Psychometric analysis and validation of the SF-34 PREG: An adaptation of the SF-36 for assessing quality of life in pregnant women.

OBJECTIVE: This study aims to perform a psychometric analysis of the 36-item short form health survey (SF-36) in a population of pregnant women and validate an adapted version of the instrument to measure health-related quality of life specific to pregnancy. METHODS: A cross-sectional study design was carried out with data collection between 7 and 36 weeks of gestation, with a total sample of 547 pregnant women divided into two randomized subsamples. Data were collected between September 2021 and April 2023. An exploratory factor analysis was initially performed on one subsample, followed by a confirmatory factor analysis on the other. Internal consistency was assessed using Cronbach's alpha and McDonald's omega, and correlations between factors were analyzed. RESULTS: Results from the exploratory factor analysis proposed a seven-factor model explaining 56% of the variance. All proposed dimensions achieved Cronbach's alpha scores above 0.75, with a total test score of 0.92. Furthermore, all dimensions exhibited positive and statistically significant correlations. Bartlett's test of sphericity and the Kaiser-Meyer-Olkin test yielded values of 5599 (P < 0.001) and 0.871, respectively. The confirmatory factor analysis reaffirmed this model with good fit indices: χ2 792 (P < 0.001), comparative fit index (CFI) and Tucker-Lewis index (TLI) >0.90, and standardized root mean square residual (SRMR) and root mean square error of approximation (RMSEA) <0.06. CONCLUSION: This study developed and validated the "SF-34 PREG," an adapted version of the SF-36, specifically designed for pregnant women. The SF-34 PREG demonstrated high reliability and a robust factorial structure, making it a more precise and relevant tool for assessing health-related quality of life during pregnancy. Although it does not include the social functioning dimension of the original SF-36, the SF-34 PREG offers improved relevance and accuracy for this specific population. Further research and clinical use of the SF-34 PREG are recommended.

Mapping skills between symbols and quantities in preschoolers: The role of finger patterns.

Mapping skills between different codes to represent numerical information, such as number symbols (i.e., verbal number words and written digits) and non-symbolic quantities, are important in the development of the concept of number. The aim of the current study is to investigate children's mapping skills by incorporating another numerical code that emerges at early stages in development, finger patterns. Specifically, the study investigates (i) the order in which mapping skills develop and the association with young children's understanding of cardinality; and (ii) whether finger patterns are processed similarly to symbolic codes or rather as non-symbolic quantities. Preschool children (3-year-olds, N = 113, Mage = 40.8 months, SDage = 3.6 months; 4-year-olds, N = 103, Mage = 52.9 months, SDage = 3.4 months) both cardinality knowers and subset-knowers, were presented with twelve tasks that assessed the mappings between number words, Arabic digits, finger patterns, and quantities. The results showed that children's ability to map symbolic numbers precedes the understanding that such symbols reflect quantities, and that children recognize finger patterns above their cardinality knowledge, suggesting that finger patterns are symbolic in essence. RESEARCH HIGHLIGHTS: Children are more accurate in mapping between finger patterns and symbols (number words and Arabic digits) than in mapping finger patterns and quantities, indicating that fingers are processed holistically as symbolic codes. Children can map finger patterns to symbols above their corresponding cardinality level even in subset-knowers. Finger patterns may play a role in the process by which children learn to map symbols to quantities. Fingers patterns' use in the classroom context may be an adequate instructional and diagnostic tool.

Analysis of Maternal Positions during the Dilation and Expulsive Phase and Their Relationship with Perineal Injuries in Eutocic Deliveries Attended by Midwives.

This cross-sectional descriptive study aimed to analyze the relationship between maternal positions during the expulsion phase and perineal outcomes in 367 eutocic births attended by midwives or midwifery residents at a public hospital in northern Spain in 2018. A total of 94.3% of women opted for horizontal positions. Limited sacral retroversion was observed in 71.7%, potentially influencing perineal outcomes. A low incidence of tears indicated effective management during the expulsive phase, with an episiotomy rate of 15.3%, which was slightly above the 15% standard. Primiparity and maternal age were identified as risk factors associated with episiotomy. Additionally, sacral mobilization and vertical positions during delivery were significantly related to fewer perineal injuries, suggesting benefits for both mother and newborn. The correlation between maternal positions and the need for epidural analgesia highlighted the importance of considering these in pain management during childbirth. Despite limitations, the study provides valuable insight into obstetric practices and advocates for a woman-centered approach that respects autonomy during childbirth. Further research is needed to explore biomechanical parameters and enhance childbirth experiences.

Numeral order and the operationalization of the numerical system.

Recent years have witnessed an increase in research on how numeral ordering skills relate to children's and adults' mathematics achievement both cross-sectionally and longitudinally. Nonetheless, it remains unknown which core competency numeral ordering tasks measure, which cognitive mechanisms underlie performance on these tasks, and why numeral ordering skills relate to arithmetic and math achievement. In the current study, we focused on the processes underlying decision-making in the numeral order judgement task with triplets to investigate these questions. A drift-diffusion model for two-choice decisions was fit to data from 97 undergraduates. Findings aligned with the hypothesis that numeral ordering skills reflected the operationalization of the numerical system, where small numbers provide more evidence of an ordered response than large numbers. Furthermore, the pattern of findings suggested that arithmetic achievement was associated with the accuracy of the ordinal representations of numbers.

Disentangling the Mechanisms of Symbolic Number Processing in Adults' Mathematics and Arithmetic Achievement.

A growing body of research has shown that symbolic number processing relates to individual differences in mathematics. However, it remains unclear which mechanisms of symbolic number processing are crucial-accessing underlying magnitude representation of symbols (i.e., symbol-magnitude associations), processing relative order of symbols (i.e., symbol-symbol associations), or processing of symbols per se. To address this question, in this study adult participants performed a dots-number word matching task-thought to be a measure of symbol-magnitude associations (numerical magnitude processing)-a numeral-ordering task that focuses on symbol-symbol associations (numerical order processing), and a digit-number word matching task targeting symbolic processing per se. Results showed that both numerical magnitude and order processing were uniquely related to arithmetic achievement, beyond the effects of domain-general factors (intellectual ability, working memory, inhibitory control, and non-numerical ordering). Importantly, results were different when a general measure of mathematics achievement was considered. Those mechanisms of symbolic number processing did not contribute to math achievement. Furthermore, a path analysis revealed that numerical magnitude and order processing might draw on a common mechanism. Each process explained a portion of the relation of the other with arithmetic (but not with a general measure of math achievement). These findings are consistent with the notion that adults' arithmetic skills build upon symbol-magnitude associations, and they highlight the effects that different math measures have in the study of numerical cognition.

Liver failure posthepatectomy and biliary fistula: multidisciplinar treatment.

The main cause of morbimor-mortality after major liver surgery is the development of liver failure posthepatectomy(LFPH). Treatment must involve multiple options and will be aggressive from the beginning. We report a case of a patient with cholangiocarcinoma perihilar treated with surgery: right hepatectomy extended to sI + IVb with develop of LFPH and biliary fistula and being management successfully in a multidisciplinary way.