Loneliness among single and coupled individuals in response to the COVID-19 pandemic: A cross-country analysis

Background/Objective: Research suggests that the COVID-19 pandemic has increased social isolation and loneliness and that, in general, single individuals experience a higher degree of loneliness than coupled individuals. Loneliness may also vary across cultures as a function of social norms and Hofstede's dimensions of national culture. Therefore, the aim of the present study was to examine whether the link between relationship status and loneliness in the context of the COVID-19 pandemic differed across countries as a function of cultural values captured in terms of Hofstede's six dimensions of national culture. Method: Multilevel modeling was used to analyze the archival data collected in the COVIDiSTRESS Global Survey (41 countries and 102,957 participants) and the COVIDiSTRESS Global Survey - Round II (23 countries and 8227 participants). Results: The analyses demonstrated the statistical significance of the interactions between relationship status and six Hofstede's dimensions of national culture in the link between relationship status and loneliness. The estimated effect sizes of these interactions were, however, almost zero. Conclusions: The lack of effect size of the interactions between relationship status and Hofstede's dimensions of national culture for loneliness may have substantive significance. This finding implies that, on average, loneliness as a function of relationship status may be less reactive in the context of the COVID-19 pandemic to the effects of social norms and values across which countries vary. (AU)

Relationship (in)congruency may differently impact mental health

Background: Being involved in romantic relationships has historically been related to better mental health compared to being single. However, research exploring heterogeneity within these status groups is still understudied. Our study examined the role of (in)congruency between relationship desire, dismissal, satisfaction with relationship status, and current relationship status on the mental health measured in terms of anxiety, depression, insomnia, and romantic loneliness. Method: The online questionnaire survey included 790 participants aged 18 – 40 (M = 26.51, SD = 5.60) at baseline and 421 at a 1-month follow-up. Participants represented five relationship statuses (single, casual dating, LAT relationships, cohabitation, and engagement/marriage). Results: Our results suggest that greater relationship desire and dismissal at baseline were associated with higher anxiety and depression in casual daters one month later, while greater relationship desire was linked to lower anxiety for individuals in living apart together relationships (LATs). Higher relationship dismissal in casual daters and engaged/married individuals was associated with lower insomnia. Higher satisfaction with relationship status was associated with lower depression in single individuals and lower romantic loneliness in cohabitors and engaged/married individuals. Conclusions: This study highlights that relationship (in)congruency may operate differently across various relationship status subgroups on mental health outcomes. (AU)

Impacto del nivel de actividad física y estado civil en la vulnerabilidad de la salud psicofísica en personas mayores de 60 años: mayor atención sociosanitaria / Impacto do nível de atividade física e do estado civil na vulnerabilidade de saúde psicofísica em pessoas com mais de 60 anos: maior cuidado social e de saúde / Impact of physical activity level and marital status on the vulnerability of psychophysical health in people over 60 years of age: greater health care

Antecedentes: Actualmente se desconocen con exactitud las repercusiones de vivir solo/a en personas mayores sanas sobre el nivel de actividad física (AF) practicada, relaciones sociales, atención sociosanitaria requerida y salud subjetiva. Objetivos: El objetivo ha sido evaluar diferencias en salud, relaciones sociales y atención sociosanitaria de personas mayores activas en función de su nivel de AF y situación familiar (estado civil). Metodología: Participan 397 personas mayores de 61 años (M=69,65; DT=4,71; 64,7% mujeres y 35,3% hombres), pertenecientes a dieciocho centros deportivos, sociales y zonas exteriores deportivas de Alicante. Se utilizó el IPAQ para evaluar la AF y CUBRECAVI para los indicadores de calidad de vida. Se realizó un análisis de varianza multivariados (MANOVAs) para estudiar las diferencias entre los/as participantes según su nivel de AF y su situación familiar. La significación se estableció en p <,05. Resultados: Los resultados mostraron que la salud subjetiva (p<,001; VCramer=,291), frecuencia de relaciones sociales (p<,001, ƞ2=,028) y satisfacción con los servicios sociosanitarios (p=,009; VCramer=,147) difieren según el nivel de AF. La frecuencia y satisfacción de las relaciones sociales (p<,001, ƞ2=,252) y la utilización de los servicios sociosanitarios difieren según la situación familiar (p=,032; VCramer=,153). Conclusión: En conclusión, el estado de bastante satisfacción con su salud subjetiva y con el uso de servicios sociosanitarios es directamente proporcional al nivel de actividad física practicada. Las relaciones sociales de solteros son menos satisfactorias y frecuentes, utilizando más los servicios sociosanitarios.

Background: Currently, the repercussions of living alone in healthy older people on the level of physical activity (PA) practiced, social relationships, required social health care, and subjective health are unknown. Objective: The objective has been to evaluate differences in health, social relations, and socio-sanitary care of active older people according to their level of PA and family situation (marital status). Methodology: 397 older people than 61 years (M=69.65; DT=4.71; 64.7% women and 35.3% men), belonging to eighteen sports, social centers and outdoor sports areas of Alicante. The IPAQ was used to assess PA and CUBRECAVI for the quality of life indicators. A multivariate analysis of variance (MANOVAs) was performed to study the differences between the participants according to their levelof PA and their family situation. Significance was set at p<.05. Results: The results showed that subjective health (p<.001; VCramer=.291), frequency of social relationships (p<.001, ƞ2=.028) and satisfaction with social and health services (p=.009; VCramer=.147) differ according to the level of PA. The frequency and satisfaction of social relationships (p<.001, ƞ2=.252) and the use of social and health services differ according to thefamily situation (p=.032; VCramer=.153). Conclusions: In conclusion, the state of enough satisfaction with their subjective health and with the use of social and health services is directly proportional to the level of physical activity practiced. Singles social relationships are less satisfactory and frequent, using more social health services. (AU)

Fundo: Atualmente, são desconhecidas as repercussões exatas de morar sozinho em idosos saudá veis sobre o nível de atividade física (AF) praticada, relações sociais, cuidados sociais e de saúde necessários e saúde subjetiva. Objetivos: O objetivo foi avaliar as diferenças de saúde, relações sociais e cuidados socio saúde de idosos ativos de acordo com seu nível de AF e situação familiar (estado civil). Metodologia: Participaram pessoas com mais de 61 anos (M=69,65; DP=4,71; 64,7% mulheres e 35,3% homens), pertencentes a dezoito centros desportivos e sociais e áreas desportivasao ar livre em Alicante. O IPAQ foi utilizado para avaliar AF e CUBRECAVI para indicadores de qualidade de vida. Uma análise de variância multivariada (MANOVAs) foi realizada para estudar as diferenças entre os participantes de acordo com seu nível de AFe sua situação familiar. A significância foi estabelecida em p<0,05. Resultados: Os resultados mostraram que a saúde subjetiva (p<0,001; VCramer=0,291), frequência de relacionamentos sociais (p<0,001, ƞ2=0,028) e satisfação com os serviços sócio-saúde (p=0,009; VCramer=0,147) diferem dependendo do nível de AF. A frequência e satisfação das relações sociais (p<0,001, ƞ2=0,252) e o uso de serviços socio saúde diferem de acordo com a situação familiar (p=0,032; VCramer=0,153). Conclusão: Em conclusão, o estado de satisfação suficiente com a sua saúde subjetiva e com a utilização dos serviços sócio sanitários é diretamente proporcional ao nível de atividade física praticada. As relações sociais dos solteiros são menos satisfatórias e frequentes, utilizando mais serviços sociais e de saúde. (AU)

The Effect of Daily Fluctuation of Abusive Supervision over Employees Positive and Negative Emotions, and Recovery Experience

Abusive supervision impacts employees’ emotions negatively and creates feelings of shame and fear. But it remains unclear how daily employees’ positive and negative emotions are affected and if they can recover. Applying the affective event theory and job demands-resources model we hypothesized that daily abusive supervision influences employees’ positive and negative emotions fluctuation over the day, recovery after work, and employee emotions the next morning. Two daily surveys were answered by 52 Mexican employees for ten days providing 347 registers in the morning and 255 in the afternoon. Hierarchical linear modeling shows alteration of positive and negative emotions in the afternoon and next day, and a positive effect over recovery in relaxation, mastery and control restoring positive emotions. However, negative emotions cannot be recovered for the following day. Additionally, we found effects of predictive variables, as the days of the week go by, positive emotions in the afternoon and negative emotions in the morning decrease. Gender shows for men a more negative effect on positive emotions in the afternoon, next morning and on mastery-recovery. Marital status revealed effect over married individuals incrementing the four recovery dimensions, increasing positive emotions, and reducing negative emotions in the afternoon and next morning. Tenure has an effect over abusive supervision, the longer employees in the company, more likely they suffer abusive supervision. We show how employees restore positive emotions after daily recovery and that negative emotions cannot be recovered for the following day; revealing how abusive managers cause emotional damage to employees every day. (AU)

Diferencias entre latinoamericanos y españoles participando en un programa de intervención en violencia de género: Resultados proximales y finales / Differences between Latin American and Spanish men in a batterer intervention programme: proximal and final outcomes

The aim of this study was to test whether there are differences in the effectiveness of a Batterer Intervention Programme (BIP) for Intimate Partner Violence (IPV) perpetrators depending on the participants' countries of origin (i.e., Spanish or Latin American immigrants). The sample included 425 male offenders who participated in a court-mandated standard BIP in Spain. Official recidivism and risk of recidivism were considered the final outcomes. Intention to change, responsibility attribution, adherence to treatment and treatment compliance were taken as the proximal outcomes. No differences were found in risk of recidivism, intention to change, responsibility attribution to the legal system and to the victim between the Spanish and Latin American participants. Significant differences between both groups were found for the variable treatment compliance. The results suggest that, at least for the Latin American immigrants participating in BIPs in Spain, it is apparently not necessary to adjust BIPs to cultural differences as adopting motivational strategies to promote change suffices

El objetivo de este estudio es comprobar si existen diferencias en la efectividad de un programa de intervención para hombres condenados por violencia de género, en función del lugar de procedencia de los participantes (i.e., españoles e inmigrantes latinoamericanos). Se utilizó una muestra de 425 hombres penados por violencia de género que participaban en un programa estándar de intervención en España. Se consideraron como variables finales la reincidencia oficial y el riesgo de reincidencia y como variables proximales la intención de cambio, la asunción de responsabilidad, la adherencia al tratamiento y el compromiso con la intervención. No se encontraron diferencias entre participantes españoles y latinoamericanos en las variables riesgo de reincidencia, intención de cambio, asunción de responsabilidad al sistema legal y a la víctima. Únicamente se encontraron diferencias significativas entre estos dos grupos en la variable compromiso con la intervención. Los resultados sugieren que, al menos para los inmigrantes latinoamericanos que se encuentran participando en programas de intervención con hombres condenados por violencia de género en España, no parece necesario ajustar la intervención en función de las diferencias culturales, siendo suficiente el uso de estrategias motivacionales para promover el cambio

The effect of marital status on the survival of patients with colorectal neuroendocrine neoplasms: an analysis of the SEER database

BACKGROUND: increasing evidence suggests that marital status is associated with tumor prognosis. The prognostic impact of marital status on colorectal neuroendocrine neoplasms has not been studied adequately. This study explored the relationship between marital status and prognosis of colorectal neuroendocrine neoplasms. METHODS: during 2004-2012, 7,180 colorectal neuroendocrine neoplasm patients were identified from the Surveillance, Epidemiology and End Results database. A primary comparison (married vs unmarried) was performed with a 1:1 propensity matching score. Secondary comparisons were performed individually between three unmarried subgroups (single, divorced/separated, widowed) and the married group. The effect of marital status according to sex and extension of disease was explored. RESULTS: married patients had better survival (overall survival) (p < 0.001) and colorectal neuroendocrine neoplasm cause-specific survival (p = 0.001) rates compared to unmarried patients. Multivariate analysis indicated that marital status was an independent prognostic factor and married patients had a better overall survival (HR = 1.673; 95% CI: 1.446-1.936; p < 0.001) and colorectal neuroendocrine neoplasm cause-specific survival (HR = 1.365; 95% CI: 1.141-1.632; p = 0.001). Subgroup analysis showed that married patients had the best prognosis of cause-specific survival/overall survival and widowed patients had the worst prognosis (log-rank test p < 0.05). Marital status plays a more important role in colorectal neuroendocrine neoplasms patients with localized disease than in those with regional or distant disease. CONCLUSIONS: marital status is an independent prognostic factor for survival in colorectal neuroendocrine neoplasms patients. Married patients have a better prognosis with early stage disease. Single, widowed and male patients are regarded as a high-risk population

No dipsonible

Resultados en calidad de vida comunicados por pacientes en tratamiento antirretroviral / Health-related quality of life among people livingwith human immunodeficiency virus infection

OBJETIVO: Conocer las impresiones de los pacientes con terapia antirretroviral acerca de su calidad de vida relacionada con la salud (CVRS), salud y bienestar general respecto a la infección por VIH. MATERIAL Y MÉTODOS: Estudio observacional, descriptivo, prospectivo y transversal. Se incluyeron pacientes mayores de edad VIH positivos que recogiesen tratamiento en el Servicio de Farmacia durante 3 meses. Como medida de la CVRS, se utilizó el World Health Organization Quality of Life in HIV-infected Persons instrument (WHOQOL-HIV-BREF) versión castellano. Se midieron seis dominios: capacidad física, factores psicológicos, nivel de independencia, relaciones sociales, entorno y creencias personales/religiosas/espirituales más 5 preguntas específicas de infección por VIH/SIDA. El cuestionario fue anónimo y auto-administrado. Se recogieron edad, sexo, estado civil y nivel de educación máximo alcanzado. Se calcularon medianas y rangos intercuartílicos (IQR) para cada dominio, así como los posibles factores influyentes. RESULTADOS: Se incluyeron 69 pacientes. 72,5% varones. Edad (mediana [IQR]) = 50,4 [55,1-43] años. Nivel de educación: ninguno 5,8%; educación primaria 37,7%; secundaria 47,8%; terciaria 8,7%. Estado civil: casado/a 21,9%; en pareja 15,9%; divorciado/a 7,2%; soltero/a 47,8%; viudo/a 7,2%. Resultados para cada dominio: capacidad física (mediana [IQR]) = 75 [65-80]; factores psicológicos = 68 [57-76]; nivel de independencia = 70 [59-80]; relaciones sociales = 65 [58-80]; entorno = 70 [64-80] y creencias personales/religiosas/espirituales = 63 [55-75]. Resultado global = 67 [71-78]. La edad (≤ 50 años) se relacionó con la CVRS (diferencia de medias IC95%; p) en el dominio de capacidad física (11,41 IC95% 4,12-18,69; p = 0,03), nivel de independencia (10,47 IC95% 1,85-19,08; p = 0,018) y en el resultado global (8,33 IC95% 1,99-14,67; p = 0,011). CONCLUSIONES: La CVRS fue inferior en el dominio de creencias personales, seguida por las relaciones sociales. La edad superior a 50 años se relacionó con una peor CVRS

PURPOSE: To know about quality of life, health and general well-being among people living with HIV who take antiretroviral therapy. MATERIAL AND METHODS: Cross-sectional descriptive prospective observational study. Adults with HIV's infection and antiretroviral therapy dispensed by our Pharmacy Service during 3 months were included. World Health Organization Quality of Life in HIV-infected Persons instrument (WHOQOL-HIV-BREF) was used to explore the quality of life (QoL). The scores denote an individual's perception of QoL in six domains: physical, psychological, level of independence, social relationships, environment and spirituality. Items are rated on a 5-point Likert scale with a transformed maximum score of 100 points per item. Five questions are specific to HIV/AIDS (Q:4,8-10,17). The questionnaire was self-administered. Age (≤ 50 years), gender, civil status and level of studies was also collected. The questionnaire, anonymous and voluntary, was returned in the next visit to our centre. Median and interquartile range was calculated for each domain. Relationship among scores and demographic variables was explored. RESULTS: 69 patients were included (response rate 45.1%), 72.5% male. Age (median [IQR]) = 50.4 [55.1-43] years. Education received: none 5.8%; primary school 37.7%; secondary 47.8%; tertiary 8.7%. Civil status: married 21.9%; living as married 15.9%; divorced 7.2%; single 47.8%; widowed 7.2%. Results of domains transformed score: physical (median [IQR]) = 75 [65-80], psychological = 68 [57-76]; level of independence = 70 [59-80]; social relationships = 65 [58-80], environment = 70 [64-80]; and spirituality = 63 [55-75]. Global score = 67 [71-78]. Age (≤ 50 years) was the only variable related with test score (mean difference (IC95%; p); physical domain (11.41 (4.12-18.69); 0.03), level of independence (10.47 (1.85-19.08); 0.018) and global score (8.33 (1.99-14.67); 0.011). CONCLUSIONS: QoL score was lower regarding spirituality domain followed by social relationships. Age over 50 was statistically associated with a worse self-reported QoL

Does the Spanish version of the SWLS measure the same in Spain and Peru? / ¿La versión española de la SWLS mide lo mismo en España y Perú?

Aim: Satisfaction with life is a measure of protection in older adults. There lies the importance of providing quality instruments. The aim of the study was to evaluate the invariance of the life satisfaction scale (SWLS) in two samples of older adults in Spain and Peru. Method: The participants were 857 older adults in Spain (mean age=68.23 years, SD=5.93) and 336 older adults in Peru (average age=72.42, SD=7.07). All multi-group confirmatory factor analyzes were estimated in Mplus 8.0. Results: The results indicate the presence of a strict invariance of the one-dimensional structure of the SWLS in samples of older adults in Spain and Peru, which allows for meaningful comparisons of latent means and covariances. Comparison of latent means showed small differences in the construct between the cultural groups. Conclusions: The SWLS is a valid instrument for intercultural comparisons between Spanish and Peruvian population. The measurement invariance assessment contributes to a better understanding of life satisfaction in populations from different cultural contexts

Objetivo: La satisfacción con la vida es una medida de protección en los adultos mayores. Aquí radica la importancia de tener instrumentos de calidad para medirla. El objetivo de este estudio fue evaluar la invarianza de la Escala de Satisfacción con la Vida (SWLS) en 2 muestras de adultos mayores de España y Perú. Método: Los participantes fueron 857 adultos mayores españoles (edad media: 68,23 años y DT: 5,93) y 336 adultos mayores peruanos (edad media: 72,42 años y DT: 7,07). Todos los análisis factoriales multi-muestra se estimaron en Mplus 8.0. Resultados: Los resultados indican la presencia de una invarianza estricta de la estructura unifactorial de la SWLS en muestras de adultos mayores de España y Perú, lo que permite realizar comparaciones adecuadas, tanto de medias latentes como de relaciones con otras variables. La comparación de las medias latentes mostró pequeñas diferencias en el constructo entre las 2 culturas. Conclusiones: La SWLS es una escala válida para realizar comparaciones transculturales entre poblaciones peruanas y españolas. La evaluación de la invarianza de medida contribuye a entender mejor la satisfacción vital desde contextos culturales diferentes

Calidad de vida en pacientes ecuatorianos con artritis reumatoide: un estudio transversal / Quality of life in Ecuadorian patients with rheumatoid arthritis: a cross-sectional study

OBJETIVOS: Evaluar la calidad de vida relacionada con la salud (CVRS) y los factores clínicos, demográficos y socioeconómicos asociados en una cohorte de pacientes ecuatorianos con artritis reumatoide (AR). PACIENTES Y MÉTODOS: Estudio descriptivo transversal que evaluó la CVRS con la versión en español del instrumento Quality of Life-Rheumatoid Arthritis (QoL-RA) en pacientes con diagnóstico de AR según los criterios del Colegio Estadounidense de Reumatología y de la Liga Europea Contra el Reumatismo. Adicionalmente, se obtuvieron los siguientes datos: edad, estado civil, sexo, estrato socioeconómico, comorbilidades, duración de la enfermedad, medicación, positividad de factor reumatoide, de ACPA, actividad de la enfermedad mediante el índice de actividad de la enfermedad simplificado y funcionalidad física medida con MHAQ. RESULTADOS: Se evaluaron un total de 163 pacientes con AR, la puntuación media de la escala QoL-RA fue de 6,84+/-1,5 puntos. Las medias más altas se obtuvieron en los dominios de interacción (8,04+/-1,9) y apoyo (8,01+/-2). Los factores que estuvieron asociados con la valoración global de la calidad de vida fueron: funcionalidad medida con MHAQ (r=-0,70; p < 0,001); duración de la enfermedad en años (r=-0,178; p < 0,05) y actividad de la enfermedad (diferencia de medias de 1,5; IC 95%: 1,09-1,91). CONCLUSIÓN: Los pacientes evaluados tuvieron una CVRS de buena a moderada. Los dominios relacionados con soporte y vida social fueron los mejor puntuados y los más bajos los relacionados con dolor y tensión nerviosa. La funcionalidad, la duración y la actividad de la enfermedad estuvieron estadísticamente asociadas a la CVRS

OBJECTIVES: To evaluate health-related quality of life (HRQoL) and associated clinical, demographic and socioeconomic factors in a cohort of Ecuadorian patients with rheumatoid arthritis (RA). PATIENTS AND METHODS: A cross-sectional descriptive study evaluating (HRQoL) with the Spanish version of the Quality of Life Rheumatoid Arthritis (QoL-RA) instrument in patients diagnosed with RA according to the criteria of the American College of Rheumatology and the European League Against Rheumatism. In addition, the following data were obtained: age, sex, marital status, socioeconomic stratum, comorbidities, disease duration, medication, rheumatoid factor positivity, disease activity using the simplified disease activity index and physical functionality measured with the modified Health Assessment Questionnaire (MHAQ). RESULTS: A total of 163 patients were assessed, the mean score of the QoL-RA scale was 6.84+/-1.5 points. The highest measurements were obtained in the domains of interaction (8.04+/-1.9) and support (8.01+/-2). The factors that were associated with the overall quality of life assessment were: functionality measured with MHAQ (r=-0.70; P<.001); disease duration in years (r=-0.178; P<.05); and disease activity (mean difference of 1.5; 95%CI: 1.09 to 1.91). CONCLUSION: The patients evaluated had a good to moderate HRQoL. The domains related to support and social life were those with the highest scores and the lowest scores were related to pain and nervous tension. Functionality, duration, and disease activity were statistically associated with HRQoL

Assessing the effects of an education program on mental health problems in separated parents / Evaluación de los efectos de un programa educativo en los problemas de salud mental en padres separados

Background: Parental separation is a stressful experience that can lead to parents suffering mental health problems (MHPs). Parental separation education programs for coping with post-separation adjustment have proven to be effective in reducing conflict and improving co-parenting. However, the effects of these programs on MHPs have not been assessed. A field study was carried out to assess the impact of a parental separation education program on parental MHPs. Method: A total of 116 separated parents who completed the program "Parental separation, not family breakdown" completed the Brief Symptom Inventory (BSI) pre- and post-intervention. Results: Separated parents had significantly higher pre-intervention scores on the nine symptom dimensions and the global indexes of distress in comparison to the normative population. The intervention yielded a significant improvement (i.e., reduction of clinical symptoms) in all MHPs, ranging from 19% in phobic anxiety to 36% in depression and general anxiety; and in the global indexes of distress (36% in the global severity index; 28% in the positive symptom distress index; and 33% in the positive symptom total). Approximately 45% of parents significantly improved through the intervention. Conclusions: The implications of the outcomes of the separation and intervention in parents’ MHPs and children wellbeing are discussed

Antecedentes: la ruptura de pareja, como evento estresante, puede derivar en Problemas en la Salud Mental (PSM) de los progenitores. Para afrontar esta contingencia se han desarrollado programas educativos que han mostrado su eficacia en la reducción del conflicto y la mejora de la coparentalidad. Pero los efectos en los PSMs no han sido estudiados. Así, nos planteamos un estudio campo para conocer los efectos de un programa educativo para la ruptura de pareja en los PSMs. Método: 116 progenitores separados que cumplimentaron el programa "Ruptura de Pareja, no de Familia" respondieron, pre- y post-intervención, al Brief Symptom Inventory (BSI). Resultados: los resultados mostraron, en contraste con la población normativa, que los progenitores separados puntuaban significativamente más alto en los PSMs. La intervención implicó una mejora significativa en todos PSMs, oscilando desde el 19% en ansiedad fóbica al 36% en depresión y ansiedad generalizada, así como en los índices generales de malestar (36% en el Índice de Severidad Global; 28% en el Índice de Malestar referido a Síntomas Positivos; y el 33% en el Total de Síntomas Positivos). Conclusiones: se discuten las implicaciones de los resultados de la ruptura e intervención en los PSMs de los padres separados y el bienestar de los hijos

Factores demográficos, prácticas sexuales y características del VIH asociados a la percepción de estigma / Demographic factors, sexual practices and HIV characteristics associated with stigma perception

Introducción: El estigma se considera una marca impuesta por la sociedad para negativamente diferenciar unas personas de otras y ser causa de rechazo, en este caso por ser portadoras de VIH. Objetivo: Explorar los factores demográficos, las prácticas sexuales y las características de la enfermedad relacionados con la percepción de estigma en un grupo de personas con VIH en la ciudad de Medellín en el 2014. Materiales y métodos: Estudio observacional, descriptivo, transversal, donde se incluyeron 217 pacientes de Medellín con diagnóstico de VIH para explorar el estigma mediante la escala de Berger, Se realizaron medidas de resumen y frecuencia, regresión logística binaria. Resultados: La edad promedio fue 39,3 (DE 10,79), predominaron los hombres con un 83,9 %, los solteros 67 %, los homosexuales 51,2 %, 41 % llevan más de cinco años con la enfermedad. El estigma se presenta en un 50,7%, siendo más elevado en los hombres (78,2 %), las mujeres tenían 2,3 veces la probabilidad de percepción de estigma alto con respecto a los hombres (IC 95% 1,12 - 5,26), las personas en la categoría 'separado/divorciado/viudo' tenían 2,9 veces la probabilidad de percepción de estigma alto que en la categoría 'casado/unión libre' (IC 95% 1,02 - 8,44). Conclusiones: Se logró explorar la asociación entre percepción de estigma en pacientes con VIH. Se evidencia que ser del sexo femenino presenta una prevalencia alta al estigma por su condición tal como se ha descrito en otros estudios, así como ser 'soltero/separado/viudo' se asocia a la percepción de estigma alto

Introduction: Stigma is considered a mark imposed by society to deny the differentiation of people from others and the cause of rejection, in this case by being carriers of HIV. Objective: To explore the demographic factors, sexual practices and disease characteristics related to the perception of stigma in a group of people with HIV in the city of Medellín in 2014. Materials and methods: an observational, descriptive, cross-sectional study, which included 217 Medellin patients with HIV diagnosis to explore the calculation using the Berger scale. We performed summary and frequency measures, binary logistic regression. Results: The mean age was 39.3 (SD 10.79), men predominated with 83.9%, single individuals 67%, homosexuals 51.2%, 41% had more than five years with the disease. Estimates are presented in 50.7%, with men (78.2%) being higher, women being 2.3 times more likely to perceive high stigma than men (95% CI 1.12 - 5.26), persons in the 'separated / divorced / widowed' category had 2.9 times the probability of perceiving high stigma than in the 'married / free-union' category (95% CI 1.02 -8.44). Conclusions: It was possible to explore the association between the perception of stigma in patients with HIV. It is evident that the female sex presents a high prevalence of high quality because of its condition as described in other studies, as being 'single / separated / widowed' is associated with the perception of high stigma

Control preconcepcional en la diabetes: factores predisponentes y barreras / Preconception care in diabetes: Predisposing factors and barriers

Antecedentes y objetivo: El control preconcepcional ha demostrado reducir el riesgo del embarazo asociado a la diabetes, pero muchas mujeres siguen quedando gestantes sin planificación previa. Nuestro objetivo fue identificar los factores predisponentes y las barreras relacionadas con la realización de control preconcepcional. Material y métodos: Se incluyeron, de forma consecutiva, 50 mujeres con diabetes pregestacional (28 tipo 1) y 50 gestantes sin diabetes que acudían a nuestro centro. Se les pidió que cumplimentaran un cuestionario y se revisaron sus historias clínicas. Resultados: Las 33 pacientes con diabetes y control preconcepcional tenían una edad actual (34,3±5,3 años) y al diagnóstico de la diabetes (20,3±11,3 años) similares a las 17 pacientes sin control (31,8±5,3 y 19,1±10,6 años, respectivamente; p>0,1), pero estaban con más frecuencia viviendo en pareja (97% vs. 70,6%; p=0,014), laboralmente activas (69,7% vs. 29,4%; p=0,047), eran seguidas por un/a endocrinólogo/a (80,6% vs. 50%; p=0,034), habían tenido abortos previos (78,6% vs. 10%; p=0,001), y conocían la repercusión de la diabetes en el embarazo (87,5% vs. 58,8%; p=0,029). No hubo diferencias significativas en la toma de ácido fólico pregestacional entre las gestantes con y sin diabetes (23,8% vs. 32%; p>0,1). Conclusiones: En las pacientes con diabetes, acudir a control preconcepcional se asoció con vivir en pareja, estar laboralmente activas, conocer el riesgo de complicaciones, tener abortos previos y ser seguidas por un/a endocrinólogo/a. Existe un bajo porcentaje de preparación de la gestación, también en el grupo sin diabetes (AU)

Background and objective: Preconception care has been shown to decrease the risk of pregnancy-related complications in women with diabetes, but many women do not plan their pregnancies. Our aim was to identify the associated factors and barriers related to involvement of these women in preconception care. Material and methods: Fifty women with pregestational diabetes (28 with type 1 diabetes) and 50 non-diabetic pregnant women were consecutively enrolled at our hospital. They completed a questionnaire, and their medical histories were reviewed. Results: All 33 patients with diabetes who received preconception care had a similar current age (34.3±5.3 years) and age at diagnosis (20.3±11.3) than those with no preconception care (n=17) (31.8±5.3 and 19.1±10.6 years respectively; P>.1), but were more frequently living with their partners (97% vs. 70.6%; P=.014), employed (69.7% vs. 29.4%; P=.047), and monitored by an endocrinologist (80.6% vs. 50%; P=.034), had more commonly had previous miscarriages (78.6% vs. 10%; P=.001), and knew the impact of diabetes on pregnancy (87.5% vs. 58.8%; P=.029). The frequency of preconceptional folic acid intake was similar in pregnant women with and without diabetes (23.8% vs. 32%; P>.1). Conclusions: Preconception care of diabetic patients is associated to living with a partner, being employed, knowing the risks of pregnancy-related complications, having previous miscarriages, and being monitored by an endocrinologist. Pregnancy planning is infrequent in both women with and without diabetes (AU)

Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures: retrospective study

Background: To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. Material and Methods: A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. Results: A total of 338 patients rendered 355 fractures. Males were the most affected (p <0.001), with prevalence in the third decade of life (p <0.001). There was a predominance of motorcycle accidents (p <0.001), home workers (p <0.001), low educational status (p = 0.032), and no cigarette use (p <0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p <0.001). Conclusions: The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period (AU)

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El efecto del estado civil sobre las desigualdades sociales y de género en la mortalidad por diabetes mellitus en Andalucía / The effect of marital status on social and gender inequalities in diabetes mortality in Andalusia

Objetivos: Evaluar el efecto modificador del estado civil sobre las desigualdades sociales y de género en la mortalidad por diabetes mellitus (DM) en Andalucía. Material y métodos: Estudio transversal a partir de la Cohorte Censal 2001 de Andalucía. Se estudiaron defunciones por DM entre 2002 y 2013 según nivel de estudios y estado civil. Se calcularon tasas de mortalidad ajustadas por edad (TA) y razones de tasas de mortalidad (RTM) mediante modelos de regresión de Poisson, controladas por otras variables sociodemográficas. Se evaluó el efecto modificador del estado civil incorporando a los modelos un término de interacción. Todos los análisis se realizaron separadamente para hombres y mujeres. Resultados: Sobre un total de 4.229.791 sujetos se registraron 18.158 muertes por DM (10.635 mujeres y 7.523 hombres). A medida que disminuye el nivel educativo aumenta el riesgo de muerte. El estado civil modifica la desigualdad social en la mortalidad por DM de forma diferente en cada sexo. Las mujeres viudas y separadas/divorciadas con menor nivel de estudios presentan las mayores RTM: 5,1 (IC95%: 3,6-7,3) y 5,6 (IC95%: 3,6-8,5), respectivamente, mientras que los hombres solteros tienen la RTM más elevada: 3,1 (IC95%: 2,7-3,6). Conclusiones: El nivel de estudios es un determinante fundamental de la mortalidad por DM en ambos sexos; su relevancia es mayor entre las mujeres, mientras que en los hombres también el estado civil es un factor clave. Para abordar las desigualdades en la mortalidad nuestros resultados sugieren que el énfasis actual en los factores individuales y el autocuidado debería extenderse hacia intervenciones sobre la familia, la comunidad y los contextos sociales más cercanos a los pacientes (AU)

Objective: To assess the modifying effect of marital status on social and gender inequalities in mortality from diabetes mellitus (DM) in Andalusia. Material and methods: A cross-sectional study was conducted using the Andalusian Longitudinal Population Database. DM deaths between 2002 and 2013 were analyzed by educational level and marital status. Age-adjusted rates (AARs) and mortality rate ratios (MRRs) were calculated using Poisson regression models, controlling for several social and demographic variables. The modifying effect of marital status on the association between educational level and DM mortality was evaluated by introducing an interaction term into the models. All analyses were performed separately for men and women. Results: There were 18,158 DM deaths (10,635 women and 7,523 men) among the 4,229,791 people included in the study. The risk of death increased as the educational level decreased. Marital status modified social inequality in DM mortality in a different way in each sex. Widowed and separated/divorced women with the lowest educational level had the highest MRRs, 5,1 (95%CI: 3,6-7,3) and 5,6 (95% CI:3,6-8,5) respectively, while single men had the highest MRR, 3,1 (95%CI: 2,7-3,6). Conclusions: Educational level is a key determinant of DM mortality in both sexes, and is more relevant in women, while marital status also plays an outstanding role in men. Our results suggest that in order to address inequalities in DM mortality, the current focus on individual factors and self-care should be extended to interventions on the family, the community, and the social contexts closest to patients (AU)

Are Socio-Demographic Factors Associated to Burnout Syndrome in Police Officers? A Correlational Meta-Analysis / ¿Están los factores sociodemográficos asociados al síndrome de burnout en policias? Un meta-análisis correlacional

Burnout is considered a long term stress reaction which is seen primarily among professionals who work face-to-face with other people. Socio-demographic characteristics have been suggested as risk factors to its development, although empirical studies have yield contradictory results. The objective of this study is to conduct a meta-analysis of four sociodemographic factors (age, sex, marital status, and number of children) that may be correlated to the Maslach Burnout Inventory dimensions (emotional exhaustion, depersonalization, and personal accomplishment) in police officers. These professionals have been considered a high-risk occupational group to suffer burnout due to specific characteristics of their job. We collected 43 empirical studies that fulfilled the inclusion criteria: 23 on age, 32 on sex, 9 on marital status, and 4 on number of children. The bivariate correlation coefficient was used as the effect size measure. The results show that all the average effect were small, and the majority of them were not statistically significant. We can conclude that sex and age are factors to discard in the development of the burnout in police officers. We found that many studies did not report enough statistical information to estimate effect sizes. This systematic lack of information is likely to contribute finding contradictory results

El síndrome de burnout se considera una reacción al estrés crónico que se ha observado principalmente en profesionales que trabajan de cara a otras personas. Las características sociodemográficas pueden afectar al desarrollo del síndrome, aunque los resultados obtenidos en los estudios empíricos han sido contradictorios. El objetivo del presente estudio es realizar una revisión meta-analítica sobre cuatro factores sociodemográficos (edad, sexo, estado civil y número de hijos) que pueden estar correlacionados con las dimensiones del Maslach Burnout Inventory (cansancio emocional, despersonalización y realización personal) en policías. Estos profesionales han sido considerados como un grupo de riesgo para desarrollar el síndrome debido a las características de su trabajo. Se obtuvieron 43 estudios empíricos que cumplían con los criterios de inclusión: 23 para edad, 32 para sexo, 9 para estado civil y 4 para número de hijos. Se utilizó el coeficiente de correlación bivariada como métrica del tamaño del efecto. Los resultados mostraron que todos los tamaños del efecto medio fueron bajos y la mayoría de ellos estadísticamente no significativos. Muchos de los estudios empíricos no informaban de suficiente información estadística para estimar los tamaños del efecto medio. Esta falta sistemática de información puede estar contribuyendo a que se sigan encontrando resultados contradictorios

Food habits in Mexican pregnant adolescents according to their civil status / Hábitos de alimentación en adolescentes embarazadas de acuerdo a su estado civil

Objective: To identify the feeding habits of pregnant adolescents in four different civil status: married, cohabiting with a partner, single with no partner and single with a partner. Methods: In a cross-sectional study, 321 pregnant adolescents aged 13 to 19 years old who attended the Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara (Jalisco, Mexico) were included. They were healthy, in any trimester of pregnancy and had either a low or medium-low socioeconomic status. The civil status of adolescents was stratified into: a) married, b) cohabiting with a partner, c) single with a partner and d) single without a partner. Socio-demographic, economic and feeding habits data were included. ANOVA, post-hoc tests for Chi2 , odds ratio and logistic regression models were used. Results: The frequency of married adolescents was 9.3%; 59.8% of the adolescents were cohabiting, 15.3% of the adolescents were single without a partner and 15.6% of the adolescents were single with a partner. Low schooling (OR 2.6 [1.5-4.4]) and occupation in housework (OR 4.47 [1.99-10.0]) predominated among adolescents in cohabitating with a partner; an occupation at home (OR 0.28 [0.127 to 0.61]) and unaccompanied dining (OR 4.12 [1.62-10.8]) were the factors with the most epidemiological significance in single without a partner adolescents. The consumption of vegetables was significantly lower in married adolescents and cohabiting-with-partner adolescents; consumption of beans and sweet bread was significantly lower in pregnant married adolescents. Conclusion: Because some variables and eating habits depended on civil status, it is pertinent to analyze them in each group of pregnant teenagers separately (AU)

Objetivo: identificar los hábitos alimentarios de adolescentes embarazadas en cuatro estados civiles diferentes: casada, cohabita con una pareja, soltera sin pareja y soltera con una pareja. Métodos: en estudio transversal, se incluyeron 321 adolescentes embarazadas de 13-19 años que acudieron al Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara (Jalisco, México). Se encontraban sanas, en cualquier trimestre del embarazo y pertenecían a un nivel socioeconómico bajo o medio-bajo. El estado civil se estratificó en: casadas; en unión libre; soltera con una pareja y soltera sin pareja. Se incluyeron datos socio-demográficos, económicos y de hábitos de alimentación. Se utilizaron pruebas de ANOVA, pruebas post-hoc para Chi2 , razón de momios y modelos de regresión logística. Resultados: la frecuencia de las adolescentes casadas fue de 9,3%, 59,8% en unión libre, 15,3% eran solteras sin pareja y 15,6% solteras con pareja. La baja escolaridad (RM 2,6 [1,5-4,4]) y la ocupación en el hogar (RM 4,47 [1,99-10,0]) predominaron entre las adolescentes en unión libre; la ocupación en el hogar (RM 0,28 [0,127-0,61]) y cenar sin compañía (RM 4,12 [1,62-10,8]) fueron significativamente más frecuentes en adolescentes sin pareja. El consumo de verduras fue menor en las adolescentes casadas y en quienes cohabitaban con pareja; el consumo de frijoles y pan dulce fue menor en adolescentes embarazadas casadas. Conclusión: debido a que ciertas variables y hábitos de alimentación mostraron diferencias entre los grupos es pertinente analizar las adolescentes embarazadas de acuerdo a su estado civil (AU)

Anxiety and psychological wellbeing in couples in transition to parenthood / Ansiedad y bienestar psicológico de la pareja en la transición a la paternidad

The aim of this study is to analyze the impact of anxiety and psychological well-being of couples in the transition to parenthood. A sample of 256 participants was divided into five groups: 54 "not seeking pregnancy", two groups seeking pregnancy, 50 "infertile that did not get pregnant" and 50 "infertile that achieves pregnancy", 50 "natural pregnancy", and 52 "fertile with children". State-Trait Anxiety Inventory (STAI) and Psychological Well-being in Couple Scale (EBP in Spanish) were used. The "infertile group that achieves pregnancy" gets the highest state-anxiety levels, even though regarding the anxiety-trait the group that is "not seeking pregnancy" shows the highest levels. Regarding psychological wellbeing in couples, the "natural pregnancy" group shows the lowest scores. These results demonstrate the possible functional role that anxiety-state in non-clinical levels can play in getting pregnant and confirm that psychological well-being in couple's relationship decreases only during pregnancy

El objetivo de este estudio es analizar el impacto de la ansiedad y el bienestar psicológico de la pareja en la transición a la paternidad. Una muestra de 256 participantes se dividió en cinco grupos: 54 "no buscan embarazo", dos grupos que buscan el embarazo, 50 "infértil que no consiguen embarazo" y 50 "infértil que logra el embarazo", 50 "embarazo natural" y 52 "fértil con niños". Se utilizó el Inventario de Ansiedad Estado-Rasgo (STAI) y la Escala de Bienestar Psicológico de la pareja (EBP). El "grupo infértil que logra el embarazo" es el que tiene más altos niveles de ansiedad estado, aunque, en relación con la ansiedad rasgo, es el grupo que "no busca embarazo" el que muestra los niveles más altos. En cuanto al bienestar psicológico en la pareja, el grupo "embarazo natural" es el que muestra las puntuaciones más bajas. Estos resultados demuestran el posible papel funcional que la ansiedad estado en los niveles no clínicos puede jugar en el embarazo y confirma que el bienestar psicológico en la relación de pareja disminuye sólo durante el embarazo

Filiación por técnicas de reproducción humana asistida, gestación por sustitución y consentimiento informado en Argentina. Aportes y cambios introducidos por el Código Civil y Comercial / Filiation by Human Assisted Reproduction Techniques, gestational surrogacy and informed consent in Argentina. Contributions and changes introduced by the Civil and Commercial Code

Este artículo busca describir los aportes del Código Civil y Comercial de Argentina en relación al consentimiento informado y la gestación por sustitución en el marco de la filiación (AU)

This article seeks to describe the contributions of the Civil and Commercial Code for Argentina, in relation to the informed consent and gestational surrogacy in the context of filiation (AU)

Características de los suicidios consumados en Navarra en función del sexo (2010-2013) / Characteristics of suicides in Navarra by gender (2010-2013)

Fundamento: Determinar el número de suicidios y las principales variables sociodemográficas, temporales y métodos empleados en los mismos en Navarra en el periodo 2010-2013 en función del sexo. Material y métodos: Revisión de las historias clínicas informatizadas del Servicio Navarro de Salud-Osasunbidea de los suicidios consumados en Navarra. Resultados: Se produjeron 180 suicidios. El número de suicidios se mantuvo estable: 41 en el año 2010, 51 en el año 2011 y 44 en los años 2012 y 2013. El 75,4% (n=136) eran hombres y el 24,6% (n=44) mujeres. En la franja de edad comprendida entre los 13 y los 26 años de 13 suicidios, 12 (92,3%) fueron de hombres. En cuanto a la situación laboral, el 49,3% (n=70) eran pensionistas. La mayor frecuencia de suicidios se dio en verano (n=71) y primavera (n=39). El lunes fue el día de la semana con más suicidios (n=37) y el intervalo entre las 8:00 y las 12:00 el momento del día en que más suicidios (n=80) se produjeron. Los métodos más empleados fueron el ahorcamiento (n=59), la precipitación desde altura (n=41) y la sobre ingesta farmacológica (n=23). Los varones emplearon con mayor frecuencia métodos violentos. Es necesario destacar que en algunas de las variables sociodemográficas había hasta un 60% de casos sin información. Discusión: Los resultados encontrados muestran algunas especificidades del fenómeno del suicidio en Navarra que deben considerarse para su prevención. Asimismo se recomienda desarrollar e implementar protocolos específicos de recogida de información para mejorar las estrategias preventivas (AU)

Objective: To determine the number of suicides and the main social and demographic characteristics, time frames and methods involved during the period 2010-2013 in Navarra by gender. Methods: A study of the Electronic Clinical Records provided by Navarra's Healthcare Service in which suicides in Navarra are detailed. Results: One hundred and eighty individuals committed suicide. The number of suicides remained stable: 41 in 2010, 51 in 2011 and 44 in 2012 and 2013. Seventyfive point four percent were males (n=136) and 24.6 % (n=44) were females. In the 13 to 26 age group, 12 (92.3%) out of 13 suicides were committed by males. In terms of employment status, 49.3% (n=70) were pensioners. The highest rate of suicides was reached in summer (n=71) and spring (n=39). Monday was the day with the highest rate of suicides (n=37) and the time period between 8:00 and 12:00 hours was when the highest number of suicides (n=80) took place. The most usual ways of committing suicide were hanging (n=80), falling from a height (n=41) and pharmacological overdose (n=23). Males used violent methods more frequently. It is necessary to highlight the fact that in some of the sociodemographic characteristics there was up to 60% of cases without enough information. Conclusion: The results obtained show some specific features of the phenomenon of suicide in Navarra that should be considered for its prevention. Furthermore, the implementation of effective protocols of data collection is recommended to develop prevention strategies (AU)

Predictors of adherence to the Mediterranean diet from the first to the second trimester of pregnancy / Los predictores de la la dieta mediterránea desde el primero hasta el segundo trimestre del embarazo

Background: Although changes in eating patterns may occur during gestation, predictors of these changes have not been explored. This study aimed to identify predictors of adherence to the Mediterranean diet (MD) from the first to second trimester of pregnancy. Methods: A prospective study was conducted with 102pregnant women aged 18-40, from the city of Porto, Portugal. Socio-demographic and lifestyle characteristics were assessed through a questionnaire. Food consumption was assessed with a three-day food diary completed during the first and second trimesters. Participants were categorized according to their change in adherence to the MD into the negative change group (i.e., women who had low adherence in each trimester or had high adherence in the first trimester and then low adherence in the second) and the positive change group (i.e., women who had high adherence in both trimesters or had low adherence in the first trimester and then high adherence in the second). Conditional stepwise logistic regression models were performed to assess the potential predictors of negative MD change. Results: Among the 102 women, 39.2% had negative change from the first to the second trimester. The logistic model’s results show that being married (OR=0.26,95%CI: 0.10, 0.76) and having a higher intake of vegetables in the first trimester (OR=0.17, 95%CI: 0.10, 0.43) were associated with lower odds of having a negative change in adherence to the MD from the first to second trimester. Conclusion: Marital status and vegetable consumption seem to be associated with a lower occurrence of negative change in adherence to the MD from early to middle pregnancy (AU)

Introducción: Aunque los cambios en los patrones pueden ocurrir durante la gestación, predictores de estos cambios no han sido exploradas. Este estudio pretende identificar predictores de la adhesión a la dieta mediterránea (DM) desde el primer al segundo trimestre del embarazo. Metodología: Se realizó un estudio prospectivo con 102 embarazadas de edad 18-40, de la ciudad de Oporto, Portugal. Se evaluaron las características socio-demográficas y de estilo de vida a través de un cuestionario. Consumo de alimentos se evaluó con un diario de alimentos de tres días concluido durante los primeras y segundo trimestres. Los participantes fueron categorizados según su cambio en la adhesión a la DM en el cambio negativo (es decir, las mujeres que tenían poca adhesión en cada trimestre o tenido alta adhesión en el primer trimestre y luego baja adhesión en el segundo) y el grupo de cambio positivo (es decir, las mujeres que tenían alta adhesión en ambos trimestres o tenía baja adhesión en el primer trimestre y luego elevada adhesión en el segundo). Modelos de regresión logística stepwise condicional se realizaron para evaluar los posibles predictores de la variación negativa de DM. Resultados: Entre las 102 mujeres, 39,2% tenían cambio negativo del primer al segundo trimestre. Los resultados model´s logística muestran que estar casada (OR = 0,26, IC95%: 0,10, 0,76) y tener una mayor ingesta de verduras en el primer trimestre (OR = 0,17, IC95%: 0,10, 0,43) se asociaron con menor probabilidad de tener un cambio negativo en la adhesión a la DM del primer al segundo trimestre. Conclusiones: Estado civil y el consumo de vegetal parecen estar asociado con una menor ocurrencia de cambio negativo en la adhesión a la MD desde temprano a medio embarazo (AU)