Beyond femininity or masculinity: gender typologies and healthy eating in early adulthood.

PURPOSE: In the field of health sciences gender is often confused with biological sex (male/female) or reduced to a dichotomous classification (masculinity/femininity). The concepts of sex and gender interact with each other, but they are not equivalent. According to Sandra Bem four gender typologies can be established (androgynous, masculine, feminine and undifferentiated). A relationship has been shown to exist between gender and health. Yet, there is little evidence as to the relationship between gender typologies and adherence to the Mediterranean diet. The aim of this research is to evaluate the association between Bem's gender typologies and adherence to the Mediterranean diet. METHODS: Mediterranean Diet Adherence Screener (MEDAS) and Bem's gender typologies were the main variables. Sex, age, socioeconomic status (SES), body mass index (BMI) and obesity were analyzed as covariates. RESULTS: Multilevel multivariate analysis showed that androgynous typology was associated with increased adherence to Mediterranean diet (ß = 0.46 (SE 0.21), p = 0.033), adjusting by covariates, in a university population in Spain. Moreover, this was not the case with masculinity or femininity typologies. CONCLUSION: Thus, the results of this study suggest (1) that androgynous typology is not only associated with better mental health but also with healthy/healthier lifestyles, and (2) the complexity of the relationship between sex-gender and health would advise researchers avoid dichotomies such as male/female or masculinity/femininity.

Personality and gender prototypes for predicting health: a multilevel and cluster analysis.

Prior studies have identified that mentally healthy people tend to share common characteristics and common ways of coping with stressful life events; they show similar patterns of behavior and more flexible and adaptive social roles. The objectives of the study are to assess the influence of personality factors on gender roles and mental health, to identify personality patterns along with gender roles, and to assess the influence of the patterns identified on mental health. Data collection from a sample of 795 university students was carried out during 2019. Multilevel analyses tested the associations between gender (BSRI) and personality (TIPI) and between personality and health -mental health (GHQ12) and wellbeing (MHC-SF). Cluster analysis explored tendencies of gender and personality, and each cluster showed different health patterns. Individuals with high scores in extraversion, conscientiousness, emotional stability, openness to experience, and very high agreeableness score, as well as high femininity and masculinity scores, presented a decreased psychological morbidity (ß= -3.62, 0.57 (SE), p<0.001) and an increased well-being (ß=7.68, 1.15 (SE), p<0.001). The most relevant indicators of mental health were identified in androgynous individuals, those individuals with high scores in masculinity and femininity, as well as high scores in extraversion, openness to experience, emotional stability, agreeableness, and conscientiousness.

Duodenal tuberculosis.

Gastrointestinal tuberculosis (TB) is a rare disease and only involves the duodenum in 2-2,5% of all cases. A 60-year-old female with no reported medical history, presented with constitutional syndrome with a 10 kg weight loss in three months, epigastric pain, bloating and vomiting. She denied fever or respiratory symptoms. Laboratory examination revealed elevated C-reactive protein levels and low prealbumin. Abdominal computed tomography (CT) showed duodenal wall thickening, mainly in its third part, with infiltration of the root of the mesentery and numerous subcentimeter adenopathies at that level.

Reflective based learning for nursing ethical competency during clinical practices.

BACKGROUND: A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students. AIM: To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies. RESEARCH DESIGN: Qualitative study with a content analysis according to Elo and Kinglas framework. PARTICIPANTS AND RESEARCH CONTEXT: Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women. METHODOLOGY: The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method. ETHICAL CONSIDERATIONS: Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form. FINDINGS: Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity. CONCLUSION: All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas.

Adaptation and validation of the Interprofessional Socialization and Valuing Scale (ISVS) in Spanish university health sciences students.

Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 [95% CI 0.903, 0.923]. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization.

Exploring new tendencies of gender and health in university students.

In light of the impact of gender roles on health, the aims of the present study are (1) to assess the associations between femininity/masculinity and gender typologies, and health indicators (mental health, wellbeing, and self-perceived health) and (2) to identify patterns of gender roles and health indicators, thus exploring new tendencies in gender and health in Spanish university students in the framework of the androgyny model. The sample was made up of 795 university students from Madrid and Toledo. Data collection was completed during 2019. Measures of self-rated health, mental health (GHQ12), and wellbeing (MHC-SF) were considered as health indicators, while the Bem Sex Roles Inventory (BSRI) was used to measure gender roles. Multilevel analysis was employed to value associations between masculinity and femininity and gender typologies with self-rated health, mental health, and wellbeing. Furthermore, cluster analysis was used to explore general tendencies in gender roles and health, while also considering biological sex composition. The best predictor of mental health was found to be masculinity, rather than femininity. Cluster analysis showed a dominance of androgyny and undifferentiated typologies with proportionally similar biological sex composition. Results confirmed the androgyny model, highlighting the role of androgyny and masculinity as protective factors of mental health. Cluster analysis suggested less gender-typed individuals and more flexible ways of adapting to gender roles in university students. Health systems, governments, and public institutions must take these results into account when designing health prevention and intervention policies. Social agents, educators, and the media must also collaborate in the achievement of equalitarian gender roles, which could result in a minimization of gender-related health differences.

Adherence to initial exclusive breastfeeding among Chinese born and native Spanish mothers.

BACKGROUND: Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. METHODS: A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. RESULTS: Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05-0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. DISCUSSION: The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding.

The relationship between conformity to male and female gender norms and depression during pregnancy.

To analyze whether there is an association between conformity to male and female gender norms and the Edinburgh Postnatal Depression Scale (EPDS) score as an indicator of depression during pregnancy, a cross-sectional study was made to a sample of 200 pregnant women being seen at any of the public primary care centers in Segovia (Spain) for the prenatal care. A score of 13 points or higher on the Spanish version of the EPDS is considered to be an indicator of antenatal depression. The Conformity to Feminine Norms Inventory (CFNI-84) and the Conformity to Masculine Norms Inventory (CMNI-94) were used to determine the degree of conformity to gender norms. Descriptive and inferential statistics, as well as multivariate analysis, were carried out. Logistic regression analysis showed the Nice in Relationships Subscale score to be associated with a decreased risk of depression (OR = 0.88; 95%CI 0.79-0.98; p = 0.029). In addition, the CMNI total score, as well as the Self-Reliance subscale, were associated with an increased risk of depression (OR = 1.04; 95%CI 1.01-1.07; p = 0.022; OR = 1.30; 95%CI 1.08-1.55; p = 0.004, respectively). An association between conformity to male gender norms and nonconformity to some female gender norms in pregnant women and a score on the EPDS indicating depression during pregnancy was found. Particularly, an increase in the CMNI total score was associated to increased risk of suffering depression in the pregnant women studied.

Digital Technology for Internet Access by Patients With Early-Stage Schizophrenia in Spain: Multicenter Research Study.

BACKGROUND: Digital technology and social networks are part of everyday life in the current internet age, especially among young people. To date, few studies have been published worldwide on the pattern of use of digital technology devices and applications in patients with early-stage schizophrenia and even fewer comparing them with healthy participants (not using data from general population surveys) from the same demographic areas. In Spain, no such study has been carried out. OBJECTIVE: The aim of this study was to analyze how patients with early-stage schizophrenia use internet and social networks compared with healthy participants matched by age and gender and also to examine which devices are utilized to access internet resources. METHODS: A cross-sectional, multicentric study was carried out through a semistructured interview asking about the use of digital technology devices and internet. The sample comprised 90 patients and 90 healthy participants. The semistructured interview was conducted on 30 outpatients and 30 healthy subjects in each of the 3 different cities (Madrid, Alicante, and Cuenca). Student t test was used for continuous variables and chi-square test for categorical variables. In the case of ordinal variables, nonparametric Mann-Whitney U and Kruskal-Wallis H tests for independent samples were performed to compare groups. RESULTS: The results indicated that a large proportion of patients with early-stage schizophrenia have access to different digital devices and use them frequently. In addition, both groups coincide in the order of preference and the purpose for which they use the devices. However, a lower frequency of use of most digital technology devices was detected in patients compared with healthy participants. In the case of some devices, this was due to the impossibility of access and not a lack of interest. CONCLUSIONS: To our knowledge, this is the first study to analyze patterns of internet access and use of digital technology devices and applications in Spanish patients with early-stage schizophrenia compared with healthy participants from the same demographic areas. The results on significant access and use of digital technology and internet shown in this cross-sectional study will allow enhanced and more efficient treatment strategies to be planned, utilizing digital technology devices, for patients with early-stage schizophrenia.

A longitudinal perspective of eating disorder risk in immigrant and Spanish native adolescents: The longitudinal up & down study.

OBJECTIVES: Previous research has postulated immigrant status as a relevant factor influencing eating disorder (ED) risk in adolescents. The present study assesses differences by sex in ED risk between Spanish native and immigrant adolescent populations residing in Spain and analyzes longitudinal differences in ED risk between immigrant and native adolescents over 2-year follow-up. METHOD: The study sample was 981 adolescents aged 11-19 years at baseline. ED risk was evaluated using the Spanish version of the SCOFF Questionnaire. Logistic regression was used to value associations between country of origin and ED risk prevalence by sex, as well as changes in ED risk at 2-year follow-up. RESULTS: Immigrant adolescent girls and boys presented greater ED risk than their Spanish counterparts. Prospective analyses showed that immigrant boys presented greater likelihood of acquiring ED risk over 2 years compared to Spanish adolescent boys. CONCLUSION: Immigrant adolescent populations, particularly boys, seem to be vulnerable to ED. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Ambient Intelligence Environment for Home Cognitive Telerehabilitation.

Higher life expectancy is increasing the number of age-related cognitive impairment cases. It is also relevant, as some authors claim, that physical exercise may be considered as an adjunctive therapy to improve cognition and memory after strokes. Thus, the integration of physical and cognitive therapies could offer potential benefits. In addition, in general these therapies are usually considered boring, so it is important to include some features that improve the motivation of patients. As a result, computer-assisted cognitive rehabilitation systems and serious games for health are more and more present. In order to achieve a continuous, efficient and sustainable rehabilitation of patients, they will have to be carried out as part of the rehabilitation in their own home. However, current home systems lack the therapist's presence, and this leads to two major challenges for such systems. First, they need sensors and actuators that compensate for the absence of the therapist's eyes and hands. Second, the system needs to capture and apply the therapist's expertise. With this aim, and based on our previous proposals, we propose an ambient intelligence environment for cognitive rehabilitation at home, combining physical and cognitive activities, by implementing a Fuzzy Inference System (FIS) that gathers, as far as possible, the knowledge of a rehabilitation expert. Moreover, smart sensors and actuators will attempt to make up for the absence of the therapist. Furthermore, the proposed system will feature a remote monitoring tool, so that the therapist can supervise the patients' exercises. Finally, an evaluation will be presented where experts in the rehabilitation field showed their satisfaction with the proposed system.

Impact of the first interprofessional education undergraduate program in Spain.

In 2015, the Universidad Europea de Madrid started the first interprofessional education program in Spain. Nursing students undergo different interprofessional education activities in all four academic years, covering various aspects of the following competencies: interprofessional communication, role clarification (definition, interaction and defense), and authority models and decision making. In second year, they integrate these activities with students from psychology, pharmacy and medicine. We assessed the self-perception of second year nursing students with an adapted and validated IPEC (Interprofessional Education Collaborative) questionnaire, in four different transversal moments of the academic year 2015-16. Differences in mean values were analyzed with the Kruskal-Wallis test and post-hoc Mann-Whitney tests with Bonferroni corrections in case of statistical significance. Results showed that this IPE program improves the self-perception second year students have about their competence in interprofessional communication, especially in the dimensions of oral expression, active listening, communication tools and interprofessional conflict resolution.

Galectin-9 binds to O-glycans on protein disulfide isomerase.

Changes in the T cell surface redox environment regulate critical cell functions, such as cell migration, viral entry and cytokine production. Cell surface protein disulfide isomerase (PDI) contributes to the regulation of T cell surface redox status. Cell surface PDI can be released into the extracellular milieu or can be internalized by T cells. We have found that galectin-9, a soluble lectin expressed by T cells, endothelial cells and dendritic cells, binds to and retains PDI on the cell surface. While endogenous galectin-9 is not required for basal cell surface PDI expression, exogenous galectin-9 mediated retention of cell surface PDI shifted the disulfide/thiol equilibrium on the T cell surface. O-glycans on PDI are required for galectin-9 binding, and PDI recognition appears to be specific for galectin-9, as galectin-1 and galectin-3 do not bind PDI. Galectin-9 is widely expressed by immune and endothelial cells in inflamed tissues, suggesting that T cells would be exposed to abundant galectin-9, in cis and in trans, in infectious or autoimmune conditions.

The effect of stereotypes and prejudices regarding gender roles on the relation between nurses and "Muslim fathers" in health institutions within the Community of Madrid (Spain).

Modern Western societies are characterized by a considerable cultural and ethnic diversity whereby different groups and minorities live side by side. However, not all people are viewed in the same light by the autochthonous population. This is particularly true in the case of Muslim immigrants, who are often prone to negative stereotyping and prejudice. This has become increasingly apparent since the 2001 terrorist attacks in New York and the subsequent attacks in various Western countries. This study seeks to analyze the relation between female nurses and those labeled by nurses as "Muslim fathers," as part of a research project on the care of immigrant children in Madrid (Spain). The findings promote reflection on the effects of nurses' stereotypes and prejudices regarding the gender roles of "Muslim fathers" and the relations between these groups. These prejudices can lead to situations of cultural imposition and/or discrimination. Self-reflection regarding stereotypes and prejudices is necessary in order to provide culturally competent care. The anthropobiological approach by Marie Françoise Collière may be useful for extending this type of care universally, not only to immigrant groups, as everyone, including nurses, patients, and family members, belong to part of a specific sociocultural context.

[Risk factors associated with postoperative acute renal failure in pediatric patients undergoing cardiopulmonary bypass surgery]. / Factores de riesgo asociados a insuficiencia renal aguda postoperatoria en pacientes pediátricos intervenidos de cirugía cardiaca que requirieron de circulación extracorpórea.

Acute renal failure (ARF) is a complication associated with cardiac surgery with cardiopulmonary bypass (CPB) with an impact on morbidity and mortality. OBJECTIVE: To identify risk factors associated with postoperative IRA according to pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease scale in children undergoing cardiac surgery with CPB. PATIENTS AND METHOD: A nested case-control study was conducted. We included children under 16 years of age attended postoperative for CBP in a pediatric intensive care unit over a period of 18 months. The cases were those who developed ARF according to the classification pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease scale during their stay in the pediatric intensive care unit. Controls were those who did not develop this complication. Logistic regression analysis was performed and adjusted odds ratio (OR) and confidence intervals at 95% (95% CI) were calculated. RESULTS: 91 patients (31 cases and 60 controls) with a median age of 20 months and predominance of males (53.8%) were analyzed. Independent risk factors for ARF were the intraoperative lactate level > 6 mmol/l (OR = 4.91; 95% CI 1.26-19.05; p = .02) and cyanotic heart disease (OR = 3.62; 95% CI 1.11-11.63; p = .03). CONCLUSIONS: This study identified that pediatric patients with lactate levels >6 mmol/l during CPB and those with cyanotic congenital heart disease are a subgroup of high risk to develop ARF after heart surgery and should be closely monitored to prevent, detect and/or treat this complication timely manner.

A Bio-Inspired Model-Based Approach for Context-Aware Post-WIMP Tele-Rehabilitation.

Tele-rehabilitation is one of the main domains where Information and Communication Technologies (ICT) have been proven useful to move healthcare from care centers to patients' home. Moreover, patients, especially those carrying out a physical therapy, cannot use a traditional Window, Icon, Menu, Pointer (WIMP) system, but they need to interact in a natural way, that is, there is a need to move from WIMP systems to Post-WIMP ones. Moreover, tele-rehabilitation systems should be developed following the context-aware approach, so that they are able to adapt to the patients' context to provide them with usable and effective therapies. In this work a model-based approach is presented to assist stakeholders in the development of context-aware Post-WIMP tele-rehabilitation systems. It entails three different models: (i) a task model for designing the rehabilitation tasks; (ii) a context model to facilitate the adaptation of these tasks to the context; and (iii) a bio-inspired presentation model to specify thoroughly how such tasks should be performed by the patients. Our proposal overcomes one of the limitations of the model-based approach for the development of context-aware systems supporting the specification of non-functional requirements. Finally, a case study is used to illustrate how this proposal can be put into practice to design a real world rehabilitation task.

Spontaneous retroperitoneal hemorrhage (Wünderlich syndrome): a two-case report.

OBJECTIVE: To review the etiology, diagnosis and treatment of spontaneous retroperitoneal hemorrhage. METHODS/RESULTS: We report the cases of two men 59 and 79 years old, presenting acute abdominal pain secondary to retroperitoneal bleeding (Wünderlich's syndrome) due to spontaneous renal rupture caused by urolithiasis and angiomyolipoma respectively. CONCLUSIONS: Diagnosis of acute abdomen due to retroperitoneal hemorrhage requires a combination of clinical information and imaging tests. We emphasize the role of IV contrast helical CT scan for a definitive diagnosis, which demonstrated the active bleeding point, the amount of hemorrhage, and the probable origin, and provided guide for therapeutic planning.

Occupational Stress in Healthcare Professionals in Spain: A Multicenter Study.

Introduction: Occupational stress significantly impacts healthcare professionals in the Spanish public hospital system. This study, conducted from April to June 2022, focuses on analyzing stress levels using the Nursing Stress Scale through an online survey. Methods: A cross-sectional study was carried out using an online survey from April to June 2022 in four hospitals. The Nursing Stress Scale was used to comprehensively assess stress levels among healthcare professionals. Results: The findings revealed a substantial contrast in stress outcomes based on personal circumstances. Healthcare professionals in stable partnerships and with children exhibited lower stress levels, acting as protective factors during the pandemic. Conversely, those engaged in rotating shifts, especially those working over 60 h per week, showed a sevenfold increase in high-stress probability (p < 0.05). Temporary contract holders and those with heightened exposure to COVID-19 reported elevated stress levels, highlighting the complex dynamics impacting the mental well-being of healthcare workers. Conclusions: Findings emphasize the necessity for targeted interventions to safeguard healthcare professionals' well-being, focusing on the psychological consequences of factors like rotating shifts and extended working hours. Protective elements such as stable partnerships and parenthood could serve as a foundation for initiatives supporting work-life balance, potentially involving government policies and hospital management.

Effect of Action Units, Viewpoint and Immersion on Emotion Recognition Using Dynamic Virtual Faces.

Facial affect recognition is a critical skill in human interactions that is often impaired in psychiatric disorders. To address this challenge, tests have been developed to measure and train this skill. Recently, virtual human (VH) and virtual reality (VR) technologies have emerged as novel tools for this purpose. This study investigates the unique contributions of different factors in the communication and perception of emotions conveyed by VHs. Specifically, it examines the effects of the use of action units (AUs) in virtual faces, the positioning of the VH (frontal or mid-profile), and the level of immersion in the VR environment (desktop screen versus immersive VR). Thirty-six healthy subjects participated in each condition. Dynamic virtual faces (DVFs), VHs with facial animations, were used to represent the six basic emotions and the neutral expression. The results highlight the important role of the accurate implementation of AUs in virtual faces for emotion recognition. Furthermore, it is observed that frontal views outperform mid-profile views in both test conditions, while immersive VR shows a slight improvement in emotion recognition. This study provides novel insights into the influence of these factors on emotion perception and advances the understanding and application of these technologies for effective facial emotion recognition training.

Behavioral intention of mental health practitioners toward the adoption of virtual humans in affect recognition training.

This paper explores the key factors influencing mental health professionals' behavioral intention to adopt virtual humans as a means of affect recognition training. Therapies targeting social cognition deficits are in high demand given that these deficits are related to a loss of functioning and quality of life in several neuropsychiatric conditions such as schizophrenia, autism spectrum disorders, affective disorders, and acquired brain injury. Therefore, developing new therapies would greatly improve the quality of life of this large cohort of patients. A questionnaire based on the second revision of the Unified Theory of Acceptance and Use of Technology (UTAUT2) questionnaire was used for this study. One hundred and twenty-four mental health professionals responded to the questionnaire after viewing a video presentation of the system. The results confirmed that mental health professionals showed a positive intention to use virtual reality tools to train affect recognition, as they allow manipulation of social interaction with patients. Further studies should be conducted with therapists from other countries to reach more conclusions.