189 results
Feed intake, microbial adherence and fibrolytic activity in residues of forage samples incubated in the rumen of sheep fed grass forages and/or a total mixed ration
- A. Pérez-Ruchel, J. L. Repetto, C. Cajarville, M. P. Mezzomo, G. V. Kozloski
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- Journal:
- The Journal of Agricultural Science / Volume 161 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 15 February 2024, pp. 871-876
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Three male sheep were fed, throughout three experimental periods, with either only forage, only total mixed ration (TMR) or a mixed diet (TMR + forage). The rich-fibre ingredients of each diet were incubated daily in situ for three days and the ruminal pH was measured every 2 h during the last day of each experimental period. Rumen pH decreased at increased proportion of TMR in diet (P < 0.05). The dry matter (DM) degradability of the grass forage was higher (P < 0.05) in animals receiving only forage than in those receiving the mixed diet whereas the DM degradability of the corn silage was higher (P < 0.05) in animals receiving the mixed diet than in those receiving only TMR. The level of microbial adherence in residues of grass forage was higher (P < 0.05) in animals fed with only forage than in those fed with the mixed diet and, the level of microbial adherence in residue of corn silage was higher (P < 0.05) in animals receiving the mixed diet than in those receiving TMR. The carboxymethylcellulase activity in residues of grass forage was higher (P < 0.05) in sheep fed the mixed diet whereas not significant effect of diet type was observed for this variable in residues of corn silage. In conclusion, increased inclusion of TMR in sheep diet showed a negative impact on microbial adherence and forage degradability in situ, an effect mediated by changes in rumen pH which was not compensated by increased fibrolytic activity.
Proton and helium ions acceleration in near-critical density gas targets by short-pulse Ti:Sa PW-class laser
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- J.L. Henares, P. Puyuelo-Valdes, C. Salgado-López, J.I. Apiñaniz, P. Bradford, F. Consoli, D. de Luis, M. Ehret, F. Hannachi, R. Hernández-Martín, A. Huber, L. Lancia, M. Mackeviciute, A. Maitrallain, J.-R. Marquès, J.A. Pérez-Hernández, C. Santos, J.J. Santos, V. Stankevic, M. Tarisien, V. Tomkus, L. Volpe, G. Gatti
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- Journal:
- Journal of Plasma Physics / Volume 89 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 28 December 2023, 965890601
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The ability to quickly refresh gas-jet targets without cycling the vacuum chamber makes them a promising candidate for laser-accelerated ion experiments at high repetition rate. Here we present results from the first high repetition rate ion acceleration experiment on the VEGA-3 PW-class laser at CLPU. A near-critical density gas-jet target was produced by forcing a 1000 bar H$_2$
and He gas mix through bespoke supersonic shock nozzles. Proton energies up to 2 MeV were measured in the laser forward direction and 2.2 MeV transversally. He$^{2+}$
ions up to 5.8 MeV were also measured in the transverse direction. To help maintain a consistent gas density profile over many shots, nozzles were designed to produce a high-density shock at distances larger than 1 mm from the nozzle exit. We outline a procedure for optimizing the laser–gas interaction by translating the nozzle along the laser axis and using different nozzle materials. Several tens of laser interactions were performed with the same nozzle which demonstrates the potential usefulness of gas-jet targets as high repetition rate particle source.
The evolving role of data & safety monitoring boards for real-world clinical trials
- Bryan J. Bunning, Haley Hedlin, Jonathan H. Chen, Jody D. Ciolino, Johannes Opsahl Ferstad, Emily Fox, Ariadna Garcia, Alan Go, Ramesh Johari, Justin Lee, David M. Maahs, Kenneth W. Mahaffey, Krista Opsahl-Ong, Marco Perez, Kaylin Rochford, David Scheinker, Heidi Spratt, Mintu P. Turakhia, Manisha Desai
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 02 August 2023, e179
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Introduction:
Clinical trials provide the “gold standard” evidence for advancing the practice of medicine, even as they evolve to integrate real-world data sources. Modern clinical trials are increasingly incorporating real-world data sources – data not intended for research and often collected in free-living contexts. We refer to trials that incorporate real-world data sources as real-world trials. Such trials may have the potential to enhance the generalizability of findings, facilitate pragmatic study designs, and evaluate real-world effectiveness. However, key differences in the design, conduct, and implementation of real-world vs traditional trials have ramifications in data management that can threaten their desired rigor.
Methods:Three examples of real-world trials that leverage different types of data sources – wearables, medical devices, and electronic health records are described. Key insights applicable to all three trials in their relationship to Data and Safety Monitoring Boards (DSMBs) are derived.
Results:Insight and recommendations are given on four topic areas: A. Charge of the DSMB; B. Composition of the DSMB; C. Pre-launch Activities; and D. Post-launch Activities. We recommend stronger and additional focus on data integrity.
Conclusions:Clinical trials can benefit from incorporating real-world data sources, potentially increasing the generalizability of findings and overall trial scale and efficiency. The data, however, present a level of informatic complexity that relies heavily on a robust data science infrastructure. The nature of monitoring the data and safety must evolve to adapt to new trial scenarios to protect the rigor of clinical trials.
Assessment of executive functions through a virtual reality task in euthymic patients with bipolar disorder and influence in psychosocial functioning
- J. Andreu Martínez, D. Beltrán Cristancho, P. Navalón, P. Sierra San Miguel, A. García Blanco, A. Chicchi Glioli, S. Cervera Torres, M. Alcañiz Raya, Y. Cañada Pérez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S700
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Introduction
Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia in in patients with bipolar disorder (BD) and that those are associated with an impairment of psychosocial functioning. The assessment of executive functions (EFs) is normally carried out using laboratory tests. Novel methodologies such as virtual reality (VR) allow the creation of immersive environments, to evaluate executive performance with greater potential for ecological validity than evaluations with standard tasks.
ObjectivesThe objectives of this project are to evaluate executive performance in euthymic patients with BD with a novel virtual reality task compared to standard computerized tasks, and to find predictors of functioning associated with cognitive performance.
MethodsThis is a cross sectional study in which 46 euthymic patients with BD treated at La Fe University and Polytechnic Hospital were assessed with a battery of standard computerized tasks (ST) (TMT/Stroop,/Go-No-Go/TOL/DOT) and with the Cooking Task virtual reality task. The Cooking Task presents 4 tasks of increasing difficulty in which you must cook food in a specific time. It records total time to complete the task, whether food is cooled or burned, the simultaneous use of two fires, the proper use of seasonings and the time to set the table.
Functioning was assessed with the Functioning Assessment Short Test (FAST) that evaluates the overall functioning of patients with a mental illness in 6 subscales.
Correlation analyses between cognitive performance variables and clinical variables were done. Multiple linear regression was performed with the FAST score as a dependent variable and cognitive performance variables and relevant clinical variables to executive functioning (months of euthymia, age, and number of total episodes) were included as independent variables.
ResultsA worse psychosocial functioning was significantly associated with a worse performance in standard tasks (TMTA, TMTB, STROOP, and TOL) and cooking task (total time spent on task 2, burning time and total time spent on task 3, and total time spent on task 4). In the regression analysis, the correct simultaneous use of the two fires was the best predictor of a better psychosocial functioning in BD patient. This implies the preserved ability of planning and performing dual tasks.
ConclusionsOur findings suggest that euthymic patients with BD present deficits in executive functions related with a worse psychosocial functioning. Among the tasks, the cooking task may have a greater sensitivity than standards task to predict real functioning. This in an opportunity to design virtual applications for diagnostic and therapeutic purposes.
Disclosure of InterestNone Declared
Group psychotherapy for patients with first-episode psychosis: Effect on the clinical status and use of resources
- P. Herrero Ortega, A. Oliva Lozano, J. Garde González, C. Bayón-Pérez, R. Mediavilla, M. P. Vidal-Villegas, B. Rodríguez-Vega, S. Cebolla, E. Román, E. V. Pérez Pérez, M. F. Bravo-Ortiz, O. B. O. AGES-Mind Group
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S635-S636
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Introduction
Psychotic disorders carry several economical, psychological and social consequences, both at individual and community levels. Early intervention programs after first-episode psychosis which combine pharmacological and psychosocial strategies are aimed at reducing symptoms, lowering costs in the use of health and non-health care resources and improving overall functioning. AGES-Mind study is based on manualized psychotherapeutic interventions for people with first-psychosis episodes.
ObjectivesThe aim of the study was to evaluate the effect of a group psychotherapeutic intervention on the clinical status and use of clinical resources in a sample of patients with first-episode psychosis at 12 and 24 months after the beginning of the intervention. This cohort will be compared to patients with first-psychosis episodes without group psychotherapeutic intervention.
MethodsLongitudinal, observational, retrospective study on a cohort of N=46 patients with first-episode psychosis within the last 5 years. Two groups of 23 patients each were formed. The participants of one of those groups received group psychotherapy in the context of the AGES-Mind study and the other group received treatment as usual without group intervention. Non-exposed patients were matched by age, gender and time elapsed since first-episode psychosis with those exposed to the intervention. Sociodemographic data, clinical status and use of clinical resources outcome variables were assessed.
ResultsNo significant differences were found in clinical status and use of resources between participants and non-participants in the psychotherapeutic group intervention after 12 and 24 months.
ConclusionsAfter controlling for potentially confounding variables as sociodemographic, age and time since first-episode, participating in a group psychotherapeutic program does not seem to improve clinical variables or use of resources. Further studies with larger samples would be necessary to explore other variables, such as symptoms, satisfaction with the intervention or social functioning.
Disclosure of InterestNone Declared
Continuous Theta-Burst Stimulation in a 9-year-old girl with a history of neurotoxicity after Acute Lymphoblastic Leukemia B
- A. Moleon, M. Martín-Bejarano, T. Javier, I. Pérez, T. Rosa, M. Garcia-Ferriol, P. Rocío, J. M. Oropesa, N. Javier
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S144-S145
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Introduction
Transcranial Magnetic Stimulation is a non invasive brain stimulation technique used for several neuropsychiatric conditions. The treatment of Acute Lymphoblastic Leukaemia (ALL) involves many cytotoxic drugs that inhibit the rapid growth of cancer cells, but also damage healthy cells, resulting in a wide range of adverse effects (Śliwa-Tytko et al., 2022). Studies have shown that approximately 10-30% of paediatric ALL patients suffer from psychiatric disorders. Therefore, new therapeutic tools are needed, and repetitive transcranial magnetic stimulation (rTMS) has demonstrated tolerability, effectiveness and safety in children (Allen et al., 2017).
ObjectivesWe discuss the first case of a 9-year-old girl diagnosed with acute lymphoblastic leukaemia B in who underwent Continuous Theta-Burst Stimulation
MethodsCase Presentation. In this study, we describe a case of a 9-year-old girl diagnosed with acute lymphoblastic leukaemia B in November 2016 who completed treatment in July 2019. Since April 2018 she presented symptoms of intracranial hypertension and encephalopathy with behavioural alterations, attention deficit secondary to toxicity. Psychotic outbreaks after toxicity from different treatments was also present. Since starting pericyazine (July 2022) there has been a slight improvement, but her symptoms continue to have a severe impact in her daily functioning. Baseline developmental profile assessed with the Battelle Inventory was significantly below the expected level in all developmental areas except for gross motor skills. Treatment. The TMS intervention consisted of the application on right DLPFC (F4), inhibitory cTBS protocol (5Hz bursts and 3 pulses of 50 Hz each). The protocol consisted in delivering 2 sessions per day for 15 days (separated by 55 minutes), 4 minutes per session (3600 pulses/session), 30 sessions in total. An intensity of 100% of resting motor threshold (C4). TMS was performed with the Magventure Magpro X100 MagOption equipment, Cool DB-80 double cone coil. The Child Behaviour Checklist (CBCL) for parents was used to assess intervention effects.
ResultsCBCL results reflect improvements in both internalising and externalising total scores after treatment. Specifically, the patient presents clinically significant decreases in several dimensions such as anxious/depressed symptoms, somatic complaints, and social problems. No adverse effects have been reported since the beginning of the intervention.
ConclusionsInternalising and externalising behaviours severity were reduced after 30 TMS sessions. In accordance with the latest systematic reviews on the safety of TMS in the paediatric patient (Zewdie et al, 2020) we propose the development of paediatric guidelines to offer this technique to patients with a history of intolerability or poor drug response.
Disclosure of InterestNone Declared
AGESMind clinical trial: SocialMIND® results at 16 weeks
- M. P. Vidal-Villegas, A. Abad Pérez, P. Herrero Ortega, A. Oliva Lozano, J. Garde González, J. Andreo-Jover, A. Muñoz-Sanjosé, R. Mediavilla, B. Rodríguez-Vega, G. Lahera, Á. Palao-Tarrero, C. Bayón-Pérez, M. F. Bravo-Ortiz
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S480-S481
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Introduction
Early intervention on a first psychotic episode is fundamental for a more favorable prognosis, and it usually combines pharmacological treatment, which mainly affects positive psychotic symptoms, with interventions that can improve the rest of the symptoms and associated problems such as deterioration in social functioning (Harvey & Penn, 2010; Fusar-Poli, McGorry & Kane, 2017). While Mindfulness is gaining more and more prominence in the field of psychotherapy (Chan et al., 2019; Cillesen et al., 2019), social cognition and social functioning are being researched as key targets on which to intervene after a first psychotic episode (Green, Horan & Lee, 2015).
SocialMIND® is a mindfulness-based social cognition training tailor-made to improve social functioning in people who have suffered a first psychotic episode within the last five years. It is currently being compared with a group Psychoeducational Multicomponent Intervention (PMI) in a Randomized Controlled Trial (RCT) (Mediavilla et al., 2019). Both group psychotherapies include 17 sessions delivered over a 9 month period: 8 weekly sessions, 4 biweekly sessions and 5 monthly sessions.
The results of SocialMIND® at 8 weeks showed improvements in social cognition and social functioning, specifically on affective social cognition and self-care (Mediavilla et al., 2021).
ObjectivesTo evaluate the efficacy of SocialMIND® in improving social functioning, measured by the Personal and Social Functioning (PSP) scale 16 weeks after starting the intervention, in people who have suffered a first psychotic episode in the last 5 years.
MethodsRandomized, controlled pilot trial (use of a psychoeducational multicomponent intervention or PMI as active comparator) of two parallel groups (SocialMIND® and PMI) with a 1:1 ratio using a blind evaluator.
ResultsNo statistically significant differences were found in the social functioning variable between the two treatment arms. Intragroup differences are observed in other secondary variables studied (social cognition) 16 weeks after starting the interventions.
ConclusionsSocialMIND® has not been shown to be more effective than a PMI in improving social functioning at 16 weeks after starting the intervention in people who have suffered a first psychotic episode in the five years prior to being included in the study.
Disclosure of InterestNone Declared
Risk factors contributing to the possibility of conducting intensive home treatment and to the risk of hospitalization of 1045 home treated patients with Schizophrenia
- A. Sabaté, R. Talisa, D. Córcoles, J. León, A. Malagon, A. M. González, M. Bellsolà, P. Samos, F. Casanovas, M. A. Jerónimo, L. M. Martin, V. Pérez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S184
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Introduction
Home Treatment (HT) teams are among the better-studied options to reduce admission at the hospital, having been described as an alternative to hospitalization in patients with schizophrenia. There may be certain risk factors which has already been described such as living alone (Dean and Gadd, BMJ, 1990; 301, 1021–1023; Schnyder et al., Acta Psychiatr. Scand. 1999; 99, 179–187), lack of awareness of the illness, uncooperativeness (Cotton et al., BMC Psychiatry, 2007; 7, 52) and fewer visits carried out (Morgan et al., Aust. New Zeal. J. Psychiatry,2006; 40, 683–690) which together can negatively influence the possibility of conducting intensive home follow-up and, therefore, increase the likelihood of hospitalization.
ObjectivesTo describe de relative contribution of several risk factors to patient hospitalization related to the possibility of conducting intensive home follow-up of patients diagnosed with Schizophrenia following home treatment. Second, to determine de risk of hospitalization related to the possibility of conducting intensive home follow-up according to the presence of one or more risk factors of patients diagnosed with Schizophrenia following home treatment.
MethodsAll patients with schizophrenia who were visited by a home treatment team in Barcelona between January 2017 and December 2021 were included in the study. To assess whether there was an increased risk of hospitalization associated with factors such as living alone, uncooperativeness (PANSS G8 item >= 4) and ≤1 home visit, two bivariate logistic regression analyses were conducted. We studied these factors as independent variables to assess the relative contribution to the risk of hospitalization, and we studied if the presence of 1, 2, 3 or 4 of these risk factors as independent variables worsened the risk of hospitalization.
ResultsUncooperativeness shows the highest contribution to the risk of hospitalization, followed by ≤ 1 home visit, lack of insight and living alone, all results reaching significance (p=0.000).
There is an increase in the risk of hospitalization depending of the presence of 1,2,3 or 4 of these risk factors (1 risk factor (Odds Ratio = 1.21), 2 risk factors (Odds Ratio = 5.28), 3 risk factors (Odds ratio = 13.53), 4 risk factors (Odds ratio = 29.18).
ConclusionsThere are a number of factors directly related to the possibility of conducting intensive follow-up that appear relevant in the case of psychotic patients in acute crisis treated at home. This set of variables are the lack of awareness of the illness, lack of collaboration, living alone and the number of visits that have been made, all with statistically significant differences in our study. These factors together also greatly increase the risk of hospitalization, becoming almost 30 times more likely when these 4 factors are present.
Disclosure of InterestNone Declared
Understanding socio-labor inclusion among young adults with autism spectrum and mental disorders: preliminary findings
- M. S. Burrone, M. J. González, M. T. Solís-Soto, P. Valenzuela, L. Rojas, L. Colantonio, C. Cortés, C. Pérez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S436-S437
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Introduction
Previous studies suggest that adults with mental disorders (MD) or Autism Spectrum Disorder (ASD) are more likely to be unemployed than those without MD. However, it is unclear whether working adults with MD or ASD perceive the same effort-reward balance as their counterparts without MD or ASD.
ObjectivesTo analyze labor conditions and to identify factors associated with effort-reward imbalance among young adults with ASD, MD and those from the general population (GP).
MethodsA qualitative and quantitative study design is being conducted to analyze the rates of employment among young adults with ASD, and to identify factors associated with employment rates (Fondecyt ID11201028.). As part of this study, we conducted a quantitative analysis in young adults 16 to 30 years of age in two regions of Chile between August and October, 2022. Young adults with MD and ASD were compared with adults of similar age recruited from the GP. We applied a questionnaire to collect data on participant’s sociodemographic information, autonomy level and employment status. We applied the short Spanish version of the effort–reward imbalance (ERI) and overcommitment (OC) questionnaire, which has been widely used in Latin American countries.
Chi-square test was used and the Kruskal Wallis H Test was applied to compare among groups. The statistical significance was set at P<0.05.
ResultsOverall, 422 participants were included in the analysis (mean age 22±3.2, 64.2% women, 65.2% students, and 4.4% unemployed). Of the total respondents, 22% of young adults from GP, 17.8% with MD, and 4.8% with ASD were working at the moment of the survey. Regarding autonomy level, a higher proportion of participants with ASD needed support (36.4%), compared with 9.7% and 0.8% of young adults with MD and GP, respectively. Of the population who reported working (n=125), about 56.0% have a permanent job, and 44% a seasonal or occasional job. The median value for the effort–reward ratio was 0.96 (range 0.4–1.8), with no significant differences between the groups. Of those participants working, 44.3% showed an ERI ratio higher than 1, which was higher in participants with ASD (60%). ERI-esteem was significantly different (P=0.01) among ASD (7.0; range 5-8), MD (6.0; range 2-8) and PG (6.0; range 2-8). In the OC questionnaire, young adults with ASD were more likely to think about work (P=0.01) and having trouble sleeping at night due to work issues (P=0.03) than GP and MD groups.
ConclusionsThe ASD group showed higher overcommitment and a considerable proportion of subjects at risk of effort-reward imbalance at work, were more likely to think about work at home, and had trouble sleeping thinking about work. Our preliminary results highlight the importance of considering the working conditions of young adults diagnosed with ASD and the need to provide them with enough support to promote labor inclusion.
Disclosure of InterestNone Declared
Psychiatric comorbidity profiles among suicidal attempters: A cohort study
- Y. Sanchez-Carro, M. Diaz-Marsa, V. Fernandez-Rodrigues, W. Ayad-Ahmed, A. Pemau, I. Perez-Diaz, A. Galvez-Merlin, P. de la Higuera-Gonzalez, V. Perez-Sola, P. Saiz, I. Grande, A. Cebria, J. Andreo-Jover, P. Lopez-Peña, M. Ruiz-Veguilla, A. de la Torre-Luque
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S318-S319
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Introduction
More than 700,000 people die by suicide in 2019 globally (World Health Organitation 2021). Mental health problems constitute a risk factor for suicidal behavior and death by suicide (Hoertel et al. Mol Psychiatry 2015; 20 718–726). Different mental disorders have been related to different forms of suicidal ideation and behavior (Conejero et al. Curr Psychiatry Rep 2018; 20, 33) (Quevedo et al. Compr Psychiatry 2020; 102 152194). However, little is known on comorbidity profiles among suicide attempters.
ObjectivesThe aim of our work was to identify the psychiatric comorbidity profiles of individuals who were admitted a hospital emergency department due to a suicide attempt. Moreover, it intended to know their clinical characteristics according to comorbidity profile.
MethodsA sample of 683 attempters (71.30% female; M age= 40.85, SD= 15.48) from the SURVIVE study was used. Patients were assessed within the 15 days after emergency department admission. Sociodemographic (i.e., sex, age, marital status and employment status) and clinical data were collected. The International Neuropsychiatric Interview (MINI) was used to assess DSM-V Axis 1 mental health diagnoses and the Columbia Suicide Rating Scale (C-SSRS) to assess suicidal ideation and behavior. The Acquired Capacity for Suicide-Fear of Death Scale (ACSS-FAD), the Patient Health Questionnaire (PHQ-9) to assess the frequency of depressive symptoms during the past 2 weeks, and the General Anxiety Disorder-7 (GAD-7) scale to assess symptoms of worry and anxiety were also conducted. For the identification of comorbidity profiles, latent class analysis framework was followed considering diagnosis to each individual disorder as clustering variables. On the other hand, binary logistic regression was used to study the relationship between comorbidity profile membership and clinical factors.
ResultsTwo classes were found (Class I= mild symptomatology class, mainly featured by emotional disorder endorsement; and Class II= high comorbidity class, featured by a wide amount of endorsed diagnoses) (see figure 1). Individuals from the High comorbidity class were more likely to be female (OR= 0.98, p<.05), younger in age (OR= 0.52, p< .01), with more depressive symptoms (OR=1.09, p<.001) and have greater impulsivity (OR= 1.01, p<.05).
Image:
ConclusionsWe found two profiles of people with suicidal behavior based on the presence of mental disorders. Each of the suicidal subtypes had different associated risk factors. They also had a different profile of suicidal behavior.
Disclosure of InterestNone Declared
Positive and Negative Syndrome Scale (PANSS) predictors of hospitalization during home treatment on 1045 patients with schizophrenia in acute crisis
- R. Talisa, A. Sabaté, D. Córcoles, J. Leon, A. Malagón, A. M. González, M. Bellsolà, P. Samos, M. Á. Jerónimo, L. M. Martín, V. Pérez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S640-S641
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Introduction
Several factors related to the risk of requiring psychiatric hospitalization have been described in patients diagnosed with schizophrenia treated with methods other than home treatment. With regard to the symptoms, high global illness severity and positive symptoms of schizophrenia have been most frequently related to the risk of hospitalization in patients with schizophrenia. However, there are no studies describing which clinical factors increase the likelihood of being hospitalized while undergoing home follow-up.
ObjectivesTo determine which of the clinical factors assessed in the PANSS predict the risk of hospitalization in patients diagnosed with schizophrenia following a home treatment program.
MethodsAll patients with schizophrenia who were visited by a home treatment team in Barcelona between January 2017 and December 2021 were included in the study. A comparative, bivariate analysis of each item of the PANSS and of the global results of each category was conducted on those who were hospitalized and those who were not hospitalized. Finally, a logistic regression of each category of the PANSS was done on both groups, controlling for other socio-demographic and clinical factors.
ResultsA total of 1045 patients with schizophrenia were evaluated in this study. PANSS positive symptom subscale (PANSS-S), PANSS General Psychopathology, PANSS Excited Component and PANSS Global Score scored higher in patients who were finally hospitalized in a conventional acute treatment unit. Regarding the PANSS negative symptom subscale, no significant differences were found between the two groups.
In patients who required hospitalization, the scores of all the PANSS positive symptom subscale (PANSS-P) items and all items on the PANSS excited component (excitement, tension, hostility, uncooperativeness and poor impulse control) were significantly higher. Some items regarding general psychopathology (Somatic concern, anxiety, guilt feelings, tension, and mannerisms) were also significantly higher in the hospitalization group. Only 3 items—blunted affect, guilt feelings and motor retardation—scored significantly higher in patients who did not require hospitalization. In the logistic regression, only the global score of the PANSS-P reached statistical significance (P = 0.001).
ConclusionsPositive symptoms scored in the PANSS seem to be the most predictive factors of hospitalization regarding clinical symptoms in patients with Schizophrenia following home treatment. Other items regarding exciting symptoms and general psychopathology also showed as relevant regarding the risk of conventional hospitalization in those patients.
Disclosure of InterestNone Declared
Post-compression of high-energy, sub-picosecond laser pulses
- P.-G. Bleotu, J. Wheeler, S. Yu. Mironov, V. Ginzburg, M. Masruri, A. Naziru, R. Secareanu, D. Ursescu, F. Perez, J. De Sousa, D. Badarau, E. Veuillot, P. Audebert, E. Khazanov, G. Mourou
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- Journal:
- High Power Laser Science and Engineering / Volume 11 / 2023
- Published online by Cambridge University Press:
- 16 February 2023, e30
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The post-compression technique based on self-phase modulation of high-energy pulses leads to an increase in achievable peak power and intensity. Typically, the pulses considered in experiments have been less than 100 fs in duration. Here, the method is applied to the ELFIE laser system at the LULI facility, for a pulse of 7 J energy and an initial measured duration of 350 fs. A 5-mm-thick fused silica window and a 2 mm cyclic-olefin polymer were used as optical nonlinear materials. The 9 cm diameter beam was spectrally broadened to a bandwidth corresponding to 124 fs Fourier-limited pulse duration, and then it was partly post-compressed to 200 fs. After measuring the spatial spectra of the beam fluence, a uniform gain factor of 4 increase in the fluctuations over the studied range of frequencies is observed, due to small-scale self-focusing.
Reinforcing the new diagnosis of Complex Post-Traumatic Stress disorder (CPTSD) of ICD-11: exploring the clinical outcomes in youth exposed to complex trauma
- L. Marques Feixa, S. Romero, J. Moya-Higueras, P. Santamarina-Pérez, J. March-Llanes, M.J. Muñoz, I. Zorrilla, M. Rapado-Castro, H. Blasco-Fontecilla, E. Anglada, M. Ramirez, L. Fañanas
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S448-S449
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Introduction
Youth exposed to complex trauma (CT) show an increased risk of psychiatric morbidity, including a wide range of psychiatric disorders. However, to date, there is no specific diagnosis in the DSM-5 that capture the clinical complexity of these patients. Properly, the last version of the ICD-11 includes a diagnosis termed Complex Post-Traumatic Stress Disorder (CPTSD), which considers the pattern of post-traumatic stress symptoms, plus life-impairing disturbances in self-organization (emotion dysregulation, negative self-concept and interpersonal problems). Clinical research about CPTSD, especially in younger population, is still limited.
ObjectivesTo explore the symptomatology of CPTSD in a sample of youth exposed to CT and its association with worse clinical outcomes.
Methods187 youth aged 7 to 17 years participated in the EPI_young_stress_project (116 with current psychiatric disorder and 71 healthy controls). CT was evaluated following the TASSCV criteria. To identify CPTSD symptomatology, we performed an exploratory factor analysis including CBCL and TEIQue items. The global level of functioning was measured by CGAS.
ResultsPreliminary results pointed that youth exposed to CT showed greater internalizing (p<.001) and externalizing (p<.001) symptomatology. Regardless of their current primary diagnosis based on DSM-5, youth exposed to CT reported more CPTSD symptomatology (p<.001). Moreover, youth with CPTSD showed greater use of psychotropic drugs (p<.001), higher and longer hospitalizations (p=.002) and worse overall functioning (p<.001).
ConclusionsThe inclusion of the CPTSD in future versions of mental disorders manuals should increase the implementation of early specific trauma interventions, which may improve victims’ lives and reduce the risk of worse clinical outcomes.
DisclosureNo significant relationships.
Comorbility symptoms in AHDH adult patients
- P. Marqués Cabezas, A.I. Segura Rodríguez, P. García Barriuso, L. Gallardo Borge, M.J. Mateos Sexmero, J.A. Blanco, M. Queipo De Llano De La Viuda, M. Perez Carranza, A. Aparicio Parras, J. Espina Barrio, A. Rodriguez Campos
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S466
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Introduction
Adults may continue suffering AHDH symptoms after this condition is recognized and typified in children. Different works provide evidence that adults have an even more complicated variety of psychiatric disorders than children, as an increased risk of problems stemming from substance abuse, depression, anxiety, increased risk of traffic accidents, and also sexual transmission diseases.
ObjectivesThere was known that adults could continue suffering symptoms derived from his infantile ADHD. We wonder if the majority of the young males derived to our consultation present compatible symptoms with adult ADHD. This condition promotes the onset of substance use and may lead to latent psychosis onset.
MethodsWe analyzed 39 patients derived by suspicion of psychiatric pathology, aged between 17 and 35. They stem to clinical psychology for study of features of personality (Million Questionnaire). Another questionnaire was used also autoapplied for sifted of the ADHD in adults (ASRS_V1:1). According to the criteria DSM-IV TR, the patient had moderate symptoms of ADHD if it was fulfilling 6 or more diagnostic criteria according to their answers in the screening questionnaire.
ResultsThe results supported the existence of impulsivity, aggression, irritability, problems with compliance and substance abuse.
ConclusionsADHD is not only a problem of distractibility or worry, but a deeper and extensive alteration caused by the deterioration of a set of cerebral activities. An early treatment in the childhood could prevent devastating consequences for their development, since they include the majority of the functional areas of the patient and it impedes their later social and labor adjustment.
DisclosureNo significant relationships.
Use of verbal de-escalation in reducing need for mechanical restraint in patients with psychotic disorders during non-voluntary transfers from home to the psychiatric emergency department
- E. Miranda Ruiz, A. Gonzalez, P. Samos, M. Bellsola, A. Sabate, J. Leon, M.A. Jerónimo, V. Pérez-Solà, L.M. Martin, D. Corcoles
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S589
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Introduction
Little is known about the need for mechanical restraint during non-voluntary transfers from patient’s homes to the psychiatric emergency department in patients diagnosed with Paranoid Schizophrenia. Although there is no evidence of its efficacy, one of the main tools used for the reduction of mechanical restraints is verbal de-escalation training.
ObjectivesThe aim is to describe which symptoms predispose to mechanical restrain in patients with Paranoid Schizophrenia transferred in a non-voluntary manner from home to the psychiatric emergency department, and the effect on reducing mechanical restraints after receiving verbal de-escalation training.
MethodsAll patients with Paranoid Schizophrenia who, after being visited by a home psychiatry team, have required non-voluntary transfer from their homes to the psychiatric emergency department were selected (N = 442).
ResultsYoung age, being male, having a poor adherence to treatment, higher scores for de following variables; Excitement, Grandiosity, Suspiciousness, Hostility, Abstract thinking, Motor tension, Uncooperativeness, Poor attention, Lack of insight and Poor impulse control as well as lower scores in motor retardation on the PANSS, are related to a higher frequency of mechanical restrain (P<0,005). Before the verbal de-escalation training, 43.9% of the transferred patients required mechanical restraint, after the training, the need for restraints was reduced to 25.5% (P<0.001).
ConclusionsTraining in verbal de-escalation has allowed an important reduction in mechanical restraints in patients with schizophrenia who have required non-voluntary transfers from home to the psychiatric emergency department.
DisclosureNo significant relationships.
Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health
- M. R. Gutierrez-Colosia, P. Hinck, J. Simon, A. Konnopka, C. Fischer, S. Mayer, V. Brodszky, L. Hakkart-van Roijen, S. Evers, A. Park, H. H König, W. Hollingworth, J. A Salinas-Perez, the PECUNIA Group, L. Salvador-Carulla
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 31 / 2022
- Published online by Cambridge University Press:
- 22 August 2022, e59
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Aims
Health services research (HSR) is affected by a widespread problem related to service terminology including non-commensurability (using different units of analysis for comparisons) and terminological unclarity due to ambiguity and vagueness of terms. The aim of this study was to identify the magnitude of the terminological bias in health and social services research and health economics by applying an international classification system.
MethodsThis study, that was part of the PECUNIA project, followed an ontoterminology approach (disambiguation of technical and scientific terms using a taxonomy and a glossary of terms). A listing of 56 types of health and social services relevant for mental health was compiled from a systematic review of the literature and feedback provided by 29 experts in six European countries. The disambiguation of terms was performed using an ontology-based classification of services (Description and Evaluation of Services and DirectoriEs – DESDE), and its glossary of terms. The analysis focused on the commensurability and the clarity of definitions according to the reference classification system. Interrater reliability was analysed using κ.
ResultsThe disambiguation revealed that only 13 terms (23%) of the 56 services selected were accurate. Six terms (11%) were confusing as they did not correspond to services as defined in the reference classification system (non-commensurability bias), 27 (48%) did not include a clear definition of the target population for which the service was intended, and the definition of types of services was unclear in 59% of the terms: 15 were ambiguous and 11 vague. The κ analyses were significant for agreements in unit of analysis and assignment of DESDE codes and very high in definition of target population.
ConclusionsService terminology is a source of systematic bias in health service research, and certainly in mental healthcare. The magnitude of the problem is substantial. This finding has major implications for the international comparability of resource use in health economics, quality and equality research. The approach presented in this paper contributes to minimise differentiation between services by taking into account key features such as target population, care setting, main activities and type and number of professionals among others. This approach also contributes to support financial incentives for effective health promotion and disease prevention. A detailed analysis of services in terms of cost measurement for economic evaluations reveals the necessity and usefulness of defining services using a coding system and taxonomical criteria rather than by ‘text-based descriptions’.
Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey
- J. Alonso, G. Vilagut, I. Alayo, M. Ferrer, F. Amigo, A. Aragón-Peña, E. Aragonès, M. Campos, I. del Cura-González, I. Urreta, M. Espuga, A. González Pinto, J. M. Haro, N. López Fresneña, A. Martínez de Salázar, J. D. Molina, R. M. Ortí Lucas, M. Parellada, J. M. Pelayo-Terán, A. Pérez Zapata, J. I. Pijoan, N. Plana, M. T. Puig, C. Rius, C. Rodriguez-Blazquez, F. Sanz, C. Serra, R. C. Kessler, R. Bruffaerts, E. Vieta, V. Pérez-Solá, P. Mortier, MINDCOVID Working group
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 31 / 2022
- Published online by Cambridge University Press:
- 29 April 2022, e28
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Aims
Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors.
Methods8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview.
Results4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar.
ConclusionsOur study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565
Simulating infrared spectro-photometric surveys with a Spritz
- Part of
- L. Bisigello, C. Gruppioni, F. Calura, A. Feltre, F. Pozzi, C. Vignali, L. Barchiesi, G. Rodighiero, M. Negrello, F. J. Carrera, K. M. Dasyra, J. A. Fernández-Ontiveros, M. Giard, E. Hatziminaoglou, H. Kaneda, E. Lusso, M. Pereira-Santaella, P. G. Pérez González, C. Ricci, D. Schaerer, L. Spinoglio, L. Wang
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- Journal:
- Publications of the Astronomical Society of Australia / Volume 38 / 2021
- Published online by Cambridge University Press:
- 17 December 2021, e064
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Mid- and far-infrared (IR) photometric and spectroscopic observations are fundamental to a full understanding of the dust-obscured Universe and the evolution of both star formation and black hole accretion in galaxies. In this work, using the specifications of the SPace Infrared telescope for Cosmology and Astrophysics (SPICA) as a baseline, we investigate the capability to study the dust-obscured Universe of mid- and far-IR photometry at 34 and
$70\, {\rm{\mu }}\mathrm{m}$ and low-resolution spectroscopy at
$17{-}36\, {\rm{\mu }}\mathrm{m}$ using the state-of-the-art Spectro-Photometric Realisations of Infrared-selected Targets at all-z (Spritz) simulation. This investigation is also compared to the expected performance of the Origins Space Telescope and the Galaxy Evolution Probe. The photometric view of the Universe of a SPICA-like mission could cover not only bright objects (e.g.
$L_{IR}>10^{12}\,{\rm L}_{\odot}$ ) up to
${z}=10$ , but also normal galaxies (
$L_{IR}<10^{11}\,{\rm L}_{\odot}$ ) up to
$\textit{z}\sim4$ . At the same time, the spectroscopic observations of such mission could also allow us to estimate the redshifts and study the physical properties for thousands of star-forming galaxies and active galactic nuclei by observing the polycyclic aromatic hydrocarbons and a large set of IR nebular emission lines. In this way, a cold, 2.5-m size space telescope with spectro-photometric capability analogous to SPICA, could provide us with a complete three-dimensional (i.e. images and integrated spectra) view of the dust-obscured Universe and the physics governing galaxy evolution up to
$\textit{z}\sim4$ .
426 - Character Strengths association with Personal Growth in Grandparents providing Regular Care
- C. Noriega, J. López, G. Pérez-Rojo, L. Galarraga, C. Velasco, M.I. Carretero, P. López-Frutos
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, p. 47
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Introduction
The number of grandparents providing regular care for their grandchildren has increased substantially. Data drawn from the SHARE survey shows regular caregivers care for more than 30 hours per week in Europe. This means that many regular caregivers are performing tasks that are part of parents’ responsibilities. Some research has shown lower perceived health and role strain. However, it can also offer opportunities to grow. Rapid social changes have led to grandparents not perceiving their predecessors as role models, making them having to update themselves to relate with their grandchildren. Character strengths are the natural ability by which thoughts, feelings and behaviours allow to achieve goals. They could help grandparents increase their perceptions of personal growth. However, the role played by character strengths in personal growth has not been studied yet.
MethodThis study aimed to analyze what character strengths predict extended babysitters´ personal growth. This study included 107 grandparents providing regular care (more than 15 hours per week) to at least one grandchild from Spain. The average age was 69.46 (SD=7.02), 63.6% were women, 76% were maternal grandparents and the average daily hours of care provided was 5.07 (DT=14.61). To analyze data, we conducted stepwise multiple regressions.
Results:In step one, the total score of character strengths explained 21.1% of the variance in personal growth (F(1, 105)= 28.14; p≤.001). The total score of character strengths and emotional intelligence accounted for 25.6% of the variance in step two (F(1, 104)= 17.91; p≤.001). In the final step, total character strengths, emotional intelligence and creativity explained 28.6% of the variance (F(1, 103)= 13.79; p≤.05). The higher scores in character strengths, emotional intelligence and creativity, the more personal growth grandparents showed.
Conclusion:These results reflect the importance of considering character strengths as factors associated with grandparents´ personal growth. Future interventions focused on extended babysitters could consider character strengths. Especially, creativity and emotional intelligence, strengths that may help grandparents to connect and dialogue with their own emotions and those of their grandchildren as well as experience the difficulties associated with caregiving as opportunities for growth and development.
Funding:This Project was funded by Fundación San Pablo CEU (M02.0401.000.MPFI20CN)
427 - Psychoeducation Program for the Prevention of Older Adults´ Infantilization in Professionals working in Nursing Homes
- C. Noriega, G. Pérez-Rojo, J. López, C. Velasco, M.I. Carretero, P. López-Frutos, L. Galarraga
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, p. 48
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Introduction
Kayser-Jones (1981) described infantilization as one of the four most frequent types of violence in nursing homes. Older people perceive infantilization as disrespectful and patronizing. In professionals, it can lead to protective behaviors that reduce autonomy and generate more dependency. Despite the importance of this phenomenon, the interventions are scarce and show methodological limitations.
ObjectiveThis study analyzed the efficacy of a psychoeducation program for the prevention of infantilization in professionals working in nursing homes. The sample included 154 direct-care workers. The experimental group (N=111) attended a psychoeducational group intervention program while the control group (N=43) did not attend any intervention program. We assessed the infantilized practices the professionals recognized they conducted and the ones observed in the institution before and after the intervention. The intervention lasted 6 hours and included four sessions distributed in two days. These sessions aimed to reduce negative stereotypes, preventing infantilized communication patterns and the use of behaviors or practices that are frequently used with children. We also offered professionals alternative practices that recognize autonomy, decision-making and respect older adults´ dignity and uniqueness. To analyze data, we conducted Repeated measures of ANOVA and one-way ANCOVAs.
Results:The scores of infantilization in the experimental group significantly decreased from pre-intervention to post-intervention in the professional, F(1, 85) = 37.184, p = .01, partial η2 = .030, and in the institution, F(1, 84) = 32.128, p = .01, partial η2 = .277, while the control group did not show any changes. There was a statistically significant difference in post-intervention between the experimental and the control group when participants scored their infantilization practices, F(1, 115) = 5.175, p = .03, partial η2 = .043, and infantilization practices observed in the institution, F(1, 115) = 5.810, p = .018, partial η2 = .048.
Conclusion:These results reflect the importance of developing interventions focused on preventing infantilization, methodologically rigorous, in which professionals´ training and education are considered key pieces to generate a culture of change. More research is needed to understand this problem in greater depth to develop programs that address this problem at different levels.
Funding:This research was funded by the Spanish Ministry of Economy and Competitiveness (grant no. PSI2016-79803-R).
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