Evaluation of Fetal Lung Maturity by Quantitative Analysis (quantusFLM) in Women with Gestational Diabetes Mellitus.

OBJECTIVES: The aim of the present study was to evaluate fetal lung maturity using the noninvasive method of quantitative ultrasound analysis of fetal lung texture (quantusFLM) in women with gestational diabetes mellitus (GDM). METHODS: A total of 96 women at 36-38 weeks of gestation were enrolled. They were classified as follows: 33 GDM cases treated with diet, 30 GDM cases treated with diet plus insulin, and 33 normoglycemic women (control group). A quantitative analysis of lung texture was performed. RESULTS: There were significant differences in the lung maturity results among groups (p = 0.004). These differences were established between the insulin-treated group of patients and both the control (p = 0.006) and diet-only (p = 0.003) groups. While none of the women in the control group or in the diet group had a high risk of immaturity, 16.7% of those treated with insulin (5/30) did (p = 0.003). There was no statistically significant correlation between HbA1c and the result of the test. CONCLUSIONS: Quantitative ultrasound study of fetal lung texture suggests that a significant percentage of pregnant women with GDM treated with insulin had fetal lung immaturity in the late preterm to early term.

Criteria for implementing interventions to reduce health inequalities in primary care settings in European regions.

BACKGROUND: The current social and political context is generating socio-economic inequalities between and within countries, causing and widening health inequalities. The development and implementation of interventions in primary health care (PHC) settings seem unavoidable. Attempts have been made to draw up adequate criteria to guide and evaluate interventions but none for the specific case of PHC. This methodological article aims to contribute to this field by developing and testing a set of criteria for guiding and evaluating real-life interventions to reduce health inequalities in PHC settings in European regions. METHODS: A literature review, nominal group technique, survey and evaluation template were used to design and test a set of criteria. The questionnaire was answered by professionals in charge of 46 interventions carried out in 12 European countries, and collected detailed information about each intervention. Third-party experts scored the interventions using the set of evaluation criteria proposed. RESULTS: Nine criteria to guide and evaluate interventions were proposed: relevance, appropriateness, applicability, innovation, quality assurance, adequacy of resources, effectiveness in the process, effectiveness in results and mainstreaming. A working definition was drawn up for each one. These criteria were then used to evaluate the interventions identified. CONCLUSIONS: The set of criteria drawn up to guide the design, implementation and evaluation of interventions to reduce health inequalities in PHC will be a useful instrument to be applied to interventions under development for culturally, politically and socio-economically diverse PHC contexts throughout Europe.

[Fetal complications and early neonatal outcomes on 147 triplets]. / Complicaciones fetales y resultados neonatales tempranos en 147 embarazos triples.

BACKGROUND: During the last ten years multiple pregnancies have been increased as a result of assisted reproduction techniques, increases of even 470% are published. Multiple pregnancies are related to a higher risk of maternal and neonatal morbidity and mortality, as well as to increased use of health resources. OBJECTIVES: To review the fetal and perinatal early complications in triple pregnancies. PATIENTS AND METHOD: An observational and retrospective study of triple pregnancies followed up at the Obstetrics Department of La Paz University Hospital, Madrid, Spain, from January 2000 until May 2011. RESULTS: We reviewed the medical records of 147 triplets. The prevalence of triplets was 1 in 640 deliveries (0.15%). Among all, 79% were achieved using assisted reproductive techniques, 73% were obtained by means of in vitro fertilization. Regarding the pregnancy zigosity we found: 85% trichorionic triamniotic, 10% bichorionic triamniotic and 5% monochorionic tramniotic. Out of 402 fetuses, 35 (9%) had the following complications: 19(5%) growth retardation or oligohydramnios, nine (2%) intrauterine death, three (0.74%) postnatal death due to suspected chorioamnionitis, three (0.74%) major malformations and one case (0.24%) of twin to twin transfusion. The average duration of gestation was 33 weeks: 8% were born before 28 weeks of gestation, 30% between 28 and 32 weeks and 62% after 32 weeks. The mean birth weight was 1,906 +/- 400 g. In 29 cases (7%) arterial pH was less than 7.20. Any type of resuscitation was required by 60% of newborns and 47% were admitted to the intensive care unit. There were no significant differences in neonatal early outcomes among the first, second and third newborn. CONCLUSIONS: The risk of neonatal mortality and morbidity seems to be higher in triple pregnancies. Adverse neonatal outcomes are related to the high rate of severe prematurity.

Repercussions of perceived threat to health in the Spanish population.

Studies have shown that COVID-19 has had a worldwide psychological impact. Confinement due to COVID-19 has had important repercussions on the mental health of the general population, with high levels of stress, anxiety, depressive symptoms, post-traumatic stress disorder, and so forth. Similarly, important labor, economic and social changes taking place are affecting people's well-being. The objective of this study was to analyze the repercussions of perceived threat from COVID-19 on the mental health of the population, and to evaluate the mediating role of perceived economic impact. The participants were 1160 adult residents of Spain aged 18 to 82, 69.9% of whom were women. A sociodemographic questionnaire, the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. Perceived threat had a positive direct effect on all four health dimensions analyzed. Among the indirect effects, the perceived economic impact of COVID-19 mediated in the relationship between perceived threat and each of the health dimensions. The results of this study have demonstrated the need to promote joint action promoting public mental health to minimize the psychological repercussions of new outbreaks.

What makes one feel eustress or distress in quarantine? An analysis from conservation of resources (COR) theory.

OBJECTIVE: Health quarantines produce serious deterioration in psychological health, which becomes more affected the longer the quarantine lasts. According to the Conservation of Resources theory from Hobfoll (1989, American Psychologist, 44, 513), those people who have a good supply of resources will be able to cope better with the adversities and will show less distress. The objective of this research is to identify what are the resources that, in a situation of confinement under the threat of COVID-19, predict eustress or well-being, and the loss or lack of which resources predict distress or discomfort. DESIGN AND METHOD: A total of 839 people complete an online questionnaire during the first week of COVID-19 confinement in Spain. The sample is weighted to obtain a distribution that is similar to the Spanish population. Using multiple linear regression analysis, factors are identified that are associated with eustress and distress based on the Conservation of Resources theory. RESULTS: A model is identified that explains 55% of the variance of eustress consisting mostly of personal resources, with vitality as the recourse having the most weight. The factors that explain distress (18.9% of the variance) are those related to work (employment situation, work satisfaction, and time devoted to work) and conditions in the home (space). CONCLUSIONS: The models that predict eustress and distress are completely different. Based on these results, a series of recommendations are proposed aimed at increasing eustress and reducing distress in a situation of confinement. Additionally, proposals are offered for future research.

Exploring the Psychometric Properties of the Questionnaire on Family Members Adapting to an Older Adult's Admission to a Nursing Home (CAFIAR-15) in a Colombian Sample.

Institutionalization to a nursing home can be one of the most significant and traumatic events in a senior's life, and for their family. For this reason, it is especially important to have validated instruments that evaluate the family member's adaptation to admitting the senior to a nursing home. The study included 139 family members recruited equally in two types of institutions (low-income nursing home (LINH) vs. high-income nursing home (HINH)). A sociodemographic questionnaire with questions to study antecedents and conditions for care and the Questionnaire for Admitting an Older Adult to a Nursing Home (CAFIAR-15) were used. Examining the communalities indicated that four of the five items in factor 3 presented communalities lower than 0.30 and differences in the factorial structure of the CAFIAR-15 were found. There were differences in the antecedents and conditions for care between the relatives of the older adults at LINH and HINH. Cultural differences and differences between LINH and HINH may be the basis for flaws in the conceptual validity of the CAFIAR-15 in the Colombian sample.

Adaptation to Change Questionnaire for Nurses: Validation and New Needs in the Context of COVID-19.

BACKGROUND: The worldwide pandemic caused by the SARS-CoV-2 coronavirus has challenged healthcare systems and the professionals who work in them. This challenge involves strong changes to which nurses have had to quickly adapt. Emotional and cognitive-behavioral factors influence the capacity for adaptation to change. Based on this model, the objective of this study was to validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying professionals in a population of nurses who have problems adapting to adverse situations such as those caused by COVID-19. METHODS: This study was performed with a sample of 351 nurses. (3) Results: The ADAPTA-10 questionnaire was found to have good psychometric properties, and to be an effective, useful tool for nurses in research and clinical practice. The two-dimensional structure proposed in the original model was confirmed. Scales are also provided by sex for evaluation of adaptation to change; the highest scores on the emotional component were among nurses who had not personally encountered the virus. CONCLUSIONS: This instrument will be able to detect of the needs for adaptation to the new reality associated with COVID-19, as well as other situations in which nurses are immersed that demand adaptation strategies.

Is It Possible to Find Something Positive in Being Confined Due to COVID-19? Implications for Well-Being.

In relation to COVID-19, little research has focused on the study of variables that affect well-being during this pandemic. The purpose of this research is twofold: (1) to find out if people experiencing a quarantine are able to appreciate any positive aspects of it, and to analyze how these responses are categorized and (2) to check if there are differences in levels of well-being according to these categories. There were 243 representative participants of the Spanish population according to sex, age, and educational level. The methodology was mixed, qualitative for the first objective and quantitative for the second. The first used the Thematic Network, while the second used logistic regression. From the qualitative analysis, three major categories were extracted: intrinsic orientation, extrinsic orientation, and empty orientation. The quantitative results showed a clear advantage in well-being for the intrinsically oriented group. The group of intrinsic orientation presented a better coping ability while the group of extrinsic orientation was as little adaptive as the group of empty orientation. Recommendations are extracted from the results.

Design and Validation of the Adaptation to Change Questionnaire: New Realities in Times of COVID-19.

Emotional and cognitive-behavioral factors influence people's adaptability to change. Based on this premise, the objective of this study was to develop, evaluate and validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying those who show poor adaptability to adverse situations, such as those caused by COVID-19. This study was carried out in a sample of 1160 adults and produced a 10-item instrument with good reliability and validity indices. It is an effective tool useful in research and in clinical practice. Calculation tables are provided for the general Spanish population and by sex to evaluate adaptability to change. The two-dimensional structure proposed in the original model was confirmed. This instrument will enable the needs for adaptation to the new reality associated with COVID-19 to be detected and also other situations in which the subject becomes immersed which demand adaptation strategies in the new situation lived in.

[Contextual indicators to assess social determinants of health and the Spanish economic recession]. / Indicadores contextuales para evaluar los determinantes sociales de la salud y la crisis económica española.

OBJECTIVE: To provide indicators to assess the impact on health, its social determinants and health inequalities from a social context and the recent economic recession in Spain and its autonomous regions. METHODS: Based on the Spanish conceptual framework for determinants of social inequalities in health, we identified indicators sequentially from key documents, Web of Science, and organisations with official statistics. The information collected resulted in a large directory of indicators which was reviewed by an expert panel. We then selected a set of these indicators according to geographical (availability of data according to autonomous regions) and temporal (from at least 2006 to 2012) criteria. RESULTS: We identified 203 contextual indicators related to social determinants of health and selected 96 (47%) based on the above criteria; 16% of the identified indicators did not satisfy the geographical criteria and 35% did not satisfy the temporal criteria. At least 80% of the indicators related to dependence and healthcare services were excluded. The final selection of indicators covered all areas for social determinants of health, and 62% of these were not available on the Internet. Around 40% of the indicators were extracted from sources related to the Spanish Statistics Institute. CONCLUSIONS: We have provided an extensive directory of contextual indicators on social determinants of health and a database to facilitate assessment of the impact of the economic recession on health and health inequalities in Spain and its autonomous regions.

Exposure to psychosocial risks at work in prisons: does contact with inmates matter? A pilot study among prison workers in Spain.

Research has lately increased its focus on work conditions as predictors of stress among prison workers but only few studies have focused on how the exposure of workers to psychosocial risks vary according to their occupational groups and their contact with inmates. Work psychosocial risks (demands, control and social support) were assessed using the Spanish version of the Copenhagen Psychosocial Questionnaire among 164 Spanish prison workers (43 per cent of those surveyed). Regression analysis was used to explore how psychosocial hazards and their combinations (outcome variables) vary according to occupational groups. Results suggest that psychosocial risks were highest among guards that have more contact with inmates. Implications of the findings for policy making and practice application are discussed.

Occupational stress and mental health among correctional officers: a cross-sectional study.

A harsh psychosocial environment in the workplace might cause adverse health events, but the association has not been well demonstrated in the penitentiary environment. This cross-sectional study was designed to explore the association between workplace psychosocial risks and the mental health of correctional officers in a Spanish penitentiary center. A self-administered questionnaire was distributed to correctional officers. A total of 164 responded anonymously (response rate 43%). The SF36 survey was used to measure mental health and ISTAS21 (Spanish version of Copenhagen Psychosocial Questionnaire) was used to measure exposure to workplace psychosocial conditions. Low scores were obtained for mental health, high scores were obtained for psychological demands, low self-esteem, and low control and influence and moderate scores for low social support, double exposure, and insecurity at work. A linear regression analysis was constructed to study the influence of workplace psychosocial conditions (independent variables) on mental health (dependent variable). The effect was adjusted for sex, age, seniority, and occupational group. Psychological demands (highest impact), low control and influence, and double exposure had significant inverse associations with mental health. The association between low social support, low self-esteem, and insecurity at work with mental health was insignificant. Psychosocial work conditions are a potential target for mental health promotion programs at work.