Positive body image: a qualitative study on the successful experiences of adolescents, teachers and parents.

Purpose Body image encompasses body-related self-perceptions and personal attitudes. Dissatisfaction with body image during the early stages of adolescence is negatively related to self-esteem and other health problems. A few publications focused on positive body image and directly related to the experiences and interactions of adolescents themselves. To explore positive body image in adolescents and describe the familial and educational factors that contribute to its development.Methods A qualitative study was conducted. Purposive sampling was used, and 9 adolescents, 6 families, and 8 teachers participated in semi-structured interviews, which were then theme analyzed. Results Self-care, body acceptance, confronting messages that attack body image, and the influence of social media have been identified as emerging themes in adolescents' positive body image experiences. Therefore, the pubertal period, family values, fostering, and educational actions as well as media literacy were identified as factors promoting self-esteem and positive body image in the family and educational environment. Conclusions Their parents also expressed aspects such as those that contribute to the development of healthy self-esteem, confidence, and positive body image. Alternatively, the teachers indicated educational activities to work on self-image and self-esteem when faced with situations of concern in the classroom.

Pathogen-related factors affecting outcome of catheter-related bacteremia due to methicillin-susceptible Staphylococcus aureus in a Spanish multicenter study.

Even with appropriate clinical management, complicated methicillin-susceptible Staphylococcus aureus (MSSA) catheter-related bacteremia (CRB) is frequent. We investigated the influence of molecular characteristics of MSSA strains on the risk of complicated bacteremia (CB) in MSSA-CRB. A multicenter prospective study was conducted in Spain between 2011 and 2014 on MSSA-CRB. Optimized protocol-guided clinical management was required. CB included endocarditis, septic thrombophlebitis, persistent bacteremia and/or end-organ hematogenous spread. Molecular typing, agr functionality and DNA microarray analysis of virulence factors were performed in all MSSA isolates. Out of 83 MSSA-CRB episodes included, 26 (31.3%) developed CB. MSSA isolates belonged to 16 clonal complexes (CCs), with CC30 (32.5%), CC5 (15.7%) and CC45 (13.3) being the most common. Comparison between MSSA isolates in episodes with or without CB revealed no differences regarding agr type and functionality. However, our results showed that CC15 and the presence of genes like cna, chp and cap8 were associated with the development of CB. The multivariate analysis highlighted that the presence of cna (Hazard ratio 2.9; 95% CI 1.14-7.6) was associated with the development of CB. Our results suggest that particular CCs and specific genes may influence the outcome of MSSA-CRB.

Risk of leaching in soils amended by compost and digestate from municipal solid waste.

New European directives have proposed the direct application of compost and digestate produced from municipal solid wastes as organic matter sources in agricultural soils. Therefore information about phosphorus leaching from these residues when they are applied to the soil is increasingly important. Leaching experiments were conducted to determine the P mobility in compost and digestate mixtures, supplying equivalent amounts to 100 kg P ha(-1) to three different types of soils. The tests were performed in accordance with CEN/TS 14405:2004 analyzing the maximum dissolved reactive P and the kinetic rate in the leachate. P biowaste fractionation indicated that digestate has a higher level of available P than compost has. In contrast, P losses in leaching experiments with soil-compost mixtures were higher than in soil-digestate mixtures. For both wastes, there was no correlation between dissolved reactive P lost and the water soluble P. The interaction between soil and biowaste, the long experimentation time, and the volume of leachate obtained caused the waste's wettability to become an influential parameter in P leaching behavior. The overall conclusion is that kinetic data analysis provides valuable information concerning the sorption mechanism that can be used for predicting the large-scale behavior of soil systems.

Fractionation of phosphorus biowastes: characterisation and environmental risk.

Phosphorus (P) fertilizer is essential for food production and is a limiting factor in crop yields. However, the role of P in the eutrophication of surface water has long been recognised. During recent years, the input of P from agriculture to surface waters has increased and has been the focus for strategies aimed at mitigating diffuse P losses. As not all forms of P have the same availability, it is important to know the main forms of phosphorus in biowastes, and hence to develop fractionation schemes. The standards, measurements, and testing (SMT) procedure for phosphorus fractionation in freshwater sediments, developed within the framework of the Standards, Measurements, and Testing Program of the European Commission, was applied to 15 biowastes used frequently in agriculture, to obtain total P, inorganic and organic P, apatite P, and non-apatite inorganic P. The Hedley method was applied to determine the water-soluble phosphorus (WSP) in all the biowastes. In addition, the aluminium, calcium, and iron concentrations were quantified and related to the WSP. The results confirm the applicability of the SMT protocol to all kinds of waste usually applied in agriculture. The SMT protocol revealed the existence of large amounts of inorganic P and non-apatite inorganic P, the most-available forms of P for all the biowastes. The comparison of the data for total P (SMT protocol) and WSP (Huang protocol) does not show a good linear relationship between these parameters. Instead, the relationship between [aluminium+calcium+iron] and WSP is a better indication of the availability of P.

[Quality of life in homebound elderly people in a district of Alicante (Spain)]. / Estudio de la calidad de vida en las personas mayores confinadas en el domicilio en un barrio de Alicante.

OBJECTIVE: To measure health-related quality of life (HRQoL) in homebound elderly individuals in the District of San Blas (Alicante, Spain). METHOD: The sample was composed of 107 people aged more than 75 years old included in the home care program. As a measurement instrument, the Spanish version of COOP/WONCA charts in their complete version were used. RESULTS: The mean age was 83.18 years. Distribution by sex was 76 (71%) women and 31 (29%) men. The mean overall score was 29.7 points with a standard deviation of 5.04. The association between age and total score was 0.19, which was statistically significant (p = 0.045). Comparison of these two means with Student's t-test for independent samples showed no statistically significant differences (t = -580; p > 0.05). When differences between men and women in each of the items of the scale were analyzed, only "social activities" showed a statistically significant difference (t = -2.959; p = 0.04). The time taken to administer the questionnaire was 30 +/- 5 min. CONCLUSIONS: HRQoL in our population is worse than that in other studied populations. Due to the ceiling-floor effect of some of the variables, further studies in this type of population are required. The time used in this type of population to complete the questionnaire was five times greater than that used in other populations.

Estudio de la calidad de vida en las personas mayores confinadas en el domicilio en un barrio de Alicante / Quality of life in homebound elderly people in a district of Alicante (Spain)

Objetivo. Medir la calidad de vida relacionada con la salud en personas mayores confinadas en el domicilio en el Barrio de San Blas de Alicante. Método. La muestra estuvo compuesta por 107 personas mayores de 75 años incluidas en el programa de atención domiciliaria. Como instrumento de medida se utilizó la versión española de las láminas COOP/WONCA en su versión completa. Resultados. La edad media fue de 83,18 años. La distribución por sexo fue de 76 (71%) mujeres y 31 (29%) varones. La puntuación global media fue de 29,7 con una desviación estándar de 5,04. La asociación entre la edad y la puntuación total fue de 0,19, estadísticamente significativa (p = 0,045). Al comparar estas 2 medias con la prueba t de Student de muestras independientes no resultaron estadísticamente significativas (t = ­580; p > 0,05). En cuanto a la diferencia de varones y mujeres en cada uno de los ítems de la escala tan sólo las "actividades sociales" mostraron diferencia estadísticamente significativa entre varones y mujeres (t = ­2,959; p = 0,04). El tiempo empleado para realizar la encuesta fue de 30 ± 5 min. Conclusiones. La calidad de vida de nuestra población es peor que la de otras poblaciones estudiadas. Debido al efecto suelo-techo de algunas de las variables sería necesario realizar más estudios en este tipo de población. El tiempo empleado en este tipo de población para cumplimentar el cuestionario ha sido 5 veces superior que el empleado en otras poblaciones

Objective. To measure health-related quality of life (HRQoL) in homebound elderly individuals in the District of San Blas (Alicante, Spain). Method. The sample was composed of 107 people aged more than 75 years old included in the home care program. As a measurement instrument, the Spanish version of COOP/WONCA charts in their complete version were used. Results. The mean age was 83.18 years. Distribution by sex was 76 (71%) women and 31 (29%) men. The mean overall score was 29.7 points with a standard deviation of 5.04. The association between age and total score was 0.19, which was statistically significant (p = 0.045). Comparison of these two means with Student's t-test for independent samples showed no statistically significant differences (t = ­580; p > 0.05). When differences between men and women in each of the items of the scale were analyzed, only "social activities" showed a statistically significant difference (t = ­2.959; p = 0.04). The time taken to administer the questionnaire was 30 ± 5 min. Conclusions. HRQoL in our population is worse than that in other studied populations. Due to the ceiling-floor effect of some of the variables, further studies in this type of population are required. The time used in this type of population to complete the questionnaire was five times greater than that used in other populations

Comparison of two analytical methods for the evaluation of the complexed metal in fertilizers and the complexing capacity of complexing agents.

The aim of this research is to develop an analytical methodology for the determination of complexed element in fertilizers and, then, to obtain an adequate criteria for the inclusion of these products in European Regulations on Fertilizers. This paper compares the CEN method EN 13366:2001, based on the retention of the cations into a sulfonated resin, and an AOAC modified method, based on the precipitation of the inorganic forms at pH 9. A limited interlaboratory trial was carried out to demonstrate the applicability of the AOAC modified method and to study the effect of the removal of organic compounds and the addition of a matrix modifier solution before the element quantification. Then, a global interlaboratory trial was developed to evaluate the validation and quality parameters of the method. As a second objective, the AOAC modified method was applied to the determination of the complexing capacity of complexing agents based on lignosulfonates and amino acids. The AOAC modified method was the choice methodology because it is adequate for the determination of complexing capacity of micronutrients in fertilizer.

La tomografía computarizada helicoidal sin contraste en comparación con la ecografía y la radiografía simple de abdomen en el estudio del paciente con dolor lumbar agudo / Comparision of unenhanced helical computed tomography with ultrasoun and abdominal plain radiography in patients with acute flank pain

FUNDAMENTO: El objetivo del presente estudio es evaluar la eficacia diagnóstica de la tomografía computarizada helicoidal no contrastada (TCHNC) en el diagnóstico del dolor lumbar agudo. MÉTODOS: Se trata de un estudio prospectivo en el que se evalúan 82 pacientes adultos que consultaron por dolor lumbar agudo entre enero de 1999 y junio de 2000. Se realizó radiografía simple de abdomen en 78 casos, ecografía abdominal en 73, y TCHNC en 46 pacientes. RESULTADOS: La radiografía simple detectó el 49,1 por ciento de las litiasis existentes. La ecografía mostró una sensibilidad para la localización de la litiasis del 48%, y una especificidad del 96%. La TCHNC mostró una sensibilidad del 100% y especificidad del 84% en el diagnóstico de la litiasis, permitiendo además el diagnóstico de otras patologías en 11 casos. CONCLUSIONES: La TCHNC es una técnica radiológica muy eficaz en el diagnóstico del dolor lumbar agudo. En nuestro centro la consideramos la técnica de elección en la evaluación inicial de los pacientes que consultan por dolor lumbar agudo al permitir, no sólo la localización de la litiasis urinaria cuando se trate de esta etiología, sino que además diagnosticar otras patologías abdominopélvicas (AU)

Evaluation of the application of pig slurry to an experimental crop using agronomic and ecotoxicological approaches.

The agronomic and ecotoxicological effects of the application of pig (Sus scrofa) slurry during a maize (Zea mays L.) crop cycle under conditions of forced irrigation were evaluated. The 0.2-ha experimental area, of typical xerofluvent soil and of known vulnerability to nitrate (NO3-) contamination, was divided into 12 plots and provided with water measurement instruments (TDR-probes, vertical tensiometers, and ceramic candles). Samples of soil, water, soil organisms, and the crop were subjected to analytical, agronomic, and biological test procedures. The following fertilizer treatments were applied to triplicate plots: urea (U;170 kg N ha(-1)), and an optimized (P1; 162 kg N ha(-1)) and triple (P3; 486 kg N ha(-1)) dose of pig slurry. Unfertilized plots (P0) served as controls. Calculation was made of seasonal drainage and leached NO3- and sodium losses during the experimental period. Conductivity, heavy metal concentration, hardness, pH, and redox potential were determined in soil solutions. The ecotoxicological evaluation of the soil solution and matrix was based on ecotoxicity bioassays and the quantification of organic and inorganic compounds [phenols, indols, polychlorinated biphenyls (PCBs)]. The results suggest that the P3 treatment is highly contaminating due to the leaching of nitrates and increased soil salinity. Despite the fact that a Folsomia candida reproduction test indicated chronic ecotoxicological effects on the soil in plots treated with P1 and P3, the absence of organic compounds suggests that these effects may be attributable to contaminants not considered in this study.

[Contrast-free helical computerized tomography compared with ultrasonography and simple abdominal radiography in the study of patients with acute lumbar pain]. / La tomografía computarizada helicoidal sin contraste en comparación con la ecografía y la radiografía simple de abdomen en el estudio del paciente con dolor lumbar agudo.

OBJECTIVE: Evaluation the diagnostic ability of unenhanced helical computed tomography in the evaluation of patients with acute flank pain. PATIENTS AND METHODS: Prospectively evaluation of 82 patients referred for acute flank pain between january 1999 and june 2000. 78 patients were imaged with, 73 abdominal ultrasound and 46 with TCHNC. RESULTS: Plain radiography shows 49.1% of diagnosed lithiasis. Ultrasound was 48% sensitive and 96% specific. TCHNC was 100% sensitive and 84% specific in the diagnosis of lithiasis, allowing in 11 patients a diagnosis unrelated to stone disease. CONCLUSIONS: TCHNC is a valuable radiologic technique for patients presenting with acute flank pain and consider the TCHNC as initial evaluation technique in patients with acute flank pain, allowing not only the localization of the stone as well as the diagnosis of extraurinary pathologies.

Obligatory cessation of smoking by psychiatric inpatients.

OBJECTIVE: Signs and symptoms of nicotine withdrawal and alterations in psychopathology were evaluated among acutely ill psychiatric patients admitted to a hospital with a smoking ban. It was hypothesized that smokers would experience symptoms of withdrawal and that these symptoms would aggravate and confound psychiatric symptoms. METHODS: Sixty acute psychiatric inpatients, 44 of whom were smokers, were assessed on three consecutive days using the Nicotine Withdrawal Checklist (NWC) and the Brief Psychiatric Rating Scale (BPRS). RESULTS: BPRS scores were significantly and positively correlated from day 1 through day 3, as were NWC scores. Mean BPRS scores declined significantly from day 1 to day 3, and mean NWC scores declined significantly from day 1 to day 2. Although smokers reported increased tension over the three days and a greater persistence of anxiety compared with nonsmokers, no statistically significant differences in overall BPRS scores were found between the two groups. In contrast, symptoms of nicotine withdrawal occurred significantly more frequently among smokers and were statistically significantly correlated with scores on the Fagerstrom Tolerance Questionnaire, which assesses the degree of nicotine dependence. Despite subjects' reports of feeling distressed and of experiencing nicotine withdrawal symptoms, abrupt cessation of smoking did not significantly affect either the severity or the improvement of psychopathological symptoms during hospitalization. No specific diagnostic group appeared to be selectively sensitive to nicotine withdrawal symptoms. CONCLUSIONS: No immediate benefits or adverse effects from the smoking ban were detected. No compelling reasons to reverse the smoking ban were observed.

Gender bias in psychiatric texts.

Prior research examining gender bias in textbooks used by medical students demonstrated that male models are used significantly more often than female models, raising concerns about the messages conveyed to trainees about patient care. By using a similar paradigm, this study assessed introductory psychiatric texts for gender bias. Five texts were selected for their use by medical students and based upon the presence of illustrative case vignettes. Frequencies with which vignettes featured male or female subjects were obtained. Two earlier versions of the DSM Casebooks were also reviewed for comparison with the most recent edition, to look for longitudinal trends. Male subjects were featured in case vignettes significantly more often than female subjects in the five texts combined; significantly different gender disparities were obtained in three of the five texts examined. The number of vignettes featuring female subjects exceeded those featuring males in one text. Despite repeated revision, each of the three versions of the DSM Casebooks retained a statistically significant predominance of male subjects. The observed gender discrepancies were not an artifact of use of vignettes illustrating disorders with higher prevalence rates among men. In fact, women were featured as subjects in vignettes illustrating disorders with higher prevalence rates among women. The use of predominantly male subjects was incongruent with trends in psychiatric service utilization by men and women. The potential impact of gender bias on medical trainees is discussed.

Utility of thyroid function screening in adolescent psychiatric inpatients.

OBJECTIVE: Thyroid function abnormalities have been associated with psychiatric symptoms. This study examines the utility of thyroid screening among adolescent psychiatric inpatients. METHOD: A retrospective chart review of 196 first-time admissions to an adolescent psychiatric unit was conducted. Charts were screened for demographics, presence/absence of thyroid function testing, history of thyroid disease, medication/illicit substance use, and other factors of influence on thyroid testing. Thyroid test results were reviewed for abnormalities. RESULTS: Thyroid function testing was conducted in 150 of the 196 admissions. Fifty-two patients had abnormalities, most of which were isolated abnormalities of thyroxine (T4) or triiodothyronine uptake (T3U). Laboratory diagnosis of hyperthyroidism and mild hypothyroidism was met by two and eight patients, respectively; five had profiles that were normal upon subsequent testing 1 week later. None of the patients was symptomatic, and none required thyroid supplementation or antithyroid medications. Gender differences in T4 and T3U were noted, and age was positively correlated with T3U. CONCLUSIONS: Thyroid function tests may be spuriously abnormal in routine screening of newly admitted psychiatric patients. Routine thyroid screening among adolescent psychiatric inpatients is unwarranted except in patients who display physical signs or symptoms suggestive of thyroid disease.

[Human papillomavirus (HPV) infection in sexual partners of women with condylomatous cervical dysplasia]. / Infección por el virus del papiloma humano (VPH) en parejas sexuales de mujeres afectas de displasia cervical condilomatosa.

OBJECTIVES: Human papillomavirus (HPV) genital infection is a sexually transmitted disease that appears to be involved in the pathogenesis of various tumors of the genitourinary system, especially carcinoma of the uterine cervix. Diagnosis and treatment of sexual partners of female carriers is fundamental in preventing reinfection after treatment. METHODS: A prospective study was conducted on 118 male partners of females diagnosed as having HPV infection by cytology and, in some cases, dysplasia or carcinoma in situ of the cervix. RESULTS: Patient mean age was 38.5 years; 40 had a history of other sexually transmitted diseases. Peneoscopy was performed in all cases, 44 were biopsied and 47 had a urethral cytology. The infection rate was 55%. Peneoscopy and biopsy were the best diagnostic methods. CONCLUSIONS: HPV infection in male partners of female carriers can be diagnosed by peneoscopy and biopsy of the suspected lesions. Treatment and complete eradication of the infection are fundamental since HPV has been implicated in the pathogenesis of carcinoma of the cervix and other urogenital tumors.

[Intracranial hemorrhage following thrombolytic therapy in acute myocardial infarct]. / Hemorragia intracraneal tras la terapéutica trombolítica en el infarto agudo de miocardio.

INTRODUCTION: Intracranial hemorrhage in acute myocardial infarction, under thrombolytic therapeutic, ranges from 0.3 to 3% in different trials. We carried out a study to stabilised the incidence of this complication in ours patients, as well as to analyze its characteristics and asses the presence the predictive factors. METHODS: We retrospectively reviewed 997 consecutive patients with acute myocardial infarction treated with thrombolytic agents. We used two different protocols in two consecutive periods of time. Protocols differ in the age of the patients, the thrombolytic agent and its interval of applications. We analyze the intracranial hemorrhage incidence rate in each period, as well as its relations with the age of the patients, the sex and the thrombolytic agent used. We also analyze the possible predictive risk factors: cerebral-vascular disease, hypertension, diabetes, etc. RESULTS: The overall rate of intracranial hemorrhage was 1.6%, higher in the patients of the second period (0.9% vs 1.9%, p = NS). The age over 70 years don't show a significant increase of this incidence (1.7% vs 1.5%). The APSAC group have shown a greater rate of hemorrhage (4%) than streptokinase (0.8%) and rTPA (1.2%). Cerebral-vascular disease and hypertension background were the two factors more frequently related to hemorrhage. The mortality rate was 68.7%. CONCLUSION: The intracranial hemorrhage is a severe complication of thrombolytic therapy with a relative low incidence, but in our experience, higher than described in multicenter studies. There are several factors related that we would to take into account when is applied this therapy.

[Comparative study of protected alveolar lavage versus occluded telescopic catheter in patients with suspected pneumonia and under mechanic ventilation]. / Estudio comparativo del lavado alveolar protegido frente al catéter telescópico ocluido en pacientes con sospecha de neumonía y en ventilación mecánica.

BACKGROUND: The pneumonias associated to mechanical ventilation present great difficulty in diagnosis and have a high mortality. The invasive diagnostic technique of choice in these patients is bronchial curettage by a double telescopic catheter with distal occlusion (OTC) based on its good sensitivity/specificity relation. Recently, the use of a variant of the classical bronchoalveolar lavage (BRL), bronchoalveolar lavage or protected alveolar lavage (PAL) has appeared in the diagnosis of conventional bacterial pneumonia. This new technique provides good specificity of OTC by its use with "protected" catheters and a high sensitivity due to exploration of a greater area of the lung. METHODS: Twenty patients receiving mechanical ventilation (MV) suspected of pneumonia in whom 21 fibrobronchoscopies (FB) were performed with OTC and PAL were studied with quantification of the cultures obtained being carried out. The OTC was performed according to the usual technique and PAL by the instillation of 40 ml of saline serum administered through a Combicath type catheter. RESULTS: OTC and PAL provided diagnostic results which coincided in 8 cases: the same germs were isolated at significant concentrations in six patients and in the two remaining cases direct immunofluorescence for Legionella was positive. PAL was diagnosed in 4 more cases with the diagnosis of viral inclusion bodies being possible in one upon cytologic examination. The count of cells with intracellular bacteria (ICB) was greater than 7% and was always related with positivity in the PAL. CONCLUSIONS: A greater sensitivity was observed with the protected alveolar lavage technique. Moreover, this technique makes virologic investigation and the counting of cells with intracellular bacteria, which may be a marker of rapid diagnosis of bacterial pneumonia, possible.

[Sepsis at an internal medicine department]. / Sepsis en un departamento de medicina interna.

185 cases of bacteremia admitted at the internal medicine department of "C.S. Virgen de la Arrixaga" in Murcia from 1977 to 1986, were studied retrospectively. The common infection was significantly associated to Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus A group and Neisseria meningitidis and the nosocomial infection was associated to Klebsiella Pneumoniae, Serratia Marcescens y Pseudomonas aeruginosa, Staphylococcus epidermidis and Enterobacter. We did not find significant differences between the common and nosocomial infection caused by E. Coli and Proteus mirabilis. These factors were associated to an increase of mortality: age greater than 40 years, nosocomial infection, Pseudomonas aeruginosa, other associated rapidly lethal diseases, acute clinical state at the beginning of bacteremia, shock and non-correct antibiotic therapy.

[Etiologic and diagnostic aspects of Peyronie's disease. Apropos of 42 cases]. / Aspects étiologiques et diagnostiques de la maladie de La Peyronie. A propos de 42 cas.

The authors present the results from a retrospective study conducted on 42 patients with Peyronie's disease. For each case, all possible etiological factors were investigated, such as family history, history of trauma, history of other collagenoses, of diabetes, and so on. These studies yielded results comparable to published data. Calcifications within the plaques were found on simple X-ray films in 10.8% of cases. Out of 20 radiological examinations of the corpora cavernosa that were performed, 80% demonstrated pathological processes. It was possible, in some of the cases, to measure echographically the plaque widths, while autophotography was useful in a small number of cases. We were more particularly concerned with sexual dysfunction, impotence, and premature ejaculation, which could be observed in 14 patients.