Documento internacional de consenso sobre apnea obstructiva del sueño / International Consensus Document on Obstructive Sleep Apnea

El objetivo principal de este documento internacional de consenso sobre apnea obstructiva del sueño es proporcionar unas directrices que permitan a los profesionales sanitarios tomar las mejores decisiones en la asistencia de los pacientes adultos con esta enfermedad según un resumen crítico de la literatura más actualizada. El grupo de trabajo de expertos se ha constituido principalmente por 17 sociedades científicas y 56 especialistas con amplia representación geográfica (con la participación de 4 sociedades internacionales), además de un metodólogo experto y un documentalista del Centro Cochrane Iberoamericano. El documento consta de un manuscrito principal, con las novedades más relevantes, y una serie de manuscritos online que recogen las búsquedas bibliográficas sistemáticas de cada uno de los apartados del documento internacional de consenso. Este documento no cubre la edad pediátrica ni el manejo del paciente en ventilación mecánica crónica no invasiva (que se publicarán en sendos documentos de consenso aparte). Palabras clave: Apnea obstructiva del sueño Diagnóstico Tratamiento

The main aim of this international consensus document on obstructive sleep apnea is to provide guidelines based on a critical analysis of the latest literature to help health professionals make the best decisions in the care of adult patients with this disease. The expert working group was formed primarily of 17 scientific societies and 56 specialists from a wide geographical area (including the participation of 4 international societies), an expert in methodology, and a documentalist from the Iberoamerican Cochrane Center. The document consists of a main section containing the most significant innovations and a series of online manuscripts that report the systematic literature searches performed for each section of the international consensus document. This document does not discuss pediatric patients or the management of patients receiving chronic non-invasive mechanical ventilation (these topics will be addressed in separate consensus documents). Keywords: Obstructive sleep apnea Diagnosis Treatment

International Consensus Document on Obstructive Sleep Apnea. / Documento internacional de consenso sobre apnea obstructiva del sueño.

The main aim of this international consensus document on obstructive sleep apnea is to provide guidelines based on a critical analysis of the latest literature to help health professionals make the best decisions in the care of adult patients with this disease. The expert working group was formed primarily of 17 scientific societies and 56 specialists from a wide geographical area (including the participation of 4 international societies), an expert in methodology, and a documentalist from the Iberoamerican Cochrane Center. The document consists of a main section containing the most significant innovations and a series of online manuscripts that report the systematic literature searches performed for each section of the international consensus document. This document does not discuss pediatric patients or the management of patients receiving chronic non-invasive mechanical ventilation (these topics will be addressed in separate consensus documents).

Nasal versus oronasal masks for home non-invasive ventilation in patients with chronic hypercapnia: a systematic review and individual participant data meta-analysis.

BACKGROUND: The optimal interface for the delivery of home non-invasive ventilation (NIV) to treat chronic respiratory failure has not yet been determined. The aim of this individual participant data (IPD) meta-analysis was to compare the effect of nasal and oronasal masks on treatment efficacy and adherence in patients with COPD and obesity hypoventilation syndrome (OHS). METHODS: We searched Medline and Cochrane Central Register of Controlled Trials for prospective randomised controlled trials (RCTs) of at least 1 month's duration, published between January 1994 and April 2019, that assessed NIV efficacy in patients with OHS and COPD. The main outcomes were diurnal PaCO2, PaO2 and NIV adherence (PROSPERO CRD42019132398). FINDINGS: Of 1576 articles identified, 34 RCTs met the inclusion criteria and IPD were obtained for 18. Ten RCTs were excluded because only one type of mask was used, or mask data were missing. Data from 8 RCTs, including 290 IPD, underwent meta-analysis. Oronasal masks were used in 86% of cases. There were no differences between oronasal and nasal masks for PaCO2 (0.61 mm Hg (95% CI -2.15 to 3.38); p=0.68), PaO2 (-0.00 mm Hg (95% CI -4.59 to 4.58); p=1) or NIV adherence (0·29 hour/day (95% CI -0.74 to 1.32); p=0.58). There was no interaction between the underlying pathology and the effect of mask type on any outcome. INTERPRETATION: Oronasal masks are the most used interface for the delivery of home NIV in patients with OHS and COPD; however, there is no difference in the efficacy or tolerance of oronasal or nasal masks.

Brain resilience across the general cognitive ability distribution: Evidence from structural connectivity.

Resting state functional connectivity research has shown that general cognitive ability (GCA) is associated with brain resilience to targeted and random attacks (TAs and RAs). However, it remains to be seen if the finding generalizes to structural connectivity. Furthermore, individuals showing performance levels at the very high area of the GCA distribution have not yet been analyzed in this regard. Here we study the relation between TAs and RAs to structural brain networks and GCA. Structural and diffusion-weighted MRI brain images were collected from 189 participants: 60 high cognitive ability (HCA) and 129 average cognitive ability (ACA) individuals. All participants completed a standardized fluid reasoning ability test and the results revealed an average HCA-ACA difference equivalent to 33 IQ points. Automated parcellation of cortical and subcortical nodes was combined with tractography to achieve an 82 × 82 connectivity matrix for each subject. Graph metrics were derived from the structural connectivity matrices. A simulation approach was used to evaluate the effects of recursively removing nodes according to their network centrality (TAs) versus eliminating nodes at random (RAs). HCA individuals showed greater network integrity at baseline and prior to network collapse than ACA individuals. These effects were more evident for TAs than RAs. The networks of HCA individuals were less degraded by the removal of nodes corresponding to more complex information processing stages of the PFIT network, and from removing nodes with larger empirically observed centrality values. Analyzed network features suggest quantitative instead of qualitative differences at different levels of the cognitive ability distribution.

Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea.

BACKGROUND: Obesity hypoventilation syndrome (OHS) is treated with either non-invasive ventilation (NIV) or CPAP, but there are no long-term cost-effectiveness studies comparing the two treatment modalities. OBJECTIVES: We performed a large, multicentre, randomised, open-label controlled study to determine the comparative long-term cost and effectiveness of NIV versus CPAP in patients with OHS with severe obstructive sleep apnoea (OSA) using hospitalisation days as the primary outcome measure. METHODS: Hospital resource utilisation and within trial costs were evaluated against the difference in effectiveness based on the primary outcome (hospitalisation days/year, transformed and non-transformed in monetary term). Costs and effectiveness were estimated from a log-normal distribution using a Bayesian approach. A secondary analysis by adherence subgroups was performed. RESULTS: In total, 363 patients were selected, 215 were randomised and 202 were available for the analysis. The median (IQR) follow-up was 3.01 (2.91-3.14) years for NIV group and 3.00 (2.92-3.17) years for CPAP. The mean (SD) Bayesian estimated hospital days was 2.13 (0.73) for CPAP and 1.89 (0.78) for NIV. The mean (SD) Bayesian estimated cost per patient/year in the NIV arm, excluding hospitalisation costs, was €2075.98 (91.6), which was higher than the cost in the CPAP arm of €1219.06 (52.3); mean difference €857.6 (105.5). CPAP was more cost-effective than NIV (99.5% probability) because longer hospital stay in the CPAP arm was compensated for by its lower costs. Similar findings were observed in the high and low adherence subgroups. CONCLUSION: CPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA. TRIAL REGISTRATION NUMBER: NCT01405976.

Sleep-disordered breathing, circulating exosomes, and insulin sensitivity in adipocytes.

BACKGROUND: Sleep-disordered-breathing (SDB), which is characterized by chronic intermittent hypoxia (IH) and sleep fragmentation (SF), is a prevalent condition that promotes metabolic dysfunction, particularly among patients suffering from obstructive hypoventilation syndrome (OHS). Exosomes are generated ubiquitously, are readily present in the circulation, and their cargo may exert substantial functional cellular alterations in both physiological and pathological conditions. However, the effects of plasma exosomes on adipocyte metabolism in patients with OHS or in mice subjected to IH or SF mimicking SDB are unclear. METHODS: Exosomes from fasting morning plasma samples from obese adults with polysomnographically-confirmed OSA before and after 3 months of adherent CPAP therapy were assayed. In addition, C57BL/6 mice were randomly assigned to (1) sleep control (SC), (2) sleep fragmentation (SF), and (3) intermittent hypoxia (HI) for 6 weeks, and plasma exosomes were isolated. Equivalent exosome amounts were added to differentiated adipocytes in culture, after which insulin sensitivity was assessed using 0 nM and 5 nM insulin-induced pAKT/AKT expression changes by western blotting. RESULTS: When plasma exosomes were co-cultured and internalized by human naive adipocytes, significant reductions emerged in Akt phosphorylation responses to insulin when compared to exosomes obtained after 24 months of adherent CPAP treatment (n = 24; p < 0.001), while no such changes occur in untreated patients (n = 8). In addition, OHS exosomes induced significant increases in adipocyte lipolysis that were attenuated after CPAP, but did not alter pre-adipocyte differentiation. Similarly, exosomes from SF- and IH-exposed mice induced attenuated p-AKT/total AKT responses to exogenous insulin and increased glycerol content in naive murine adipocytes, without altering pre-adipocyte differentiation. CONCLUSIONS: Using in vitro adipocyte-based functional reporter assays, alterations in plasma exosomal cargo occur in SDB, and appear to contribute to adipocyte metabolic dysfunction. Further exploration of exosomal miRNA signatures in either human subjects or animal models and their putative organ and cell targets appears warranted.

Primary Care Physicians Can Comprehensively Manage Patients with Sleep Apnea. A Noninferiority Randomized Controlled Trial.

Rationale: General practitioners play a passive role in obstructive sleep apnea (OSA) management. Simplification of the diagnosis and use of a semiautomatic algorithm for treatment can facilitate the integration of general practitioners, which has cost advantages.Objectives: To determine differences in effectiveness between primary health care area (PHA) and in-laboratory specialized management protocols during 6 months of follow-up.Methods: A multicenter, noninferiority, randomized, controlled trial with two open parallel arms and a cost-effectiveness analysis was performed in six tertiary hospitals in Spain. Sequentially screened patients with an intermediate to high OSA probability were randomized to PHA or in-laboratory management. The PHA arm involved a portable monitor with automatic scoring and semiautomatic therapeutic decision-making. The in-laboratory arm included polysomnography and specialized therapeutic decision-making. Patients in both arms received continuous positive airway pressure treatment or sleep hygiene and dietary treatment alone. The primary outcome measure was the Epworth Sleepiness Scale. Secondary outcomes were health-related quality of life, blood pressure, incidence of cardiovascular events, hospital resource utilization, continuous positive airway pressure adherence, and within-trial costs.Measurements and Main Results: In total, 307 patients were randomized and 303 were included in the intention-to-treat analysis. Based on the Epworth Sleepiness Scale, the PHA protocol was noninferior to the in-laboratory protocol. Secondary outcome variables were similar between the protocols. The cost-effectiveness relationship favored the PHA arm, with a cost difference of €537.8 per patient.Conclusions: PHA management may be an alternative to in-laboratory management for patients with an intermediate to high OSA probability. Given the clear economic advantage of outpatient management, this finding could change established clinical practice.Clinical trial registered with www.clinicaltrials.gov (NCT02141165).

Echocardiographic changes with non-invasive ventilation and CPAP in obesity hypoventilation syndrome.

RATIONALE: Despite a significant association between obesity hypoventilation syndrome (OHS) and cardiac dysfunction, no randomised trials have assessed the impact of non-invasive ventilation (NIV) or CPAP on cardiac structure and function assessed by echocardiography. OBJECTIVES: We performed a secondary analysis of the data from the largest multicentre randomised controlled trial of OHS (Pickwick project, n=221) to determine the comparative efficacy of 2 months of NIV (n=71), CPAP (n=80) and lifestyle modification (control group, n=70) on structural and functional echocardiographic changes. METHODS: Conventional transthoracic two-dimensional and Doppler echocardiograms were obtained at baseline and after 2 months. Echocardiographers at each site were blinded to the treatment arms. Statistical analysis was performed using intention-to-treat analysis. RESULTS: At baseline, 55% of patients had pulmonary hypertension and 51% had evidence of left ventricular hypertrophy. Treatment with NIV, but not CPAP, lowered systolic pulmonary artery pressure (-3.4 mm Hg, 95% CI -5.3 to -1.5; adjusted P=0.025 vs control and P=0.033 vs CPAP). The degree of improvement in systolic pulmonary artery pressure was greater in patients treated with NIV who had pulmonary hypertension at baseline (-6.4 mm Hg, 95% CI -9 to -3.8). Only NIV therapy decreased left ventricular hypertrophy with a significant reduction in left ventricular mass index (-5.7 g/m2; 95% CI -11.0 to -4.4). After adjusted analysis, NIV was superior to control group in improving left ventricular mass index (P=0.015). Only treatment with NIV led to a significant improvement in 6 min walk distance (32 m; 95% CI 19 to 46). CONCLUSION: In patients with OHS, medium-term treatment with NIV is more effective than CPAP and lifestyle modification in improving pulmonary hypertension, left ventricular hypertrophy and functional outcomes. Long-term studies are needed to confirm these results. TRIAL REGISTRATION NUMBER: Pre-results, NCT01405976 (https://clinicaltrials.gov/).

Non-invasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea.

BACKGROUND: Non-invasive ventilation (NIV) is an effective form of treatment in patients with obesity hypoventilation syndrome (OHS) who have concomitant severe obstructive sleep apnoea (OSA). However, there is a paucity of evidence on the efficacy of NIV in patients with OHS without severe OSA. We performed a multicentre randomised clinical trial to determine the comparative efficacy of NIV versus lifestyle modification (control group) using daytime arterial carbon dioxide tension (PaCO2) as the main outcome measure. METHODS: Between May 2009 and December 2014 we sequentially screened patients with OHS without severe OSA. Participants were randomised to NIV versus lifestyle modification and were followed for 2 months. Arterial blood gas parameters, clinical symptoms, health-related quality of life assessments, polysomnography, spirometry, 6-min walk distance test, blood pressure measurements and healthcare resource utilisation were evaluated. Statistical analysis was performed using intention-to-treat analysis. RESULTS: A total of 365 patients were screened of whom 58 were excluded. Severe OSA was present in 221 and the remaining 86 patients without severe OSA were randomised. NIV led to a significantly larger improvement in PaCO2 of -6 (95% CI -7.7 to -4.2) mm Hg versus -2.8 (95% CI -4.3 to -1.3) mm Hg, (p<0.001) and serum bicarbonate of -3.4 (95% CI -4.5 to -2.3) versus -1 (95% CI -1.7 to -0.2 95% CI)  mmol/L (p<0.001). PaCO2 change adjusted for NIV compliance did not further improve the inter-group statistical significance. Sleepiness, some health-related quality of life assessments and polysomnographic parameters improved significantly more with NIV than with lifestyle modification. Additionally, there was a tendency towards lower healthcare resource utilisation in the NIV group. CONCLUSIONS: NIV is more effective than lifestyle modification in improving daytime PaCO2, sleepiness and polysomnographic parameters. Long-term prospective studies are necessary to determine whether NIV reduces healthcare resource utilisation, cardiovascular events and mortality. TRIAL REGISTRATION NUMBER: NCT01405976; results.

The gendered división of housework / La división generizada de las tareas domésticas

BACKGROUND: In spite of the verifiable achievements obtained in gender equity, one wonders if they still exist in our societies gendered activities (roles) at the household level. This study states an affirmative prediction. Gender role is here organized in four different nuclei: instrumentality inside and outside home for men; expressiveness and instrumentality inside home for women, pertaining to two clearly different domains (household activities for men and household activities for women). METHOD: 98 women and 86 men completed the Gender Roles Questionnaire (GRQ). RESULTS: Obtained results showed that: (a) men and women do not do certain household activities (roles) with the same frequency; (b) the four-dimensional approach fits the data better than the one-dimensional and even better than the two-dimensional approach (household gender roles for men and women separately). CONCLUSION: Discussion focuses on the implications of these results for both research and education

ANTECEDENTES: pese a los constatables logros en la igualdad de género, cabe preguntarse si todavía existen, en nuestras sociedades, actividades (roles) generizadas en el ámbito doméstico. La predicción es que sí. El rol de género se organiza aquí en cuatro núcleos diferentes: instrumentalidad intra y extra-hogar para los varones y expresividad e instrumentalidad intra-hogar para las mujeres, dentro de dos claros dominios (doméstico varón y doméstico mujer). MÉTODO: 98 mujeres y 86 varones respondieron al Cuestionario de Roles de Género (CRG). RESULTADOS: los resultados pusieron de manifiesto: a) que varones y mujeres claramente difieren en el ejercicio de ciertas actividades (roles) domésticas; b) que el planteamiento de cuatro dimensiones se ajusta mejor a los datos que el unidimensional e, incluso, que el bidimensional (roles de género domésticos de varones y roles de género domésticos de mujeres). CONCLUSIONES: se establecen las posibles implicaciones derivadas de estos resultados, tanto para el ámbito de la investigación como para el educativo

Explicit and implicit assessment of gender roles / Evaluación explícita e implícita de los roles de género

BACKGROUND: Gender roles have been assessed by explicit measures and, recently, by implicit measures. In the former case, the theoretical assumptions have been questioned by empirical results. To solve this contradiction, we carried out two concatenated studies based on a relatively well-founded theoretical and empirical approach. METHOD: The first study was designed to obtain a sample of genderized activities of the domestic sphere by means of an explicit assessment. Forty-two raters (22 women and 20 men, balanced on age, sex, and level of education) took part as raters. In the second study, an implicit assessment of gender roles was carried out, focusing on the response time given to the sample activities obtained from the first study. A total of 164 adults (90 women and 74 men, mean age = 43), with experience in living with a partner and balanced on age, sex, and level of education, participated. RESULTS: Taken together, results show that explicit and implicit assessment converge. The current social reality shows that there is still no equity in some gender roles in the domestic sphere. CONCLUSIONS: These consistent results show considerable theoretical and empirical robustness, due to the double implicit and explicit assessment

ANTECEDENTES: los roles de género han sido evaluados con medidas explícitas y, recientemente, implícitas. En el primer caso, los supuestos teóricos no se ajustan a los resultados empíricos. Para intentar resolver este problema hemos realizado dos estudios consecutivos con un enfoque, teórico y empírico, bien fundamentado. MÉTODO: el primero fue diseñado para obtener una muestra de actividades de género de la esfera doméstica mediante medidas explícitas. Los evaluadores fueron 42 adultos (22 mujeres y 20 varones, equiparados en edad, sexo y nivel educativo). En el segundo se utilizó una medida implícita, centrada en los tiempos de respuesta que las personas dan a las actividades de género, obtenidas en el primer estudio. Participaron 164 adultos (90 mujeres y 74 varones, media de edad= 43) con experiencia de vida en pareja y equiparados en edad, sexo y nivel educativo. RESULTADOS: tomados conjuntamente, estos dos estudios muestran que es posible validar los datos obtenidos con una medida explícita mediante otra implícita: en la realidad social actual sigue sin haber equidad en ciertos roles de género del ámbito doméstico. CONCLUSIONES: estos resultados, concordantes, manifiestan consistencia teórica y empírica, debido a la doble medida utilizada: explícita e implícita

Explicit and implicit assessment of gender roles.

BACKGROUND: Gender roles have been assessed by explicit measures and, recently, by implicit measures. In the former case, the theoretical assumptions have been questioned by empirical results. To solve this contradiction, we carried out two concatenated studies based on a relatively well-founded theoretical and empirical approach. METHOD: The first study was designed to obtain a sample of genderized activities of the domestic sphere by means of an explicit assessment. Forty-two raters (22 women and 20 men, balanced on age, sex, and level of education) took part as raters. In the second study, an implicit assessment of gender roles was carried out, focusing on the response time given to the sample activities obtained from the first study. A total of 164 adults (90 women and 74 men, mean age = 43), with experience in living with a partner and balanced on age, sex, and level of education, participated. RESULTS: Taken together, results show that explicit and implicit assessment converge. The current social reality shows that there is still no equity in some gender roles in the domestic sphere. CONCLUSIONS: These consistent results show considerable theoretical and empirical robustness, due to the double implicit and explicit assessment.

Hippocampal structure and human cognition: key role of spatial processing and evidence supporting the efficiency hypothesis in females.

Here we apply a method for automated segmentation of the hippocampus in 3D high-resolution structural brain MRI scans. One hundred and four healthy young adults completed twenty one tasks measuring abstract, verbal, and spatial intelligence, along with working memory, executive control, attention, and processing speed. After permutation tests corrected for multiple comparisons across vertices (p < .05) significant relationships were found for spatial intelligence, spatial working memory, and spatial executive control. Interactions with sex revealed significant relationships with the general factor of intelligence (g), along with abstract and spatial intelligence. These correlations were mainly positive for males but negative for females, which might support the efficiency hypothesis in women. Verbal intelligence, attention, and processing speed were not related to hippocampal structural differences.

Objective assessment of gender roles: Gender Roles Test (GRT-36).

This study was designed to develop a computerized test to assess gender roles. This test is presented as a decision-making task to mask its purpose. Each item displays a picture representing an activity and a brief sentence that describes it. Participants have to choose the most suitable sex to perform each activity: man or woman. The test (Gender Roles Test, GRT-36) consists of 36 items/activities. The program registers both the choices made and their response times (RTs). Responses are considered as stereotyped when the chosen sex fits stereotyped roles and non-stereotyped when the chosen sex does not fit stereotyped roles. Individual means (RTs) were computed for stereotyped and non-stereotyped responses, differentiating between domestic and work spheres. A "D" score, reflecting the strength of association between activities and sex, was calculated for each sphere and sex. The study incorporated 78 participants (69% women and 31% men) ranging from 19 to 59 years old. The results show that: (a) reading speed does not explain the variability in the RTs; (b) RTs show good internal consistency; (c) RTs are shorter for stereotyped than for neutral stimuli; (d) RTs are shorter for stereotyped than for non-stereotyped responses. Intended goals are supported by obtained results. Scores provided by the task facilitate both group and individual detailed analysis of gender role, differentiating the gender role assigned to men from that assigned to women, at the domestic and work spheres. Obtained data fall within the scope of the genderology and their implications are discussed.

Objective assessment of gender roles: gender roles test (GRT-36)

This study was designed to develop a computerized test to assess gender roles. This test is presented as a decision-making task to mask its purpose. Each item displays a picture representing an activity and a brief sentence that describes it. Participants have to choose the most suitable sex to perform each activity: man or woman. The test (Gender Roles Test, GRT-36) consists of 36 items/activities. The program registers both the choices made and their response times (RTs). Responses are considered as stereotyped when the chosen sex fits stereotyped roles and non-stereotyped when the chosen sex does not fit stereotyped roles. Individual means (RTs) were computed for stereotyped and non-stereotyped responses, differentiating between domestic and work spheres. A «D» score, reflecting the strength of association between activities and sex, was calculated for each sphere and sex. The study incorporated 78 participants (69% women and 31% men) ranging from 19 to 59 years old. The results show that: (a) reading speed does not explain the variability in the RTs; (b) RTs show good internal consistency; (c) RTs are shorter for stereotyped than for neutral stimuli; (d) RTs are shorter for stereotyped than for non-stereotyped responses. Intended goals are supported by obtained results. Scores provided by the task facilitate both group and individual detailed analysis of gender role, differentiating the gender role assigned to men from that assigned to women, at the domestic and work spheres. Obtained data fall within the scope of the genderology and their implications are discussed (AU)

El objetivo del estudio ha sido elaborar un test informatizado, para valorar los roles de género, presentado como tarea de toma de decisiones para enmascarar su objetivo. En cada ítem hay que elegir entre varones o mujeres, según se los/as considere más idóneos para realizar cada actividad. La prueba consta de 36 ítems/actividades. El programa registra tanto la elección como el tiempo de respuesta (TR). Las respuestas se clasifican en estereotipadas (concordancia sexo y rol estereotipado) y no estereotipadas (discordancia sexo y rol estereotipado). Para cada uno de estos grupos se calcula el TR medio, diferenciando ámbito doméstico y laboral. También se calcula una puntuación de fuerza de asociación de la respuesta (D) para cada ámbito y sexo. En el estudio participaron 78 personas (69% mujeres y 31% varones) entre 19 y 59 años. Los resultados manifiestan que: (a) la velocidad de lectura no explica la variabilidad en los TR; (b) los TR muestran buena consistencia interna; (c) los TR son más breves ante estímulos estereotipados que neutros; (d) los TR son más breves para las respuestas estereotipadas que para las no estereotipadas. Los resultados avalan el ajuste del test a los objetivos establecidos. Las puntuaciones facilitan tanto el análisis del rol de género en grupos como el perfil individual, diferenciando el rol de género adscrito a la mujer del adscrito al varón, tanto en el ámbito doméstico como en el laboral. Estos resultados se enmarcan dentro del ámbito de la generología y se discuten sus implicaciones (AU)

Temporal Stability and Cross-National Consistency of the Dimensional Structure of the Sexual Attraction Questionnaire (SAQ)

The Sexual Attraction Questionnaire (SAQ) was designed to measure sexual attraction (Fernández, Quiroga, & Rodríguez, 2006), because the current questionnaires were considered inadequate. The purpose of this research was to test whether the SAQ factors remain meaningful after several years (stability) and whether the Italian version is equivalent to the Spanish one (consistency). Three groups of university students participated: two from Spain (n = 182 and 255, respectively) and one from Italy (n = 293). The Spanish groups were tested with a 7-year interval (2001-2008). The Italian group was tested in 2008. The main hypotheses were to test, across time interval and countries: (a) factor congruence, (b) predictive power of factors (proportion of variance accounted for), and (c) scale reliability. Sexual attraction typology also was analyzed, within and between countries, to test the validity of the underlying theoretical model. The results obtained show that the SAQ factor structure remains the same, the resulting factors have high predictive power, and the SAQ scales are highly reliable. Sexual dimorphism and sexual attraction typology are highly associated, thus validating the underlying theoretical model (AU)

El Cuestionario de Atracción Sexual (CAS) se creó para valorar la atracción sexual (Fernández, Quiroga, & Rodríguez, 2006) debido a la ausencia de instrumentos específicos. Se pretende analizar ahora si la estructura dimensional del CAS permanece estable con el paso del tiempo y si es semejante en la versión italiana. Participaron tres grupos de estudiantes universitarios: dos españoles (182 y 255) y uno italiano (293). Los datos del primer grupo español se obtuvieron en 2001 y los del segundo en 2008, junto con los del grupo italiano. Las hipótesis se centran en analizar: (a) la congruencia de las estructuras factoriales; (b) el poder predictivo de los factores (proporción de varianza explicada) y (c) la fiabilidad de las escalas del CAS, tanto entre países como entre los dos momentos temporales. Además, para poner a prueba la validez del modelo teórico subyacente, se analiza la semejanza en la tipología de la atracción sexual intra e inter-países. Los resultados muestran que la estructura factorial del CAS se mantiene, sus factores poseen un alto poder predictivo y las escalas gozan de alta fiabilidad. El dimorfismo sexual y la tipología de atracción sexual están altamente relacionados, lo que apoya la validez del modelo teórico subyacente (AU)

Neuroticism, intelligence, and intra-individual variability in elementary cognitive tasks: Testing the mental noise hypothesis / Neuroticismo, inteligencia y variabilidad intra-individual en tareas cognitivas elementales: contraste de la hipótesis del ruido neuronal

Some studies show positive correlations between intraindividual variability in elementary speed measures(reflecting processing efficiency) and individual differences in neuroticism (reflecting instability in behaviour). The so-called neural noise hypothesis assumes that higher levels of noise are related both to smaller indices of processing efficiency and greater levels of neuroticism. Here, we test this hypothesis measuring mental speed by means of three elementary cognitive tasks tapping similar basic processes but varying systematically their content (verbal, numerical, and spatial). Neuroticism and intelligence are also measured. The sample comprised 196 undergraduate psychology students. The results show that (1) processing efficiency is generally unrelated to individual differences in neuroticism,(2) processing speed and efficiency correlate with intelligence, and (3) only the efficiency index is genuinely related to intelligence when the colinearity between speed and efficiency is controlled (AU)

Una serie de estudios han observado correlaciones entre la variabilidad intra-individual en medidas de velocidad mental en tareas cognitivas elementales (que expresa la eficiencia de procesamiento) y las diferencias individuales en neuroticismo (que expresa la inestabilidad de la conducta). La conocida como hipótesis del ruido neuronal asume que mayores niveles de ruido se relacionan tanto con menores índices de eficiencia de procesamiento como con mayores niveles de neuroticismo. En este artículo se contrasta esta hipótesis midiendo la velocidad mental mediante tres tareas cognitivas elementales que valoran procesos básicos similares pero que varían sistemáticamente su contenido (verbal, numérico y espacial). También se mide el neuroticismo y la inteligencia. La muestra estuvo compuesta por 196 estudiantes de psicología. Los resultados indican que (1) la eficiencia de procesamiento no se relaciona con las diferencias individuales en neuroticismo, (2) tanto la velocidad como la eficiencia de procesamiento correlacionan con la inteligencia y (3) solamente el índice de eficiencia se relaciona genuinamente con la inteligencia cuando se controla la co-linealidad entre velocidad y eficiencia (AU)

Influence of impulsivity-reflexivity when testing dynamic spatial ability: sex and g differences.

This work analyzes the possibility that the differences in the performance of men and women in dynamic spatial tasks such as the Spatial Orientation Dynamic Test-Revised (SODT-R; Santacreu & Rubio, 1998), obtained in previous works, are due to cognitive style (Reflexivity-Impulsivity) or to the speed-accuracy tradeoff (SATO) that the participants implement. If these differences are due to cognitive style, they would be independent of intelligence, whereas if they are due to SATO, they may be associated with intelligence. In this work, 1652 participants, 984 men and 668 women, ages between 18 and 55 years, were assessed. In addition to the SODT-R, the "Test de Razonamiento Analitico, Secuencial e Inductivo" (TRASI [Analytical, Sequential, and Inductive Reasoning Test]; Rubio & Santacreu, 2003) was administered as a measure of general intelligence. Impulsivity scores (Zi) of Salkind and Wright (1977) were used to analyze reflexivity-impulsivity and SATO. The results obtained indicate that (a) four performance groups can be identified: Fast-accurate, Slow-inaccurate, Impulsive, and Reflexive. The first two groups solve the task as a function of a competence variable and the last two as a function of a personality variable; (b) performance differences should be attributed to SATO; (c) SATO differs depending on sex and intelligence level.

Influence of impulsivity-reflexivity when testing dynamic spatial ability: sex and g differences

This work analyzes the possibility that the differences in the performance of men and women in dynamic spatial tasks such as the Spatial Orientation Dynamic Test-Revised (SODT-R; Santacreu & Rubio, 1998), obtained in previous works, are due to cognitive style (Reflexivity-Impulsivity)or to the speed-accuracy trade off (SATO) that the participants implement. If these differences are due to cognitive style, they would be independent of intelligence, whereas if they are due to SATO, they may be associated with intelligence. In this work, 1652 participants, 984 men and 668 women, ages between 18 and 55 years, were assessed. In addition to the SODT-R, the «Test de Razonamiento Analítico, Secuencial e Inductivo» (TRASI [Analytical, Sequential, and Inductive Reasoning Test]; Rubio & Santacreu, 2003) was administered as a measure of general intelligence. Impulsivity scores(Zi) of Salkind and Wright (1977) were used to analyze reflexivity-impulsivity and SATO. The results obtained indicate that (a) four performance groups can be identified: Fast-accurate, Slowinaccurate, Impulsive, and Reflexive. The first two groups solve the task as a function of a competence variable and the last two as a function of a personality variable; (b) performance differences should be attributed to SATO; (c) SATO differs depending on sex and intelligence level (AU)

El trabajo analiza la posibilidad de que las diferencias en la ejecución de varones y mujeres en tareas espaciales dinámicas como el Spatial Orientation Dynamic Test-Revised (SODT-R Santacreu y Rubio, 1998), obtenidas en trabajos previos, se deban al estilo cognitivo (Reflexividad-Impulsividad) o al balance velocidad-exactitud; (Speed-Accuracy Trade-Off, SATO) que los participantes pongan en marcha. De deberse al estilo cognitivo serían independientes de la inteligencia mientras que si se deben al balance Velocidad-Exactitud pueden estar asociadas a la inteligencia. Se evaluó a 1652 participantes, 984 varones y 668 mujeres, de edades comprendidas entre 18 y 55 años.Además del SODT-R se administró el Test de Razonamiento Analítico, Secuencial e Inductivo (TRASI; Rubio y Santacreu, 2003) como medida de inteligencia general. Para el análisis de la Reflexividad-Impulsividad (R-I) y el balance velocidad-exactitud se utilizaron las puntuaciones de impulsividad (Zi) de Salkind y Wright (1977). Los resultados obtenidos indican que: a/ se pueden identificar cuatro grupos de ejecución: Rápidos-exactos, Lentos inexactos, Impulsivos y Reflexivos.Los dos primeros resuelven la tarea en función de una variable competencial y los dos últimos en función de una variable de personalidad; b/ las diferencias en la ejecución deben atribuirse al balance VE; c/ este balance es diferente según el sexo y el nivel de inteligencia (AU)

Role of stressful life events in homelessness: an intragroup analysis.

The present paper describes the results of an analysis of individual differences-using multi-dimensional strategies-in stressful life event data collected from a representative sample of homeless people (N = 289) in Madrid, Spain, which revealed the existence of three subgroups within the sample. Each subgroup can be defined by the following differentiating characteristics: The first cluster (n = 124) was characterized by economic problems; the second (n = 80) by health problems, alcohol abuse, and death of one or both parents; and the third cluster (n = 50) by an accumulation of stressful life in childhood events and alcohol abuse. In order to define the subgroups, the article also examines the differences found in other variables such as total duration of homelessness, mental and physical health status, and social support availability, among others. The existence of such subgroups within the homeless population emphasizes the importance of designing different interventions for each of these groups, adapted to their diverse needs.