The McMaster Family Assessment Device (FAD) dimensions involved in the prediction of adolescent depressive symptoms and their mediating role in regard to socioeconomic status.

Family functioning plays an important role in explaining the high prevalence of depressive symptoms in adolescents and it is necessary to identify the family functioning characteristics responsible for this relationship. In turn, while socioeconomic status (SES) is associated with adolescent depressive symptoms, the mechanisms that explain this relationship are largely unknown. In this study, we used the McMaster Family Assessment Device (FAD) to obtain a picture of the family functioning dimensions that genuinely contribute to explaining the relationship between family functioning and adolescent depressive symptoms and analyzed the mediating effect of family functioning on the impact of SES on depressive symptoms. Regression-based conditional process analysis was used with a sample of 636 adolescents aged 12-17 years. Pratt's measures in regression analyses showed that 95% of the variance in depressive symptoms was accounted for by three of the six FAD dimensions: the ability to experience and express emotions appropriately-Affective Responsiveness-the ability to maintain adequate involvement among family members-Affective Involvement-and the ability to set and abide by rules and standards of behavior-Behavioral Control. Results also showed that the impact of SES on depressive symptoms was mediated by the existence of clear expectations about standards of behavior and behavioral patterns for handling family tasks-Behavioral Control and Roles-and, for the boys, by experiencing and expressing emotions appropriately. The results emphasize the importance of affect and clear-cut family rules to prevent adolescent depressive symptoms and suggest that the existence of family rules and roles buffer the impact of SES on adolescent wellbeing.

Health, social and legal supports for migrant agricultural workers in France, Italy, Spain, Germany, Canada, Australia and New Zealand: a scoping review.

Introduction: We carried out a scoping review to examine what previous literature can teach us about practices and possibilities for support services for migrant agricultural workers. Methods: Following guidelines for scoping reviews as outlined by Arksey and O'Malley (2005) and further refined by Levac et. al (2010) we conducted searches of several databases and two additional searches to capture regions of focus and more current literature. We used a thematic analysis to generate our themes. Results: Our analysis yielded four key themes: (1) political, economic and legal factors; (2) living and working conditions; (3) facilitators/barriers to navigating services and supports and; (4) potential and existing strategies for social support for migrant agricultural workers. The first two themes pointed more to structural and material conditions that both posed barriers for this population to access supports, but also illustrated vulnerabilities that pointed to the need for a variety of services and protections. Under the third, we highlighted the ways that the design of services and supports, or their degree of accessibility, could shape the level of help available to this population. Lastly, potential and existing strategies for social support discussed in the literature included an emphasis on mental health and wellbeing, occupational health and safety training and documentation, and policy reforms to secure the status and address the precarity of this workforce. Discussion: While research on social support and service provision for migrant agricultural workers is still in its infancy, a strength of this body of work is its attention to macro-level issues that advocate for strategies that address root factors that shape this group's health. Further research is required to expand our understanding of social support roles and possibilities across other domains and sectors for this population.

Treating postpartum affective and/or anxiety disorders in a mother-baby day hospital: preliminary results.

INTRODUCTION: Women experiencing perinatal mental-health illness have unique needs. The present study analyzes preliminary data about the effectiveness of MBDH in treating postpartum women with affective and anxiety disorders. METHODS: We analysed 33 mothers with affective and/or anxiety disorders treated at the MBDH with their babies between March 2018 and December 2019. All women were assessed at admission, discharge and three months after discharge. Outcomes included symptoms of depression (EPDS) and anxiety (STAI-S), mother-infant bonding (PBQ) and functional impairment (HoNOs). We also assessed the clinical significance of changes in patients' scores on these scales and patient satisfaction. RESULTS: At discharge, no patients still met the full criteria for the main diagnosis. Between admission and discharge, symptoms of depression and anxiety, mother-infant bonding, functional impairment and autonomy in caring for babies improved significantly. These gains were maintained at three months follow-up. Patient satisfaction was high. CONCLUSIONS: These preliminary results suggest that multidisciplinary intervention for postpartum women with affective or anxiety disorders at the MBDH improves maternal psychopathology, mother-infant bonding and mothers' ability to care for their babies. MBDHs are a promising approach for delivering specialised perinatal mental-health care for mother-baby dyads.

Mother-baby day hospital (MBDH) could be an adequate device for women with perinatal mental disordersMultidisciplinary intervention is effective for treating postpartum anxiety and depressive disorders.Interventions at MBHD improve mother-infant bonding and mothers' ability to care for their babies.Further research is needed to assess the effectiveness at long term not only on maternal health also on child neurodevelopment.

Clinical utility of urinary gluten immunogenic peptides in the follow-up of patients with coeliac disease.

BACKGROUND: Gluten-free diet (GFD) is the only treatment for patients with coeliac disease (CD) and its compliance should be monitored to avoid cumulative damage. AIMS: To analyse gluten exposures of coeliac patients on GFD for at least 24 months using different monitoring tools and its impact on duodenal histology at 12-month follow-up and evaluate the interval of determination of urinary gluten immunogenic peptides (u-GIP) for the monitoring of GFD adherence. METHODS: Ninety-four patients with CD on a GFD for at least 24 months were prospectively included. Symptoms, serology, CDAT questionnaire, and u-GIP (three samples/visit) were analysed at inclusion, 3, 6, and 12 months. Duodenal biopsy was performed at inclusion and 12 months. RESULTS: At inclusion, 25.8% presented duodenal mucosal damage; at 12 months, this percentage reduced by half. This histological improvement was indicated by a reduction in u-GIP but did not correlate with the remaining tools. The determination of u-GIP detected a higher number of transgressions than serology, regardless of histological evolution type. The presence of >4 u-GIP-positive samples out of 12 collected during 12 months predicted histological lesion with a specificity of 93%. Most patients (94%) with negative u-GIP in ≥2 follow-up visits showed the absence of histological lesions (p < 0.05). CONCLUSION: This study suggests that the frequency of recurrent gluten exposures, according to serial determination of u-GIP, could be related to the persistence of villous atrophy and that a more regular follow-up every 6 months, instead of annually, provides more useful data about the adequate adherence to GFD and mucosal healing.

Negative predictive value of the repeated absence of gluten immunogenic peptides in the urine of treated celiac patients in predicting mucosal healing: new proposals for follow-up in celiac disease.

BACKGROUND: The treatment of celiac disease (CD) is a lifelong gluten-free diet (GFD). The current methods for monitoring GFD conformance, such as a dietary questionnaire or serology tests, may be inaccurate in detecting dietary transgressions, and duodenal biopsies are invasive, expensive, and not a routine monitoring technique. OBJECTIVES: Our aim was to determine the clinical usefulness of urine gluten immunogenic peptides (GIP) as a biomarker monitoring GFD adherence in celiac patients and to evaluate the concordance of the results with the degree of mucosal damage. METHODS: A prospective observational study was conducted involving 22 de novo CD patients, 77 celiac patients consuming a GFD, and 13 nonceliac subjects. On 3 d of the week, urine samples were collected and the GIP concentrations were tested. Simultaneously, anti-tissue transglutaminase antibodies, questionnaire results, clinical manifestations, and histological findings were analyzed. RESULTS: Approximately 24% (18 of 76) of the celiac patients consuming a GFD exhibited Marsh II-III mucosal damage. Among this population, 94% (17 of 18) had detectable urine GIP; however, between 60% and 80% were asymptomatic and exhibited negative serology and appropriate GFD adherence based on the questionnaire. In contrast, 97% (31 of 32) of the celiac patients without duodenal damage had no detectable GIP. These results demonstrated the high sensitivity (94%) and negative predictive value (97%) of GIP measurements in relation to duodenal biopsy findings. In the de novo CD-diagnosed cohort, 82% (18 of 22) of patients had measurable amounts of GIP in the urine. CONCLUSIONS: Determining GIP concentrations in several urine samples may be an especially convenient approach to assess recent gluten exposure in celiac patients and appears to accurately predict the absence of histological lesions. The introduction of GIP testing as an assessment technique for GFD adherence may help in ascertaining dietary compliance and to target the most suitable intervention during follow-up.

Tamaño y porciones del consumo de alimentos de la población: disponibilidad de información actualizada / Size and portions of the population's food consumption: availability of updated information

El objetivo de este estudio fue identificar la producción científica y el comportamiento relacionado al tamaño y porción del consumo de alimentos de la población. Se seleccionó 110 artículos relacionados al tema de la base de datos Scopus, a través, de operadores lógicos, AND entre palabras y OR entre sinónimos. La revista Appetive obtuvo 117 citas. Los artículos publicados corresponden a 64 con autoría de más de tres autores. La mayor producción científica fue en el año 2016 con 37 publicaciones. En todos los artículos revisados no existe información sobre el tamaño y porción en gramos, ni en medida casera adecuada para el consumo. Esta propuesta de revisión permitirá desarrollar futuras investigaciones para precisar el tamaño y porción adecuada según estado fisiológico y grupo etario.

The objective of this study was to identify the scientific production and its behavior related to the size and servings of the population's food consumption. It was selected 110 articles related to the topic from the Scopus database, through logical operators, AND among words and OR among synonyms. The Appetive magazine obtained 117 citations. The published articles correspond to 64 with authorship of more than three authors. The largest scientific production was in 2016 with 37 publications. In all the articles reviewed, there is no information on the size and servings in grams, nor in the home measure suitable for consumption. This revision proposal will allow the development of future research to determine the appropriate size and servings according to physiological status and age group.

Sobrepeso y obesidad en niños de 5 a 12 años

Fundamento: la obesidad constituye un grave problema de salud a nivel mundial, que ha dejado de ser una enfermedad poco frecuente, para convertirse en una epidemia emergente con efectos inmediatos en la infancia. Objetivo: determinar la presencia de sobrepeso y obesidad en niños de 5-12 años. Método: se realizó un estudio descriptivo de corte transversal, en el que se incluyeron 39 niños, seleccionados al azar, pertenecientes al área V del municipio Cienfuegos, en el período de marzo 2014-junio 2015. Las variables analizadas fueron: edad, sexo, peso, talla, evaluación nutricional, cifras de tensión arterial, antecedentes familiares de enfermedades no transmisibles. Los datos derivados del formulario aplicado fueron llevados a una base de datos extendida en el programa estadístico SPSS en su versión 18,0 y los resultados obtenidos se presentan en tablas mediante números y porcientos. Resultados: existió un predominio del sexo femenino (51,3 %) y de los grupos de edad de 5-6 años (41,0 %) y 7-8 años (28,2 %). El 71,8 % tuvo tensión arterial normal y el 35,90 % de los niños fue evaluado como obeso según el índice de masa corporal. El sobrepeso/obesidad y la hipertensión fueron los antecedentes más referidos por las madres (60,0 % y 33,3 %); entre los padres la hipertensión arterial ocupó el primer lugar, seguida del sobrepeso/obesidad y la diabetes mellitus. Conclusiones: un alto porciento de los niños son obesos desde edades tempranas de sus vidas.

Foundation: obesity is a serious health problem worldwide, from an infrequent disease it has become an emerging epidemic with immediate effects in childhood. Objective: to determine the presence of overweight and obesity in 5 to 12 year old children. Method: a descriptive transverse study was carried out in which 39 children were included, selected at random. They belong in area V Cienfuegos municipality during the period from March 2014 to June 2015. The variables analyzed were: age, sex, weight, height, nutritional evaluation, blood pressure values and family history of non transmissible diseases. The data derived from the applied questionnaire were taken to an extended database in the statistical program SPSS in its version 18.0 and the results obtained are presented in tables by numbers and percentages. Results: there was a predominance of the female sex (51.3 %) and age groups from 5 to 6 years (41, 0 %) and 7-8 years old (28.8 %). Normal blood pressure values were found in 71.8 % and 35.90 % of the children was evaluated like obese according to the index of corporal mass. Overweight, obesity and hypertension were the mostly referred antecedents by mothers (60.0 %, and 33.3 %), among parents arterial hypertension was in the first place, followed by overweight/obesity and diabetes mellitus. Conclusion: a high percentage of children are obese from early ages of their lives.

Autoestima en la adolescencia: análisis y estrategias de intervención / Self-Esteem in Adolescence: Analysis and Intervention Strategies

This paper reviews the current state of research on self-esteem by focusing on the factors that are relevant for the intervention in adolescents. Firstly, a conceptual distinction is made between self-concept, self-esteem and the perception of self-worth, and the relationship between them is analysed. It also considers the functioning of self-esteem on the basis of the contingencies of reinforcement and reviews their effects on the cognitive styles and behavioural coping. Secondly, it reviews the course of self-esteem on the basis of gender and discusses the role that contingencies of reinforcement play on its decline and instability during early adolescence. Thirdly, it reviews the findings that show the relationship of the shortcomings of self-esteem and the generation of a series of behavioural, emotional and health problems. Finally, the findings of the research on the intervention in self-esteem are reviewed, and the most useful strategies to help promote a change in teenagers are discussed (AU)

En este artículo se revisa el estado actual de la investigación sobre autoestima centrándose en los factores que son relevantes para la intervención en adolescentes. En primer lugar, se realiza una distinción conceptual y se analizan las relaciones entre autoconcepto, autoestima y percepción de autovalía. Se analiza también el funcionamiento de la autoestima en base a las contingencias de reforzamiento y se revisan sus efectos en los estilos cognitivos y conductuales de afrontamiento. En segundo lugar, se revisa la trayectoria de la autoestima en función del género y se analiza el papel que juegan las contingencias de reforzamiento en su disminución e inestabilidad durante la adolescencia temprana. En tercer lugar, se revisan los hallazgos que muestran la relación entre las deficiencias de autoestima y la generación de una serie de problemas de conducta, emocionales y de salud. Por último, se revisan los hallazgos sobre la intervención en autoestima y se analizan las estrategias más útiles para su cambio en la adolescencia (AU)

Development and validation of an attributional style questionnaire for adolescents.

We describe the development and psychometric characteristics of a new version of the Attributional Style Questionnaire (ASQ; Seligman, Abramson, Semmell, & Von Baeyer, 1979)--a version called the Attributional Style Questionnaire for Adolescents (ASQ-A)--using 3 samples (Ns = 547, 438, and 240) of Spanish secondary school students. In Study 1, the initial pool of 87 items was reduced to 54. Study 2 further analyzed the 54 scale items and revealed that the Internality, Stability, and Globality subscale scores had good reliability, good factorial construct validity, and satisfactory associations with maladaptive mood ratings. In Study 3, the regression analyses showed good and specific predictive validities of ASQ-A subscales for the attributions that the adolescents made about a particular real-life stressful situation. Study 4 showed that over an 8-month period the changes in the Stability and Globality subscales depended on the intensity of stressful life events experienced in this period. Overall, the studies revealed that the new ASQ-A served as an appropriate instrument to assess attributional style in adolescents.

Atención psicosocial de la embarazada / Psychosocial care of the pregnant woman

El embarazo puede ser motivo de satisfacción o insatisfacción en la mujer, dependiendo de la etapa del ciclo vital en que se produce y de las características del contexto socio familiar. La edad para el momento del embarazo, la situación económica, la funcionalidad de la familia, e incluso, la preparación socioemocional de la embarazada, pueden ser factores de riesgo que afecten el desarrollo del embarazo y el pronóstico de vida del recién nacido; por ello los aspectos psicosociales del embarazo han de ser estimados al momento de ofrecer una atención integral a la mujer embarazada. Conociendo la relación entre salud, nutrición, pobreza y calidad de vida; las condiciones socioeconómicas y de habitabilidad tienen un importante peso tanto en consumo alimentario, como en el riesgo a padecer enfermedades infecciosas que pueden afectar la evolución obstétrica y nutricional de la embarazada en el futuro hijo.

Programa de oxigenoterapia domiciliaria INERYCT / INERYCT domiciliary oxygen therapy program

La EBOC y la insuficiencia respiratoria crónica constituyen un problema importante de Salud Pública. Ha sido demostrado que la oxigenoterapia continua, mejora tanto la sobrevida como la calidad de vida de estos pacientes. Por esta razón, a partir de 1984 se inició la organización e implementación de un Programa de Oxigenoterapia (OD), dependiente del Servicio de Medicina del INERCYCT, que al momento actual dispone de una estructura operacionalmente eficiente. Los criterios de selección para ingresar pacientes al programa fueron: PaO2 <55 mmHg y ausencia de patología asociada grave y de hábitos nocivos. Se han evaluado 47 pacientes portadores de EBOC, de los cuales 16 fueron ingresados al estudio. Seis meses Post OD, observamos, disminución tanto de la frecuencia de hospitalizaciones como del número de días/cama, no observándose cambios en las espirometrías, PaO2, PaCO2 y ECG. Sin embargo, encontramos mejoría en la calidad de vida, objetivada a través de una entrevista psiquiátrica, lo cual a la luz de estudios previos, se podría atribuir a la oxigenoterapia aportada