Seasonality of month of birth in patients with autoimmune endocrine diseases: A systematic review.

BACKGROUND: Exposure to seasonal environmental factors during gestation or early in the postnatal period could influence the development of autoimmunity, determining a seasonality in the month of birth (MOB). There are studies evaluating this potential seasonality in patients with type 1 diabetes (T1D), autoimmune thyroid diseases (AITD), and Addison's disease (ADD), but results have been controversial. METHODS: Systematic review according to PRISMA guidelines, using PubMed, Web of Science and WorldCat databases (2005-2020) of studies that explored the association between the seasonality of the MOB and T1D, AITD and ADD. Information on sex and age, location, methodology and internal quality, seasonal patterns, hypotheses and other factors proposed to explain seasonality were extracted. Differences in season and month of birth were further discussed. RESULTS: The initial search retrieved 300 articles, and after further screening, 11 articles fulfilled inclusion criteria and were finally selected and reviewed. 73% found a seasonal pattern and 64% showed birth peaks in spring and/or summer. Hashimoto's thyroiditis and women exhibited a higher seasonality. Ultraviolet radiation, Vitamin D levels and viral infections were identified as influencing factors. CONCLUSIONS: The effect of certain seasonal factors during foetal development, reflected by the seasonal differences in the MOB, could contribute to the development of endocrine autoimmune diseases in predisposed patients. Further research is needed to elucidate the mechanisms underlying the observed seasonality.

Continuity of Nursing Care in Patients with Coronary Artery Disease: A Systematic Review.

Coronary artery disease is the leading cause of death worldwide and patient continuity of care is essential. Health professionals can help in the transition stage by providing resources to achieve pharmacological treatment adherence, as well as social and emotional support. The objective was to analyse the effects of nursing interventions based on continuity of care in patients with coronary artery disease after hospital discharge. A systematic review of randomised controlled trials and quasi-experimental studies was carried out. Cochrane, CINAHL, Health & medical collection, Medline, and Scopus databases were consulted in January 2022. PRISMA guidelines were followed with no time limits. In total, 16 articles were included with a total of 2950 patients. Nurse-led continuity of care programs improved the monitoring and control of the disease. Positive effects were found in the quality of life of patients, and in mental health, self-efficacy, and self-care capacity dimensions. Clinical parameters such as blood pressure and lipid levels decreased. The continuity of care provided by nurses had a positive influence on the quality of life of patients with coronary artery disease. Nurse-led care focused on the needs and resources, including continuity of care, plays a key role.

Dissection as a modulator of emotional attitudes and reactions of future health professionals.

CONTEXT: There is ongoing discussion within the medical education community about dissection as an educational strategy and as a professional training tool in technical and emotional skills training. OBJECTIVES: This study aimed to discover the emotional reactions, attitudes and beliefs of new students faced with human cadaver dissection; to evaluate the changes produced in these variables by the exhibition and practice of dissection; to analyse the level of anxiety students feel when faced with death, and to elucidate the possible relationships between these items. METHODS: The study used a sample of 425 students who were first-time enrolees in a human anatomy course. Three new instruments were designed, with items covering emotional reactions (cognitive, physiological and motor reactions), beliefs and attitudes related to what the student expects to experience or has experienced in dissection. Death anxiety was measured using the Death Anxiety Inventory. RESULTS: As students gained more experience of dissection, their emotional reactions were reduced and their attitudes and beliefs changed. Statistically significant differences in the level of death anxiety emerged, depending on the perceptions students had of their degree of preparation for dissection, and emotional control and deeper thoughts about life and death during dissection. DISCUSSION: The practice of anatomy allows the student to learn how to face up to and adapt his or her emotional reactions and attitudes; this gives human cadaver dissection great importance as an educational strategy and as a professional training tool in technical and emotional skills training.

Dissection from the Spanish anatomist's perspective: aims, attitudes, and related aspects.

We present the results of a study conducted on participants of the 21st Congress of the Spanish Society of Anatomy, in which anatomists were asked their opinions about a range of issues related to anatomical dissection: its relative roles as the exclusive source of anatomy teaching, as a source for medical research, or to assist the future professional to acquire emotional control; the attitudes and behaviors they expect the student to have in the dissecting room; whether the student-cadaver relationship can convey knowledge and attitudes affecting the future doctor-patient relationship; and the anatomists' attitudes toward donation. Anatomists considered dissection to be mainly an instrument for professional training and to help develop professional skills. They gave little importance to the role it could play in helping students to control their emotions. However, this aspect was considered to be more important by anatomists who also valued a close doctor-patient relationship. On the other hand, a majority of anatomists felt that the student's attitude and behavior during dissection could be to some extent reflected in future relationships with patients. However, they did not feel that dissection-related attitudes would distinguish between future good or bad doctors. Finally, anatomy teachers are generally in favor of donation (86.5%), especially of organs alone (52.7%), and this aspect was not affected by their religious beliefs.

Anxiety and dissection of the human cadaver: an unsolvable relationship?

Anxiety is an emotional reaction frequently shown by students when a human cadaver is being dissected. Nonetheless, few studies analyze the nature of the anxiety response in this situation and the ones that do exist are mainly limited to English-speaking countries. Our research has three aims: to study the characteristic anxiety reaction to dissection practices, to determine the weight exerted by internal and environmental variables on this anxiety reaction, and to design practices aimed at reducing the state of anxiety experienced by pupils in their human anatomy practices. The studies were carried out in the dissection room of the Department of Human Anatomy and Embryology II at the Faculty of Medicine of the Complutense University, Madrid, during the 3 academic years 2000-2003. The anxiety response to the first dissection of a human cadaver is mainly determined by a situation considered to be threatening, with novelty as its main characteristic. The students' anxiety response is first determined by the situation itself and reactions depend on individual differences. Repeated or gradual exposure (detailed verbal information on the situation, visits to dissecting rooms when no cadaver is present, videos showing pictures of human dissections, etc.) before carrying out the first dissection reduce the students' anxiety response.