Enhancing Global Development of Palliative Care: Insights from Country Experts on ATLANTES Observatory's Role.

Background: Despite a steady increase in palliative care (PC)-oriented research, authentic engagement of stakeholders with findings needs to be more used. Objective: This study aimed to explore how ATLANTES Observatory can effectively promote the global development of PC by engaging with stakeholders and addressing their specific needs and priorities. Design: An international e-survey among Observatory collaborators explored key audiences, best ways to reach them, and priority activities. Answers were evaluated according to respondents' roles (Academics, Policymakers, and clinicians) and toward impact on diverse key stakeholders. Correlation between respondents' roles with select products was studied. Results: One hundred fifty-five collaborators participated. The collaborators suggested addressing ATLANTES Global Observatory's activities to policymakers (5,6/7), professional associations (5,2/7), and health care practitioners (4,4/7). Preferred activity to reach all stakeholders is the use of websites and social networks, while particularly for policymakers, academics, and general practitioners, the conduction of atlases and articles stand out. Conclusions: Our study emphasizes prioritizing policymakers and all health care practitioners as key stakeholders in promoting PC and driving global development and integration into health care systems. By leveraging innovative web tools and social networks for dissemination, our aim is to extend the reach of our efforts beyond the PC community.

Palliative care stay room - designing, testing and evaluating a gamified social intervention to enhance palliative care awareness.

INTRODUCTION: The message of palliative care can be promoted using creative thinking and gamification. It can be an innovative strategy to promote changes in behaviour, promote thinking, and work on skills such as empathy. AIM: Design, test and evaluate a gamified social intervention to enhance palliative care awareness among young university students from non-health background. METHODS: Participatory action research study with mixed methods, Design Thinking and using the Public Engagement strategy. Forty-three undergraduate students participated in a Palliative Care Stay Room and completed the Test of Cognitive and Affective Empathy (TECA) before and after the game. At the end of the game, a ten-minute debriefing was held with the participants, which was concluded with an open conversation. The content analysis was done independently and the sum of the scores of each dimension was compared before and after the activity. FINDINGS: The Stay Room improved the participants' knowledge and new perspectives about palliative care. Before the game, their views focused on the end of life and after the game on their values, highlighting the dedication of the healthcare professionals who do not treat death but the life until death. After de game, participants (N = 43: female = 23; male = 20; x̄ 19.6 years old) presented higher values in perspective adoption (intellectual ability to put oneself in the other's place) p = 0.046 and in emotional understanding (ability to recognize emotional states) p = 0.018, and had high scores on empathic joy (p = 0.08). CONCLUSION: Gamification can be used in teaching and transmitting positive attitudes. Palliative Care and can help young university students to think positively about care issues.

Palliative care in the Eastern Mediterranean: comparative analysis using specific indicators.

BACKGROUND: Monitoring the development of palliative care (PC) illustrates the capacity of health systems to respond to the needs of people experiencing serious health-related suffering. AIM: To analyse comparatively the situation of PC in the countries of the Easter Mediterranean region using context-specific indicators. METHOD: An online questionnaire with 15 context-specific PC indicators investigating service provision, use of medicines, policy, education, and vitality was designed. Authors Institution 1 nominated in-country experts to complete the survey. Data were analysed using a comparative description of indicators per domain and a multivariate analysis. RESULTS: In-country experts were identified in 17/22 countries. 12/17 contributed to the survey. In total, 117 specialized PC services were identified. Specialized services per population ranges from 0.09 per 100,000 inhabitants in Lebanon and Saudi Arabia, Qatar and Kuwait; to zero services in the Occupied Palestinian Territories. On average, opioid consumption was 2.40 mg/capita/year. National PC strategies were reported in nine countries. In six countries, PC is officially accredited either as a specialty or sub-specialty, and PC mandatory courses are implemented in 36% of medical schools and 46% of nursing schools. National PC associations were documented in six countries. A higher pattern of development was identified in Jordan, Kuwait, Saudi Arabia, Oman, Lebanon, Qatar. CONCLUSIONS: Despite a higher development in the Arabian Peninsula, the region is characterised by a very low provision of specialized PC services and opioid consumption. Policy improvements represent an opportunity to improve access to PC.

Matched and Fully Private? A New Self-Generated Identification Code for School-Based Cohort Studies to Increase Perceived Anonymity.

Anonymous questionnaires are frequently used in research with adolescents in order to obtain sincere answers about sensitive topics. Most longitudinal studies include self-generated identification codes (SGICs) to match information. Typical elements include a combination of letters and digits from personal data. However, these data may make the participant feel that their answers are not truly anonymous, and some studies using these types of SGICs have been perceived as not entirely anonymous by some participants. Furthermore, data protection laws could place limits on research carried out with these codes. The objective of our article is to test an SGIC with a higher degree of anonymity. We conducted two studies. In Study 1, we tested the perceived anonymity of this new SGIC code. Adolescents aged 12 to 18 years (N = 601) completed an anonymous questionnaire about lifestyles and risk behaviors, which also included the SGIC. Adolescents with and without risk behaviors were compared regarding whether or not they answered to the SGIC questions. We did not find any differences to suggest that participants felt identifiable. In Study 2, we assessed the efficiency of the new SGIC. At baseline, 123 students from two high schools (eighth grade) filled in questionnaires consisting of the new SGIC and their full names. Two years later, these same students (then in the 10th grade) were invited to fill in the same information again (116 students responded to this second call). A total of 97 students were present in both waves. The SGIC showed a moderate performance, with good enough indices of recall and precision. Evidence suggests that the new SGIC is a suitable tool for the anonymous matching of adolescents in follow-ups of school cohorts.

Adolescents' Alcohol Use: Does the Type of Leisure Activity Matter? A Cross-National Study.

The main objective of this study was to analyze the relationship between structured, unstructured, and family leisure activities on the frequency of adolescent alcohol intake across three different countries (Spain, Peru, and The Netherlands). The self-control of adolescents was also investigated as a moderator in the relationship between leisure activities and alcohol consumption. METHODOLOGY: This research involved 4608 adolescents aged between 12 and 17 from three countries (Spain, Peru, and The Netherlands). In Spain and Peru, data was collected through a self-report questionnaire which was part of the Your Life project. In The Netherlands, a self-questionnaire was used, collected by the University of Utrecht. A multiple logistic regression was performed for each country. RESULTS: The results showed that participation in unstructured leisure activities increased the likelihood of drinking more frequently and more heavily in all three countries. Structured leisure activities, in general, did not have a significant predictive effect on alcohol consumption in any of the countries. Family leisure activities reduced the risk of engaging in yearly alcohol use and yearly binge drinking among adolescents, especially in The Netherlands and Spain. The protective effect of family leisure and unstructured leisure risk on yearly alcohol use applied especially to Dutch adolescents with a low level of self-control. DISCUSSION: The article emphasizes the need for parents to engage in leisure activities with their child; participation in unstructured activities is not to be encouraged.

Palliative Care Coverage across European National Health Systems: Proposal of a Synthetic Indicator.

BACKGROUND: The coverage of palliative care (PC) may be understood as a country's capacity to offer prevention and relief from serious health-related suffering in relation to an existing need. The aim of this study is to estimate European countries´ coverage capacities. METHOD: Secondary analysis of three indicators, including the number of specialized services (SSPC), integration capacity scores (ICS) and the PC needs. By means of a K-medians clustering supervised algorithm, three coverage profiles were obtained: (1) Advanced: countries with high ICS and SSPC, and low PC needs; (2) Limited: countries with low ICS and SSPC, and low PC needs; and (3) Low: countries with low ICS and SSPC and high PC needs. RESULTS: On average, the ratio of specialized services per population was 0.79 per 100,000 inhabitants, the average ICS was 19.62 and the average number of deceased patients with SHS per 100,000 inhabitants was 5.69. Twenty countries (41%) reached an advanced coverage profile. Nine countries (18%) demonstrated a limited coverage profile; and 20 countries (41%) fell under a low-coverage capacity. CONCLUSION: The level of palliative care coverage across Europe shows that 59% of European countries have either limited or very low availability of PC resources as regards their palliative care needs.

Maternal and paternal parenting styles as a whole: validation of the simple form of the Parenting Style Evaluation Scale / Estilos parentales materno y paterno en conjunto: validación de la forma simple de la Escala de Evaluación del Estilo Parental

Oliva's Escala para la Evaluación del Estilo Parental (EEEP) [Scale for the evaluation of parenting styles] asks adolescents about their parents' education styles separately ("your father" and "your mother") or in a combined way ("your parents"), but only the separated version has been tested for validity. The objective of this work was to carry out a validation of the combined version. A sample of 1507 adolescents, aged 12 to 18 years, was recruited. Exploratory and confirmatory factor analyses were run in two independent subsamples. Then, structural equation models (SEM) were run in order to test the association between the EEEP's subscales and adolescent outcomes (optimism, pessimism, and academic achievement). Results showed a good fit of the instruments' structure. Furthermore, the subscales showed associations with the outcomes. The EEEP can be reliably used in its combined form, which results in a reduction of items, often beneficial for research

La Escala para la Evaluación del Estilo Parental (EEEP) pregunta a los adolescentes sobre los estilos educativos de sus padres por separado ("tu padre" y "tu madre") o de forma conjunta ("tus padres"), pero solo se ha evaluado la validez en la versión por separado. El objetivo de este trabajo fue evaluar la validez de las inferencias de la versión conjunta. Se reclutó una muestra de 1507 adolescentes, de 12 a 18 años. Se realizaron análisis factoriales exploratorios y confirmatorios en dos submuestras independientes. Después se probó un modelo de ecuaciones estructurales para comprobar la asociación de las subescalas de la EEEP con desenlaces de los adolescentes (optimismo, pesimismo y resultados académicos). Los resultados muestran buenas medidas de ajuste de la estructura del instrumento. Además, las subescalas mostraron asociación con los desenlaces. La EEEP puede ser usada con fiabilidad en su forma conjunta, resultando en una reducción de ítems, los cual es a menudo beneficioso para la investigación

The conditions for women's autonomy: Statistical data for Valle del Cauca.

In this article, we describe the data set on theconditions for women's autonomy in the municipalities of Cali, Buenaventura, Yumbo, and Jamundí (Colombia). The database was developed by the Observatoriopara la Equidad de las Mujeres (OEM), an entity resulting from an alliancebetween Universidad Icesi and Fundación WWB Colombia. The OEM's purpose is toconstruct measurements that make it possible to account for women's autonomy,based on three main dimensions: physical autonomy (associated with aspects ofpersonal and family life), economic and financial autonomy (the type of work,income, decision-making with respect to these aspects, entrepreneurship orbusiness units, among others), and leadership and public participation(electoral practices, type of participation, relation to institutions, etc.),while fundamentally, considering women's capacity to make decisions onthese  aspects, based on both theirperception and their actions. As well as helping to overcome the limitations ofexisting information, this primary data collection is aimed at generatingvalid, reliable and high-quality inputs to formulate local and national publicpolicies to improve the living conditions of women in Colombia's Pacificregion. The survey, designed and applied by the OEM, was first implemented inOctober and November 2018 through multi-stage probability sampling. The samplesize was 1,507 women in the four mentioned municipalities.

Association of DEAR1 Tagging Single Nucleotide Polymorphisms With Breast Cancer in a Sample of Colombian Population: A Case Control Study.

PURPOSE: Ubiquitin ligase genes can act as oncogenes or tumor suppressor genes. They play a role in various diseases, including development and progression of breast cancer; the objective of this study was to evaluate the association of common variants in the ductal-epithelium-associated RING chromosome 1 (DEAR1) gene with breast cancer risk in a sample of Colombian population. METHODS: We carried out a case-control study to investigate associations of variants in DEAR1 with breast cancer in women from Colombia. Single nucleotide polymorphisms (SNPs) rs584298, rs2927970, rs59983645, and rs599167 were genotyped in 1022 breast cancer cases and 1023 healthy controls using the iPLEX® and Kompetitive Allele Specific PCR (polymerase chain reaction) (KASP) method. The associations between SNPs and breast cancer were examined by conditional logistic regression. The associations between SNPs and epidemiological/histopathological variables were examined by multinomial logistic regression. RESULTS: Associations were found between tag SNPs and breast cancer adjusted for the epidemiological risk factors rs584298 genotypes AG and GG (P = .048 and P = .004, respectively). The analysis of the disease characteristics showed that SNP rs584298 (genotype AG) (P = .015) shows association with progesterone receptor (PR) status and (genotype AA) (P = .048) shows association with human epidermal growth factor receptor 2 (HER2) status. CONCLUSIONS: The SNP rs584298 in DEAR1 showed associations with breast cancer and the expression of HER2 receptor; when this receptor is amplified, the result is aggressive tumoral subtype and expression of PR receptor that is associated with high-proliferative tumor grade. Validation of this SNP is important to establish whether this variant or the tagged variant is the cause for the risk association showed.

Antibacterial mechanism of gold nanoparticles on Streptococcus pneumoniae.

Streptococcus pneumoniae is a causal agent of otitis media, pneumonia, meningitis and severe cases of septicemia. This human pathogen infects elderly people and children with a high mortality rate of approximately one million deaths per year worldwide. Antibiotic-resistance of S. pneumoniae strains is an increasingly serious health problem; therefore, new therapies capable of combating pneumococcal infections are indispensable. The application of gold nanoparticles has emerged as an option in the control of bacterial infections; however, the mechanism responsible for bacterial cell lysis remains unclear. Specifically, it has been observed that gold nanoparticles are capable of crossing different structures of the S. pneumoniae cells, reaching the cytosol where inclusion bodies of gold nanoparticles are noticed. In this work, a novel process for the separation of such inclusion bodies that allowed the analysis of the biomolecules such as carbohydrates, lipids and proteins associated with the gold nanoparticles was developed. Then, it was possible to separate and identify proteins associated with the gold nanoparticles, which were suggested as possible candidates that facilitate the interaction and entry of gold nanoparticles into S. pneumoniae cells.

Thermogenic capacity of human periaortic adipose tissue is transformed by body weight.

The anatomical location of adipose tissue might have direct implications for its functionality and risk of cardiovascular disease. Adipose tissue surrounding blood vessels may be thermogenically more active in specific areas of the body, releasing substances that regulate vascular metabolism. In humans, the phenotypic characteristics of adipose tissue surrounding the aorta and the cardiovascular disease risk that it might entail remain largely unknown. Here, we compared thermogenesis-related molecular features of human periaortic adipose tissue samples with those of subcutaneous adipose tissue, obtained by sternotomy from 42 patients undergoing cardiovascular surgery. To determine the expression of genes related to energy expenditure and the levels of some adipokines, histological examinations, quantitative PCR, and protein expression measurements in adipocyte precursor cells were performed. Periaortic adipocytes were smaller than those from subcutaneous tissue. Moreover, weight gain induced periaortic adipocyte hypertrophy (r = -0.91, p<0.01). Compared to subcutaneous tissue, adiponectin, FABP4, IL-4 and IL-6 was decreased in periaortic adipocytes, whereas FGF21, UCP-1, PGC-1a, CITED1, Omentin and TFAM (Mitochondrial protein) increased. Upon analyzing patients' clinical conditions, it emerged that the levels of PGC-1a both in male (r = -0.48 p<0.04) and female (r = -0.61, p<0.05) and TFAM in male (r = -0.72, p<0.0008) and female (r = -0.86, p<0.002) decreased significantly with progressive weight gain. However, no differences were observed in patients with diabetes mellitus 2 or Hyperlipidemia. Adipocytes surrounding the ascending aorta present markers of major thermogenic activity than those in subcutaneous tissue. Nevertheless, this characteristic might change, due to unfavorable metabolic conditions such as obesity, which is a risk factor for cardiovascular disease.

Inclusion bodies and pH lowering: as an effect of gold nanoparticles in Streptococcus pneumoniae.

Streptococcus pneumoniae is a human pathogen whose principal virulence factor is its capsule. This structure allows the bacterium to evade the human immune system. Treatment of infections caused by this bacterium is based on antibiotics; however, the emergence of antibiotic-resistant strains makes this task increasingly difficult. Therefore, it is necessary to investigate new therapies, such as those based on gold nanoparticles, for which unfortunately the mechanisms involved have not yet been investigated. As far as we know, this study is the first that attempts to explain how gold nanoparticles destroy the bacterium Streptococcus pneumoniae. We found that the mean particle size was an important issue, and that the effect on the bacterium was dose-dependent. Cellular growth was inhibited by the presence of the nanoparticles, as was cell viability. The pH of the bacterial growth media was acidified, but interestingly the reactive species were not affected. A transmission electron microscopy analysis revealed the presence of inclusion bodies of gold nanoparticles within the bacterium. We present the first findings that attempt to explain how gold nanoparticles lyse Gram-positive bacteria.

[Comparison of two methodologies used for determining metabolic syndrome in adult population]. / Comparación de dos metodologías utilizadas para la determinación del síndrome metabólico en población adulta.

INTRODUCTION: Metabolic syndrome is characterized by the simultaneous or sequential appearance of various metabolic and inflammatory changes at molecular, cellular or hemodynamic level associated with the presence of insulin resistance and dominant visceral adiposity. Different expert groups, including the International Diabetes Federation and the National Cholesterol Education Program, have tried to develop criteria for its diagnosis. OBJECTIVE: To establish diagnostic criteria concordance levels for metabolic syndrome. MATERIALS AND METHODS: A total of 357 people were part of the study. We performed a descriptive analysis of qualitative variables, and laboratory and anthropometric measurement results to determine the prevalence of metabolic syndrome according to the International Diabetes Federation and National Cholesterol Education Program - ATP III definitions. We used kappa concordance and logistic regression for the comparison of methodologies. RESULTS: The prevalence of metabolic syndrome was 19.9% according to the International Diabetes Federation, and 10.4% using the National Cholesterol Education Program - ATP III. The estimate of agreement between the two diagnostic criteria of the International Diabetes Federation and the National Cholesterol Education Program - ATP III was fair (low) (κ=0.3997, CI 95% 0.28-0.52). CONCLUSIONS: In the working population who participated in this study, the obtained prevalence of metabolic syndrome occurred at a higher rate using the International Diabetes Federation definition, being higher in men than in women. The use of diagnostic criteria for metabolic syndrome must take into account the study population as well as sex and age.

Psicología de la justicia distributiva: antecedentes y tipos de estudios para su comprensión / The psychology of distributive justice: background and types of studies for its understanding / Psicología da justiça distributiva: antecedentes e tipos de estudos para sua compreessão

Debido al incremento del estudio de la justicia como un fenómeno social de interés para la psicología,se hace una revisión que precisa los antecedentes de la psicología social en el estudio de las distribuciones materiales individuales en diversas situaciones, y las limitaciones de los análisis derivados de dichos estudios. Además, se presentan las posibilidades de indagación de las decisiones distributivas en al menos tres tipos de estudios que se reseñan en amplias revisiones y finaliza con la presentación de una reflexión sobre un "contexto" experimental como nueva perspectiva para el estudio de la justicia distributiva. Desde ese contexto, se describe el término "decisiones distributivas", y se propone como alternativa metodológica la consideración de variables habitualmente utilizadas en el análisis de algunos procesos cognitivos de interés para la economía experimental y comportamental.

Due to the increased study of justice as a social phenomenon of interest to psychology, a revision is carried out to specify the social psychology background in the study of individual material distributions in various situations and the constraints derived from such studies. In addition, the possibilities of inquiry into allocation decisions in at least three types of studies summarized in extensive reviews are presented, and finally, there is a reflection about an experimental "context" as a new perspective for the study of distributive justice. From this context, the term "distributive decisions" is described and, as a methodological alternative, the consideration of variables commonly used for the analysis of cognitive processes of interest for experimental and behavioral economics is proposed.

Devido ao aumento do estudo da justiça como um fenômeno social de interesse para a psicologia se faz uma revisão que especifica os antecedentes da psicologia social no estudo das distribuições materiais individuais em diversas situações, e as limitações das análises derivadas desses estudos. Além disso, apresentam-se as possibilidades de indagação das decisões distributivas em pelo menos três tipos de estudos que são resenhados em amplas revisões e finaliza com a apresentação de uma reflexão sobre um "contexto" experimental como nova perspectiva para o estudo da justiça distributiva. Desde esse contexto, descreve-se o termo "decisões distributivas", e propõe-se como alternativa metodológica a consideração de variáveis habitualmente utilizadas na análise de alguns processos cognitivos de interesse para a economia experimental e comportamental.