Depressive symptoms and suicide attempts among farmers exposed to pesticides.

Pesticides safeguard crop health but may diminish cholinesterase activity in farmers, potentially leading to psychiatric disorders like depression and suicide attempts. This study, with 453 participants (225 pesticide-exposed farmers, 228 non-farmers) in Almería, Spain, aimed to investigate the presence of depressive symptoms and suicide attempts, the decrease acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity, and their relationship with pesticide exposure in farmers. Depressive symptoms were evaluated using the Spanish adaptation of the Beck Depression Inventory, and blood samples were analyzed for AChE and BChE activity. Farmers showed significantly increased risk of moderate/severe depression and suicide attempts compared to non-farmers (OR = 2.18; p = 0.001), with highest risks observed among mancozeb users (OR = 2.76; p = 0.001 for depression) and malathion users (OR = 3.50; p = 0.001 for suicide attempts). Findings emphasize elevated depression and suicide risks among pesticide-exposed farmers, particularly associated with chlorpyrifos, mancozeb, and malathion exposure.

The relationship between female orgasmic disorder, attention-deficit/hyperactivity disorder, and depression in Dominican women.

BACKGROUND: Female orgasmic disorder is listed in the DSM-5 and is defined as the persistent or recurrent inability to have an orgasm. Many depressed women may experience sexual dysfunction, including female orgasmic disorder. AIM: The study sought to analyze the relationship between depressive disorders and attention-deficit/hyperactivity disorder (ADHD) and their influence on the development of female orgasmic disorder. METHODS: A total of 221 Dominican women participated in this case-control study. The case group consisted of 107 women diagnosed with female orgasmic disorder, while the control group consisted of 114 women without any sexual dysfunction. OUTCOMES: The diagnosis of ADHD was obtained from the participants' medical records, previously conducted using the DSM-5-TR criteria. The Beck Depression Inventory II was used to assess the severity of depressive symptoms in both groups. RESULTS: There was a significant relationship between female orgasmic disorder and ADHD and depression. The results of multiple logistic regression indicated that the highest risk of female orgasmic disorder was observed in women with ADHD (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.46-9.20; P < .001), women with severe depression (OR, 2.50; 95% CI, 1.08-6.96; P = .04), and women who had sexual intercourse that focused on penetration (OR, 2.02; 95% CI, 1.03-3.98; P = .04). CLINICAL IMPLICATIONS: These findings may have important implications for the prevention and treatment of sexual disorders in women. STRENGTHS AND LIMITATIONS: This design selected all diagnosed cases of female orgasmic disorder and did not select a specific subgroup. However, some limitations must be considered. This study was conducted in a single clinic, although it should be noted that it is the main clinic for the treatment of sexual dysfunction in the country. A further limitation could be that this type of study design does not allow for statements about causality to be made. CONCLUSION: There is an increased risk of female orgasmic disorder in women with ADHD, with severe depression, and who engage in penetrative sex.

State-trait anxiety levels and vital signs of pregnant women following intervention with virtual reality during the nonstress test: A randomized controlled trial.

BACKGROUND: Pregnant women often experience anxiety due to pregnancy, negatively impacting their and their fetus' health. Non-pharmacological interventions, such as virtual reality (VR), could reduce anxiety levels, potentially impacting non-stress tests or the physiological responses of the pregnant woman and the fetus. METHODS: A randomized clinical trial conducted between February and December 2022 involved 286 term pregnant women. They were divided into a VR intervention group (146 women) and a control group (140 women). The intervention consisted of 20 min of 3D glasses with images and sounds during a third-trimester nonstress test. Anxiety was measured using the Spielberg State-Trait Anxiety Inventory (STAI), alongside physiological parameters. RESULTS: The VR group exhibited lower anxiety levels compared to controls (STAI score: Rosenthal's r: -0.54, p = 0.01; state anxiety: Rosenthal's r: -0.40, p = 0.001; trait anxiety: Rosenthal's r: -0.41, p = 0.001). Within the VR group, there was a significant reduction in trait anxiety (Rosenthal's r, 1.27; p < 0.001) and total anxiety (Rosenthal's r, 1.63; p < 0.001) post-intervention, along with decreased systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), and maternal heart rate (p = 0.02). LIMITATIONS: Future research could explore additional pregnancy-related variables, such as postpartum anxiety. CONCLUSIONS: The results confirm that the use of VR is beneficial for pregnant women and their fetuses, as it decreases anxiety levels, and improves physiological parameters such as blood pressure and maternal heart rate during the nonstress test. VR is a technique that is easy to integrate into the healthcare system due to its non-invasive and non-pharmacological nature.

Experiences of Dyspareunia in Dominican Women with a History of Sexual Abuse: A Phenomenological Study.

INTRODUCTION: Dyspareunia refers to painful sexual intercourse that negatively affects a person's psychological well-being and quality of life and can also have an impact on their partner, family, and social circle. The objective of this study was to understand the experiences of women with dyspareunia and a history of sexual abuse in the Dominican Republic. METHODS: This was a qualitative study based on Merleau-Ponty's hermeneutic phenomenology. Fifteen women with a diagnosis of dyspareunia and a history of sexual abuse participated. The study was carried out in Santo Domingo, Dominican Republic. RESULTS: In-depth interviews were conducted for data collection. Through inductive analysis using ATLAS.ti, 3 main themes were developed that represent women's experiences of dyspareunia and sexual abuse: (1) a history of sexual abuse as a background to dyspareunia, (2) living in fear in a society that revictimizes the survivor, and (3) the sexual consequences of dyspareunia. DISCUSSION: In some Dominican women, dyspareunia stems from their history of sexual abuse, which was unknown to their families and partners. The participants experienced dyspareunia in silence and found it difficult to seek help from health care professionals. In addition, their sexual health was marked by fear and physical pain. There are individual, cultural, and social factors that influence the occurrence of dyspareunia; a better understanding of these factors is vital for planning innovative preventive strategies that reduce the progression of sexual dysfunction and its impact on the quality of life of people with dyspareunia.

Determination of Foetal Scalp Blood Sampling pH as an Indicator of Loss of Foetal Well-Being in Women Undergoing Caesarean Section.

Asphyxia during birth is one of the three leading causes of neonatal morbidity and mortality among newborns carried to term. The objective of this study was to evaluate the measurement of the foetal scalp blood pH as a measure of foetal status, evaluating: cord gases, meconium-stained fluid, APGAR score or the need for neonatal resuscitation in pregnant women undergoing caesarean sections. A cross-sectional study was carried out over a period of 5 years (2017-2021) at the Hospital de Poniente (southern Spain). A total of 127 pregnant women participated from whom a foetal scalp blood pH sample was taken and used to indicate the need for an urgent caesarean section. The results showed a correlation between the pH of the scalp blood and the pH of the umbilical cord artery, umbilical cord vein (Rho of Spearman arterial pH: 0.64, p < 0.001; Rho of Spearman venous pH: 0.58, p < 0.001) and the APGAR test one minute after delivery (Spearman's Rho coefficient of 0.33, p < 0.01). These results suggest that the foetal scalp pH should not be considered a foolproof method to indicate an urgent caesarean section. Foetal scalp pH sampling can be used as a complementary test, in conjunction with cardiotocography, to indicate whether an emergency caesarean section is necessary due to loss of foetal well-being.

Occupational Exposure to Pesticides as a Risk Factor for Sleep Disorders.

Inadequate sleep has been linked to a variety of impairments in bodily functions, including endocrine, metabolic, higher cortical function, and neurological disorders. For this reason, the aim of this study was to analyze the link between occupational pesticide exposure and sleep health among farmers in Almeria. A cross-sectional study was conducted among a population living on the coast of Almeria (southeastern Spain), where about 33,321 hectares of land are used for intensive agriculture in plastic greenhouses. A total of 380 individuals participated in the study: 189 greenhouse workers and 191 control subjects. The participants were contacted during their annual scheduled occupational health survey. Data on sleep disturbances were collected using the Spanish version of the Oviedo Sleep Questionnaire. Agricultural workers were found to be at a significantly higher risk of insomnia, especially among those who did not wear protective gloves (OR = 3.12; 95% C.I. = 1.93-3.85; p = 0.04) or masks (OR = 2.43; 95% C.I. = 1.19-4.96; p = 0.01). The highest risk of insomnia related to pesticide applicators was observed in those who did not wear a mask (OR = 4.19; 95% C.I. = 1.30-13.50; p = 0.01) or goggles (OR = 4.61; 95% C.I. = 1.38-10.40; p = 0.01). This study supports previous findings indicating an increased risk of sleep disorder in agricultural workers exposed to pesticides at work.

Effect of Virtual Reality and Music Therapy on the Physiologic Parameters of Pregnant Women and Fetuses and on Anxiety Levels: A Randomized Controlled Trial.

INTRODUCTION: Anxiety negatively affects pregnant women and their fetuses. It can cause misleading test readings in electronic fetal monitoring, affect the duration of the first stage of labor, and influence certain aspects related to childbirth. This study aimed to evaluate the effects of virtual reality and music therapy on anxiety levels, maternal and fetal physiologic parameters, and labor and birth outcomes. METHODS: A total of 343 full-term pregnant women participated in a randomized controlled trial and were divided into 3 parallel groups: music therapy intervention (n = 104), virtual reality intervention (n = 124), and control (n = 115). The interventions were delivered during a nonstress test in the third trimester and during labor. Data were collected from April 2017 to May 2018. Measures included the Spielberger State-Trait Anxiety Inventory, maternal blood pressure, maternal and fetal heart rates, and labor and birth outcomes. The study was registered in the Australian New Zealand Clinical Trial Registry (ACTRN12621001647820). RESULTS: Women in the music therapy and virtual reality groups had lower levels of anxiety after a nonstress test (P < .001), and the women were more likely to have a reactive nonstress test (P < .001) compared with the control group. After the nonstress test and intervention were complete, the music therapy and virtual reality groups had significant decreases in systolic blood pressure (P < .001), diastolic blood pressure (P < .001), and maternal heart rate (P = .003) compared with the control group. Furthermore, fetuses in the control group were more likely to experience nonreassuring fetal heart rate tracings compared with the music therapy and virtual reality groups, respectively (P = .004). DISCUSSION: Our findings support the use of music and virtual reality during nonstress tests and labor as nonpharmacologic interventions to reduce anxiety, improve maternal and fetal physiologic parameters, and improve labor and birth outcomes. This research should be replicated in diverse perinatal settings.

Use of Digital Technology as a Collaborative Tool among Nursing Students-Survey Study and Validation.

BACKGROUND: This research aimed to develop a questionnaire to analyze perceived aspects of using digital technology among nursing students as a collaborative tool. We further sought to evaluate the psychometric reliability of the instrument. METHODS: A cross-sectional observational study was performed using a questionnaire developed from scratch. Psychometric studies and univariate and bivariate analyses were performed. RESULTS: 132 nursing students participated. The exploratory and confirmatory analyses of the questionnaire excluded 4 of the initial 18 items and established four domains, and internal consistency was found. The mean global score of the answers to the questionnaire was 4.67 on a scale of 1-5 points, and all the domains obtained high scores. Men scored higher on the usefulness and the global score, while no differences were found regarding age. CONCLUSIONS: Nursing students positively assess the use of digital technology as a collaborative tool, regardless of age. Digital technology as a collaborative tool is perceived as beneficial, improves their involvement, and allows nursing students to obtain a better knowledge of their partners. These findings can help develop group projects and tools based on technology to train future nursing professionals. The questionnaire developed is a valid tool to assess this.

The Impact of COVID-19 on the Monitoring of Pregnancy and Delivery of Pregnant Women in the Dominican Republic.

Pregnancy monitoring is vital to guaranteeing that both the foetus and the mother are in optimal health conditions. WHO protocols recommend at least eight medical examinations during the pregnancy period. While the cancellation or reduction of appointments during pregnancy due to the pandemic may help reduce the risk of infection, it could also negatively influence perinatal outcomes and the birthing process. The aim of this research was to analyse the differences in perinatal outcomes and birth characteristics in two groups of pregnant women: women who gave birth before and during the pandemic, and whether these differences are due to changes in pregnancy monitoring because of the COVID-19 situation. A retrospective study was carried out from July 2018 to December 2021, at the Santo Domingo Hospital (Dominican Republic). A total of 1109 primiparous pregnant women were recruited for this study during the birthing process and perinatal visits. The results describe how women who gave birth before the pandemic had greater control and monitoring of their pregnancy, more doctor visits (p = 0.001), fewer caesarean sections (p = 0.006), and more skin-to-skin contact after birth (p = 0.02). During the COVID-19 pandemic, pregnant women's attendance at routine pregnancy monitoring, both doctor visits and ultrasound scans, has decreased, leading to an increase in the number of caesarean and instrumental deliveries. At the perinatal level, processes such as skin-to-skin contact after birth between mother and newborn or the introduction of early breastfeeding in the delivery room have also been reduced.

Comparison of Analytical Values D-Dimer, Glucose, Ferritin and C-Reactive Protein of Symptomatic and Asymptomatic COVID-19 Patients.

Those infected by COVID-19 develop various kinds of complications with varying degrees of severity. For this reason, it is necessary to evaluate its analytical values to predict and reduce the risks and complications derived from this pathology. A cross-sectional study was carried out a population in Almeria (south-eastern Spain) who had a positive Polymerase Chain Reaction test result from 1 March 2020 to 30 November 2020. The study involved 4575 patients, with 1346 who were asymptomatic, 1653 mildly symptomatic (no hospitalisation needed) and 1576 severely symptomatic (symptomatic patients hospitalised). Laboratory values for D-dimer, glucose, serum ferritin, and C-reactive protein were analysed. The mean age of the participants in the study was 53.60 (16.89) years old. A total of 70.6% of the patients were symptomatic, of which 36.1% had mild symptoms. For all of the laboratory predictors analysed (D-dimer, glucose, serum ferritin, and C-reactive protein), it was found that severe alterations in the parameters were more frequent in severely symptomatic patients with statistically significant differences (p < 0.001), although these alterations also occurred in asymptomatic patients. Age correlated with analytical values (D-dimer, glucose, serum ferritin, and C-reactive protein) with statistically significant differences. Patients with severe symptoms presented alterations in the analytical values of D-dimer, glucose, serum ferritin, and C-reactive protein. Asymptomatic patients presented alterations in the analysed parameters, though with less frequency and severity than patients with severe symptoms.

Motivation and Barriers to Research among Nursing Professionals in Southeast Spain.

Background: Nursing research promotes quality care and is essential. Thus, it is important to acknowledge the main motivations and barriers that nursing professionals find in their work, the aim of this study was to establish the main aspects that motivate and make nursing research difficult, for nursing professionals; Methods: a descriptive cross-sectional study was carried out on 91 nursing professionals. A validated structured questionnaire composed of 42 items that defined five domains was used. Descriptive and bivariant analyses were performed; Results: the highest scores were obtained for the domain of Knowledge and Preparation (33.79 ± 3.38), while the domain of Available Resources and Support obtained lower mean values (22.60 ± 5.61). Significant differences were found in two domains: Knowledge and Preparation and Professional Development domains, when regarding the service in which the participants were working (p < 0.05); in the Available Resources and Support domain, when regarding sex (p < 0.05), in the Motivations domain, regarding the number of children (p < 0.05); Conclusions: nursing professionals show a positive attitude towards nursing research. The nurses find motivation in their work environment, in the economic incentives, or in the possibility to improve their curriculum vitae. The main barriers are the lack of time, the lack of institutional support, and the lack of training, especially in languages, such as English. These findings could be useful to design programs to overcome these barriers.

Alexithymia and Insecure Attachment among Male Intimate Partner Violence Aggressors in the Dominican Republic.

The complexity of intimate partner violence and the impossibility of understanding it from single factors have been studied from different biological, psychological, and socio-cultural factors. A cross-sectional study was conducted on 187 men involved in legal proceedings for problems of violence in their intimate partner relationships in the Dominican Republic in order to explore whether insecure attachment represents a risk factor for alexithymia in men with violent behaviors. The attachment style was determinate by the Casullo and Fernández-Liporace Attachment Styles Scale, and alexithymia was assayed using the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20), a modification of the Toronto Alexithymia Scale (TAS-20). Chi-square test and multiple binary logistic regression analysis were performed to explore the phenomena of alexithymia and attachment styles in the context of a confinement center for male intimate partner offenders in the Dominican Republic. The results showed that insecure attachment represents a risk factor for alexithymia, being highest for avoidant attachment in the population studied. The results also highlight the influence of other factors such as education and maternal-familial relationships as a factor risk for alexithymia.

Association between Crystalline Silica Dust Exposure and Silicosis Development in Artificial Stone Workers.

Occupational exposure to respirable crystalline silica (SiO2) is one of the most common and serious risks because of the health consequences for the workers involved. Silicosis is a progressive, irreversible, and incurable fibrotic lung disease caused by the inhalation of respirable crystalline silica dust. A cross-sectional epidemiological study was carried out to assess the occupational risk factors that may contribute to the onset of silicosis in workers carrying out work activities with the inhalation of silica compact dust. The study population consisted of 311 artificial stone workers from the province of Almeria (southeast of Spain). Among them, 64 were previously diagnosed with silicosis and the rest of the participants (n = 247 workers) were not diagnosed with such a disease. The workers showing a greater risk of developing silicosis were those who installed kitchen worktops at consumers' homes, as they did not use face-masks or were not provided with personal protective equipment (PPE) by their business. The results of this study provide support for the evidence indicating that silicosis is a major emerging health concern for workers in the artificial stone sector. Exposure to crystalline silica dust thus can influence the development of silicosis in those cases where individual and collective protection measures are not used or adequately applied.

Analysis of Anxiety Levels of Nursing Students Because of e-Learning during the COVID-19 Pandemic.

The continued expand of the coronavirus disease 19 (COVID-19) pandemic, confinement measures and an urgent change in the education of nursing students from traditional education to distance learning throughout the country affect the mental health of university students. This study analyzed state-trait anxiety levels of nursing students because of e-Learning during two periods of the COVID-19 confinement. A mixed follow-up study was used, which evaluates the same cohort cross-sectionally but with a longitudinal component. A sample of 460 nursing students of the Nursing Degree at the University of Lorca (Murcia) and University of Almería (Spain) completed an online anxiety level questionnaire using the Spielberger State-Trait Anxiety Inventory (STAI) during the first and fourth weeks of the COVID-19 confinement. Total anxiety levels increased in the fourth week, as compared to the first week (first week: 50.4 ± 20.8 and fourth week: 59.9 ± 10.6 (p < 0.001)). The linear regression model showed that the significant predictors for STAI anxiety in nursing students were being in the last year of the degree program, being female, and spending confinement in a house without a garden. In general, most nursing students were emotionally affected by high levels of anxiety of state-trait during the COVID-19 outbreak.

Evaluation of Gonadal Alterations in a Population Environmentally Exposed to a Mixture of Endocrine Active Pesticides.

Although there are studies that show that some pesticides produce gonadal dysfunction and gonadal cancer in different animals, there are not many studiesregardinghumans. This study determined the prevalence and risk in humans of developing ovarian or testicular dysfunction or cancer in areas with distinct exposure to pesticides, which have endocrine disrupting properties. A population-based case-control study was carried out on humans living in ten health districts of Andalusia (Southern Spain) classified as areas of high or low environmental exposure to pesticides according to agronomic criteria. The study population included 5332 cases and 13,606 controls. Data were collected from computerized hospital records between 2000 and 2018.The risk of gonadal dysfunction or cancer was significantly higher in areas with higher use of pesticides in relation to those with lower use.