Disdainful Hookups: a Powerful Social Determinant of Health.

The health consequences of gender violence, a global health and social problem, are increasingly studied. Among its roots, research has identified a coercive dominant discourse imposing the idea that masculinities and relationships marked by abuse and domination are more attractive than egalitarian ones. To prevent the health consequences of gender violence, it is necessary to understand the factors that lead many adolescents to fall into it. This study aims to identify the specific mechanisms by which the coercive dominant discourse manifests in the peer group and its consequences for adolescents. Forty-one 15- and 16-year-old female adolescents from three high schools in Barcelona participated in the study. Eight communicative discussion groups were conducted to deepen on participants' perceptions regarding how peer interactions promote the learning of attraction to violence in sexual-affective relationships. The results show that the participants perceived and experienced different types of coercion to have violent relationships in their peer group interactions. Those interactions fostered the reproduction of the association between sexual-affective attraction and males with aggressive attitudes and behaviors. Many peers coerce others to have disdainful hookups which have very negative health consequences for the victims, including suicidal ideation and committing suicide. Some peer groups become a risk developmental context for female adolescents as far as they foster the coercive dominant discourse, push some young women to engage in violent sporadic relationships, and even harass some others afterwards. This clarifies the importance of peer group-level interventions when addressing the health consequences of gender violence in adolescence.

"It was Very Liberating". Dialogic Literary Gatherings Supporting Mental Health Literacy.

Mental health is being reframed as a fundamental right for all people, and mental health literacy is a tool that can enable patients to gain the knowledge, personal skills, and confidence to take action to improve their mental health, and their lives overall. This exploratory study analysed the power of dialogic literary gatherings (DLGs) to foster it in a group of patients with mental health disorders who gathered for 1 h once a week to share their readings of literature masterpieces. During the year-long study, a total of 140 patients participated in the DLGs in groups of 12 to 15 people. Results suggest that DLGs promoted the development of the participants' mental health literacy and produced gains in emotional and social wellbeing by strengthening reading, speaking, and listening skills, fostering supportive relations, contributing to overcoming stigma, and enhancing agency. The transferability of DLGs to mental health care is discussed.

Lung Ultrasound Performed by Primary Care Physicians for Clinically Suspected Community-Acquired Pneumonia: A Multicenter Prospective Study.

PURPOSE: We investigated whether lung ultrasound (US) performed in primary care is useful and feasible for diagnosing community-acquired pneumonia (CAP) compared with chest radiography, as most previous research has been conducted in hospital settings. METHODS: We undertook a prospective observational cohort study of lung US performed in 12 primary care centers. Patients aged 5 years and older with symptoms suggesting CAP were examined with lung US (by 21 family physicians and 7 primary care pediatricians) and chest radiograph on the same day. We compared lung US findings with the radiologist's chest radiograph report as the reference standard, given that the latter is the most common imaging test performed for suspected CAP in primary care. The physicians had varied previous US experience, but all received a 5-hour lung US training program. RESULTS: The study included 82 patients. Compared with chest radiography, positive lung US findings (consolidation measuring >1 cm or a focal/asymmetrical B-lines pattern) showed a sensitivity of 87.8%, a specificity of 58.5%, a positive likelihood-ratio of 2.12, and a negative likelihood-ratio of 0.21. Findings were similar regardless of the physicians' previous US training or experience. We propose a practical algorithm whereby patients having consolidation measuring greater than 1 cm or normal findings on lung US could skip chest radiography, whereas patients with a B-lines pattern without consolidation (given its low specificity) would need chest radiography to ensure appropriate management. Lung US was generally performed in 10 minutes or less. CONCLUSION: Point-of-care lung US in primary care could be useful for investigating suspected CAP (avoiding chest radiography in most cases) and is likely feasible in daily practice, as short training programs appear sufficient and little time is needed to perform the scan.

Female university students' preferences for different types of sexual relationships: implications for gender-based violence prevention programs and policies.

BACKGROUND: Gender-based violence among young women is a growing problem worldwide. The consequences of this victimization have been well reported in the scientific literature, among which negative health outcomes stand out. The factors influencing this problem are many; one highlighted by research is socialization into a dominant coercive discourse that associates sexual-affective attraction to males with violent attitudes and behaviors, while in turn, such discourse empties males with egalitarian behaviors from sexual attractiveness. This coercive discourse may be shaping the sexual preferences of female youth. The current paper explores young women's preferences for different types of sexual relationships and, more particularly, for what type of sexual affective relationships they coercively preferred men with violent attitudes and behavior. METHODS: A quantitative, mixed-design vignette study was conducted with 191 college females in Spain. We focused the analysis only on responses about vignettes including narratives of men with violent attitudes and behaviors. In addition, we examined whether participants would report higher coerced preferences for violent men when asked about the coerced preferences of their female friends than when asked about their own preferences. RESULTS: Only 28.95% of participants responded that their female friends would prefer a young man with violent behavior for a stable relationship, meanwhile 58.42% would do it for hooking up. When reporting about themselves, the difference was greater: 28.42% would prefer a young man with violent behavior for hooking up and just 5.78% for a stable relationship. CONCLUSIONS: The dominant coercive discourse that links attractiveness to people with violent attitudes and behaviors may be explaining the results obtained in this study. The findings can help eliminate the stereotype largely adopted by some intervention and prevention programs which assume that gender-based violence occurs mainly in stable relationships, considering that falling in love is the reason that lead women to suffer from violence. Our results can also support health professionals and others serving young women to enhance their identification of gender violence victimization, as well as our findings point to the need to include the evidence of gender violence in sporadic relationships in prevention programs and campaigns addressed to young women.

Evidence-Based Reconstruction of Memories of a Disdainful Hookup: Identifying Risk Factors and Preventing Further Victimization.

Autobiographical memories of close relationships have been shown to have strong influence in health and life. Yet, there is no research published about longitudinal memory reconstruction of violent sporadic relationships while reading and discussing scientific evidence on gender violence victimization. This article presents a novel case of the reconstruction throughout time of the memory of a disdainful hookup experienced by a young woman. The victim's diary and an interview were the sources of data collection. The analytical categories were developed in dialogue with the participant. The results indicate that, as the subject learned scientific evidence on gender violence in sporadic relationships, she progressively recalled details of the episode that she had self-censored before, became aware of the very violent nature of the hookup, rejected the relationship, and freed her desire for satisfactory romantic relationships.

"Your Friends Do Matter": Peer Group Talk in Adolescence and Gender Violence Victimization.

Research on gender violence has identified as one main component leading to gender violence a dominant socialization process which associates attractiveness to men who show violent behaviors and attitudes, while egalitarian and non-violent men are emptied of attractiveness. This is known as coercive dominant discourse. Starting from the evidence that the peer group is a main context of socialization in adolescence, quantitative data were collected from six classes of secondary education (14-15-year-old adolescents) to explore whether the coercive dominant discourse is displayed in social interactions in the peer group and, if so, how it influences attractiveness patterns and sexual-affective behavior in adolescence. The analyses reveal that the coercive dominant discourse is often reproduced in the peer group interactions, creating group pressure, and pushing some girls to violent relationships. Alternative ways of interaction are also reported, which allow a socialization leading to more freedom, less coercion, and more healthy relationships.

I Do It, but I Decide With Whom.

Social interactions and communication shape the desires and preferences of men and women. While it is true that some men have modified their behavior due to feminist women, the same happened with some women, who changed attraction patterns thanks to new alternative masculinities (NAM). This study examines the latter, focusing on social interactions mediated by language, as a crucial element to impact and change the desires of people. For this purpose, six autobiographical interviews were conducted with women aged 19-39 years, from two different countries and continents, paying attention to the narratives of their sexual-affective relationships. Using the communicative methodology, interactions have been analyzed from verbal communication and nonverbal communication, based on the consequences of the actions rather than intentionality. The results of this study show how dialogic communicative acts with NAMs influenced some women who first defended or justified actions of male perpetrators to later prefer to support female survivors against their perpetrators. Analysis reveals that communicative acts grounded in such language that enacted the desire of NAM for women of solidarity have shaped some memories of women of relationships with dominant traditional masculinities (DTM) and, ultimately, contributed to change their attraction and election patterns.

Contributions of Socioneuroscience to Research on Coerced and Free Sexual-Affective Desire.

Neuroscience has well evidenced that the environment and, more specifically, social experience, shapes and transforms the architecture and functioning of the brain and even its genes. However, in order to understand how that happens, which types of social interactions lead to different results in brain and behavior, neurosciences require the social sciences. The social sciences have already made important contributions to neuroscience, among which the behaviorist explanations of human learning are prominent and acknowledged by the most well-known neuroscientists today. Yet neurosciences require more inputs from the social sciences to make meaning of new findings about the brain that deal with some of the most profound human questions. However, when we look at the scientific and theoretical production throughout the history of social sciences, a great fragmentation can be observed, having little interdisciplinarity and little connection between what authors in the different disciplines are contributing. This can be well seen in the field of communicative interaction. Nonetheless, this fragmentation has been overcome via the theory of communicative acts, which integrates knowledge from language and interaction theories but goes one step further in incorporating other aspects of human communication and the role of context. The theory of communicative acts is very informative to neuroscience, and a central contribution in socioneuroscience that makes possible deepening of our understanding of most pressing social problems, such as free and coerced sexual-affective desire, and achieving social and political impact toward their solution. This manuscript shows that socioneuroscience is an interdisciplinary frontier in which the dialogue between all social sciences and all natural sciences opens up an opportunity to integrate different levels of analysis in several sciences to ultimately achieve social impact regarding the most urgent human problems.

Identifying violence against the LGTBI+ community in Catalan universities.

Social struggles have led to the legal recognition of the rights of LGTBI+ people in some countries. Even so, violence against LGTBI+ people is a social problem throughout the world, and has resulted in the vulnerability and victimization of the members of this group. In Spain, no research has been published to date that analyzes this problem in the university context. Considering the scarcity of studies on the identification of this type of violence in Spain, the main objective of this study was to identify violence against LGBTI+ people in Catalan universities. We administered a battery of questions to a sample of 571 university students from six universities in Catalonia (77.8% women) between 17 and 55 years old (M = 21.0; SD = 3.96). Of the 12 situations of violence presented, psychological violence was identified as the most common type. Within our sample, 61.0% reported either being aware of or having experienced some type of violence related to the university context and motivated by the sexual orientation, gender identity, or gender expression of the victim. The results also show that these types of violence in the university context are rarely reported, especially when they do not include physical violence. This study highlights a previously unreported problem and identifies future research avenues in university contexts.

Gender violence among youth: an effective program of preventive socialization to address a public health problem.

Gender violence among youth is a worldwide public health problem. Youth is increasingly exposed to violence in sexual-affective relationships, both stable and sporadic, and the age of victimization decreases. This adverse life experience affects many areas of youth's life, such as education, social relationships and, especially, their physical and mental health, with consequences that can be very harmful in the short and long-term. This situation has given rise to many anti-violence programs for adolescents and youth, yet as some worldwide prestigious organizations, like the American Psychological Association, have pointed out, many of those programs do not work. In this article, we present a program of preventive socialization of gender violence addressed to adolescents that has proven effectiveness. The program was composed of seven interventions based on the social impact of the evidence on preventive socialization of gender violence. It was applied at a group level in groups of 15-16 years old teenagers in three high schools in Barcelona. The interventions were conducted over a period of one school year and shared the trait of discussing research evidence on preventive socialization of gender violence with the youth through egalitarian dialogue. These interventions have proved to have a preventive effect of gender violence victimization on the participating teenagers by raising their critical consciousness regarding a coercive dominant discourse in society that associates attractiveness and violence, supporting the transformation of their memories of violent sexual-affective relationships, and providing them tools to better analyze their and their friends' sexual-affective relationships along the lines of identifying gender violence and being more prepared to help others in this regard. The manuscript describes every intervention applied.

Management of primary immune thrombocytopenia. A comparison between two historical cohorts.

INTRODUCTION: In recent years, there have been changes in the management of patients with primary immune thrombocytopenia. In this study, a review is presented of the characteristics and outcomes of children with primary immune thrombocytopenia in a children's hospital (Hospital Infantil Niño Jesús). Moreover, an analysis is made of the changes in the care of these patients diagnosed before and after 2011, when new guidelines were published by the Spanish Society of Paediatric Haematology Oncology (SEHOP). MATERIAL AND METHODS: Data from a cohort of primary immune thrombocytopenia patients followed up in this hospital have been retrospectively reviewed. The statistical package used for the analysis was SPSS Statistics 22.0 (IBM Corp., Chicago, IL, USA). RESULTS: A review is presented on the clinical data from 235 paediatric patients diagnosed with primary immune thrombocytopenia. It was observed that some features at diagnosis, such as age younger than five years and a previous history of infection, influenced the probability of cure. Regarding the changes in the management of patients since 2011, the steroid doses received during the first month and the first year, and the number of days corresponding to the patient's first admission have both significantly decreased. Splenectomies were also significantly reduced. CONCLUSIONS: Since 2011, there have been changes in the medical care of our primary immune thrombocytopenia patients: they receive lower doses of steroids, they stay fewer days in the hospital, and the number of splenectomies has decreased without increasing bleeding or worsening the clinical evolution. Furthermore, it was observed that age younger than 5 years and a history of infection prior to diagnosis were related to higher chances of recovery.

Beyond the School Walls: Keeping Interactive Learning Environments Alive in Confinement for Students in Special Education.

The COVID-19 pandemic and the accompanying safety measures, including confinement, has meant an unprecedented challenge for the world population today. However, it has entailed additional difficulties for specific populations, including children and people with disabilities. Being out of school for months has reduced the learning opportunities for many children, such as those with less academic resources at home or with poorer technological connectivity. For students with disabilities, it has entailed losing the quality of the special attention they often need, in addition to a more limited understanding of the situation. In this context, a case study was conducted in a special education classroom of a secondary education school. This class started implementing Dialogic Literary Gatherings with their special education students before the COVID-19 confinement and continued online during the confinement. Qualitative data was collected after a period of implementation of the gatherings showing positive impacts on the participants. The case study shows that interactive learning environments such as the Dialogic Literary Gatherings can provide quality distance learning for students with disabilities, contributing to overcome some of the barriers that the pandemic context creates for the education of these students.

Alternative Friendships to Improve Men's Health Status. The Impact of the New Alternative Masculinities' Approach.

BACKGROUND: Men who develop behaviors connected with the model of hegemonic masculinity present several health problems. Previous research has shown the types of problems that men commonly suffer in this regard such as chronic diseases, dietary disorders, and traffic accidents. To combat and overcome this situation, several campaigns, policies and recommendations have been undertaken, and consequently, their influence has been analyzed. However, there have been few investigations into the role of men's friendship in the reduction of these physical health problems. The findings presented in this article are focused on this issue, illustrating the impact of male friendship on the shaping of healthy behaviors. METHODS: Drawing upon a qualitative-based methodology articulated in a case study of the Men in Dialogue association, located in Spain, the study has followed the premises of the communicative approach, a total of 15 structured online open-ended questionnaires have been performed and analyzed. The median age of the participants is 37.5 years. RESULTS: The findings show how men involved in Men in Dialogue are promoting a kind of masculine friendship that is improving men's emotional well-being and, consequently, their physical health.

Toxic Nightlife Relationships, Substance Abuse, and Mental Health: Is There a Link? A Qualitative Case Study of Two Patients.

Introduction and Aims: This article explores the role of toxic close relationships in night life on substance use disorders and mental health conditions. We also contrast the quality and effects of social relationships when doing drugs with those produced by a mental health program that fosters quality relationships between patients. Design and Methods: This qualitative case study was carried out at a mental health day care center of a hospital in Malaga (Spain). The cases of two patients with severe mental disorders and a history of drug addiction were analyzed. Data were collected through in-depth interviews with every patient, semi-structured interviews about each patient with the psychologist of the medical team of the program, and medical documentation. The analysis involved a combination of inductive and deductive approaches. Results: The analysis of the data revealed, on the one hand, the influence of toxic relationships in nightlife, including violent sporadic sexual relationships, in the initiation and persistence of substance use that took part of the mental health disorder in these patients. On the other hand, the findings show that these participants' current involvement in a mental health program, which fosters quality relationships between patients, has brought emotional benefits to both of them. Discussion and Conclusion: This paper points out the relevance of considering quality of social relationships when examining substance use disorders and related mental health problems. Additionally, the findings indicate the importance of fostering quality peer relationships in mental health rehabilitation programs addressed to patients with histories of drug addiction to improve treatment outcome.

"Architects of Their Own Brain." Social Impact of an Intervention Study for the Prevention of Gender-Based Violence in Adolescence.

Research in psychology has evidenced both the prevalence of gender-based violence among youth worldwide and the negative impacts that such violence has on the victims' mental and physical health. Neuroscience has proven that violent intimate relationships harm the brain, while very simple social experiences can change the brain architecture in positive directions. Also, interventions that have been demonstrated to be successful in preventing and responding to gender violence in adolescence have been informed by psychology. This article reviews the social impact of psychology in the field of teen gender violence and then reports on the potential social impact achieved by an intervention study consisting of seven interventions framed by the research line on the preventive socialization of gender violence. The program was addressed to 15- and 16-year-old adolescents and focused on supporting free reconstruction of mental and affective models of attractiveness via critical analysis of the dominant coercive discourse, which links attraction to violence. The communicative methodology involved working with an Advisory Committee from the beginning of the study, as well as continuous dialog between the researchers and the participants, which was used to refine subsequent interventions. The results show that the program contributed to raising participants' critical consciousness regarding the dominant coercive discourse in their life, provided the participant subjects with cognitive tools to better understand their own and others' sexual-affective thinking, emotions, and behaviors, in favor of rejecting violence, and supported the modification of female adolescents' sexual preferences for different types of men. Importantly, the findings also indicate that the interventions aided some participants' use of the knowledge gained in the project to help their friends and communities in reflecting upon coercive patterns of sexual attraction, the quality of their intimate relationships, and the different effects of sexual violence and toxic relationships on health. Some individuals reported leaving toxic relationships after the interventions. This intervention research illustrates Santiago Ramón y Cajal's metaphor, employed to explain plasticity: that every person, if s/he decides it, can be the architect of her or his own brain. With evidence-based cognitive tools within the reach of every adolescent, and upon individual free choice for transformation, a new sexual-affective socialization free from violence is possible.

Socioneuroscience and its contributions to conscious versus unconscious volition and control. The case of gender violence prevention.

Research in neuroscience is being very fruitful in providing evidence about the influence of social experience in the architecture and functioning of the brain. In so doing, neuroscience is posing new and fascinating research questions to examine in depth the social processes that produce those neural changes. To undertake the task of tackling such research questions, evidence from the social sciences are necessary to better understand how different types of social experiences produce different types of synaptic changes and even modify subcortical brain structures differently. It will be the dialogue between neuroscience, other natural sciences and the social sciences which will advance the scientific understanding of plastic changes in the brain which result from complex social experiences that have been traditionally studied by the social sciences. Socioneuroscience constitutes the arena for such interdisciplinary dialogue and research that can both advance the scientific understanding of the human brain and provide evidence-based solutions to most urgent social problems. Socioneuroscience studies the relations between the human brain and social interactions taking into account knowledge from all social sciences and the natural sciences. Processes of conscious versus unconscious social volition and control is one central area of inquiry in socioneuroscience. In this article, we discuss the dominant coercive discourse in society -which presents males with aggressive attitudes and behaviors as more attractive- as an example of social control of human volition which imprisons many individuals' sexual freedom. However, due to brain plasticity, certain experiences that question such dominant discourse and empty violence from attractiveness open up the possibility for the individual and the society to break free from the neural wiring imposed by the dominant coercive discourse and, in the words of Santiago Ramón y Cajal, be ourselves "the architects of our brain", contributing to overcome violence against women.

Reconstruction of Autobiographical Memories of Violent Sexual-Affective Relationships Through Scientific Reading on Love: A Psycho-Educational Intervention to Prevent Gender Violence.

Violence in sexual-affective relationships among teens and young people is recognized as a social, educational, and health problem that has increased worldwide in recent years. Educational institutions, as central developmental contexts in adolescence, are key in preventing and responding to gender violence through implementing successful actions. In order to scientifically support that task, the research reported in this article presents and discusses a psycho-educational intervention focused on autobiographical memory reconstruction that proved to be successful in raising young women's critical consciousness about the force of the coercive discourse upon sexual-affective experiences and memories. We examined among a sample of young women (n = 32, age range 17-30) whether reading a scholarly text about love, the Radical Love book, modified autobiographical memories of violent sexual-affective relationships in line with preventing future victimization. This group was compared with a control group (n = 31, age range 17-30). Memory reports were collected before and after the reading and coded to analyze their content, both quantitatively and qualitatively. Memory quality features were assessed with the Memory Quality Questionnaire (MMQ). A focus group was also conducted to examine the personal impact of the intervention on participants. Compared with controls, the experimental group had stronger critical memories (of episodes involving violence), an average decrease in positive emotions induced by recall, and an average increase in negative emotions. The results show the effectiveness of the reading intervention designed in relation to gender violence prevention, as they indicate the ability of the psycho-educational action to debilitate the force of the coercive discourse in young women's memories. The findings both advance knowledge on the reconstructive nature of autobiographical memories of violent sexual-affective relationships in female youth and indicate the potential of memory-based interventions as an instrument to prevent and reduce gender violence in school contexts. Teachers and teaching staff, and educational psychologists, among others, can benefit from these results by expanding the tools they have to address gender violence among female adolescents and youth.

Fatal Hepatic Failure Secondary to Acute Herpes Simplex Virus Infection.

Acute hepatitis with severe hepatic failure is an uncommon manifestation of herpes simplex virus (HSV) infection. It has been described in both immunocompromised and immunocompetent patients and is usually fatal. Due to the better survival after acyclovir treatment in a few reported cases, physicians need to be aware of the characteristic clinical abnormalities so that early diagnosis and treatment can be implemented. The authors describe an adolescent diagnosed with Hodgkin disease who developed fatal hepatic failure secondary to acute HSV. Typical signs and symptoms in patients at risk, when there is no other obvious cause of fulminant hepatitis, should lead to early empirical treatment with acyclovir.

Risks and methods for peripheral blood progenitor cell collection in small children.

Peripheral blood progenitor cells (PBPC) are increasingly used as a source of stem cells for either autologous or allogeneic hematopoietic transplantation in children. Although technically similar to adult procedures, apheresis in small children worries some operators and physicians that have little experience in managing pediatric patients or donors. However several published series have showed that these procedures, when performed by experienced teams are safe and can obtain enough amount of PBPC for either autologous or allogeneic hematopoietic transplantation. Some technical aspects must be considered in pediatric apheresis due to the size of the patient/donor. Factors that must be evaluated are extracorporeal circuit volume, blood flow rates, type of anticoagulant and vascular access. Other important issue to be considered is the emotional stress for them and their relatives. Leukaphereses in children may be performed with any of the reported continuous blood cell separator without sedation. Adverse events are mainly related either to vascular access or to metabolic or hemodynamic changes. Anyway, taking all these complications together, they are not higher than those adverse events or toxicities reported after general anesthesia and bone marrow harvesting.