RESUMENEl objetivo de este estudio radica en profundizar sobre el comportamiento vocacional de los jóvenes madrileños de entre 14 y 18 años. A través de análisis estadísticos como la T de Student y ANOVAs realizamos una evaluación del tipo y grado de dificultades que experimentan los jóvenes en el desarrollo de su proceso de decisión vocacional, y analizamos las diferencias existentes entre éstas en función del género, el curso académico y los intereses profesionales. Para ello se ha realizado la adaptación y validación de una escala basada en la teoría del procesamiento de la información denominada Escala de Dificultades en la Toma de Decisión de la Carrera. Tras los análisis realizados observamos que en líneas generales se confirman las hipótesis planteadas ampliando el marco de la investigación en Orientación Vocacional. Finalmente se presentan las conclusiones, limitaciones e implicaciones del estudio.ABSTRACTThe purpose of this research is to deepen on the vocational behaviour of 2.783 Spanish students aged between 14 and 18. Through statistical analysis like T Student and ANOVA, we analyze the difficulties that this sample experiments, and we investigate if it experiments different kinds or levels of difficulties based on variables like gender, academic grade, and professional interests. To do that we have adapted and validated a Career Decision-Making Questionnaire based on Processing Career Information Theory. We have confirmed the hypothesis raised, and we thus extend Vocational Guidance researches. Finally, implications for counselling and future research are also discussed.

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ObjectiveWe sought to investigate prevalence, incidence and prognostic implications of permanent pacemaker (PPM) implantation in patients with cardiac amyloidosis (CA), thereby identifying the predictors of time to PPM implantation.MethodsSeven hundred eighty-seven patients with CA (602 men, median age 74 years, 571 transthyretin amyloidosis (ATTR), 216 light-chain amyloidosis (AL)) evaluated at two European referral centres were retrospectively included. Clinical, laboratory and instrumental data were analysed. The associations between PPM implantation and mortality, heart failure (HF) or a composite endpoint of mortality, cardiac transplantation and HF were analysed.Results81 (10.3%) patients had a PPM before initial evaluation. Over a median follow-up time of 21.7 months (IQR 9.6–45.2), 81 (10.3%) additional patients (18 with AL (22.2%) and 63 with ATTR (77.8%)) underwent PPM implantation with a median time to implantation of 15.6 months (IQR 4.2–40), complete atrioventricular block was the most common indication (49.4%). Independent predictors of PPM implantation were QRS duration (HR 1.03, 95% CI 1.02 to 1.03, p<0.001) and interventricular septum (IVS) thickness (HR 1.1, 95% CI 1.03 to 1.17, p=0.003). The model to estimate the probability of PPM at 12 months and containing both factors showed a C-statistic of 0.71 and a calibration of slope of 0.98.ConclusionsConduction system disease requiring PPM is a common complication in CA that affects up to 20.6% of patients. QRS duration and IVS thickness are independently associated with PPM implantation. A PPM implantation at 12 months model was devised and validated to identify patients with CA at higher risk of requiring a PPM and who require closer follow-up.