Variables with a negative impact on the quality of life of gays and lesbians in Spain: evaluation of homophobic and lesbophobic indicators to guide youth education.

Background: Despite the evidence about the negative impact of homophobic and lesbophobic attitudes on the quality of life of these individuals, the World Health Organisation (WHO) continues to report a lack of research and understanding regarding the health of gays and lesbians and LGTB people in general. There is a growing commitment in public health to understand and improve the health and well-being of LGTB people, and it is very important that professionals in social, educational and health care settings are adequately trained and informed to solve the problems that persist in this population. The aim of this study was to identify homophobic and lesbophobic attitudes in a Spanish youth population, analyzing the relationship of these attitudes with sociodemographic, cultural, political and personal variables. Methods: A descriptive, cross-sectional study was carried out with 325 young people aged 18-30 years. The information was collected through the Modern Homophobia Scale of Raja & Stokes, in which sociodemographic and sociocultural variables were also gathered. The data were analyzed and correlations were estimated. Results: The males showed a more negative attitude toward homosexual people compared to the females. The participants with a higher education level presented more positive attitudes toward homosexual people. Younger people with a heterosexual orientation had more negative attitudes toward homosexual people compared to those with a homosexual orientation. The participants with a stronger right-wing political tendency presented a greater percentage of negative attitudes toward LGTB people. Conclusion: Variables such as education level, sexual orientation and political ideology may have a significant influence on the attitudes toward homosexual men and/or lesbian women. Different results were obtained as a function of sex, thus it is important to consider the gender perspective in future studies that tackle this topic.

External Validation of SAFE Score to Predict Atrial Fibrillation Diagnosis after Ischemic Stroke: A Retrospective Multicenter Study.

Introduction: The screening for atrial fibrillation (AF) scale (SAFE score) was recently developed to provide a prediction of the diagnosis of AF after an ischemic stroke. It includes 7 items: age ≥ 65 years, bronchopathy, thyroid disease, cortical location of stroke, intracranial large vessel occlusion, NT-ProBNP ≥250 pg/mL, and left atrial enlargement. In the internal validation, a good performance was obtained, with an AUC = 0.88 (95% CI 0.84-0.91) and sensitivity and specificity of 83% and 80%, respectively, for scores ≥ 5. The aim of this study is the external validation of the SAFE score in a multicenter cohort. Methods: A retrospective multicenter study, including consecutive patients with ischemic stroke or transient ischemic attack between 2020 and 2022 with at least 24 hours of cardiac monitoring. Patients with previous AF or AF diagnosed on admission ECG were excluded. Results: Overall, 395 patients were recruited for analysis. The SAFE score obtained an AUC = 0.822 (95% CI 0.778-0.866) with a sensitivity of 87.2%, a specificity of 65.4%, a positive predictive value of 44.1%, and a negative predictive value of 94.3% for a SAFE score ≥ 5, with no significant gender differences. Calibration analysis in the external cohort showed an absence of significant differences between the observed values and those predicted by the model (Hosmer-Lemeshow's test 0.089). Conclusions: The SAFE score showed adequate discriminative ability and calibration, so its external validation is justified. Further validations in other external cohorts or specific subpopulations of stroke patients might be required.

Upregulation of Heat-Shock Protein (hsp)-27 in a Patient with Heterozygous SPG11 c.1951C>T and SYNJ1 c.2614G>T Mutations Causing Clinical Spastic Paraplegia.

We report a 49-year-old patient suffering from spastic paraplegia with a novel heterozygous mutation and analyzed the levels of heat shock proteins (hsp)-27, dopamine (DA), and its metabolites in their cerebrospinal fluid (CSF). The hsp27 protein concentration in the patient's CSF was assayed by an ELISA kit, while DA levels and its metabolites in the CSF, 3,4-dihydroxyphenylacetic acid (DOPAC), Cys-DA, and Cys-DOPA were measured by HPLC. Whole exome sequencing demonstrated SPG-11 c.1951C>T and novel SYNJ1 c.2614G>T mutations, both heterozygous recessive. The patient's DA and DOPAC levels in their CSF were significantly decreased (53.0 ± 6.92 and 473.3 ± 72.19, p < 0.05, respectively) while no differences were found in their Cys-DA. Nonetheless, Cys-DA/DOPAC ratio (0.213 ± 0.024, p < 0.05) and hsp27 levels (1073.0 ± 136.4, p < 0.05) were significantly higher. To the best of our knowledge, the c.2614G>T SYNJ1 mutation has not been previously reported. Our patient does not produce fully functional spatacsin and synaptojanin-1 proteins. In this line, our results showed decreased DA and DOPAC levels in the patient's CSF, indicating loss of DAergic neurons. Many factors have been described as being responsible for the increased cys-DA/DOPAC ratio, such as MAO inhibition and decreased antioxidant activity in DAergic neurons which would increase catecholquinones and consequently cysteinyl-catechols. In conclusion, haploinsufficiency of spatacsin and synaptojanin-1 proteins might be the underlying cause of neurodegeneration produced by protein trafficking defects, DA vesicle trafficking/recycling processes, autophagy dysfunction, and cell death leading to hsp27 upregulation as a cellular mechanism of protection and/or to balance impaired protein trafficking.

Domestic Dogs as Sentinels for West Nile Virus but not Aedes-borne Flaviviruses, Mexico.

We tested 294 domestic pet dogs in Mexico for neutralizing antibodies for mosquito-borne flaviviruses. We found high (42.6%) exposure to West Nile virus in Reynosa (northern Mexico) and low (1.2%) exposure in Tuxtla Gutierrez (southern Mexico) but very limited exposure to Aedes-borne flaviviruses. Domestic dogs may be useful sentinels for West Nile virus.

Vertebrate-Aedes aegypti and Culex quinquefasciatus (Diptera)-arbovirus transmission networks: Non-human feeding revealed by meta-barcoding and next-generation sequencing.

BACKGROUND: Aedes aegypti mosquito-borne viruses including Zika (ZIKV), dengue (DENV), yellow fever (YFV), and chikungunya (CHIKV) have emerged and re-emerged globally, resulting in an elevated burden of human disease. Aedes aegypti is found worldwide in tropical, sub-tropical, and temperate areas. The characterization of mosquito blood meals is essential to understand the transmission dynamics of mosquito-vectored pathogens. METHODOLOGY/PRINCIPAL FINDINGS: Here, we report Ae. aegypti and Culex quinquefasciatus host feeding patterns and arbovirus transmission in Northern Mexico using a metabarcoding-like approach with next-generation deep sequencing technology. A total of 145 Ae. aegypti yielded a blood meal analysis result with 107 (73.8%) for a single vertebrate species and 38 (26.2%) for two or more. Among the single host blood meals for Ae. aegypti, 28.0% were from humans, 54.2% from dogs, 16.8% from cats, and 1.0% from tortoises. Among those with more than one species present, 65.9% were from humans and dogs. For Cx. quinquefasciatus, 388 individuals yielded information with 326 (84%) being from a single host and 63 (16.2%) being from two or more hosts. Of the single species blood meals, 77.9% were from dogs, 6.1% from chickens, 3.1% from house sparrows, 2.4% from humans, while the remaining 10.5% derived from other 12 host species. Among those which had fed on more than one species, 11% were from dogs and humans, and 89% of other host species combinations. Forage ratio analysis revealed dog as the most over-utilized host by Ae. aegypti (= 4.3) and Cx. quinquefasciatus (= 5.6) and the human blood index at 39% and 4%, respectively. A total of 2,941 host-seeking female Ae. aegypti and 3,536 Cx. quinquefasciatus mosquitoes were collected in the surveyed area. Of these, 118 Ae. aegypti pools and 37 Cx. quinquefasciatus pools were screened for seven arboviruses (ZIKV, DENV 1-4, CHIKV, and West Nile virus (WNV)) using qRT-PCR and none were positive (point prevalence = 0%). The 95%-exact upper limit confidence interval was 0.07% and 0.17% for Ae. aegypti and Cx. quinquefasciatus, respectively. CONCLUSIONS/SIGNIFICANCE: The low human blood feeding rate in Ae. aegypti, high rate of feeding on mammals by Cx. quinquefasciatus, and the potential risk to transmission dynamics of arboviruses in highly urbanized areas of Northern Mexico is discussed.

Tratamiento y evolución del síndrome de tormenta de citoquinas asociados a infección por SARS-CoV-2 en pacientes octogenarios / Evolution and treatment of storm cytoquine syndrome associated to SARS-CoV-2 infection among octogenarians

INTRODUCCIÓN: El síndrome de tormenta de citoquinas (STC) es una complicación muy grave de los pacientes con infección por SARS-CoV-2. El tratamiento y la evolución no están bien definidos. Nuestro objetivo es describir sus características clínicas, los tratamientos empleados y su evolución clínica. PACIENTES Y MÉTODO: Estudio retrospectivo observacional de pacientes consecutivos ingresados en el período comprendido entre el 23 de marzo y el 12 de abril de 2020 con infección por SARS-CoV-2 confirmada, con neumonía por estudio radiológico o tomografía de tórax, que cumplían criterios de STC y que recibieron tratamiento. Clasificamos a los pacientes en los que recibieron solo pulsos de glucocorticoides (GC), o pulsos de GC y tocilizumab. Determinamos niveles séricos de ferritina, PCR y dímeros-D. La variable final fue la supervivencia. RESULTADOS: Veintiún pacientes con una edad de 83 años (80-88 años). La ferritina media fue de 1.056 microg/L (317-3.553), la PCR de 115,8mg/dL (22-306) y los dímeros-D de 2,9mg/L (0,45-17,5). Todos los pacientes recibieron pulsos de GC y en 2 casos simultáneamente tocilizumab. El tiempo medio de seguimiento fue de 13,7 días (8-21). La mortalidad global fue del 38,1% (8/21pacientes). Los 2 pacientes que recibieron tocilizumab fallecieron. Los fallecidos presentaron niveles significativamente más elevados de ferritina (1.254 vs. 925microg/L; p = 0,045) y PCR (197,6 vs. 76mg/dL; p = 0,007). Al final del seguimiento se observó una disminución en los parámetros bioquímicos con ferritina de 727microg/L, PCR de 27mg/dl y dímeros-D de 1,18mg/L. En 13/21 pacientes (61,9%) el STC se controló sin necesidad de añadir otros tratamientos. CONCLUSIONES: La mortalidad del STC por SARS-CoV-2 es alta a pesar del tratamiento. Una mayor respuesta inflamatoria se asoció con una mayor mortalidad. Aunque parece que el uso precoz de pulsos de GC puede controlarlo, pudiendo disminuir la necesidad de uso de otros tratamientos, con el diseño del estudio y sus limitaciones, no se puede establecer esta conclusión

INTRODUCTION: Cytokine storm syndrome (CTS) is a serious complication of patients with SARS-CoV-2 infection. Treatment and evolution in octogenarians are not well defiREVned. Our objective is to describe its clinical characteristics, the treatments and its clinical evolution. PATIENTS AND METHOD: Retrospective observational study of consecutive patients admitted in the period between March 23 and April 12, 2020 with confirmed SARS-CoV-2 infection, with pneumonia by radiological study or chest tomography, whith STC criteria and who received treatment. We classified patients as those who received only glucocorticoid (GC) pulses, or GC and tocilizumab pulses. We determined serum levels of ferritin, CRP and D-dimers. The final variable was survival. RESULTS: 21 patients, (80-88 years). The mean ferritin was 1056 microg/L (317-3,553), CRP 115.8mg/dL (22-306) and D-dimers 2.9m/L (0.45-17.5). All patients received GC pulses and in 2 cases simultaneously tocilizumab. The mean follow-up time was 13.7 days (8-21). The overall mortality was 38.1% (8/21 patients). The 2 patients who received tocilizumab died. The deceased had significantly higher levels of ferritin (1,254 vs. 925microg/L; P=.045) and CRP (197.6 vs. 76mg / dL; P=.007). At the end of the follow-up, a decrease in the biochemical parameters was observed with ferritin of 727microg/L, CRP of 27mg/dl and D-dimers of 1.18mg/L. In 13/21 patients (61.9%), the CTS was controlled without the need to add other treatments. CONCLUSIONS: STC mortality from SARS-CoV-2 is high despite treatment. A greater inflammatory response was associated with a higher mortality. Although it seems that the early use of GC pulses could control it, and the use of other treatments such as tocilizumab shouldo be, with the study design and its limitations, this conclusion cannot be stablished

[Evolution and treatment of storm cytoquine syndrome associated to SARS-CoV-2 infection among octogenarians]. / Tratamiento y evolución del síndrome de tormenta de citoquinas asociados a infección por SARS-CoV-2 en pacientes octogenarios.

INTRODUCTION: Cytokine storm syndrome (CTS) is a serious complication of patients with SARS-CoV-2 infection. Treatment and evolution in octogenarians are not well defined. Our objective is to describe its clinical characteristics, the treatments and its clinical evolution. PATIENTS AND METHOD: Retrospective observational study of consecutive patients admitted in the period between March 23 and April 12, 2020 with confirmed SARS-CoV-2 infection, with pneumonia by radiological study or chest tomography, whith STC criteria and who received treatment. We classified patients as those who received only glucocorticoid (GC) pulses, or GC and tocilizumab pulses. We determined serum levels of ferritin, CRP and D-dimers. The final variable was survival. RESULTS: 21 patients, (80-88 years). The mean ferritin was 1056 microg/L (317-3,553), CRP 115.8mg/dL (22-306) and D-dimers 2.9m/L (0.45-17.5). All patients received GC pulses and in 2 cases simultaneously tocilizumab. The mean follow-up time was 13.7 days (8-21). The overall mortality was 38.1% (8/21 patients). The 2 patients who received tocilizumab died. The deceased had significantly higher levels of ferritin (1,254 vs. 925microg/L; P=.045) and CRP (197.6 vs. 76mg / dL; P=.007). At the end of the follow-up, a decrease in the biochemical parameters was observed with ferritin of 727microg/L, CRP of 27mg/dl and D-dimers of 1.18mg/L. In 13/21 patients (61.9%), the CTS was controlled without the need to add other treatments. CONCLUSIONS: STC mortality from SARS-CoV-2 is high despite treatment. A greater inflammatory response was associated with a higher mortality. Although it seems that the early use of GC pulses could control it, and the use of other treatments such as tocilizumab shouldo be, with the study design and its limitations, this conclusion cannot be stablished.

How COVID-19 has Been Transforming the Notion of Care

The year 2020 surprised us with COVID-19, which expanded throughout Asia and Europe and became a pandemic, reaching Latin America and our cities and everything seemed to change, including the most intimate and private relationships of social life in general, with repercussions in the human condition that lead to thinking about its setbacks. For the population not expert in epidemiology, it results quite difficult to understand what is happening and know what to do and how to assimilate discourses that break into the private sphere and ­ at the same time ­ amalgamate with social, environmental, economic, political, and other problems that even lead epidemiologists themselves to new reflections they thought already overcome. But also, within this context positive issues are unveiled, like solidarity, reflecting on consumerism, and caring for nature.

Healthcare students' personality traits and competence-based learning methodologies.

The European Higher Education Area was implemented more than a decade ago with the aim of improving internationally the competitiveness of European university education putting the spotlight on skills and competence development (and not only on knowledge acquisition). This work intends to analyze the impact of competence-based teaching methodologies on university students, as well as to contribute to the study of the individual personality traits differences regarding this impact. For this, a descriptive, quantitative, cross-sectional study was conducted with a non-randomised sample of university students. The sample was composed of a total of 499 students of the University of Huelva (350 from the Health Sciences degree, and 149 form other degrees), who completed a questionnaire on professional skills and teaching methods developed ad hoc for this research, as well as the brief version of the Spanish adaptation of the NEO Five-Factor Inventory. The results show that Health Sciences students feel more satisfied with the most participative and active methodologies, and they consider these better contribute to their future professional competence development. On the other hand, in relation to the big 5 personality traits studied, links have been found between competence development perception and personal preferences and the dimensions of extraversion, agreeableness, conscientiousness and openness to experience. This last factor, openness to experience, appears when analyzing the main differences among both groups, being Health Sciences students more intellectually curious, showing more openness and diversity of interests, in addition to being more creative, innovative, and flexible.

Sobrecarga, empatía y resiliencia en cuidadores de personas dependientes / Burden, empathy, and resilience in dependent people caregivers

Objetivo: Analizar las diferencias en la sobrecarga percibida entre personas cuidadoras de familiares dependientes que son usuarias de asociaciones y que no lo son, así como evaluar la relación entre sobrecarga, capacidad de resiliencia y nivel de empatía. Método: Estudio ex post facto retrospectivo de dos grupos, uno de ellos casi control. Conformaron la muestra 155 personas que prestan cuidados informales (28 hombres y 127 mujeres); 109 eran usuarios/as de asociaciones de familiares de personas enfermas y 46 no usuarios/as. Se llevaron a cabo análisis tanto descriptivos como comparativos bivariados. Resultados: Las personas cuidadoras integradas en asociaciones muestran una menor sobrecarga y nivel de empatía, poniéndose de manifiesto que, a mayor nivel de sobrecarga percibida, menor es la capacidad de resiliencia. Conclusiones: La pertenencia a asociaciones de personas dependientes supone, para las personas cuidadoras, un menor nivel de sobrecarga percibida y un menor riesgo de desarrollo de síndrome de desgaste por empatía

Objective: To analyse the differences in perceived burden between family caregivers who are users of patient associations and those who are not; to assess the relationship between burden, resilience, and empathy levels. Method: Retrospective ex post facto study of two groups, one of them quasi control. The sample was composed of 155 informal caregivers (28 men and 155 women); 109 of them were users of patient relatives' associations and 46 were not. Both descriptive and bivariate comparative analyses were carried out. Results: Caregivers who were members of patient associations showed lower burden and empathy levels than those who were not. This highlighted that the higher their level of perceived burden, the lower their level of resilience. Conclusions: Belonging to carers' associations results in a lower level of perceived burden and a lower risk of developing compassion fatigue syndrome

Grieving for Job Loss and Its Relation to the Employability of Older Jobseekers.

Introduction: Loss of employment is an experience that is lived and interpreted differently depending on a series of individual variables, including the psychological resources available to the affected person as well as their perception of their degree of employability. Losing one's job can be one of the most painful and traumatic events a person has to withstand. Following a dismissal, the worker needs to overcome a period of emotional adaptation to the loss. But that period of grieving can also condition the job searching process of the individual and can be influenced by different variables, highlighting the age and work experience. The objective of this study is to analyse the relationship between intensity and type of affliction due to the loss of employment in older workers and their level of employability. Methods: We carried out a descriptive and analytical cross-sectional study. The sample consisted of 140 unemployed participants, from 19 to 65 years of age-users of Job Orientation in the Public Employment Service of Andalusia (Spain). Of the total participants, 66 were unemployed and over 45 years of age. They all took the Labour Insertion Potential Assessment Test and the Texas Revised Inventory of Grief, adapted for job loss. Results: Significant differences are shown in the grieving process due to loss of employment between both groups, with the older unemployed living the process more intensely. In relation to the employability potential, differences are found between both groups in terms of availability, perceived difficulties and fears. Interrelationships between total grieving intensity and the importance that older jobseekers give to work are also indicated. Conclusion: Loss of employment and the psychological and health consequences of this situation are identified with those that arise in the grieving process. Older workers present a series of features that determine that their job loss grieving process is more intense and lasts longer than that of other younger workers, regardless of whether the job loss was recent or not. On the other hand, it is shown that the intensity of grieving for job loss is related to the decrease of certain variables that are part of the concept of employability.

Engagement, Passion and Meaning of Work as Modulating Variables in Nursing: A Theoretical Analysis.

Nurses are continuously exposed to stressors and psychological and physical risks that can negatively influence their daily work. These adverse psychosocial circumstances, accompanied by the poor self-perception of health, well-being, and quality of life, may trigger burnout. The positive psychology approach pursues a growth of passion at work, increased job satisfaction, and occupational health, both mental and physical, for the optimal performance of the nursing role. In this way, a theoretical analysis was conducted to describe the basic constructs of positive psychology, elements such as engagement, passion at work, centrality, and meaning of work, which could act as protective factors in the nursing profession. The results show that if health professionals are not physically involved, cognitively alert, and emotionally connected, they may not offer the quality care patients require. Positive psychology helps nurses in facing their complex reality and relevant daily activities in order to provide quality care. These efforts towards a humanist nursing care in which professionals are able to care for the others as well as themselves should be made.

[Burden, empathy, and resilience in dependent people caregivers]. / Sobrecarga, empatía y resiliencia en cuidadores de personas dependientes.

OBJECTIVE: To analyse the differences in perceived burden between family caregivers who are users of patient associations and those who are not; to assess the relationship between burden, resilience, and empathy levels. METHOD: Retrospective ex post facto study of two groups, one of them quasi control. The sample was composed of 155 informal caregivers (28 men and 155 women); 109 of them were users of patient relatives' associations and 46 were not. Both descriptive and bivariate comparative analyses were carried out. RESULTS: Caregivers who were members of patient associations showed lower burden and empathy levels than those who were not. This highlighted that the higher their level of perceived burden, the lower their level of resilience. CONCLUSIONS: Belonging to carers' associations results in a lower level of perceived burden and a lower risk of developing compassion fatigue syndrome.

Risk factors for mental workload: influence of the working environment, cardiovascular health and lifestyle. A cross-sectional study.

OBJECTIVES: Mental workload is a condition which can negatively influence the overall health of workers. In this study, we aimed to investigate the risk factors for the onset of mental workload, including working conditions, cardiovascular comorbidities and lifestyle habits, in a working population. METHODS: This is a cross-sectional study including 408 workers from a risk prevention service of small/medium companies in Murcia (Spain). Workers from the secondary and tertiary sectors or primary/secondary sectors with administrative management tasks who underwent a routine medical examination between 1 January 2017 and 31 April 2017 were included. Workers from the primary sector and construction were excluded to avoid a sex and age bias. RESULTS: From 408 workers, 206 (50.5%) were females; with mean age 36.8±10.4 years. 164 (40.2%) workers had a moderate to significant risk of mental workload. Based on multivariate logistic regression analyses, independent predictors of mental workload were age ≥30 years (OR 2.42, 95% CI 1.22 to 4.80; p=0.012), working in tertiary (OR 7.89, 95% CI 3.59 to 17.31; p<0.001) or administrative sectors (OR 87.57, 95% CI 35.22 to 217.79; p<0.001) and alcohol consumption (OR 2.08, 95% CI 1.16 to 3.73; p=0.014). Smoking habit (OR 0.47, 95% CI 0.26 to 0.85; p=0.012) was found as a protective variable so non-smoking was considered as a risk factor. CONCLUSION: In the present study from a risk prevention service including workers of small/medium companies from the secondary and tertiary sectors and workers with administrative tasks, the labour sector, age, alcohol consumption and smoking habits, are independently associated with a higher risk of developing moderate to significant mental workload.

What Does Work Signify for Those in Search of Labor? Meaning of Work for the Unemployed Who Attend an Employee Orientation Program.

Introduction: Work is one of the most important areas in people's lives. This is highly related to the meaning of work people possess and the social culture that surrounds them. However, unemployment stands out as a major social phenomenon of the 21st century of concern for governments, institutions, and professionals, generating the need to reflect, among other issues, on the processes that favor and keep the person in the situation of unemployment, and to think about the real effects of the measures aimed at supporting and guiding the unemployed. The objective of this work is to analyze the existing differences in relation to societal norms, values, and work centrality in unemployed people who attended employment guidance with respect to another group of unemployed people who didn't received this guidance. Method: A descriptive, analytical, cross-sectional study was conducted. The sample consisted on a total of 227 users of the Employment Guidance Service Center of the province of Huelva, who were divided into two groups. A first group of 112 users who make use of the employment guidance programs of the Andalusian Public Employment Services, and a second group, or control group, made up of 115 unemployed people who do not make use of these services. The MOW International Research Team questionnaire has been used for the assessment of the participants. Results: In relation to societal norms, people who do not place their trust in employment guidance conceptualize work as a right and not as a duty; in terms of work values, those with lower levels of training value professional status and prestige with higher scores, whereas people with a higher level of training value the satisfactory nature of work. Regarding centrality, high-level results are obtained throughout the sample, and it ranks second only to family when assessing relative centrality. Conclusion: It can be seen how some variables will determine a greater or lesser level of motivation toward the search for employment. This work should lead to a reflection on the need to generate employment insertion programs that are more adapted to the idiosyncratic characteristics of individuals and groups.