Factors related to a disturbance in the mother-child bond and attachment.

INTRODUCTION: Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future. PURPOSE: To identify the factors related to a disturbance of the mother-child bond or attachment. METHODS: A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn. RESULTS: 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance. CONCLUSIONS: Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment. IMPLICATIONS TO PRACTICE: Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study.

AIM: To determine and describe the experiences of pregnant women who receive a diagnosis of chromosomopathy and/or foetal malformation during a prenatal check-up and who decide to legally terminate the pregnancy. BACKGROUND: When a pregnancy is terminated, the woman must cope with frustrated motherhood. The psychological consequences of this will largely depend on the care and support provided by health professionals. When a congenital anomaly is diagnosed, a patient-centred communication helps understanding, influences adaptation to the new situation and ensures the person concerned has sufficient (autonomy or independence or ability) to make appropriate decisions. METHODS: A qualitative study, based on a phenomenological approach, was carried out through nonparticipant observation and semi-structured interviews with 27 obstetric patients. NVivo 11 software was used, and content analysis was performed. The manuscript was developed using the COREQ guidelines to inform qualitative studies. RESULTS: The clinical relationship may be affected by communication problems such as patients' perceptions of scarce emotional involvement by obstetricians, by poor psychosocial support during the termination of the pregnancy and by insufficient follow-up after discharge. CONCLUSION: Nurses are in a privileged position to promote the empowerment of affected women. It is necessary to improve aspects related to the privacy of patients and the awareness and training of the interdisciplinary team in interpersonal communication. Post-loss follow-up is recommended to assess individual needs, thus facilitating an optimal approach to ease the grieving process. RELEVANCE TO CLINICAL PRACTICE: During the prenatal diagnosis, the existence of a fetal anomaly is emphasized, but support and follow up of the mother may be neglected; therefore, exhaustive knowledge about the obstetric history, the state of health and the expectations of patients is as important as a multidisciplinary team trained in counseling strategies and with a comprehensive care plan that covers all areas, especially those that control maternal emotions.

Sexual and reproductive health beliefs and practices of female immigrants in Spain: a qualitative study.

BACKGROUND: Sexuality and reproduction are two areas that have been dealt with differently over time and across cultures. Immigrant women resident in Spain, are largely of childbearing age and have some specific needs. Female immigrants have specific beliefs and behaviors which may influence how they approach to the Spanish sexual and reproductive health services. There is less visibility of the health problems presented by women immigrants. This article aims to shed light on the sexual and reproductive health beliefs and experiences of female immigrants in a region of southern Spain. METHODS: A descriptive study design with qualitative data collection and analysis methods were used. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women's perception and beliefs about their sexual and reproductive health. Thirteen interviews were conducted in 2013 with a multi-ethnic sample of female immigrants, currently all are residing in Andalusia. Interview topics included questions about awareness and beliefs about sexuality and reproduction. Content analysis was used. RESULTS: We have found that female immigrant brings along all of her beliefs, opinions, attitudes and behaviors regarding sexuality, contraceptives, what is "correct" and what is not, etc. The sexual behavior is conditioned by the prevailing social rules of country of origin, and these rules act ambivalently. In general, knowledge of contraceptive methods was big, but there were perceptions that reproductive health was woman's domain, due to gender norms and traditional family planning geared exclusively towards women. CONCLUSION: Results suggest that women's behavior is influenced by the precepts of their origin societies. Therefore, sexual and reproductive health processes should be adapted and incorporated into our society, with special attention being paid to the immigrant population.

Development of a Predictive Model for Skin-to-Skin Contact Immediately after Birth: A Cross-Sectional Study.

The aim of this study was to develop and validate a predictive model for the establishment of skin-to-skin contact immediately after birth. A descriptive cross-sectional study was conducted during the last trimester of 2022 and the first trimester of 2023 with women who had given birth in Spain. A questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn, as well as the Bond and Attachment questionnaire (VAMF, for its name in Spanish) for the analysis of the mother-child bond and attachment, were administered. A multivariate analysis was performed, and areas under the ROC curve (AUC) with their 95% confidence intervals (CI) and the predictive characteristics of these models were estimated. In total, 1077 women participated. The prevalence of early skin-to-skin contact after delivery was 50.2% (468) in the derivation cohort and 49.8% (464) in the validation cohort. Multivariate analysis showed that prematurity, type of delivery, and birth experience were statistically significant, so they were included in the model (p ≤ 0.05). The predictive ability (AUC ROC) was good in both the derivation cohort, yielding 0.92 (95% CI: 0.89-0.95), and in the validation cohort, yielding 0.89 (95% CI: 0.85-0.93). This study developed a predictive model identifying factors facilitating early skin-to-skin contact between a mother and her newborn immediately after birth.

[Laparoscopic treatment of acute gastric volvulus]. / Tratamiento del vólvulo gástrico agudo mediante abordaje laparoscópico.

INTRODUCTION: Gastric volvulus is an uncommon clinical condition and is associated with type ii-iii hiatal hernias. Its acute presentation constitutes a surgical emergency. Despite its low frequency, results of laparoscopic treatment have already been published. MATERIAL AND METHODS: A retrospective study was performed on all cases diagnosed with gastric volvulus undergoing laparoscopic surgery between 1998 and 2010. The surgical technique, the post-operative outcome, and the clinical follow-up are described. RESULTS: A total of 10 cases were identified, one was a primary gastric volvulus, and the remainder were secondary. A laparoscopic anterior gastropexy as the sole procedure was performed on 7 patients. A Nissen fundoplication with mesh reinforcement of the crural closure was performed on the 3 remaining cases. Postoperative outcome was uneventful in 9 patients, with an early start of the diet, and hospital discharge between 48-72 h. After a mean follow-up period of 18 months, radiological hernia recurrence occurred in one case but recurrence of the volvulus was not observed. CONCLUSION: Laparoscopic anterior gastropexy is, in our experience, an effective and safe procedure with a low morbidity, for the treatment of acute gastric volvulus in patients with high surgical risk.

Rare earth elements as statistical sentinels of pollution and paleoenvironments?: Application to a highly polluted estuary in southwestern Spain.

Multivariate analyses have been applied to the REE contents of three cores collected in the Tinto estuary, SW Spain, an extremely polluted area. Results indicate an extremely correlation between all REE, which behave as a single variable. A slight natural pollution peak and three anthropogenic pollution peaks are identified, related with the first mining activities, the Roman period and a recent intensive mining accompanied by a heavy industrial pollution. In all these peaks, the increase of Cu is parallel to that of MREE, which are configured as the best indicators of pollution among REE. Statistical analyses clearly differentiate four groups, each consisting of samples from different environments. Although grain size and this strong pollution alter the study of REE as environmental indicators, it is possible to recognise groups of samples with a common origin or to identify the surface extent of a given pollution peak.

Isolation and identification of actinomycetes from a compost-amended soil with potential as biocontrol agents.

The search for new biocontrol strategies to inhibit the growth of phytopathogenic microorganisms has become widely widespread due to environmental concerns. Among actinomycetes, Streptomyces species have been extensively studied since they have been recognized as important sources of antibiotics. Actinomycete strains were isolated from a calcareous soil, 2 two-phase olive mill waste ('alperujo') composts, and the compost-amended soil by using selective media, and they were then co-cultured with 5 phytopathogenic fungi and 1 bacterium to perform an in vitro antagonism assay. Forty-nine actinomycete strains were isolated, 12 of them showing a great antagonistic activity towards the phytopathogenic microorganisms tested. Isolated strains were identified by 16S rDNA sequence analysis and phenotypic procedures. Eleven isolates concerned the genus Streptomyces and 1 actinomycete with chitinolytic activity belonged to the genus Lechevalieria.

Did a 3800-year-old Mw ~9.5 earthquake trigger major social disruption in the Atacama Desert?

Early inhabitants along the hyperarid coastal Atacama Desert in northern Chile developed resilience strategies over 12,000 years, allowing these communities to effectively adapt to this extreme environment, including the impact of giant earthquakes and tsunamis. Here, we provide geoarchaeological evidence revealing a major tsunamigenic earthquake that severely affected prehistoric hunter-gatherer-fisher communities ~3800 years ago, causing an exceptional social disruption reflected in contemporary changes in archaeological sites and triggering resilient strategies along these coasts. Together with tsunami modeling results, we suggest that this event resulted from a ~1000-km-long megathrust rupture along the subduction contact of the Nazca and South American plates, highlighting the possibility of Mw ~9.5 tsunamigenic earthquakes in northern Chile, one of the major seismic gaps of the planet. This emphasizes the necessity to account for long temporal scales to better understand the variability, social effects, and human responses favoring resilience to socionatural disasters.

Evaluating risk propensity using an objective instrument.

Risk propensity is the stable tendency to choose options with a lower probability of success, but greater rewards. Its evaluation has been approached from various perspectives: from self-report questionnaires to objective tests. Self-report questionnaires have often been criticized due to interference from voluntary and involuntary biases, in addition to their lack of predictive value. Objective tests, on the other hand, require resources that make them difficult to administer to large samples. This paper presents an easy-to-administer, 30-item risk propensity test. Each item is itself an objective test describing a hypothetical situation in which the subject must choose between three options, each with a different gain function but equivalent in expected value. To assess its psychometric fit, the questionnaire was administered to 222 subjects, and we performed a test of its reliability as well as exploratory factor analysis. The results supported a three-factor model of risk (Sports and Gambling, Long-term Plans, and Loss Management). After making the necessary adjustments and incorporating a global factor of risk propensity, confirmatory factor analysis was done, revealing that the data exhibited adequate goodness of fit.

Mechanical Performance of 3D-Printed Biocompatible Polycarbonate for Biomechanical Applications.

Additive manufacturing has experienced remarkable growth in recent years due to the customisation, precision, and cost savings compared to conventional manufacturing techniques. In parallel, materials with great potential have been developed, such as PC-ISO polycarbonate, which has biocompatibility certifications for use in the biomedical industry. However, many of these synthetic materials are not capable of meeting the mechanical stresses to which the biological structure of the human body is naturally subjected. In this study, an exhaustive characterisation of the PC-ISO was carried out, including an investigation on the influence of the printing parameters by fused filament fabrication on its mechanical behaviour. It was found that the effect of the combination of the printing parameters does not have a notable impact on the mass, cost, and manufacturing time of the specimens; however, it is relevant when determining the tensile, bending, shear, impact, and fatigue strengths. The best combinations for its application in biomechanics are proposed, and the need to combine PC-ISO with other materials to achieve the necessary strengths for functioning as a bone scaffold is demonstrated.

Leaching composted lignocellulosic wastes to prepare container media: feasibility and environmental concerns.

The leaching of salt and mineral elements from three composts prepared with residual vegetable crop biomass (melon, pepper or zucchini) was studied using methacrylate columns and distilled water. The benefits of the leached composts to be used for ornamental potted plant production were also analysed. After leaching 5 container capacities of effluent, both the electrical conductivity and the concentration of soluble mineral elements in compost leachates decreased substantially and remained close to the target levels. Composts reacted differently to leaching due to differences in the raw waste sources and the composting process and hence, in their physical and chemical characteristics. At the end of the experiment, after pouring 8 container capacities of water, the leaching efficiency of the salts was 96%, 93% and 87% for melon, pepper and zucchini-based composts, respectively. Mineral elements differed in their ability to be removed from the composts; N (NH(4)(+) and NO(3)(-)), K(+), Na(+), Cl(-), and SO(4)(2-) were leached readily, whereas H(2)PO(4)(-), Ca(2+), and Mg(2+) were removed hardly. Leached composts showed a range of physico-chemical and chemical characteristics suitable for use as growing media constituents. Potted Calendula and Calceolaria plants grew in the substrates prepared with the leached composts better than in those made with the non-leached ones. Finally, special emphasis must be paid to the management of the effluents produced under commercial conditions to avoid environmental pollution.

Differences and similarities among volunteers who drop out during the first year and volunteers who continue after eight years.

Differences and similarities between 130 volunteers who remain for more than eight years in the same non-profit organization and 110 volunteers who quit during the first year were analyzed in this paper. Both groups were chosen from a sample of 851 volunteers that were working as volunteers when we assessed the independent variables (Time 1). After a 12-month follow-up (Time 2), 209 (25%) of them had dropped out and 642 (75%) continued in the same organization. Using the previous time, we formed two groups made up of those who dropped out and had been in the organization less than a year and those who continued and had been in the organization more than 8 years. Results show that differences and similarities between both groups are coherent with the three-stage model of volunteer's duration (Chacón, Vecina, & Dávila, 2007). This model includes the functional approach of volunteers' motivations (Clary & Snyder, 1991), and the role identity approach (Callero, 1985), and indicates that people will remain as volunteers insofar as this satisfies the motivations that are relevant for them at the first stage, they develop organizational commitment at the second stage, and they develop role identity as volunteers at the third stage. More specifically, results show that it is possible to predict 85% of the cases correctly using seven variables. Volunteers who remain after eight years feel a higher level of emotional exhaustion, a higher level of organizational commitment, and a strong role identity as volunteers. They are also highly satisfied with the friendships in the organization and have a stronger intention to remain at the long-term (2 years).

Breastfeeding at 1, 3 and 6 Months after Birth According to the Mode of Birth: A Correlation Study.

BACKGROUND: Breastfeeding is a determinant of child and maternal health. However, evidence is limited on how mode of birth influences breastfeeding. Research aim: To examine the mode of birth and breastfeeding duration and the type of lactation at one, three and six months after birth in XXX, during 2017. METHODS: Correlation study on breastfeeding duration and type of lactation during the six months after birth, and mode of birth, in a randomised sample. Women ≥18 years of age with term singleton infants, were included. Collected data through interviews and hospital records. Pearson's and Spearman's correlation analyses were conducted. SPSSv21 and α = 0.05 were used. RESULTS: Breastfeeding duration was shorter in women with greater parity (-0.055 **) (p < 0.01) and epidural analgesia (0.057 **) (p < 0.01), and longer in mothers with episiotomy (-0.267 **) (p < 0.01). Episiotomy was associated with breastfeeding at one month (0.112 **) (p < 0.01), and at six months (0.347 *) (p < 0.01). The prevalence of breastfeeding was lower in women who received epidural analgesia at three months (-0.140 **) (p < 0.01) and higher at six months (0.013 **) (p < 0.01). The percentages of breastfeeding at three months were significantly greater in women with no perineal tears (2.1) (p < 0.05). At six months, small rates of breastfeeding were found in women with greater parity (0.051 **) (p < 0.01). No significant association was detected, neither between the type of lactation and the mode of birth, nor between breastfeeding duration and the mode of birth. CONCLUSIONS: Epidural analgesia, episiotomy, perineal tears and parity influence the type of lactation and duration of breastfeeding during the six months after birth. The results suggest no association between the type of lactation and the mode of birth or between breastfeeding duration and the mode of birth.

Umbilical cord separation time, predictors and healing complications in newborns with dry care.

OBJECTIVE: The objective of this study was to explore the umbilical cord separation time, predictors, and healing complications from birth until the newborn was one month old. DESIGN: A quantitative longitudinal observational analytical study by stratified random sample was adopted. SETTING: Public health system hospitals in southern Spain and at newborns' homes. PARTICIPANTS: Between April 2016 and December 2017, the study included 106 neonates born after 35-42 weeks of gestation whose umbilical cord was cured with water and soap and dried later as well as newborns without umbilical canalisation whose mothers enjoyed a low-risk pregnancy. METHODS: The data collection procedure comprised two blocks: from birth to the time of separation of the umbilical cord and from cord separation to the first month of life of the newborn. Umbilical cord separation time was measured in minutes; socio-demographic and clinical characteristics were measured by means of questionnaires, and the external diameter of the umbilical cord was measured using an electronic stainless-steel calliper and trailing roller. RESULTS: The mean umbilical separation time: 6.61 days (±2.33, IC 95%:6.16-7.05). Incidence of omphalitis was 3.7%; granuloma was 8.6%. Separation time predictors were wetting recurrence, birth weight, intrapartum antibiotics, birth season, and Apgar < 9 (R2 = 0.439 F: 15.361, p <0.01). CONCLUSION: The findings support the World Health Organization recommendations: dry umbilical cord cares is a safe practice that soon detaches the umbilical cord, taking into account the factors studied that will vary the length of time until the umbilical cord is separated.

Silver and copper as pollution tracers in Neogene to Holocene estuarine sediments from southwestern Spain.

Estuaries are very sensitive ecosystems to human activities and the natural evolution of their drainage basins located upstream. Pollution derived from human activities, such as historical mining or recent industrial wastes, can significantly affect their environmental quality. This paper analyzes the silver and copper contents of four cores extracted in two estuaries of SW Spain. Its chronology and vertical evolution allow to differentiate the effects of several pollution episodes (natural, Roman, 19th-20th centuries) on its different sedimentary environments in the last 6 million years. Possible future applications are included in the fields of environmental management or even education.

Decreased Consumption of Added Fructose Reduces Waist Circumference and Blood Glucose Concentration in Patients with Overweight and Obesity. The DISFRUTE Study: A Randomised Trial in Primary Care.

The relationship between fructose intake and insulin resistance remains controversial. Our purpose was to determine whether a reduction in dietary fructose is effective in decreasing insulin resistance (HOMA2-IR). This field trial was conducted on 438 adults with overweight and obese status, without diabetes. A total of 121 patients in a low fructose diet (LFD) group and 118 in a standard diet (SD) group completed the 24-week study. Both diets were prescribed with 30-40% of energy intake restriction. There were no between-group differences in HOMA2-IR. However, larger decreases were seen in the LFD group in waist circumference (-7.0 vs. -4.8 = -2.2 cms, 95% CI: -3.7, -0.7) and fasting blood glucose -0.25 vs. -0.11 = -0.14 mmol/L, 95% CI: -0.028, -0.02). The percentage of reduction in calorie intake was similar. Only were differences observed in the % energy intake for some nutrients: total fructose (-2 vs. -0.6 = -1.4, 95% CI: -2.6, -0.3), MUFA (-1.7 vs. -0.4 = -1.3, 95% CI: -2.4, -0.2), protein (5.1 vs. 3.6 = 1.4, 95% CI: 0.1, 2.7). The decrease in fructose consumption originated mainly from the reduction in added fructose (-2.8 vs. -1.9 = -0.9, 95% CI: -1.6, -0.03). These results were corroborated after multivariate adjustments. The low fructose diet did not reduce insulin resistance. However, it reduced waist circumference and fasting blood glucose concentration, which suggests a decrease in hepatic insulin resistance.

[Volunteer satisfaction: Internal structure and relationship with permanence in organizations]. / Satisfacción en el voluntariado: estructura interna y relación con la permanencia en las organizaciones.

Volunteer satisfaction: Internal structure and relationship with permanence in organizations. The concept of satisfaction is considered theoretically relevant in practically all the studies that have investigated the factors that influence the permanence of volunteer participation in organizations. However, the practical results are not conclusive, perhaps due to the wide range of ways in which the concept is understood and measured. The object of this study is: to analyse the internal structure of satisfaction and to verify its relationship with volunteer duration in organizations. The results of the factor analysis yield a three-factor structure: Satisfaction with the management of the organization, Satisfaction with the tasks, Satisfaction of motivations. The three factors allow us to differentiate between individuals who remain in the organization for a period of 12 consecutive months, and those who leave earlier. The results of structural equation model analysis show that the relationship between satisfaction and the length of time that volunteers stay with the organization is affected by the intention to remain.

Is It Possible to Become a Nurse in a Refugee Camp?

The history of the Western Sahara has been marked by several events that have contributed to the protracted refugee situation in which the Sahrawi people have found themselves since 1975: the Spanish colonization and the subsequent decolonization process, the armed struggles between the indigenous population and the states of Morocco and Mauritania to occupy Western Saharan territory, assassinations and repression of the Sahrawi population, and the economic interests of external agents with regards to mineral resources. Twenty-five years ago, in the hostile environment of the Sahrawi refugee camps, a nursing school was founded. Essentially depending on foreign aid, this school has been responsible for training nursing professionals to meet the healthcare needs of the population. The aim of this paper is to provide an approach to the origin and evolution of nursing education for the Sahrawi refugee camps. The Sahrawi are the only refugee camps in the world to host such nursing schools.

Is it possible to become a midwife in a refugee camp?

The historical backdrop of Western Sahara has meant that, for the last 43 years, part of its indigenous population has survived in refugee camps located in the Algerian desert. International aid from abroad has become the main source of sustenance for all people living in this hostile environment. Since the beginning of this type of settlement, the Sahrawi Arab Democratic Republic has been concerned with creating the necessary infrastructures to meet the health needs of the people living in these conditions. As a result, the Ahmed Abdel-Fatah School of Nursing was created in the Sahrawi refugee camps, which began to train midwives to care for women during the stages of pregnancy, childbirth and postpartum in 2002. The aim of this paper is to provide an approach to the origin and evolution of midwifery education for the Sahrawi refugee camps, in the only school of nursing that exists worldwide in a refugee camp.