetuses with trisomy 18 and 13. METHODS: UA pulsatility index (PI) and half-peak systolic velocity deceleration time (hPSV-DT) were measured in fetuses with trisomy 18 and 13. Correlation with gestational age, birthweight, and perinatal outcome was analyzed. RESULTS: A total of 80 measurements were taken from 33 fetuses with trisomy 18 and 19 with trisomy 13. Overall, there was a high prevalence of abnormal UA Doppler velocimetry. In fetuses with trisomy 18, 54% (27/50) of the UA PI values and 58% (29/50) of the UA hPSV-DT values were abnormal. In fetuses with trisomy 13, 80% (24/30) of the UA PI values and 87% (26/30) of the UA hPSV-DT values were abnormal. The prevalence of abnormal UA Doppler velocimetry increased with gestational age in both types of aneuploidy. However, this trend was only significant for trisomy 13 (p<0.05). All fetuses with trisomy 18 and 86% of fetuses with trisomy 13 were classified at birth as FGR. There were no perinatal survivors in this series. CONCLUSIONS: A high prevalence of abnormal UA Doppler velocimetry was found in second- and third-trimester fetuses with trisomy 18 and 13, which further increased with gestational age. These results may well correlate with alterations described previously in the placenta, suggesting placental insufficiency has an important role in the development of FGR in these autosomal aneuploid fetuses.


Assuntos
Velocidade do Fluxo Sanguíneo , Fluxo Pulsátil , Síndrome da Trissomia do Cromossomo 13 , Síndrome da Trissomía do Cromossomo 18 , Artérias Umbilicais/diagnóstico por imagem , Adulto , Feminino , Humanos , Gravidez , Sístole , Ultrassonografia Doppler de Pulso
9.
Heliyon ; 6(9): e04980, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33033768

RESUMO

This paper contributes to the corporate governance and innovation literature by providing empirical evidence with respect to the influence of composition of the board and its leadership structure on innovation. Also, this study seeks to investigate if such influence differs when comparing family and non-family business. Data were collected from 86 Spanish companies of innovative sectors from 2003 to 2014. The results show that innovation is affected positively by board size, especially in the case of family businesses, and gender diversity, especially in non-family businesses. Similarly, findings also point out that duality is better than the independence of functions in the case of non-family businesses. Finally, obtained results support that independent directors have a negative impact on innovation and such negative influence is even stronger in family firms. These findings contribute to an inconclusive literature regarding board effects on innovation, highlighting different recommendations depending on whether the companies are family businesses or not.

10.
Trop Anim Health Prod ; 52(6): 3241-3250, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32783132

RESUMO

The objective of this research was to evaluate the productive and reproductive characteristics of the Caqueteño Creole cattle breed. Data was taken from 655 animals organized into 6 groups: group 1 (n = 185), pure Caqueteño Creole cattle breed (Caqueteño); group 2 (n = 34), Caqueteño Creole cattle breed crossing for multiracial animals (Caqueteño 50% × multiracial 50%); group 3 (n = 10) (Caqueteño 75% × Bos indicus 25%); group 4 (n = 56), crossbreed F1 (Bos taurus × B. indicus); group 5 (n = 168), animals with B. taurus percentage greater than 50% (B. taurus > 50%); group 6 (n = 202), animals with B. indicus percentage greater than 50% (B. indicus > 50%). Subsequently were done descriptive statistics and analysis of variance (ANOVA) with the LSD Fisher test (P < 0.05), with the software InfoStat version 2018. A significant difference was found (P < 0.05); in weight at birth (WB), Caqueteño presented the smallest value (29.8 kg); in daily weight gain (DWG), weight adjusted at 9 months (W9), and weight adjusted at 18 months (W18), Caqueteño presented highest values corresponding to 574.5 g/day, 183.0 kg, and 343.6 kg, respectively; in age at the first service (AFS), the lowest value was obtained by B. taurus × B. indicus (24.5 months), and in calving interval (CI), no significant differences were found (P > 0.05). In conclusion, the Caqueteño Creole cattle breed is efficient in the productive variables (daily weight gain, adjusted weight at 9 and 18 months); in age at the first service, the F1 group indicated precocity, followed by Caqueteño Creole.


Assuntos
Peso Corporal , Bovinos/fisiologia , Reprodução , Animais , Bovinos/crescimento & desenvolvimento , Colômbia , Feminino , Masculino , Aumento de Peso
11.
Siglo cero (Madr.) ; 51(2): 99-117, abr.-jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193114

RESUMO

La asistencia personal para personas con discapacidad intelectual puede contribuir a la aplicación de los nuevos paradigmas de autodeterminación e inclusión social y a una mejora de la calidad de vida. Mediante revisión de la literatura y un análisis con expertos profesionales, expertos por experiencia y potenciales usuarios, se elaboró un modelo breve de asistencia personal para ser ejecutado por agentes comunitarios con supervisión profesional. El modelo considera actividades en los espacios habituales de las personas y sus familias, con apoyo para el uso de recursos formales e informales de la comunidad y el refuerzo de redes de apoyo que continúen operando una vez que termine la intervención. Con una duración de 9 meses, el modelo se desarrolla mediante un proceso de 3 etapas: 1) establecimiento de vínculo y elaboración de un plan individualizado, 2) implementación del plan y 3) refuerzo de los aprendizajes de los participantes y traspaso a redes de apoyo. Se discute la factibilidad de la aplicación del modelo en países latinoamericanos y la necesidad de realizar estudios que evalúen su implementación


Personal assistance for people with intellectual disabilities can contribute to the application of the new paradigms of self-determination and social inclusion and to an improvement in the quality of life. Through a literature review and analysis with professional experts, experts from experience and potential users, a brief model of personal assistance was developed to be executed by community agents with professional supervision. The model considers activities in the usual spaces of people and their families, with support for the use of community formal and informal resources and the reinforcement of social support networks that continue operating once the intervention ends. With duration of 9 months, the model is developed through a 3-stage process: 1) engagement and formulation of an individualized plan, 2) implementation of the plan, and 3) participants' learning reinforcement and transfer to support networks. The feasibility of the model in Latin American countries and the need for studies to evaluate its implementation are discussed


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Deficiência Intelectual/reabilitação , Deficiência Intelectual/psicologia , Qualidade de Vida , Desejabilidade Social , Apoio Social , Política Pública , 57353 , Prova Pericial , Chile
12.
Artigo em Inglês | MEDLINE | ID: mdl-32183282

RESUMO

Several studies have linked physical fitness (PF) with improvements in health, at a physiological and psychological level; however, there is little evidence of its relationship with health in the social field. Hence, the main aim of this study was to determine the existing relationship between PF and peer relations, as an indicator of social health in Spanish pre-teens. For that purpose, 642 participants aged 9 to 12 were chosen and given the high-priority Alpha Fitness battery in order to assess the PF, as well as the Classroom Social Experiences Query (CESC) to assess their social status. The results showed that those students with a better cardio-respiratory fitness obtained more nominations from their classmates in pro-sociality and positive status, and fewer in victimisation and negative status. Additionally, although to a lesser extent, muscular fitness was also related to a higher positive status and lower victimisation. The weight condition was also related to social behaviours, although the resulting data were differentiated by sex. While females with a standard weight stood out for their positive status, underweight males obtained worse results in positive status and fewer in negative status. These results all correspond with the aesthetic models imposed by society for females and males, respectively. These results show that PF is related to social health, which makes necessary the promotion of physical activity and the development of PF within the school environment, with attention to its relationship with the social health of the students.


Assuntos
Aptidão Cardiorrespiratória , Relações Interpessoais , Grupo Associado , Criança , Exercício Físico , Feminino , Força da Mão , Humanos , Masculino , Espanha , Estudantes
13.
Travel Med Infect Dis ; 35: 101481, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31521805

RESUMO

BACKGROUND: Chikungunya (CHIKV) and Zika (ZIKV) significantly affected Latin America in the period 2015-2017. Most studies were reported from urban areas of Brazil and Colombia. In this paper we estimate Incidence rates for CHIKV and ZIKV in Caqueta, the Amazonian gateway area of Colombia, from 2015 to 2018. METHODS: Using surveillance data of CHIKV and ZIKV in Caqueta, Colombia, incidence rates were estimated (cases/100,000 population). Sixteen geographical information systems (GIS)-based municipal maps were developed. GIS software used was Kosmo 3.0®. RESULTS: From 1st of January 2015 to the 24th of November 2018, 825 cases of CHIK and 1079 of ZIKV were reported, yielding cumulated incidence rates of 169.42 and 221.59 cases/100,000 population respectively. In 2016, 48.7% of the CHIKV cases (402) and 96.6% of the ZIKV cases (1042) were reported. The highest number of both arboviral diseases occurred at Florencia (capital department city), 225 cases for CHIKV (127.17 cases/100,000 pop.) and 611 for ZIKV (345.34 cases/100,000 pop.). DISCUSSION: The temporo-spatial distribution of CHIKV and ZIKV infections in Caquetá reflected the pattern of concurrent epidemics, especially in 2016. Studies using GIS-linked maps are necessary to attain accurate epidemiological analyses for public health decisions. That is also useful for an epidemiologically based assessment of traveler risks when visiting specific areas in destination countries.


Assuntos
Febre de Chikungunya/epidemiologia , Análise Espaço-Temporal , Infecção por Zika virus/epidemiologia , Vírus Chikungunya , Colômbia/epidemiologia , Sistemas de Informação Geográfica , Humanos , Incidência , Medicina de Viagem , Zika virus
14.
J Matern Fetal Neonatal Med ; 33(20): 3469-3475, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30741044

RESUMO

Objective: To analyze placental vascular resistance and the role of placental insufficiency in the etiology of reduced fetal growth in fetuses with trisomy 21 as determined by umbilical artery (UA) Doppler velocimetry.Methods: Second- and third-trimester UA Doppler ultrasound studies were performed in fetuses with trisomy 21 at the time of clinically indicated obstetric ultrasound assessment. The UA pulsatility index (PI) and half-peak systolic velocity deceleration time (hPSV-DT) were measured and recorded. Perinatal outcome was reviewed and the results from UA Doppler velocimetry were compared with birthweight according to gestational age at the time of the delivery.Results: A total of 60 fetuses with trisomy 21 were studied and information from 147 UA Doppler studies was analyzed. Overall, at least one of the UA PI and hPSV-DT values was abnormal in 82% (n = 49) and 90% (n = 54) of the cases, respectively. The incidence of abnormal UA PI values increased with gestational age from 39% (7/18) before 21 weeks to 78% (18/23) after 35 weeks (p < .05). The increase was even more evident for UA hPSV-DT values from 28% (5/18) before 20 weeks to 91% (21/23) after 35 weeks (p < .01). After exclusion of four fetuses with hydrops or isolated hydrothorax/ascites, 16 (29%) were classified at birth as small for gestational age (SGA), 34 (61%) as adequate for gestational age, and six (11%) as large for gestational age, with a mean birthweight z-score of -0.36. When only considering the last Doppler ultrasound assessment prior to delivery, UA PI and hPSV-DT values were abnormal in 73% (41/56, mean z-score = +1.72) and 82% (46/56; mean z-score = -2.18) of the cases, respectively. Mean gestational age at delivery and birth weight were significantly lower in the group with abnormal compared to normal UA PI and hPSV-DT values. Similarly, the incidence of SGA fetuses was significantly higher in the group with abnormal compared to normal UA PI and hPSV-DT values, with 94 (n = 15) and 100% of the 16 SGA newborn infants having abnormal UA PI and hPSV-DT values prior to delivery, respectively.Conclusions: Trisomy 21 fetuses have a progressively higher incidence of abnormal UA impedance indices throughout pregnancy, which suggests developing placental vascular resistance as the pregnancy progresses. This alteration likely begins around the mid second trimester and increases with gestational age; however, increasing placental vascular resistance seems to produce a discrete decrease in fetal growth, despite severe alteration of the UA Doppler impedance indices. As a general hypothesis, we postulate that trisomy 21 fetuses have increasing placental vascular resistance but there may be some factors that protect these fetuses from severe fetal growth restriction.


Assuntos
Síndrome de Down , Artérias Umbilicais , Velocidade do Fluxo Sanguíneo , Desaceleração , Síndrome de Down/diagnóstico por imagem , Feminino , Retardo do Crescimento Fetal , Feto , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Placenta , Gravidez , Ultrassonografia Doppler , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem
15.
BMJ Open ; 9(11): e031032, 2019 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-31722940

RESUMO

INTRODUCTION: Risk calculators (RCs) are easy-to-use tools considering available clinical variables that could help to select those patients with risk of prostate cancer (PCa) who should undergo a prostate biopsy. OBJECTIVE: To perform a comparison for the prediction of significant PCa (SigPCa) between the European Randomised Study of Screening for PCa (ERSPC) and the PCa Prevention Trial (PCPT) RCs in patients with prostate-specific antigen (PSA) between 3 and 10 ng/mL through an evaluation of the accuracy/variability between two consecutive PSA values. SETTING: An observational study in a major university hospital in the south of Spain. METHODS AND PARTICIPANTS: An observational study was performed in patients who underwent a prostate biopsy. SigPCa probabilities were calculated with the two PSA measures using ERSPC3/4+digital rectal examination and PCPT v2+free PSA RCs. The prediction of SigPCa was determined by the area under the receiver operating characteristic curve (AUC). Calibration, discrimination and decision curve analysis were studied. The variability between both RCs' agreement was compared using Cohen's kappa coefficient. RESULTS: 510 patients were analysed (87 diagnosed with SigPCa). The median PSA values were 5.3 and 5 ng/mL for PSA1 and PSA2, respectively. Both RCs overestimated the risk in the case of high-risk probabilities. Discriminative ability for SigPCa was similar between models with an AUC=0.73 (0.68-0.79) for ERSPC-RC versus 0.73 (0.67-0.79) for PCPT-RC. ERSPC-RC showed less variability than PCPT-RC, with a constant agreement (k=0.7-0.8) for usual range of clinical decision-making. Remarkably, a higher number of biopsies would be avoided using the ERSPC-RC, but more SigPCa would be missed along all the risk probabilities. CONCLUSIONS: Both RCs performed similar in the prediction of SigPCa. However, ERSPC-RC seems to be more stable for intraindividual PSA variations.


Assuntos
Técnicas de Apoio para a Decisão , Detecção Precoce de Câncer/métodos , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Idoso , Biópsia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco
17.
Artigo em Inglês | MEDLINE | ID: mdl-31461855

RESUMO

The aim of this study was to assess the differences in body dissatisfaction (BD) of male and female adolescents by body max index (BMI) and the quantity, type and organisation of physical activity (PA). To do so, 652 adolescents aged 12-17 years participated in a cross-sectional study. The cognitive-affective component of BD was assessed with the Body Shape Questionnaire (BSQ) and the perceptual component with Gardner's scale for the assessment of, body image (BI). PA was measured with the International Physical Activity Questionnaire (IPAQ-SF) and the item 1 from the Physical Activity Questionnaire for Adolescents (PAQ-A). The results show that sex and BMI are key variables when determining BD. Moderate-to-vigorous PA (MVPA) was moderately associated with a greater body satisfaction in males but no association was found between BD and the participation and organisation of PA. Moreover, the results suggest that participants in aesthetic/lean PA are at a higher risk of suffering from BD than participants in other PA types. These findings provide useful information for the design of programmes promoting healthy lifestyles, weight control and BI concern during the school period.


Assuntos
Insatisfação Corporal , Exercício Físico , Fatores Sexuais , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Promoção da Saúde , Humanos , Masculino , Instituições Acadêmicas , Inquéritos e Questionários
18.
Front Psychol ; 10: 1537, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354570

RESUMO

Objective: The aim of this research was to study the mediation of body dissatisfaction, physical self-concept, and body mass index (BMI) on the relationship between physical activity and self-concept in adolescents. Materials and Methods: A sample of 652 Spanish students between 12 and 17 years participated in a cross-sectional study. Physical self-concept and general self-concept were assessed with the Physical Self-Concept Questionnaire (CAF), body dissatisfaction with the Body Shape Questionnaire (BSQ), and physical activity was estimated with the International Physical Activity Questionnaire (IPAQ-SF). BMI was utilized as a measurement of body composition. Structural equation modeling was used to assess the results. Results: The resulting models showed good fit indexes. Final model for all participants explained the 17% of the variance of body dissatisfaction, 57% of physical self-concept, and 60% of general self-concept. Physical activity had a positive and indirect effect on self-concept (ß = 0.29, p < 0.01) and direct effects on body dissatisfaction (ß = -0.26, p < 0.01) and physical self-concept (ß = 0.20, p < 0.01). BMI had a direct effect on body dissatisfaction (ß = 0.31, p < 0.01) and on physical self-concept (ß = -0.10, p < 0.01) and an indirect effect on general self-concept (ß = -0.24, p < 0.01). However, it was only associated with physical activity in males, playing a mediating role between physical activity and body dissatisfaction. Conclusion: Physical activity can help individuals to achieve a positive self-concept and promote psychological well-being in adolescents through the improvement of physical perceptions and body satisfaction. The importance of BMI, body dissatisfaction, and physical self-concept on the configuration of the self-concept is also emphasized. Educational policymakers and Physical Education teachers should implement strategies to promote physical activity in the schools and provide a Quality Physical Education programs to increase physical activity during adolescence.

19.
J Sch Psychol ; 68: 154-162, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29861025

RESUMO

This study tests an explanatory model based on self-determination theory, which posits that pressure experienced by teachers when they are evaluated based on their students' academic performance will differentially predict teacher adaptive and maladaptive motivation, well-being, and ill-being. A total of 360 Spanish physical education teachers completed a multi-scale inventory. We found support for a structural equation model that showed that perceived pressure predicted teacher autonomous motivation negatively, predicted amotivation positively, and was unrelated to controlled motivation. In addition, autonomous motivation predicted vitality positively and exhaustion negatively, whereas controlled motivation and amotivation predicted vitality negatively and exhaustion positively. Amotivation significantly mediated the relation between pressure and vitality and between pressure and exhaustion. The results underline the potential negative impact of pressure felt by teachers due to this type of evaluation on teacher motivation and psychological health.


Assuntos
Motivação , Professores Escolares/normas , Estudantes/psicologia , Feminino , Humanos , Masculino
20.
An. psicol ; 34(1): 173-183, ene. 2018. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-169869

RESUMO

La imagen corporal es un constructo ampliamente estudiado, sobre todo en lo que se refiere a la percepción e insatisfacción con la propia imagen. La mayoría de las investigaciones se centran en la adolescencia y adultez, aunque los problemas de insatisfacción aparecen cada vez a edades más tempranas. Por tanto, el propósito de este estudio fue analizar los hallazgos más transcendentes sobre insatisfacción corporal y percepción del propio tamaño corporal en niños de 3 a 6 años (segundo ciclo de Educación Infantil). A tal fin, se usaron las bases de datos de Medline, SportDiscus, Scopus, ScienceDirect, Dialnet, ProQuest y EBSCO, de las cuales se seleccionaron 22 estudios, en base a criterios de exclusión como el idioma, la revisión por pares y la medición objetiva del Índice de Masa Corporal (IMC) de los niños. Los resultados son diversos en cuanto a los niveles de insatisfacción, lo cual hace imposible establecer conclusiones acertadas sobre las características y prevalencia de dicha variable a estas edades. Entre las principales razones de esta dificultad destaca el tipo de instrumento empleado y las dificultades de los niños para percibir su cuerpo con exactitud (AU)


Body image is a construct that has been widely studied, particularly with regard to image perception and dissatisfaction. Though most research studies focus on adolescence and adulthood, dissatisfaction problems are manifesting themselves at increasingly early ages. The aim of this study was, therefore, to analyse the most significant findings on body dissatisfaction and body-size perception among children aged 3 to 6 (second cycle of pre-school education). To this end the Medline, SportDiscus, Scopus, ScienceDirect, Dialnet, ProQuest and EBSCO databases were used, and from which a total of 22 studies were selected in accordance with exclusion criteria such as language, peer review and the objective measurement of the body mass index (BMI) of children. In terms of levels of dissatisfaction, results vary widely, making it impossible to draw sound conclusions on the nature and prevalence of this variable at these ages. The main reasons for this include the type of instrument used and the difficulties children had in perceiving their bodies correctly (AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Percepção , Imagem Corporal/psicologia , Comportamento Infantil/psicologia , Desenvolvimento Infantil/fisiologia , Dissonância Cognitiva , Terapia Cognitivo-Comportamental
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