The emotion of gratitude as a mediator between subjective happiness, positive and negative affect and satisfaction with life in Spanish adults / La emoción de gratitud como mediadora entre la felicidad subjetiva, el afecto positivo y negativo y la satisfacción con la vida en adultos españoles

El presente estudio investigó si la satisfacción con la vida se predice a partir de la felicidad subjetiva, afectos positivos y negativos, alteración psicológica y emociones de gratitud y si la emoción de gratitud está mediando la relación con la felicidad subjetiva, los afectos y la satisfacción con la vida. Se hicieron correlación de Pearson, pruebas de regresión lineal múltiple y modelos de mediación en una muestra de 1537 adultos españoles, 73.6% mujeres y 26.4% hombres, edad 18-88 años (M = 42.56 años; DT = 16.29). Se halló que las emociones de gratitud median la relación entre felicidad subjetiva y satisfacción con la vida y entre los afectos positivos y la satisfacción con la vida. Los afectos positivos son los que más se relacionan con la satisfacción con la vida, seguidos por la felicidad subjetiva y las emociones de gratitud. Los hombres están más satisfechos con la vida cuando sienten menos afecto negativo. Además, las emociones de gratitud median la relación entre felicidad subjetiva y satisfacción con la vida y entre los afectos positivos y la satisfacción con la vida. La diferencia principal radica en que las emociones de gratitud son más fuertes en las mujeres que en los hombres.(AU)

This study aims to examine the predictability of satisfaction with life on the basis of subjective happiness, positive and negative affect, psy-chological disturbance and emotion of gratitude. It also seeks to assess whether the emotion of gratitude is a mediating variable withsubjective happiness, affect, and satisfaction with life. Statistical analyses of Pearson'scorrelation, multiple linear regression tests, and mediation models were conducted on asample of 1537 Spanish adults, 73.6% were females, 26.4% males, age between 18-88 yearsold (M = 42.56; SD = 16.29). The emo-tions of gratitude were found to mediate therelationship between subjec-tive happiness and satisfaction with life and between positiveaffect and satisfaction with life. Of the variables studied, positive affect is the most related tosatisfaction with life, followed by subjective happiness and emo-tions of gratitude. Maleparticipants are more satisfied with life when they feel the less negative affect. Regardingmediation models, emotions of grat-itude mediate the relationship between subjectivehappiness and satisfac-tion with life and between positive affect and satisfaction with life. Themaindifferenceis thatemotions of gratitudearestronger infemalesthan in males.(AU)

Vocal Approach to Transgender Individuals: The Journey Taken in Chile and Argentina

In recent years, there have been international references to the vocal approach for the specific group of transgender individuals, although the Latin American literature is still very timid on this matter. The purpose of this article is to identify the current norms, statistics, and vocal approach towards transgender individuals in Chile and Argentina, considering the experience of two speech and language pathologists with more than twenty years of experience on voice therapy. Reflections were made on the transgender reality in these countries, the limitations in the implementation of the depathologization of the transgender group were outlined, some current and unreliable statistics were presented, some innovative actions in the public system were highlighted, and the lack of knowledge about the benefits of vocal work for transgender men and women was discussed. The identified aspects could benefit from multicenter research that strengthens speech therapy actions with this group, contributing to depathologization and positive approach.

Desde los últimos años es posible encontrar referencias internacionales sobre el abordaje vocal al grupo específico de las personas transgénero, aunque la literatura latinoamericana sigue muy tímida en este asunto. La propuesta de este artículo es identificar las normas vigentes, estadísticas y abordaje vocal hacia las personas transgénero en Chile y Argentina, considerando la experiencia de dos fonoaudiólogas con más de veinte años de experiencia en terapia vocal. Se hicieron reflexiones sobre la realidad transgénero en los países citados, se delinearon las limitaciones en la puesta en práctica de la despatologización del grupo transgénero, se expusieron algunas estadísticas -vigentes y poco confiables-, se plasmaron algunas acciones novedosas en el sistema público y el desconocimiento sobre los beneficios del trabajo vocal en hombres y mujeres transgénero. Los aspectos detectados podrían beneficiarse de investigaciones multicéntricas que fortalezcan acciones fonoaudiológicas con este grupo, contribuyendo a la despatologización y el abordaje positivo.

"Nenhuma Pessoa Idosa Merece Passar por Isso": Compreensão da Violência para Mulheres Gerontes / "Ninguna Persona Adulta Mayor Merece Pasar Por Esto": Comprensión de la Violencia para las Mujeres Adultas Mayores / "No Elderly Person Deserves to Go Through This": Understanding Violence Towards Elderly Women

Resumo Introdução: A violência contra idosos é um fenômeno crescente, ocasionando prejuízos à saúde, com diferentes desfechos e consequências às vítimas. A chance de idosas sofrerem-na no âmbito familiar supera a dos homens, sendo o gênero um fator de risco considerável. Objetivo: Analisar a compreensão da violência contra pessoas idosas segundo mulheres gerontes. Metodologia: Pesquisa descritiva com abordagem qualitativa desenvolvida com 22 idosas de uma comunidade no estado da Paraíba, Brasil, escolhidas por conveniência. Utilizou-se para coleta de dados entrevistas semiestruturadas, processadas pelo software Iramuteq, com posterior Análise de Conteúdo. Resultados: Foram evidenciadas cinco classes: ciclo de violência; rede de apoio ao idoso vítima de violência; Vivência de situações violentas; violência financeira; e simbologia da violência na sociedade, as quais denotam compreensão da violência envolvendo os diferentes tipos. Apoiam-se nos fatores da vivência familiar, cultura e outros, consubstanciando o profissional de saúde como fundamental para o desfecho. O gênero influenciou no que concerne ao olhar lançado sobre a violência física e psicológica, bem como na relevância dada às equipes de saúde para identificação de ocorrências e prevenção de possíveis danos. Conclusão: Os diversos tipos de violência contra a pessoa idosa foram reconhecidos, incluindo fatores individuais, comunitários e sociais no ciclo violento. Além disso, associaram o envelhecimento a maior suscetibilidade para sofrer violência, independente da tipologia. Destaca-se a potencialidade do serviço de saúde na assistência à pessoa idosa vítima de violência, elucidando casos e atuando precocemente para interrupção dos ciclos perpetrados, exigindo a necessidade constante de atualização profissional para lidar com situações detectadas.

Resumen Introducción: La violencia contra las personas adultas mayores es un fenómeno creciente, que causa daños a la salud, con diferentes desenlaces y consecuencias para las víctimas. La posibilidad de que las mujeres adultas mayores la sufran en el ámbito familiar supera la de los hombres, siendo el género un factor de riesgo considerable. Objetivo: Analizar la comprensión de la violencia contra las personas mayores según las mujeres adultas mayores. Metodología: Investigación descriptiva con enfoque cualitativo desarrollada con 22 mujeres adultas mayores de una comunidad en el estado de Paraíba, Brasil, elegidas por conveniencia. Para la recolección de datos, se utilizaron entrevistas semiestructuradas, procesadas por el software Iramuteq, con posterior análisis de contenido. Resultados: Se evidenciaron cinco tipos de violencia: ciclo de la violencia, red de apoyo población adulta mayor víctima de violencia, experimentar situaciones violentas, violencia financiera y simbología de la violencia en la sociedad, que denotan la comprensión de la violencia de diferentes tipos. Estas ideas están respaldadas en los factores de la experiencia familiar, la cultura y otros, donde la persona profesional de la salud se identifica como fundamental para el cuidado y apoyo. El género influyó en la mirada lanzada sobre la violencia física y psicológica, así como en la relevancia dada a los equipos de salud para la identificación de sucesos y la prevención de posibles daños. Conclusión: Se han reconocido los diversos tipos de violencia contra las personas mayores, incluidos los factores individuales, comunitarios y sociales en el ciclo de violencia. Además, asociaron el envejecimiento con una mayor susceptibilidad a sufrir violencia, independientemente de la tipología. Destaca la potencialidad del servicio de salud en la asistencia a la persona mayor víctima de violencia, mediante la identificación de casos y la actuación temprana para la interrupción de los ciclos perpetrados. De manera que, se evidencia la necesidad constante de actualización profesional para hacer frente a situaciones detectadas.

Abstract Introduction: Violence against the elderly is a growing phenomenon, causing damage to health, with different outcomes and consequences to the victims. The possibility of elderly women suffering it in the family context surpasses that of men, with gender being a considerable risk factor. Objective: To analyze the understanding of violence against the elderly according to elderly women. Method: Descriptive research with a qualitative approach developed with 22 elderly women from a community in the state of Paraíba, Brazil, chosen for convenience. The data collection was based on semi-structured interviews, processed by the Iramuteq software, with subsequent Content Analysis. Results: Five classes of violence against the elderly were evidenced: cycle of violence; support network for the elderly victims of violence; experience of violent situations; financial violence; and symbolism of violence in society, which denote an understanding of violence involving the different types. They are based on the factors of family experience, culture, and others, placing the health professional as a fundamental element for care and support. Gender influenced the perspective on physical and psychological violence, as well as the relevance given to health teams for the identification of occurrences and the prevention of possible damage. Conclusion: The various types of violence against the elderly have been recognized, including individual, community, and social factors in the violent cycle. In addition, they associated aging with greater susceptibility to suffering violence, regardless of the typology. It highlights the potential of the health service in assisting the elderly victim of violence, elucidating cases, and acting early to interrupt the cycles perpetrated, requiring the constant need for professional updating to deal with detected situations.

Executive summary: Quality standards of care units for people with sexual and gender diversity.

Comprehensive biopsychosocial care for people with gender incongruence (ICD 11) who are transgender (trans) or gender diverse is a complex process in which the quality of the medical transition can only be guaranteed after a multidisciplinary approach, through teams that integrate professionals with training and experience not only in medicine but also in diversity and gender identity. Based on this, the Gonad, Identity and Sexual Differentiation working group of the Spanish Society of Endocrinology and Nutrition (GT-GIDSEEN) has established minimum care requirements that aim to guarantee adequate health care for these people by professionals. A position paper has been produced and is available at https://www.seen.es/portal/documentos/estandares-calidad-gidseen-2024.

A qualitative investigation of gender-based violence prevention and response using digital technologies in low resource settings and refugee populations.

Background: Governmental and non-governmental organizations across medical, legal, and psychosocial sectors providing care to survivors of gender-based violence (GBV) and their families rapidly digitalized services during the COVID-19 pandemic. GBV prevention/response services working with women and children who are forcibly displaced and/or living in low-and-middle income countries (LMIC) were no exception to the rapid digitalization trend. Literature is lacking a critical synthesis of best practices and lessons learned since digitalization replaced major operations involved in GBV prevention/response.Objective: This research qualitatively investigated how GBV service providers, located in a range of socio-political settings, navigated the process of digitalizing GBV prevention/response during the COVID-19 crisis.Method: Semi-structured key informant interviews (KII) with GBV service providers in varied sectors were implemented virtually (2020-2021) in Brazil, Guatemala, Iraq, and Italy (regarding forcibly displaced women/girls for the latter). Participants were recruited using purposive and snowball sampling. Interview guides covered a range of topics: perceived changes in violence and service provision, experiences with virtual services, system coordination, and challenges. The KIIs were conducted in Portuguese, Spanish, Arabic, and Italian. Interviews were audio-recorded, transcribed, and translated into English. The research team conducted thematic analysis within and between countries using a structured codebook of data driven and theory driven codes.Results: Major themes concerned the: (1) spectrum of services that were digitalized during the COVID-19 crisis; (2) gender digital divide as a barrier to equitable, safe, and effective service digitalization; (3) digital violence as an unintended consequence of increased digitalization across social/public services.Conclusion: Digitalization is a balancing act with respect to (1) the variety of remotely-delivered services that are possible and (2) the access/safety considerations related to the gender digital divide and digital violence.

Digitalization occurs when products and services are converted to digital forms; violence prevention/response services working with women and children who are forcibly displaced and/or living in low-and-middle income countries were no exception to the rapid trend of digitalization during the COVID-19 crisis.Using key informant interviews with service providers working in violence prevention and response sectors in Brazil, Guatemala, Iraq, and in Italy regarding forcibly displaced women/girls, we investigated the rapid digitalization of gender-based violence prevention/response during the COVID-19 crisis.The effectiveness, safety, and equitability of digitalized violence prevention/response services depends on how well they are balanced vis-a-vis the gender digital divide and risk of digital GBV.

Gender trends at the annual Spanish Urologic Association (AEU) meeting: A review of AEU programmes over a 10-year period (2012-2022).

INTRODUCTION: Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community. MATERIALS AND METHODS: All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU. RESULTS: Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation. CONCLUSIONS: Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.

Ideación suicida entre reclusos: análisis con perspectiva de género, durante cinco años de seguimiento (2017-2022) / Suicidal ideation among prisoners: analysis with a gender perspective in a five-year follow-up (2017-2022)

Introducción: En el entorno penitenciario, hay una elevada incidencia de conductas autolesivas, con una tasa de suicidio superior a la existente en la población general. Estudios previos describen la asociación de factores sociodemográficos, clínicos y criminológicos, con el riesgo de suicidio en la población penitenciaria masculina, pero hay pocas investigaciones centradas en el análisis de la conducta suicida entre mujeres. El objetivo del trabajo es analizar las características de las internas que ingresan en una unidad psiquiátrica por presentar ideas de suicidio o haber realizado tentativas.Material y método: Análisis descriptivo y comparativo de 97 internos (68 hombres, 29 mujeres) ingresados en la Unidad de Hospitalización Psiquiátrica de la Penitenciaria de Cataluña (UHPP-C), por ideas de suicidio, entre el 1 de enero de 2017 y el 31 de diciembre de 2022. Resultados: Se encuentran diferencias respecto al lugar de nacimiento, con mayor presencia de nacionalidades africanas en varones no nacionales, mientras que las internas extranjeras suelen ser originarias de países latinoamericanos. Los hombres tienen menor edad media, con ingresos más prolongados y una mayor tasa de reingreso. También padecen más trastornos psicóticos y adictivos. Las mujeres presentan mayor prevalencia de trastornos de personalidad y cuadros afectivos. Conclusiones: Hay diferencias sociodemográficas y clínicas entre hombres y mujeres internos en prisión que requieren ingreso por ideación suicida. Incluir la perspectiva de género en los estudios sobre el riesgo suicida en la población penitenciaria puede proporcionar una base sólida para futuros estudios, permitiendo así una comprensión más completa de la ideación suicida y las necesidades de intervención en la población penitenciaria.(AU)

Introduction: There is a high incidence of self-harming behavior in the prison setting, with a suicide rate that is higher than that of the general population. Previous studies describe the association of sociodemographic, clinical, and criminological factors with the risk of suicide in the male prison population, but there is little research that specifically analyses suicidal behavior among women. The objective of this study is to analyze the characteristics of inmates who are admitted to a psychiatric unit for suicidal thoughts or attempted suicide. Material and method: Descriptive and comparative analysis of 97 inmates (68 men, 29 women) admitted to the Unidad de Hospitalización Psiquiátrica Penitenciaria de Cataluña (UHPP-C), for suicidal ideation, between January 1, 2017, and December 31, 2022. Results: There are differences in terms of place of birth, with a more significant presence of African nationalities in non-national males, while foreign inmates tend to come from Latin American countries. Men have a lower mean age, longer admissions, and a higher readmission rate. They also suffer from more psychotic and addictive disorders. Women have a higher prevalence of personality disorders and affective symptoms. Conclusions: There are sociodemographic and clinical differences between male and female prison inmates who require admission for suicidal ideation. Including a gender perspective in studies on suicide risk in the prison population can provide a solid foundation for future studies, thus allowing a more complete understanding of suicidal ideation and intervention needs in theprison population.(AU)

La mujer en la radiología española actual: análisis en perspectiva / Women in Radiology: A perspective from Spain

Introducción: Existen desigualdades por razón de género en todos los ámbitos, incluyendo la radiología. Aunque la situación está mejorando, la presencia de radiólogas en puestos de liderazgo continúa siendo minoritaria. El objetivo de este artículo es analizar la situación de la mujer en la radiología española, comparándola con Europa y EE. UU. Materiales y métodos: Seleccionamos como franja de referencia los años 2000-2022 para hacer una comparación con datos de feminización a lo largo de la historia. Además también se incluyeron datos puntuales relevantes del recién comenzado 2023. Las variables en las que investigamos la feminización fueron las siguientes: estudiantes de medicina, médicos graduados, residentes y especialistas en radiodiagnóstico, jefes de sección, jefes de servicio, tutores de residentes de radiodiagnóstico, radiólogos profesores universitarios, presidentes de las principales entidades y sociedades radiológicas de España, Europa y EE. UU., receptores de los principales galardones de dichas sociedades radiológicas y editores jefe de sus revistas. Para ello realizamos una amplia búsqueda bibliográfica, contactamos con las sociedades radiológicas de España, Europa y EE. UU. y realizamos una encuesta a los principales servicios de radiodiagnóstico de España. Resultados: La presencia femenina en radiología va disminuyendo a medida que ascendemos a puestos de liderazgo, situación que se constata tanto en España como en Europa y EE. UU., comparativa que analizaremos en profundidad a lo largo del artículo. En los hospitales españoles en el año 2021 había un 58,1% de mujeres residentes de radiodiagnóstico, 55% de radiólogas, 42,9% de jefas de sección y 24,4% de jefas de servicio. En la historia de la SERAM ha habido un 10% de mujeres presidentas, un 22% de mujeres medallas de oro y un 5% de editoras jefe. Analizando los datos del año 2000 al 2023 el porcentaje de presidentas alcanza el 32% y las mujeres medalla de oro el 31%.(AU)

Introduction: There are gender inequalities in all fields, including radiology. Although the situation is improving, the presence of radiologists in leadership positions continues to be a minority. The objective of this article is to analyze the situation of women in the spanish radiology, comparing it with Europe and the United States. Materials and methods: We selected the years 2000-2022 as reference period to make a comparison with feminization data throughout history. In addition, relevant specific data from the just begun 2023 were also included. The variables in which we investigated feminization were the following: medical students, medical graduates, radiology residents and specialists, section chiefs, department chairs, radiology residency programme directors, radiology university professors, presidents of the main radiological entities and societies in Spain, Europe and the United States, recipients of the main awards given by these radiological societies and chief editors of their journals. In order to perform this analysis we conducted an in-depth bibliographic research, we contacted the radiological societies of Spain, Europe and the USA and we carried out a survey in the main spanish radiology departments. Results: The female presence in radiology decreases as we rise to leadership positions, a situation that is patent in Spain, Europe and the US, comparison that will be analyzed in depth throughout the article. In spanish hospitals in 2021 there were 58.1% female radiology residents, 55% female radiologists, 42.9% female section chiefs and 24.4% female department chairs. In SERAM's history there have been 10% female presidents, 22% female gold medallists and 5% female editors-in-chief. If we analyze data from 2000 to 2023, female presidents reach 32% and female gold medallists 31%.(AU)

Drogas de abuso asociadas a las intoxicaciones agudas: descripción global y análisis de las diferencias en mujeres atendidas en el servicio de urgencias / Street drugs associated with acute poisoning: description and analysis of differences in women attended in a hospital emergency department

Objetivos. La prevalencia del uso de drogas de abuso es difícil de establecer en mujeres, debido a los estigmas asociados a ello. El objetivo principal fue analizar las posibles diferencias de las intoxicaciones agudas (IA) según el sexo en una muestra de pacientes atendidos en dos servicios de urgencias hospitalarios (SUH). El objetivo secundario fue identificar las variables asociadas a las intoxicaciones graves, definidas de forma arbitraria como las que requerían una atención intensiva médica de más de 12 horas y posterior ingreso hospitalario. Métodos. Estudio retrospectivo en dos SUH que incluyeron pacientes mayores de 18 años atendidos por IA por drogas de abuso, en el periodo comprendido entre el 1 de julio 2020 y el 31 de julio 2023. Se recogieron variables epidemiológicas, clínicas y de laboratorio. Resultados. Se incluyeron 1.032 pacientes, un 18,5% (191) mujeres. La edad media fue de 35 (DE 10) años, con elevada prevalencia de enfermedad mental aguda (32,2%) e infección por VIH (35,7%). El principal motivo de consumo fue lúdico (90,9%). Las principales drogas de abuso fueron cocaína, alcohol y metanfetaminas. El análisis multivariado mostró que únicamente la edad (OR: 1,03, IC 95%: 1,01-1,05, p = 0,003), el VIH (OR: 2,10, IC 95%: 1,29-3,41, p = 0,003), el consumo de benzodiacepinas (OR: 3,48, IC 95%: 2,14-5,66, p < 0,0001), y la ideación autolítica (OR: 1,82, IC 95%: 1,25-3,79, p = 0,004), se asociaron a gravedad de la intoxicación. Conclusiones. Las IA por drogas de abuso en mujeres presentan algunas diferencias en relación a las de los hombres, ya que son más jóvenes y asocian consumo de alcohol con mayor frecuencia. Las campañas de prevención y políticas sanitarias sobre el uso de sustancias deberían tener en cuenta las diferencias en el consumo según el sexo para adaptarlas a la población a las que vayan dirigidas. (AU)

Background. The prevalence of street drug abuse is difficult to establish in women because of stigma associated withthe practice. The main objective of this study was to analyze possible differences between men and women in a sample of patients attended for emergencies due to acute poisonings. The secondary aim was to identify variables associated with severe poisonings defined arbitrarily as requiring intensive care for more than 12 hours after hospital admission. Methods. Retrospective study in 2 hospital EDs. We included patients over the age of 18 years attended for street drug poisonings between July 1, 2020, and July 31, 2023. Epidemiologic, clinical, and laboratory variables were analyzed. Results. A total of 1032 patients were studied; 191 (18.5%) were women. The mean (SD) age was 35 years, and the prevalences of acute mental illness and HIV infection were high at 32.2% and 35.7%, respectively. Drug use was recreational in most cases (90.9%). Cocaine, alcohol, and methamphetamines were the substances most often used. Multivariate analysis showed that the factors associated with the seriousness of poisoning were age, with an odds ratio (OR) of 1.03 (95% CI, 1.01-1.05; P = .003); HIV (OR, 2.10; 95% CI, 1.29-3.41; P = .003); use of benzodiazepines (OR, 3.48; 95% CI, 2.14-5.66; P < .0001); and suicidal ideations (OR, 1.82; 95% CI, 1.25-3.79; P = .004). Conclusions. Differences in poisoning characteristics in women were found, probably related to the younger ages of men in the sample and their higher frequency of alcohol consumption. Public health policies and campaigns to prevent drug abuse should take gender differences into consideration in order to adapt messages to the target populations. (AU)

Diferencias en la evolución del sobrepeso y la obesidad infantil en España en el periodo 2011-2019 por sexo, edad y nivel socioeconómico: resultados del estudio ALADINO / Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: Results of the ALADINO study

Introducción: El exceso de peso infantil es un problema de salud pública creciente. El objetivo del trabajo es estudiar la evolución de la prevalencia de sobrepeso, de obesidad y de obesidad central en escolares de 6 a 9años en España entre 2011 y 2019 según características demográficas y socioeconómicas.MetodologíaSe incluyeron las rondas 2011, 2015 y 2019 del estudio observacional, descriptivo y transversal ALADINO en escolares de ambos sexos de 6 a 9años. Se realizó un análisis descriptivo de la evolución de la prevalencia de sobrepeso y de obesidad según los criterios de la Organización Mundial de la Salud (OMS) y la International Obesity Task Force (IOTF), así como obesidad central, y las variables demográficas y socioeconómicas asociadas.ResultadosEntre 2011 y 2019 se redujo la prevalencia de sobrepeso (criterios OMS) en niños de 6, 7 y 8años (−5,4, −5,7 y −5,3 puntos porcentuales, respectivamente) y niños cuyos progenitores tenían estudios superiores (−5,3 puntos porcentuales). Por renta, el sobrepeso en niños se redujo en todos los niveles de ingresos. Sin embargo, entre 2011 y 2019 se mantuvieron estables tanto la prevalencia de sobrepeso en niñas como la prevalencia de obesidad según las referencias OMS e IOTF y la de obesidad central en ambos sexos.ConclusionesLas prevalencias de sobrepeso y de obesidad en escolares de 6 a 9años en España siguen siendo altas. Entre 2011 y 2019 disminuyó la prevalencia de sobrepeso en niños de 6 a 8años y aquellos cuyos progenitores tienen estudios universitarios, mientras que la obesidad en niños, el sobrepeso y la obesidad en niñas, y la obesidad central en ambos sexos han permanecido estables. (AU)

Introduction: Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6 to 9years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics.MethodologyThe analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6 to 9years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization [WHO] and the International Obesity Task Force [IOTF]) and of central obesity, in addition to associated demographic and socioeconomic variables.ResultsBetween 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8years (by −5.4%, −5.7% and −5.3%, respectively) and boys whose parents had a higher educational attainment (by −5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable.ConclusionsThe prevalence of overweight and the prevalence of obesity in schoolchildren aged 6 to 9years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6 to 8years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable. (AU)

Violencia en pareja en personas seropositivas: una revisión sistemática / Violência por parceiro íntimo em pessoas soropositivas: uma revisão sistemática / Partner violence in HIV-positive people: a systematic review

El presente trabajo tiene como objetivo, caracterizar la violenciaen pareja en personas con seropositividad (prevalencia,tipos de acciones violentas, variables de riesgo/ protectorasy consecuencias), para lo cual se realizó una revisión sistemáticaa través del protocolo PRISMA. La búsqueda de artículos serealizó en Scopus, Web of Science, Eric, Scielo y Pubmedpublicados hasta 2021. Se encontraron 113 artículos, de loscuales 22 cumplieron con los criterios de elegibilidad. Losresultados indican que la violencia en pareja en personasseropositivas, además de manifestarse de manera física,psicológica, patrimonial, sexual y verbal, se puede presentar através del uso del VIH para ejercer la violencia. La prevalenciavaría en función del contexto geográfico en un intervalo del19,6% al 43,1%; la cual es superior en población migrantey en hombres que tienen sexo con hombres (HSH) mujeresseropositivas, parejas no heterosexuales y en parejas en la queambos miembros son seropositivos. Las variables de riesgo/protectoras identificadas se asociaron con las dimensiones:informativas, motivacionales, de habilidades conductuales,sociodemográficas, culturales, de salud, sociofamiliares ypolíticas. Asimismo, se evidenciaron consecuencias sociales,económicas y de salud.(AU)

The objective of this work is to characterize partner violencein people with seropositivity (prevalence, types of violentactions, risk/protective variables, and consequences), for whicha systematic review was carried out through the PRISMAprotocol. The search for articles was carried out in Scopus,Web of Science, Eric, Scielo and Pubmed published up to 2021. 113 articles were found, of which 22 met the eligibilitycriteria. The results indicate that intimate partner violencein seropositive people, in addition to manifesting itself ina physical, psychological, patrimonial, sexual, and verbalway, can be presented using HIV to exercise violence. Theprevalence varies depending on the geographical contextin a range from 19.6% to 43.1%, which is higher in themigrant population and in men who have sex with men(MSM), seropositive women, non-heterosexual couples andin couples in which both members are seropositive. Therisk/protective variables identified were associated with thedimensions: informational, motivational, behavioral skills,sociodemographic, cultural, health, socio-family and political.Likewise, social, economic and health consequences wereevidenced.(AU)

O objetivo deste trabalho é caracterizar a violência conjugalem pessoas com soropositividade (prevalência, tipos de açõesviolentas, variáveis de risco/proteção e consequências), paraa qual foi realizada uma revisão sistemática por meio doprotocolo PRISMA. A busca de artigos foi realizada no Scopus,Web of Science, Eric, Scielo e Pubmed publicados até 2021.Foram encontrados 113 artigos, dos quais 22 atenderamaos critérios de elegibilidade. Os resultados indicam que aviolência por parceiro íntimo em pessoas soropositivas, alémde se manifestar de forma física, psicológica, patrimonial,sexual e verbal, pode se apresentar por meio do uso do HIVpara exercer a violência. A prevalência varia de acordo como contexto geográfico em uma faixa de 19,6% a 43,1%; queé maior na população migrante e em homens que fazemsexo com homens (HSH), mulheres soropositivas, casais nãoheterossexuais e em casais em que ambos os membros sãosoropositivos. As variáveis de risco/proteção identificadasforam associadas às dimensões: informacional, motivacional,habilidades comportamentais, sociodemográficas, culturais,de saúde, sociofamiliares e políticas. Da mesma forma, foramevidenciadas consequências sociais, econômicas e de saúde.(AU)

Street drugs associated with acute poisoning: description and analysis of differences in women attended in a hospital emergency department. / Drogas de abuso asociadas a las intoxicaciones agudas: descripción global y análisis de las diferencias en mujeres atendidas en el servicio de urgencias.

OBJECTIVES: The prevalence of street drug abuse is difficult to establish in women because of stigma associated with the practice. The main objective of this study was to analyze possible differences between men and women in a sample of patients attended for emergencies due to acute poisonings. The secondary aim was to identify variables associated with severe poisonings defined arbitrarily as requiring intensive care for more than 12 hours after hospital admission. MATERIAL AND METHODS: Retrospective study in 2 hospital EDs. We included patients over the age of 18 years attended for street drug poisonings between July 1, 2020, and July 31, 2023. Epidemiologic, clinical, and laboratory variables were analyzed. RESULTS: A total of 1032 patients were studied; 191 (18.5%) were women. The mean (SD) age was 35 years, and the prevalences of acute mental illness and HIV infection were high at 32.2% and 35.7%, respectively. Drug use was recreational in most cases (90.9%). Cocaine, alcohol, and methamphetamines were the substances most often used. Multivariate analysis showed that the factors associated with the seriousness of poisoning were age, with an odds ratio (OR) of 1.03 (95% CI, 1.01-1.05; P = .003); HIV (OR, 2.10; 95% CI, 1.29-3.41; P = .003); use of benzodiazepines (OR, 3.48; 95% CI, 2.14-5.66; P .0001); and suicidal ideations (OR, 1.82; 95% CI, 1.25-3.79; P = .004). CONCLUSION: Differences in poisoning characteristics in women were found, probably related to the younger ages of men in the sample and their higher frequency of alcohol consumption. Public health policies and campaigns to prevent drug abuse should take gender differences into consideration in order to adapt messages to the target populations.

OBJETIVO: La prevalencia del uso de drogas de abuso es difícil de establecer en mujeres, debido a los estigmas asociados a ello. El objetivo principal fue analizar las posibles diferencias de las intoxicaciones agudas (IA) según el sexo en una muestra de pacientes atendidos en dos servicios de urgencias hospitalarios (SUH). El objetivo secundario fue identificar las variables asociadas a las intoxicaciones graves, definidas de forma arbitraria como las que requerían una atención intensiva médica de más de 12 horas y posterior ingreso hospitalario. METODO: Estudio retrospectivo en dos SUH que incluyeron pacientes mayores de 18 años atendidos por IA por drogas de abuso, en el periodo comprendido entre el 1 de julio 2020 y el 31 de julio 2023. Se recogieron variables epidemiológicas, clínicas y de laboratorio. RESULTADOS: Se incluyeron 1.032 pacientes, un 18,5% (191) mujeres. La edad media fue de 35 (DE 10) años, con elevada prevalencia de enfermedad mental aguda (32,2%) e infección por VIH (35,7%). El principal motivo de consumo fue lúdico (90,9%). Las principales drogas de abuso fueron cocaína, alcohol y metanfetaminas. El análisis multivariado mostró que únicamente la edad (OR: 1,03, IC 95: 1,01-1,05, p = 0,003), el VIH (OR: 2,10, IC 95: 1,29-3,41, p = 0,003), el consumo de benzodiacepinas (OR: 3,48, IC 95%: 2,14-5,66, p 0,0001), y la ideación autolítica (OR: 1,82, IC 95%: 1,25-3,79, p = 0,004), se asociaron a gravedad de la intoxicación. CONCLUSIONES: Las IA por drogas de abuso en mujeres presentan algunas diferencias en relación a las de los hombres, ya que son más jóvenes y asocian consumo de alcohol con mayor frecuencia. Las campañas de prevención y políticas sanitarias sobre el uso de sustancias deberían tener en cuenta las diferencias en el consumo según el sexo para adaptarlas a la población a las que vayan dirigidas.

Women in Radiology: A perspective from Spain.

INTRODUCTION: There are gender inequalities in all fields, including radiology. Although the situation is improving, the presence of radiologists in leadership positions continues to be a minority. The objective of this article is to analyse the situation of women in the spanish radiology, comparing it with Europe and the United States. MATERIALS AND METHODS: We selected the years 2000-2022 as reference period to make a comparison with feminization data throughout history. In addition, relevant specific data from the just begun 2023 were also included. The variables in which we investigated feminization were the following: medical students, medical graduates, radiology residents and specialists, section chiefs, department chairs, radiology residency programme directors, radiology university professors, presidents of the main radiological entities and societies in Spain, Europe and the United States, recipients of the main awards given by these radiological societies and chief editors of their journals. In order to perform this analysis we conducted an in-depth bibliographic research, we contacted the radiological societies of Spain, Europe and the USA and we carried out a survey in the main Spanish radiology departments. RESULTS: The female presence in radiology decreases as we rise to leadership positions, a situation that is patent in Spain, Europe and the US, comparison that will be analysed in depth throughout the article. In Spanish hospitals in 2021 there were 58.1% female radiology residents, 55% female radiologists, 42.9% female section chiefs and 24.4% female department chairs. In SERAM's history there have been 10% female presidents, 22% female gold medallists and 5% female editors-in-chief. If we analyse data from 2000 to 2023, female presidents reach 32% and female gold medallists 31%. CONCLUSIONS: Although gender inequality is declining, in radiology women continue to be underrepresented in leadership positions. Work must be done in order to build a diverse and inclusive profession that reflects demographic reality.

Unpacking gender-specific risk and protective factors for mental health status among Congolese refugees in Uganda.

Background: Research indicates refugees from the Democratic Republic of Congo (DRC), particularly females, have a higher incidence of mental health problems compared to the global norm for conflict-affected populations.Objective: This study aimed to unpack gender differences in the mental health of Congolese refugees by examining specific risk (trauma exposure, adaptation challenges, and discrimination) and protective factors (marital status, literacy, and social resources) in relation to posttraumatic stress symptoms (PTSS) and depression. Method: Utilizing systematic random sampling, we surveyed 667 adult refugees (370 females, 297 males) in the Kyaka II refugee settlement in Western Uganda. A multi-group path analysis was conducted, initially allowing for variance between genders and subsequently comparing a constrained model, where paths were set equal across groups.Results: The unconstrained model presented an excellent fit to the data. When paths were set to be equal across groups, the decline in model fit, confirmed by a chi-square difference test, indicated differences in the model for males and females. A series of Z-tests were used to compare individual paths. Experiencing discrimination was a stronger risk factor for depression among men, whereas a history of rape was more strongly associated with depression for females. Being literate and a member of a social group in the settlement were stronger protective factors for depression among men, whereas living with a partner and a felt sense of connection to their community was more important for women. Associations between risk and protective factors and PTSS were more similar across groups, only membership in a group was significantly moderated by gender; with group membership being more impactful for males.Conclusion: The results highlight similarities and differences in predictors of distress for male and female Congolese refugees and point to potential avenues for tailoring programming to be gender sensitive.

This research identified key differences in how specific traumatic experiences and social factors correlate with psychological distress for male and female Congolese refugees, underscoring the need for tailored support strategies.The study reveals that while discrimination is a stronger predictor of depression in men, experiences of rape are more closely linked to depression in women. Conversely, social factors like literacy and group membership offer more protection to men, whereas relationship status and community connection are more protective for women.The findings shed light on the importance of gender-sensitive mental health and psychosocial support interventions.

[Motivations for alcohol consumption in schooled adolescents: analysis of discussion groups]. / Motivaciones para el consumo de alcohol en adolescentes escolarizados: análisis de grupos de discusión.

OBJECTIVE: To find out the motivations of adolescents for alcohol consumption. DESIGN: Qualitative methodology with discussion groups. PARTICIPANTS AND CONTEXT: 131 adolescents (15-17 years old) enrolled in nine schools in Tarragona (Spain). METHOD: Systematic coding strategy, adapted to focus groups. Educational centers were selected through a stratified purposive sampling by educational levels (segmentation criterion) and ownership of the center (public or private). Participants within the educational levels were randomly selected for the groups. Content analysis was conducted using an open and flexible coding strategy. RESULTS: Motivations for alcohol consumption were identified, revolving around six fundamental dimensions: a) seeking fun and new sensations, b) alleviating discomfort, c) consumption due to social contagion and group pressure, d) consumption as a rite of passage into adulthood, e) environmental availability of alcohol, and f) low perception of risk. This motivation varied according to the adolescent's gender. In girls, drinking behavior appeared related to overcoming negative emotional states, while for boys, belonging to the peer group took precedence: drinking reinforces hegemonic masculinity and ensures complicity among peers. Adolescents considered that the information they receive from educational centers is sufficient, but it does not motivate change. CONCLUSIONS: Public health strategies focused on preventing alcohol consumption in adolescents should incorporate their motivations to achieve greater efficiency, paying due attention to sex/gender variables.

Sex differences in delay times in ST-segment elevation myocardial infarction: A cohort study.

BACKGROUND: The present study analyzes a cohort of consecutive patients with ST-segment elevation acute myocardial infarction (STEMI), evaluating the ischemia-reperfusion times from the perspective of gender differences (females versus males), with a long-term follow-up. METHODS: Single-center analytical cohort study of patients with STEMI in a tertiary hospital, between January 2015 and December 2020. RESULTS: A total of 2668 patients were included, 2002 (75%) men and 666 (25%) women. The time elapsed from the onset of symptoms to the opening of the artery was 197min (IQR 140-300) vs 220min (IQR 152-340), p=0.004 in men and women respectively. A delay in health care significantly impacts the occurrence of cardiovascular adverse events at follow-up, HR 1.34 [95%CI 1.06-1.70]; p=0.015. CONCLUSIONS: Women took longer to go to health care services and had a longer delay both in the diagnosis of STEMI and in coronary reperfusion. It is imperative to emphasize the necessity of educating women about the recognition of ischemic heart disease symptoms, empowering them to raise early alarms and seek timely medical attention.

Time dedicated to physical activity among medical residents: are there differences based on gender or specialty type?

INTRODUCTION: Physical activity (PA) is associated with positive health outcomes such as prevention of chronic diseases, psychological well-being and improved work performance. Medical residents are subjected to sleep deprivation, extended work schedule and high burnout prevalence. These conditions may lead to the neglect of personal health and the restriction of time dedicated to PA. The objective of the present study was to analyze the time dedicated to PA of medical residents, comparing women vs men residents and surgical vs clinical residents. METHODS: It is a cross-sectional study performed in a Spanish third-level university hospital. All medical residents from our institution were invited to voluntarily participate in the study answering a web-based questionnaire on June 2022. Data regarding demographics, residency and PA practice was recorded. RESULTS: The response rate was 20.73% (114/550). The 32.5% of the residents considered themselves to be physically inactive and mean time dedicated to PA in a regular week was 3.62 ±â€¯2.22 h. Men residents dedicated more time to PA than women residents (4.23 ±â€¯2.42 h vs 3.14 ±â€¯1.95 h, p = 0.012) and surgical residents dedicated more time than clinical residents (4.33 ±â€¯2.36 h vs 3.23 ±â€¯2.05 h, p = 0.01). CONCLUSIONS: One third of the medical residents consider themself physically inactive. Women and clinical residents practice PA less time than men and surgical residents. Efforts should be made to encourage PA among residents, especially in women and non-surgeons.

Cuidado com a saúde sexual e reprodutiva: um olhar a partir da percepção de mulheres que fazem sexo com mulheres / Sexual and Reproductive Health Care: a look from the perspective of women who have sex with women / El cuidado de la salud sexual y reproductiva: una mirada desde la perspectiva de las mujeres que tienen sexo con mujeres

Objetivo: o presente estudo se destina a compreender a percepção das mulheres que fazem sexo com mulheres, referente ao cuidado que recebem nos serviços de saúde, no âmbito de sua saúde sexual e reprodutiva, a fim de verificar se o atendimento ofertado atende a integralidade de seu direito à saúde e, também, evidenciar o papel dos profissionais de saúde na garantia desses direitos. Metodologia: foi realizada revisão de literatura nacional para elaboração do instrumento de coleta de dados e pesquisa qualiquantitativa através de formulário e entrevista individual via internet. Resultados: Foram obtidas 287 respostas, as falas revelaram as seguintes categorias: A- Violência física sofrida em serviços de saúde, B- Negligência e falta de acolhimento em consultas ginecológicas e em serviços de saúde, C- Presunção da heterossexualidade nos serviços de saúde, D- Invisibilidade e violência moral e psicológica. Conclusão: evidenciou-se que mulheres que fazem sexo com mulheres ainda sofrem uma série de discriminações e violências nos serviços de saúde, ao buscarem cuidados integrais, principalmente no que tange aos seus direitos sexuais e reprodutivos.

Objective: this study is intended to understand the perception of women who have sex with women, regarding the care they receive in health services, within the scope of their sexual and reproductive health, in order to verify whether the care offered to them meets the integrality of their right to health and, also, highlight the role of health professionals in guaranteeing these rights. Methodology: A national literature review was carried out for the elaboration of the data collection instrument and qualitative and quantitative research through an individual form and individual interview via the internet. Results: 287 responses were obtained, the statements revealed the following categories: A- Physical violence suffered in health services, B- Negligence and lack of acceptance in gynecological consultations and health services, C- Presumption of heterosexuality in health services, D- Invisibility and, moral and psychological violence. Conclusion: it was evident that women who have sex with women still suffer a series of discrimination and violence in health services, when seeking comprehensive care, especially with regard to their sexual and reproductive rights.

Objetivo: este estudio tiene como finalidad conocer la percepción de las mujeres que tienen sexo con mujeres, respecto a la atención que reciben en los servicios de salud, en el ámbito de su salud sexual y reproductiva, con el fin de verificar si la atención que se les brinda cumple con la integralidad de su derecho a la salud y, además, destacar el papel de los profesionales de la salud en la garantía de estos derechos. Metodología: se realizó una revisión de literatura nacional para la elaboración del instrumento de recolección de datos e investigación cualitativa y cuantitativa a través de formulario individual y entrevista individual vía internet. Resultados: se obtuvieron 287 respuestas, los enunciados revelaron las siguientes categorías: A- Violencia física sufrida en los servicios de salud, B- Negligencia y falta de aceptación en las consultas ginecológicas y servicios de salud, C- Presunción de heterosexualidad en los servicios de salud, D- Invisibilidad y violencia moral y psicológica. Conclusión: se evidenció que las mujeres que tienen sexo con mujeres aún sufren una serie de discriminaciones y violencias en los servicios de salud, al momento de buscar atención integral, especialmente en lo que se refiere a sus derechos sexuales y reproductivos.

Tratamiento de la informacion de violencia de género. Con aportaciones de la inteligencia artificial / Treatment of the information on gender-based violence. With contributions from artificial intelligence

Introducción/objetivos la violencia contra la mujer sigue siendo un grave problema social y de salud a pesar de las medidas puestas en marcha en los últimos años. La exploración de las víctimas por el médico forense en los juzgados es de gran interés puesto que recibe información relacionada no solo con la agresión, sino también de su entorno social, familiar y económico. El objetivo es utilizar dicha información para identificar grupos de riesgo y mejorar/obtener las medidas necesarias. Material y métodos en este trabajo, el forense ha recogido, durante 8 años, una toma abundante de datos sobre las víctimas exploradas en L’Hospitalet de Llobregat. La muestra incluye 1.622 casos de mujeres víctimas de violencia de género. Se realiza un estudio descriptivo poblacional y de las lesiones. Resultados se exponen las principales variables estudiadas tanto socioeconómicas como referentes a la agresión en sí. Se trabaja también con base en la reentrada de las víctimas o repetición de las agresiones (revictimización), que son el 10,9% de la muestra. Finalmente, se presentan los resultados obtenidos tras aplicar técnicas de inteligencia artificial, en este caso, árboles de clasificación CaRT. Conclusiones con los resultados obtenidos concluimos que el tratamiento de la información recogida y sistematizada de la intervención médico-forense permite una mejor comprensión de la violencia sobre la mujer, de la que podemos extraer sugerencias sobre la adopción de medidas de atención y soporte a las víctimas y a los colectivos más vulnerables, así como sobre los recursos administrativos y la optimización de programas de prevención. (AU)

Introduction/objectives Violence against women is still a serious social and health problem, despite the measures implemented in recent years. The examination of the victims by the forensic doctor in the courts is of great interest since it provides information related not only to the aggression, but also to their social, family and economic environment. The objective is to use this information to identify groups at risk and improve/implement the necessary measures. Material and methods In this work, the forensic has collected, for eight years, abundant data on the victims examined in L'Hospitalet de Llobregat. The sample includes 1,622 cases of women who have been victims of gender violence. A descriptive study of the population and of the lesions has been carried out. Results The paper presents the main variables studied, both socioeconomic and referring to the aggression itself. This study also analyzes the reentry of the victims, the repetition of aggressions (revictimization), which are 10.9% of the sample. Finally, the results obtained after applying artificial intelligence techniques -in this case, CaRT classification trees- are presented. Conclusions With the results obtained, we conclude that the treatment of the information collected and systematized from the medical-forensic intervention allows a better understanding of Violence Against Women, from which we can extract suggestions on the adoption of care and support measures for the victims and the most vulnerable groups, as well as administrative resources and the optimization of prevention programs. (AU)

Confirmatory Factor Analysis and Gender Invariance of the Coping Strategies Inventory in Academic University Stress / [Análisis factorial confirmatorio e invarianza de género del Inventario de Estrategias de Afrontamiento (CSI) en estrés académico universitario]

Background: Though the Spanish version of the Coping Strategies Inventory (CSI) is frequently used, it has not been subjected to any significant re-evaluation from a psychometric perspective. Method: We analysed CSI data that was focused on an academic stress situation, using a university sample of 874 participants, 50% of each gender. We conducted reliability, confirmatory factor, and factorial invariance across gender analyses. Results: The first-order factorial structure was confirmed, showing an adequate fit for the eight-factor coping strategies model with good reliability indices. Neither the second-order (problem-centred vs. emotion-centred) nor third-order (engagement vs. disengagement) strategies showed an adequate fit. Factorial invariance for gender was confirmed. Conclusions: The theoretical and applied implications of the results are discussed.(AU)

Antecedentes: Aunque la versión española del del Inventario de Estrategias de Afrontamiento (CSI) se usa frecuentemente, no se ha sometido a reevaluación psicométrica. Método: Analizamos datos del CSI aplicados a situaciones de estrés académico utilizando una muestra universitaria de 874 participantes, 50% de cada género. Llevamos a cabo análisis de fiabilidad, confirmatorios y de invarianza factorial por género. Resultados: Se confirmó la estructura factorial de primer orden, mostrando un ajuste adecuado el modelo de 8 estrategias de afrontamiento, con buenos índices de fiabilidad. No mostraron un ajuste adecuado las factorizaciones de segundo orden (centrado en el problema o en la emoción) ni de tercer orden (compromiso o retirada). Se confirmó la invarianza factorial por género. Conclusiones: Se discuten las implicaciones teóricas y aplicadas de los resultados.(AU)