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The chronological information provided by sediment cores about the beginning and evolution of anthropogenic contaminants is crucial for understanding the influence of humans on the environment. The dataset provides information about the vertical distribution of heavy metals (HMs), metalloids and various organic contaminants (OCs) including contemporary contaminants of emerging concern (CECs), such as pharmaceuticals and personal care products (PPCPs) and pesticides; as well as persistent organic contaminants (POPs) such as polycyclic aromatic hydrocarbons (PAHs), perfluoroalkyl substances (PFASs), organophosphorus flame retardants (OPFRs) in sediment cores of two different sampling areas (North and South) of L'Albufera lake. Additional information about the 14C-data of the organic matter present in the different layers of the sediment cores, and the 14C-data of the seashells found in some of them are shown. The dataset includes physico-chemical analyses of sediment characteristics at the different selected depth levels such as Organic Carbon (Corg), Inorganic Carbon (IC), Total Nitrogen (TN), Total Sulphur (TS) and texture. Furthermore, ecological risk assessment of these contaminants in surface sediment layers is performed to ascertain is potential toxicity. These data supplement the findings presented and considered in the research article "Exploring Organic and Inorganic Contaminant Histories in Sediment Cores Across the Anthropocene: Accounting for Site/Area Dependent Factors". Therefore, these data altogether are useful for researchers seeking to assess long-term impact of contamination.
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BACKGROUND: Several factors seem to be related to the use of healthcare services, and chronic pain (CP) is among these characteristics. The objective is to describe the number of visits to a doctor's surgery or emergency rooms, and the periods of hospitalization; to identify characteristics associated with frequent healthcare use, including disabling chronic pain (DCP) and non-disabling chronic pain (n-DCP). METHODS: Representative population-based cross-sectional study of 6569 people older than 16 years from southern Spain was collected. The frequency of visits to a doctor's surgery or emergency rooms and periods of hospitalization were defined as at or above the 90th percentile. Binary logistic regression analyses were conducted separately on women and men to identify characteristics associated with being frequent visitors. RESULTS: People with DCP are more frequent visitors to a doctor's surgery and emergency rooms and endure longer periods of hospitalization compared to people with n-DCP and without pain. In logistic regression models, people with DCP are twice as likely to over-visit a doctor's surgery; to endure longer periods of hospitalization and more visits to an emergency room service. No relationship was found in n-DCP. CONCLUSIONS: Disability seems to modulate a greater use of health services among the population with CP, doubling it when compared to n-DCP and n-CP, both in women and men. Understanding the role of disability in the use of healthcare services for individuals with CP allows for the identification of needs and strategies to optimize resources.
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Dor Crônica , Pessoas com Deficiência , Humanos , Masculino , Feminino , Estudos Transversais , Espanha/epidemiologia , Dor Crônica/terapia , Dor Crônica/epidemiologia , Pessoa de Meia-Idade , Adulto , Idoso , Pessoas com Deficiência/estatística & dados numéricos , Adolescente , Inquéritos Epidemiológicos , Hospitalização/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Adulto JovemRESUMO
Sedimentary records help chronologically identify anthropogenic contamination in environmental systems. This study analysed dated sediment cores from L'Albufera Lake (Valencia, Spain), to assess the occurrence of heavy metals (HMs), polycyclic aromatic hydrocarbons (PAHs), perfluoroalkyl substances (PFASs), organophosphorus flame retardants (OPFRs), pesticides and pharmaceuticals and personal care products (PPCPs). The results evidence the continuing vertical presence of all types of contaminants in this location. The sediment age was difficult to establish. However, the presence of shells together with an historical estimation and the knowledge of sedimentary rates could help. HMs contents are higher in the upper layer reflecting the most recent increase of the industrial and agricultural practices in the area since the middle 20th century. Higher availability index of these HMs in the upper sediment layers is associated with point and diffuse contamination sources in the area. PAHs and OPFRs were homogeneous distributed through the sediments with few exceptions such as phenanthrene in the North and fluoranthene in the South. Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) were detected throughout the sediment core while short-chain PFASs (except perfluoropentanoic acid (PFPeA)) were detected only in the top layer. Pesticides and PPCPs showed appreciable down-core mobility. The vertical concentration profiles of organic contaminants did not exhibit a clear trend with depth, then, it is difficult to develop a direct relationship between sediment age and contaminant concentrations, and to elucidate the historical trend of contamination based on dated sediment core. Consequently, linking contaminant occurrence in sediments directly to their historical use is somewhat speculative at least in the conditions of L'Albufera Lake.
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The experience of chronic non-cancer pain differs between women and men due to gender-related factors. This study (1) assessed the difference in responses to the impact of chronic non-cancer pain on daily life in women and men using the PAIN_Integral Scale© and (2) evaluated its invariance through multigroup confirmatory factor analysis. This was conducted by means of an analysis of invariance through a multigroup confirmatory factor analysis. A cross-sectional sample of 400 participants over 18 years of age with Chronic Non-Oncological Pain in Pain Units and Primary Care Centres belonging to the Spanish Public Health System was recruited (January to March 2020). An analysis was performed to assess whether any of the items in the instrument showed different behaviours. All analyses were performed using AMOS® v.26 software. The results showed that the structure of the PAIN_Integral© Scale remained adequate when analysing its invariance in women and men, showing no metric, scalar and/or strict invariance. Therefore, these results indicated that the PAIN_Integral Scale© instrument has a different interpretation for women and men, identifying eight items with a singular functioning in both sexes and belonging to the subscales of proactivity, resilience and support network. These findings can be explained by gender stereotypes, since the dimensions where there are differences have an important social burden.
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AIM: To examine and map alcohol consumption in children and adolescents with chronic pain (CP). METHOD: A scoping review of international databases (CINAHL, WOS, PubMed, PsycINFO, Scopus, Embase, and MEDLINE) and grey literature was conducted between September 2022 and February 2023. Documents addressing the relationship between alcohol consumption and CP in children and adolescents, published in English and Spanish between 2012 and 2023, were included. Those papers with a population suffering from CP derived from neurodegenerative diseases, chronic infectious diseases or cognitive impairment were excluded. We assessed the level of evidence (LE) and the degree of recommendation (DR) of the studies included in accordance with the Scottish Intercollegiate Guidelines Network. Finally, 11 documents were considered out of the 479 reviewed. RESULTS: The relationship between substance consumption and CP in adolescents is a scarcely investigated topic. While there is a trend towards lower rates of alcohol consumption in youth with pain, there is evidence suggesting an association, particularly in cases of intense pain. The use of various substances, both legal and illegal, for pain management underscores the importance of comprehensively addressing this phenomenon in this population. CONCLUSIONS: Further research is needed to assess the relationship between alcohol consumption in children and adolescents with CP.
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Consumo de Bebidas Alcoólicas , Dor Crônica , Humanos , Dor Crônica/epidemiologia , Adolescente , Criança , Consumo de Bebidas Alcoólicas/epidemiologiaRESUMO
INTRODUCTION: Systemic therapy of patients with metastatic renal cell carcinoma (mRCC) has improved in the past years, with the advent of new immunotherapy-based combinations as a standard treatment option for first-line therapy. Nevertheless, particularly in good-risk patients by IMDC criteria, tyrosine-kinase inhibitors (TKI) may remain as an option for some patients. We reviewed our experience with TKI as first-line therapy for mRCC patients, trying to identify subgroups of patients that may still benefit from this strategy. MATERIAL AND METHODS: All patients with mRCC treated with first-line TKI, and adequate follow-up, in University Hospital La Paz (Madrid, Spain) between 2007 and 2020 were analyzed. Patients treated inside a clinical trial were excluded from this analysis. RESULTS: A total of 90 patients treated with first-line TKI were included. Regarding IMDC criteria, 33 patients (36.7%) were good-risk, 41 patients (45.5%) intermediate-risk, and 16 patients (17.8%) poor-risk. With a median follow-up of 49 months, the median overall survival (OS) for good, intermediate, and poor-risk patients was 54, 24, and 16 months (p = 0.004). When intermediate-risk was divided into patients with 1 or 2 risk factors, differences in OS were also statistically significant: patients with 1 risk factor had a median OS of 33 months, while patients with 2 risk factors had a median OS of 16 months, the same as poor-risk patients (p = 0.003). In the multivariate analysis, trying to find out which of the IMDC factors had a more remarkable weight in the prognosis of the patients, both ECOG and hemoglobin levels by themselves were significantly associated with OS. CONCLUSION: In our group of patients, survival outcomes were different among patients with intermediate-risk with 1 or 2 risk factors by IMDC criteria. These could help select patients that may benefit from first-line treatment with a TKI, particularly in settings with difficult access to novel therapies, such as immunotherapy-based combinations.
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Carcinoma de Células Renais , Neoplasias Renais , Humanos , Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Prognóstico , Inibidores de Proteínas Quinases/uso terapêutico , Estudos Retrospectivos , Tirosina/uso terapêuticoRESUMO
Diagnosing malignant pleural effusions (MPE) is challenging when patients lack a history of cancer and cytopathology does not detect malignant cells in pleural effusions (PE). We investigated whether a systematic analysis of PE by flow cytometry immunophenotyping (FCI) had any impact on the diagnostic yield of MPE. Over 7 years, 570 samples from patients with clinical suspicion of MPE were submitted for the FCI study. To screen for epithelial malignancies, a 3-color FCI high sensitivity assay was used. The FCI results, qualified as "malignant" (FCI+) or "non-malignant" (FCI-), were compared to integrated definitive diagnosis established by clinicians based on all available information. MPE was finally diagnosed in 182 samples and FCI detected 141/182 (77.5%). Morphology further confirmed FCI findings by cytopathology detection of malignant cells in PE (n = 91) or histopathology (n = 29). Imaging tests and clinical history supported the diagnosis in the remaining samples. The median percentage of malignant cells was 6.5% for lymphoma and 0.23% for MPE secondary to epithelial cell malignancies. FCI identified a significantly lower percentage of EpCAM+ cells in cytopathology-negative MPE than in cytopathology-positive cases (0.02% vs. 1%; p < 0.0001). Interestingly, 29/52 MPE (55.8%) where FCI alerted of the presence of malignant cells were new diagnosis of cancer. Overall, FCI correctly diagnosed 456/522 samples (87.4%) suitable for comparison with cytopathology. These findings show that high sensitivity FCI significantly increases the diagnostic yield of MPE. Early detection of FCI + cases accelerates the diagnostic pathway of unsuspected MPE, thus supporting its implementation in clinical diagnostic work-up as a diagnostic tool.
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Derrame Pleural Maligno , Humanos , Derrame Pleural Maligno/diagnóstico , Citometria de Fluxo/métodos , ImunofenotipagemRESUMO
INTRODUCTION: Chronic widespread pain (CWP) and diabetes commonly co-occur; however, it is unclear whether CWP infers an additional risk for diabetes among those with known risk factors for type 2 diabetes. We aimed to examine if CWP magnifies the effect of adverse lifestyle factors on the risk of diabetes. RESEARCH DESIGN AND METHODS: The study comprised data on 25 528 adults in the Norwegian HUNT Study without diabetes at baseline (2006-2008). We calculated adjusted risk ratios (RRs) with 95% CIs for diabetes at follow-up (2017-2019), associated with CWP and body mass index (BMI), physical activity, and insomnia symptoms. The relative excess risk due to interaction (RERI) was calculated to investigate the synergistic effect between CWP and adverse lifestyle factors. RESULTS: Compared with the reference group without chronic pain and no adverse lifestyle factors, those with BMI ≥30 kg/m2 with and without CWP had RRs for diabetes of 10.85 (95% CI 7.83 to 15.05) and 8.87 (95% CI 6.49 to 12.12), respectively; those with physical activity <2 hours/week with and without CWP had RRs for diabetes of 2.26 (95% CI 1.78 to 2.88) and 1.54 (95% CI 1.24 to 1.93), respectively; and those with insomnia symptoms with and without CWP had RRs for diabetes of 1.31 (95% CI 1.07 to 1.60) and 1.27 (95% CI 1.04 to 1.56), respectively. There was little evidence of synergistic effect between CWP and BMI ≥30 kg/m2 (RERI=1.66, 95% CI -0.44 to 3.76), low physical activity (RERI=0.37, 95% CI -0.29 to 1.03) or insomnia symptoms (RERI=-0.09, 95% CI -0.51 to 0.34) on the risk of diabetes. CONCLUSIONS: These findings show no clear interaction between CWP and adverse lifestyle factors on the risk of diabetes.
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Dor Crônica , Diabetes Mellitus Tipo 2 , Distúrbios do Início e da Manutenção do Sono , Adulto , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fatores de Risco , Índice de Massa CorporalRESUMO
AIM: To review and synthesize the available evidence on the attitudes and knowledge of nurses regarding the perinatal grief of the parents. METHODS: A systematic review of original articles published from January 2016 to February 2023 without language limit in the Scopus, PubMed, Cinahl, PsycINFO, ScienceDirect and Web Of Science databases was carried out. The Prisma Statement methodological framework was used for systematic reviews and meta-analyses. The entire process was carried out in pairs, with discrepancies being resolved by a third reviewer. The quality of the articles was evaluated following the CASPe criteria (Critical Appraisal Skills Program Spanish). RESULTS: Twelve articles were obtained in this review after applying the inclusion criteria, of which. Except for one cross-sectional quantitative study (8.33%), the rest were qualitative studies carried out through interviews (75%) or discussion groups (16.66%). It is highlighted that there are different biopsychosocial problems related to the care needs demanded by the family and that, due to poor training or culture of the health professional, are not adequately addressed. DISCUSSION: The studies found show various resources to adequately attend to perinatal grief, there being discrepancies in relation to allowing or not allowing the body of the deceased baby to be shown and/or taken; There are also disagreements regarding whether the healthcare team should base its practice on protocols or theories such as the Kubler-Ross theory of grief. Most of the studies (75%) consider that more training and awareness is necessary, contemplating the biopsychosocial nature of the user.
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Cuidados de Enfermagem , Feminino , Humanos , Lactente , Gravidez , Atitude , Estudos Transversais , Pessoal de Saúde/psicologiaRESUMO
Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region's continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the "need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics". Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%-99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC.
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AIM: To explore the experiences of primary healthcare (PHC) nurses caring for women experiencing intimate partner violence (IPV) in a context of institutional support for the management of this health issue. DESIGN: Secondary qualitative analysis. METHODS: A purposeful sample (n = 19) of registered nurses, working in a PHC setting, with experience providing care to women who had disclosed intimate partner violence completed an in-depth interview. Thematic analysis was used to code, categorize and synthesize the data. RESULTS: Four themes were developed from the analysis of the interview transcripts. The first two themes address the characteristics of the type of violence most frequently encountered by participants, and how these characteristics shape the needs of women and the care nurses provide them. The third theme encompasses uncertainties and strategies developed to deal with the aggressor during the consultations as the woman's companion or as the patient himself. Finally, the fourth theme reflects the positive and negative consequences of caring for women exposed to intimate partner violence. CONCLUSION: When there is a supportive legal framework and health system to address IPV, nurses are able to implement evidence-based best practices in caring for women experiencing intimate partner violence. The predominant type of violence experienced by women at the time they enter the healthcare system shapes their needs and the service/unit they reach. These varying needs should be considered in the development of training programmes for nurses and should be adapted for different healthcare services. Caring for women experiencing intimate partner violence implies an emotional burden even in an institutional supportive context. Therefore, actions to prevent nurses' burnout should be considered and implemented. IMPACT: Lack of institutional support usually hinders the potential role nurses can play in the care provided to women who have experienced intimate partner violence. Findings from this study demonstrated that primary healthcare nurses are able to implement evidence-based best practices in the care for women experiencing intimate partner violence when there is a supportive legal framework and the health system context is openly favourable to addressing intimate partner violence. Findings from this study could inform the design and implementation of programmes and/or policies to improve nurses' responses to intimate partner violence in primary healthcare services.
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Violência por Parceiro Íntimo , Enfermeiras e Enfermeiros , Enfermagem de Atenção Primária , Feminino , Humanos , Esgotamento Psicológico , Violência por Parceiro Íntimo/legislação & jurisprudência , Violência por Parceiro Íntimo/psicologia , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Pesquisa Qualitativa , Masculino , Adulto , Pessoa de Meia-Idade , Enfermagem Baseada em EvidênciasRESUMO
No disponible.
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COVID-19 , Pandemias , Humanos , Universidades , Composição Corporal , Estudantes , LipídeosRESUMO
OBJECTIVE: To identify the strengths available for the community orientation of primary health care (PHC) in the context of the evaluation of the piloting of a training program in Community Health for Resident Internal Specialists in Andalusia (Spain). METHOD: We will conduct a qualitative, phenomenologically-oriented, explanatory research in which the opinion of the participants is analyzed. Sixty-seven professionals from six PHC Districts of Andalusia which were part of the training program called Project to Support the Revitalization of Primary Care Assets for Community Health (PARAC) were interviewed. RESULTS: There is consensus in giving training a key weight in the community orientation of PHC. For this reason, those agents linked to training are identified as assets: general practice (GP) trainers, young professionals in training who bring updated perspectives and approaches to accredited PHC training centers, whose professionals must respond to the needs of their GP trainees, the multi-professional teaching units responsible for the GP trainees training and a medium and long-term health system thinking along with structures that coordinate and support the community work at the PHC centers. CONCLUSIONS: The community orientation of PHC is an objective that requires the participation of all levels of the health system. Knowing its assets and working with them can contribute to provide proposals to advance towards a community-oriented PHC system.
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Medicina Geral , Saúde Pública , Humanos , Atenção Primária à SaúdeRESUMO
BACKGROUND: Chronic Non-Cancer Pain is pain of more than three months' duration and is not associated with an oncological condition. There is ample literature that recognises that Chronic Non-Cancer Pain impacts numerous areas of the life of the person who suffers from it. This impact is difficult to determine and quantify because Chronic Pain is a subjective experience. OBJECTIVE: The objective of this study was to test a recursive model of hypothesised factors that comprise the concept of Chronic Non-Cancer Pain Impact on daily life using Partial Least Squares-Structural Equation Modelling. DESIGN: A cross-sectional study was carried out. The sample size was calculated using G*Power V.3.1.9.4 with five parameters (two-tailed, large effect size (f2â¯=â¯0.35), power of 0.95, statistical significance of 95% (αâ¯=â¯0.05) and 36 predictors). The minimum number of subjects was considered to be 137. METHODS: A recursive model was built based on data from a sample of 395 people over 18â¯years of age with Chronic Non-Cancer Pain. Data collection was conducted between January and March 2020 at Pain Units and Primary Healthcare Centres belonging to the Spanish Public Health System in the province of Seville (Spain). Analyses were based on Partial Least Squares-Structural Equation Modelling. The internal consistency, convergent validity and discriminant validity of the internal measurement model were assessed. For the external measurement model, global model adjustment and structural validity were assessed. The predictive capacity of the final model was also evaluated. All analyses were performed using SmartPLS version 3.3.2 in consistent mode. RESULTS: Findings showed an adequate validity of the proposed model, which comprised nine factors: pain catastrophising, hopelessness due to pain, support network, proactivity, treatment compliance, self-care, mobility, resilience, and sleep. The internal validity of the model (Cronbach's alpha and rho_Aâ¯>â¯0.70; Average Variance Extracted>0.50; standardised outer loadings>0.60; Heterotrait-Monotrait-Ratioâ¯<â¯0.85), goodness of fit (Standardised Root Mean Square Residuals<0.08; Geodesic and Euclidean distance p-value<0.05) and predictive power with out-of-sample values (Stone-Geisser test>0.5) were adequate. The hypothesised structure of the instrument has also been confirmed (path coefficients>0.3; R2â¯>â¯0.1; f2â¯>â¯0.2). CONCLUSIONS: The results have shown an adequate internal consistency, convergent validity and discriminant validity of the model. Likewise, the model has shown an adequate goodness of fit, and the validity of its structure and the hypothesis have been confirmed. However, more research is needed in this regard as the possible interaction between the different factors evaluated in the model with the confounding or moderating variables that may exist.
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Dor Crônica , Humanos , Adolescente , Adulto , Análise dos Mínimos Quadrados , Analgésicos Opioides , Estudos Transversais , Inquéritos e Questionários , Reprodutibilidade dos Testes , PsicometriaRESUMO
AIM: To analyze the prevalence of dating violence (DV) and its relationship with states of depression, anxiety, and stress in young Andalusian university students. METHOD: Cross-sectional descriptive quantitative study in 8 public universities in Andalusia. Data collection was carried out from September to November 2020 through a self-administered questionnaire that included sociodemographic variables and variables related to dating violence, depression, anxiety, and stress. For the analysis of the data, descriptive and nonparametric tests were performed through the U Mann-Whitney and Spearman Rho for the relationship between variables. RESULTS: Thousand ninety-one young university students from Andalusia participated. The most prevalent DV was psychological, including behaviors related to cyberbullying, control-surveillance and psychoemotional (68.42-42.90%), followed by sexual (16.68-3.57%) and finally physical (5.60-1.92%). Statistically significant differences were shown according to sex and DV, where girls scored higher in being victims of behaviors related to cyberbullying, control-surveillance and sexual, and boys in perpetrating psycho-emotional, physical and sexual violence. All types of DV showed significant and positive correlations with depression, anxiety, and stress, except physical DV perpetrated with stress. CONCLUSIONS: The high prevalence of DV and its relationship with mental health show the importance of conducting research on this line in the educational field, since it is a space that guarantees egalitarian relationships and promotes health.
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Depressão , Violência por Parceiro Íntimo , Masculino , Feminino , Humanos , Universidades , Depressão/epidemiologia , Estudos Transversais , Violência por Parceiro Íntimo/psicologia , Ansiedade/epidemiologia , EstudantesRESUMO
AIMS: To develop and psychometrically test the short version of the Multidimensional Scale of Dating Violence (MSDV 2.0) in Spanish-language to detect violence perpetrated and suffered in dating relationships. DESIGN: A psychometric instrument development and validation study. METHODS: A two-phase approach was used: Phase (1) the items of the original instrument were revised and new items related to online violence and sexual violence were incorporated. Content validation by a Delphi panel with 25 psychometric and dating violence experts were performed. Next, a face validity was performed in 32 students followed by a pilot study in another 74 participants. Phase (2) Psychometric validation, the instrument was tested in a sample of 1091 university students, analysing the psychometric properties based on construct validity and internal consistency. The study was conducted from September to November 2020 in the context of the Andalusian Public University System. RESULTS: In phase (1) 42 items for each subscale (perpetration, victimization) were accepted by the Delphi panel, and acceptable values were obtained for the criteria of clarity, coherence, and relevance. In phase (2) the MSDV 2.0 showed acceptable psychometric properties. Confirmatory factor analysis showed a five-dimensional structure with 18 items for each subscale with excellent fit rates. Reliability analysis indicated adequate internal consistency (α = .879-.802) and correlations with the Depression, Anxiety, and Stress Scale (ρ = .418-.225) and the self-perceived health item (ρ = .380-.179), providing evidence of its convergent validity. Cut-off points were also calculated for each dimension, with their corresponding sensitivity and specificity, indicating to be a good instrument for detecting possible cases of dating violence. CONCLUSION: The MSDV 2.0 is the only short instrument published to date that measures the dating violence suffered and perpetrated taking into account all its dimensions. Its use would serve as support in prevention programs and design of public policies. IMPACT: The short version of the MSDV 2.0 could be a comprehensive enough instrument to enable a detection and evaluation of dating violence in the educational setting.
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Violência por Parceiro Íntimo , Idioma , Humanos , Psicometria/métodos , Reprodutibilidade dos Testes , Projetos Piloto , Inquéritos e QuestionáriosRESUMO
AIMS: To identify, synthesize and evaluate the psychometric properties of instruments that measure dating violence (DV). DESIGN: Psychometric systematic literature review. DATA SOURCES: The databases SCOPUS, PubMed, CINAHL, PsychINFO, and Web of Science were searched up to December 2021. REVIEW METHOD: We evaluated the psychometric properties of the instruments included and their methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and Terwee's quality criteria. The Modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to rate the best available evidence. The entire process was carried out by three independent reviewers. The review was registered at PROSPERO (registry number CRD42020161137). RESULTS: A total of 35 studies evaluated 29 instruments measuring DV. Most studies reported data on content validity, structural validity and internal consistency. No studies tested measurement error and responsiveness. Only one instruments tested cross-cultural validity. It is of interest that the data reported for content validity were the worst evaluated, despite the fact that content validity is one of the key properties in developing and validating the measuring instrument. CONCLUSIONS: There are a significant number of instruments published in this field, and it is important to evaluate and show their psychometric properties to help select evidence-based instruments. After carrying out the evaluation following the COSMIN guidelines, the authors of this study recommend that the three most suitable instruments are CADRI, WAS/Chinese version and PMWI-SF/Portuguese version (in that order). IMPACT: Identifying and evaluating DV is the first step in designing effective interventions. To achieve this, it is necessary to have validated instruments with suitable psychometric properties. To date, this is the only published systematic review evaluating the psychometric properties of instruments that measure DV which reports on their methodological qualities. The results we found show a growing trend in developing new instruments, with the most suitable approach being to make a cross-cultural adaptation and validation of the instrument that best suits the value to be measured. In this way, data can be compared between different countries and standardized health care plans and policies designed to achieve better health outcomes. This study may help future researchers to choose the most suitable instrument for their research.
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Lista de Checagem , Humanos , Psicometria/métodos , Consenso , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: QT interval prolongation can increase patients' hospital stay and mortality rate. This study aims to determine the incidence of drug-induced QT interval prolongation and establish which QT interval measurement method is the most appropriate for electrocardiographic monitoring. METHOD: A retrospective observational study was conducted of patients admitted to the Clínica Bíblica Hospital during 2018. The electronic medical records of patients hospitalized for longer than 48 hours and whose drug regimen included at least one drug potentially able to prolong the QT interval were reviewed. Manually-measured QT intervals were corrected using Fridericia's and Rautaharju's formulae, while automatically- measured QT intervals were corrected with Bazett's formula. Risk was assessed using the RISQ-PATH scale. RESULTS: Of the 141 patients analyzed, 23 had arrhythmia as per their clinical history and 14 suffered a complication during their stay in hospital. A total of 113 (80%) had a high RISQ-PATH score and only 64 were subjected to an electrocardiogram on admission. Patients received a mean of three potentially QT interval prolonging drugs. Most of the QT intervals measured automatically were shorter than those obtained manually. Of all corrections, the longest QTc interval values were obtained with Bazett's formula, and the shortest with Rautaharju's formula. None of the patients developed TdP or complex ventricular tachycardia. CONCLUSIONS: Every effort should be made to implement strategies conducive to more effective monitoring of the QT interval to prevent QT nterval prolongation related complications in hospitalized patients.
OBJETIVO: La prolongación del intervalo QT puede aumentar la estancia hospitalaria y la tasa de mortalidad de los pacientes. Esta investigación determina la incidencia de prolongación del intervalo QT debido al uso de medicamentos y evalúa el método más apropiado para realizar el monitoreo electrocardiográfico.Método: Se realizó un estudio observacional retrospectivo en pacientes hospitalizados en el Hospital Clínica Bíblica durante el año 2018. Se revisaron los expedientes de los pacientes con hospitalización superior a 48 horas cuya historia clínica incluyera al menos tratamiento con un medicamento que prolongara el intervalo QT y que las medidas manuales del intervalo QT fueran corregidas con la fórmula Fridericia y Rautaharju, y las medidas automáticas con la fórmula Bazett. La valoración del riesgo se realizó con la escala RISQ-PATH. RESULTADOS: De los 141 pacientes analizados, 23 tenían una arritmia previa en su historia clínica y 14 de ellos sufrieron complicaciones durante la hospitalización. Un total de 113 (80%) pacientes tenían un valor alto RISQPATH y sólo a 64 se les realizó un electrocardiograma al ingreso. En promedio, los pacientes recibieron tres medicamentos que aumentaban el intervalo QT. La mayoría de los QT obtenidos automáticamente fueron más cortos que aquellos obtenidos en forma manual. De todas las correcciones, los valores del intervalo QT más largos se obtuvieron con la fórmula de Bazett, y los más cortos con la fórmula Rautaharju. No ocurrieron eventos como taquicardia ventricular compleja o torsade de pointes durante el estudio. CONCLUSIONES: Es necesario implementar estrategias que permitan una mejor monitorización del intervalo QT con el fin de prevenir las complicaciones derivadas en los pacientes hospitalizados.
Assuntos
Síndrome do QT Longo , Proteínas de Ligação a DNA/farmacologia , Eletrocardiografia/métodos , Frequência Cardíaca , Humanos , Tempo de Internação , Síndrome do QT Longo/induzido quimicamenteRESUMO
Objectives: Chronic pain (CP) is an unpleasant emotional and sensory experience that can be accompanied by tissue damage that persists for more than 3 months. Recent studies show that certain nutritional strategies can help to improve pain, so this study is aimed to systematically review scientific evidence to understand and map the effect of the use of nutritional strategies on the presence or intensity of chronic non-cancer pain (CNCP) and the association of these nutritional aspects with the presence or intensity of CNCP. Study design: A systematic review. Methods: Two independent researchers searched for randomized clinical trials (RCTs) and observational studies that explored the relationship between nutrition and CNCP in adults from 2010 to 2020 in PubMed, Web of Science, Scopus, and Cochrane Library databases. A total of 24 studies were included, of which 20 were RCTs and 4 were observational studies. They are classified into the administration of nutritional supplements, dietary modification, and incorporation of food. Results: Of these studies, those that have a significant effect on pain are dietary modification and the use of nutritional supplements. On the other hand, the main results from the few observational studies included in this review point to the existence of an association relationship between less pain and a ketogenic or hypocaloric diet or adherence to the Mediterranean diet. Conclusion: Dietary modification seems to be one plausible therapeutic option to improve and relieve CNCP. However, more research is needed in this regard to obtain better conclusions. Systematic Review Registration: [www.crd.york.ac.uk/prospero], identifier [CRD42021226431].
RESUMO
Currently, metastatic colon cancer is treated with monotherapeutic regimens such as folinic acid, fluorouracil, and oxaliplatin (FOLFOX), capecitabine and oxaliplatin (CapeOX), and leucovorin, fluorouracil, and irinotecan hydrochloride (FOLFIRI). Other treatments include biological therapies and immunotherapy with drugs such as bevacizumab, panitumumab, cetuximab, and pembrolizumab. After the research, it was found that some mutations make those treatments not as effective in all patients. In this bibliographic review, we investigated the pharmacogenetic explanations for how mutations in the genes coding for rat sarcoma virus (RAS) and rapidly accelerated fibrosarcoma (RAF) reduce the effectiveness of these treatments and allow the continued proliferation of tumors. Furthermore, we note that patients with mutations in the dihydropyrimidine dehydrogenase (DPDY) gene usually require lower doses of therapies such as 5-fluorouracyl (5-FU) and capecitabine to avoid severe adverse effects. Some other mutations in the thymidylate synthase gene (TSYM), methylenetetrahydrofolate reductase gene (MTHFR), and ATP binding cassette transporter B (ABCB1 and ABCB2) affect efficacy and security of the treatments. It is important to address the clinical implication of the oncologist in the study of gene mutations than can influence in the antitumoral response and safety of colon cancer treatments.