Review of transition of care literature: Epidermolysis bullosa-A paradigm for patients with complex dermatologic conditions.

BACKGROUND: Transition from pediatric to adult care is a critical component of health care for children with long-term needs. The characteristics of epidermolysis bullosa (EB) demand higher than average levels of provider support. There is consensus among health care professionals regarding the importance of transition; however, there is a scarcity of practical information regarding models for patients with EB. OBJECTIVE: To review transition of care programs in varying specialties. Highlight practical considerations to facilitate the development of programs for patients with EB and other complex dermatologic conditions. METHODS: Articles were identified via MEDLINE and EMBASE health literature databases and screened for relevance to transition of care. RESULTS: Various models for transition exist. A well-executed formal transition program, early introduction, interdisciplinary collaboration, and psychosocial support were themes associated with successful outcomes. LIMITATIONS: Transition of care programs that have not been described in the literature are not reflected in this review. CONCLUSIONS: Patients with EB have unique needs that affect transition and span expertise across traditional boundaries, such as dependency on others for daily skin care, failure to thrive, and risk of squamous cell carcinoma. Given the rarity of the disease, patients with EB will benefit from collaborative efforts to develop programs to optimize successful transition.

A newly described cutaneous reaction at sites of insulin pump use in a child with Type 1 diabetes.

Continuous subcutaneous insulin infusion (CSII), or insulin pumps, with or without continuous glucose monitoring (CGM) devices have become the standard of care for patients with type 1 diabetes. While increasingly popular, a wide range of reported skin reactions to CSII and CGM devices was found. We present this case of a pyogenic granuloma-like neutrophilic and granulomatous response to an insulin pump to increase awareness of a previously uncharacterized cutaneous adverse reaction at insulin pump infusion sites.

The use of respiratory pathogen panel nasal polymerase chain reaction testing in predicting cutaneous enteroviral infections in the pediatric population.

BACKGROUND/OBJECTIVE: To characterize the relationship between the presence of enteroviral skin infection, defined as a positive skin polymerase chain reaction (PCR) test, and the nasopharyngeal (NP) respiratory pathogen panel (RPP) PCR test which includes enterovirus/rhinovirus as an analyte. METHODS: A retrospective chart review was performed on 543 subjects, age 18 years or younger, who had enterovirus (EV) skin swabs performed at an academic medical center in New York City between September 2014 and November 2019. Those patients with positive EV skin PCR were considered to have an enteroviral skin infection, and those with a negative EV skin PCR were considered not to have an enteroviral skin infection. Of those 543 children who had EV skin PCR, 170 also had an NP swab RPP performed. These NP swab RPP results were characterized as positive or negative, and if positive, it was noted if the patient was positive or negative for enterovirus/rhinovirus. The positive predictive value (PPV), negative predictive value (NPV), specificity, and sensitivity of a NP swab RPP for enteroviral skin infection were then calculated. RESULTS: An enterovirus/rhinovirus NP swab RPP had a NPV of 95%, PPV of 43%, sensitivity of 90%, and specificity of 62% for cutaneous enterovirus infection. CONCLUSION: The enteroviral skin PCR test is an assay that was validated at this institution. In clinically suspicious cases of EV, a positive NP swab RPP for enterovirus/rhinovirus is a sensitive test. A negative test is highly predictive of not having EV on the skin. Although further data are needed, given that NP swab RPP is readily available, these data may suggest that an NP swab RPP, when appropriately utilized, can support or exclude a clinical diagnosis of cutaneous enterovirus in the pediatric population.

Willingness to help women victims of intimate partner violence in a Spanish context: Differential factors, interactions and predictors.

This article presents two cross-sectional studies that group the most relevant (and potential) factors contemplated in the bystander literature on Intimate Partner Violence Against Women, (IPVAW). We analyzed their relationship with the intention to respond to hypothetical scenarios with specific helping behaviors based on the witnesses' gender, political ideology and on the bystander effect (study 1). We also studied them as predictors of helping behaviors (study 2). In total, 1,563 Spanish people participated in study 1 and 755 Spanish people in study 2. Participants had to study an IPVAW vignette (with a single bystander or multiple bystanders) and a control scenario (a robbery with a woman as victim or a man) and assess the perceived severity of the situation, the perceived responsibility of the victim and the aggressor(s), the personal perceived responsibility of the bystander and the intention to perform 8 helping behaviors. They also fulfilled a social desirability scale (study 1 and 2), the Inventory of Distorted Thoughts about Women and Violence and the Scale on Gender Ideology (study 2). Women tend to assess the IPVAW scenario in a way that favors displaying active helping behaviors to a greater extent than men. An individual's political opinion has also shown to affect the assessment and, to a lesser extent, the intention to help an IPVAW victim. The bystander effect only takes place when negative attitudes are present. When analyzing the interaction between the type of violence (gender versus non-gender-based violence) and the above-mentioned variables, the results tend to confirm previous studies. Regarding the predictors of the helping behaviors, perceived personal responsibility is key, together with victim blaming attitudes or the perceived severity of the situation. This study expands the knowledge on bystander behaviors in IPVAW contexts and offers elements to work on awareness campaigns.

Work-family conflict among hotel housekeepers in the Balearic Islands (Spain).

The massive incorporation of women to the labour market has increased academic and applied interest on work-life issues throughout the years. This article aims to describe the domestic burden and difficulties in work-life balance (WLB) and to understand the intersection of work and family spheres among hotel housekeepers (HHs). A cross-sectional study was conducted through Primary Health Care in the Balearic Islands (Spain); 1,043 HHs were enrolled. 56.7% reported difficulties in WLB. Risk factors for perceiving difficulties in WLB were: living with someone else (regardless of the number of co-habitants), having difficulties making ends meet, being the main person in charge of domestic tasks, having a dependant, having an external locus of control, presenting higher levels of stress at work, working more hours a week and being younger. Protective factors from experiencing work-family conflict (WFC) were job and wage satisfaction. WFC is strongly influenced by individual, economic, labour and domestic factors: these relationships show that labour and domestic spheres are non-separate worlds.

Workplace bullying and sexual harassment at work among hotel housekeepers in the Balearic Islands (Spain).

Introduction: Hotel housekeepers are close to being a 100% feminized occupational group in Spain. This fact, coupled with some features of the job, places them at high risk of sexual harassment at work and bullying in the workplace. This study aims to explore experiences of sexual harassment at work and workplace bullying among hotel housekeepers in the Balearic Islands. Second, it aims to describe and estimate the prevalence of both phenomena. Methods: This is a mixed-methods study. Ten semi-structured interviews were conducted with key informants, and six focus groups were held with hotel housekeepers. Additionally, a quantitative cross-sectional study (n = 1,043) was undertaken. Results: Most participants in focus groups had been sexually harassed at work. However, they had normalized this kind of situations, not labeling themselves as victims of sexual harassment; and harassment events were seen as unimportant, normal, and unquestioned, as well as being part of their daily work. Hotel housekeepers who were sexually harassed indicated high levels of stress at work and low social support. The prevalence of different workplace bullying behaviors was quite high among hotel housekeepers working in the Balearic Islands. Some were associated with poorer self-rated health, less satisfaction with the job and the salary, lower social support, and higher levels of stress. Despite this, qualitative methods informed us that less severe behaviors were normalized and perceived by hotel housekeepers as intrinsic to their job. Discussion: The results show the high tolerance to less severe expressions of sexual harassment at work and workplace bullying, as well as difficulties in or reluctance to labeling this kind of experiences as such.

The Questionnaire of Intention to Help in VAW Cases (QIHVC): Development and preliminary results.

Introduction: Violence against women (VAW) is a worldwide social and health problem of epidemic proportions. This violence is preventable, and bystander programs are one of the possible preventative strategies. The main purpose of this research was to develop a tool that, by applying a contrastive methodology for its application in different forms of violence (forms of gender-based violence, such as intimate partner VAW, sexual harassment at work, and street harassment, and common violence, such as a robbery), would allow measuring the probability of occurrence of bystander response in the face of these types of violence with good evidence of content validity. Method: Firstly (Study 1), an initial version of a measure tool, the Questionnaire of Intention to Help in VAW Cases (QIHVC), was developed; secondly (Study 2), a Delphi (modified) study was carried out to obtain valid, content-based evidence; and finally (Study 3), a pilot study was carried out to evaluate the appropriate functioning of the QIHVC and, if required, to make any necessary adjustments. Results and discussion: The main result is the development of a set of case scenarios and a questionnaire related to its content which constitutes the QIHVC and, in its initial approximation, seems to constitute an adequate and sensible tool to capture the differences between the characterizations of common violence and VAW and in the possible response of bystanders in the face of such violence.

Personal Traits of the People Who Help: The Case of Bystanders to Violence against Women.

Within the context of emergency situations, the terms witness or bystander are used to refer to individuals involved in oppressive incidents who are neither the victim nor the perpetrator. Among the different types of emergency situations, our study focuses on violence against women (VAW). In keeping with current efforts in the scientific literature on bystander intervention and the evidence currently available, the main focus of this study is to analyze some personal factors that reflect the characteristics or experiences of bystanders and that could have a bearing on their predisposition to help victims of VAW (i.e., empathy, a just world belief system, and expectations of self-efficacy) and later analyze the possible relationship between these personal characteristics and gender or previous experience as a VAW bystander. An opportunity sample of 546 Spanish participants (73.4% women and 26.6% men) between 18 and 56 years of age took part in this study and fill out a sociodemographic data sheet, a questionnaire to evaluate the experience as violence witness designed ad hoc, and the Characteristics of People who Help Questionnaire scale (CPHQ). The results obtained indicate that CPHQ could constitute an adequate measure for the three dimensions analyzed. Female participants are significantly more empathetic than males, but in the case of a just world belief and expectations of self-efficacy the results showed no gender-related differences. Additionally, only a just world belief was clearly influenced by having been a bystander to some form of VAW. In conclusion, this study contributes a proposal for an evaluating instrument featuring three relevant personal characteristics in the development of helping behaviors, presenting some results of interest regarding empathy, a just world belief, and expectations of self-efficacy and their relationship with gender or previous experiences as VAW bystanders. These results obtained suggest an initial path toward future research in the development of interventions with bystander participation in our environment.

Bystanders of intimate partner violence against women and their willingness to intervene: An analysis of secondary data in Spain (2005-2020).

Recent decades have seen a growing acknowledgement of violence against women (VAW) as a serious social and public health problem of epidemic proportions. The prevention of VAW and intimate partner violence against women (IPVAW) has become a priority within this context, and includes various prevention strategies such as social participation and helping behaviors. In different countries, conducting research on help-seeking behavior and bystander intervention in cases of VAW is a common practice, but addressing these issues is much less common in Spain. In this context, the objective of this study is to provide a preliminary estimation of the volume of bystanders in cases of IPVAW in Spain between 2005 and 2020 (since the entry into force of Organic Law 1/2004), their willingness to intervene and, in the case of intervention, the type of helping behavior (real or hypothetical) preferred, using the sources (secondary data) available (specifically, survey data, as the surveys of social perception of gender violence and the 2014 and 2019 macro-surveys, and also administrative data, as the database of reports filed). The data analyzed allow us to determine that, in fact, in the cases of IPVAW there are usually persons within the victim's inner circle who are firsthand witnesses or have been informed by the victim of the existence of this type of violence, but, although the bystanders generally claim they would engage in an active and supportive response, this is in fact not always the case. These results underscore the need to develop intervention programs aimed at IPVAW bystanders to improve their reaction and contribute to the development of helpful and efficient active responses.

Predicting Abusive Behaviours in Spanish Adolescents' Relationships: Insights from the Reasoned Action Approach.

(1) Background: Partner violence prevention programmes do not produce the expected behavioural changes. Accordingly, experts suggest applying evidence-based behavioural models to identify the determinants of abusive behaviours. In this research, we applied the reasoned action approach (RAA) to predict the performance (boys) and acceptance (girls) of abusive behaviours in adolescents. (2) Method: We designed a questionnaire based on the RAA and performed a cross-sectional study. We analysed the predictive capacity of the RAA constructs on intentions with the sample of single adolescents (n = 1112). We replicated the analysis only with those who were in a relationship (n = 587) and in addition analysed the predictive capacity of intention on future behaviour (3 months later). (3) Results: The hierarchical regression analysis performed with the sample of single adolescents showed that the model explained 56% and 47% of the variance of boys' intentions to perform the controlling and devaluing behaviours, respectively; and 62% and 33% of girls' intention to accept them. With those in a relationship, the model explained 60% and 53% of the variance of boys' intentions to perform the controlling and devaluating behaviour, respectively, and 70% and 38% of girls' intention to accept them. Intention exerted direct effects on boys' performance of controlling and devaluing behaviours (31% and 34% of explained variance, respectively) and on girls' acceptance (30% and 7%, respectively). (4) Conclusions: The RAA seems useful to identify the motivational determinants of abusive behaviours, regardless of adolescents´ relationship status, and for their prediction. Perceived social norms emerge as a relevant predictor on which to intervene to produce behavioural changes with both sexes.

Implicit and Explicit Attitudes Toward Intimate Partner Violence Against Women: An Exploratory Study.

There is consistent evidence that attitudes are important in understanding how people react and behave toward victims and perpetrators of intimate partner violence against women. Researchers have typically measured these attitudes through self-reports. However, explicit measures are prone to socially desirable responding. The overall objective of our research is to provide multimethod measures of public attitudes (explicit and implicit) toward intimate partner violence against women. An opportunity sample of 190 Psychology undergraduates (32 men and 158 women) took part in this study and completed two self-reports: the Inventory of Distorted Thoughts about Women and Violence, and the Inventory of Beliefs about Wife Beating. In addition, they completed a personalized Implicit Association Test, the Gender Violence Implicit Association Test. This study provides evidence of the best way to apply the Gender Violence Implicit Association Test (with feedback) and the best procedure for estimating the Implicit Association Test effect (built-in error penalty). The findings are also consistent with previous research and exhibit a significant disparity between explicit and implicit measures of attitudes toward intimate partner violence against women. These findings, although still preliminary, provide interesting information that affirms the need to incorporate implicit measures of attitudes toward intimate partner violence against women into research on this social problem.

Street Sexual Harassment: Experiences and Attitudes among Young Spanish People.

Violence against women (VAW) is gender-based violence directed at women and girls on account of being female that can take on multiple forms and manifest in different contexts. Among the many possible forms of VAW, this article focuses on "piropos", a type of stranger harassment situation. Specifically, the objectives of this study were two-fold: to analyze the usefulness of a tool to evaluate social attitudes towards this form of VAW and to analyze the influence of sociodemographic variables and prior victimization (whether as a witness or victim) on attitudes towards this type of violence among Spanish youth. An opportunity sample of 538 young Spanish people took part in this study. They filled out a sociodemographic data sheet, a victimization questionnaire designed ad hoc, and a questionnaire on attitudes towards "piropos". The results obtained indicate that the questionnaire was adequate for use as a tool to evaluate social attitudes towards this type of VAW and suggest its applicability for future studies on attitudes towards "piropos" as a type of stranger harassment situation in a Spanish context. Moreover, the results on victimization not only corroborate the magnitude of street sexual harassment in Spain and a direct effect of gender on the perception of the violence experienced, they also reinforce the need to further investigate new aspects. Regarding attitudes towards "piropos", the results obtained indicate that, in general, participants demonstrated negative attitudes or rejection, and these feelings were particularly strong among women.

Cannabinoid use and effects in patients with epidermolysis bullosa: an international cross-sectional survey study.

BACKGROUND: Epidermolysis bullosa (EB) patient anecdotes and case reports indicate that cannabinoid-based medicines (CBMs) may alleviate pain and pruritus and improve wound healing. CBM use has not been characterized in the EB patient population. OBJECTIVES: To evaluate CBM use among EB patients, including CBM types, effects on symptoms (e.g., pain and pruritus), disease process (e.g., blistering, wounds, and inflammation), well-being (e.g., sleep, appetite) and concomitant medications. METHODS: English-speaking EB patients or caregivers completed an online international, anonymous, cross-sectional survey regarding CBM use. Respondents reported the types of CBMs, subsequent effects including perceived EB symptom alteration, changes in medication use, and side effects. RESULTS: Seventy-one EB patients from five continents reported using or having used CBMs to treat their EB. Missing question responses ranged between 0 (0%) and 33 (46%). Most used more than one CBM preparation (mean: 2.4 ± 1.5) and route of administration (mean: 2.1 ± 1.1). Topical and ingested were the most common routes. Pain and pruritus were reported retrospectively to decrease by 3 points (scale: 0-10; p < 0.001 for both) after CBM use. Most reported that CBM use improved their overall EB symptoms (95%), pain (94%), pruritus (91%) and wound healing (81%). Most participants (79%) reported decreased use of pain medications. The most common side-effect was dry mouth (44%). CONCLUSIONS: CBMs improve the perception of pain, pruritus, wound healing, and well-being in EB patients and reduced concomitant medication use. Nevertheless, a direct relation between the use of CBMs and reduction of the above-mentioned symptoms cannot be proven by these data. Therefore, future controlled studies using pharmaceutically standardised CBM preparations in EB are warranted to delineate the risks and benefits of CBMs.

Face-to-Face and blended methods to improve oral competence in nursing students through simulation.

Communication and interpersonal skills are relevant to the health professions, so it is important to promote these competencies at university. This research assesses the effectiveness of teaching oral competence through simulation using face-to-face and blended methods. A public speaking workshop was conducted in a group of 144 first year nursing students. Three groups were obtained according to the teaching method (Group 1: traditional method-3 sessions, Group 2: traditional method-2 sessions, Group 3: blended method-2 sessions). Public speaking confidence was measured at the beginning and end of the training, and oral competence was assessed at the end. As a result, all groups achieved a good level of oral competence after the training. However, while students in Group 1 showed greater oral competence, with regard to confidence in public speaking, students in Group 1 showed significantly worst results than those in Group 3. We concluded that simulation is a useful strategy to improve cognitive learning, and behavioural and practical competencies such as public speaking. As for the teaching method, although blended learning did not offer better results than traditional learning, it seems useful provide there is at least one face-to-face session so that the student can perform a speech and receive corrective feedback.

The Gender Violence - Implicit Association Test to measure attitudes toward intimate partner violence against women.

Attitudes play a central role in intimate partner violence against women and are related to its origin, to the responses of women who suffer violence, and to the settings where it occurs. In fact, these attitudes are recognized as one of the risk factors linked to violent perpetration and to public, professional, and victim responses to this type of violence. However, even though available research generally shows a broad rejection of this violence, it remains a serious social and health problem that has reached epidemic proportions. This suggests that the information available about these attitudes (obtained through explicit and direct measures, i.e., self-reports) may be distorted or influenced by factors such as social desirability. In this context, the overall objective of our research project is to provide multi-method measures (explicit and implicit) of attitudes toward intimate partner violence against women, and the main goal of this paper is to propose an instrument for the implicit measurement of these attitudes. In this regard, the Implicit Association Test (IAT) is the most common procedure used, providing a superior predictive validity compared to explicit measures for socially sensitive topics. We will present an exploratory study that describes its adaptation for our purposes, and the development of the Gender Violence - Implicit Association Test (GV-IAT) to use among Spanish-speaking populations, and discuss the strengths and limitations of this proposal.

Measurement of supportive attitudes towards intimate partner violence against women among a Spanish-speaker sample.

Intimate partner violence is the most common type of violence against women. Attitudes towards this violence are increasingly recognized as key to understanding this social and public health problem because a social environment that accepts or even supports it creates a climate that breeds further violence and encourages their perpetration. The evidence available shows that these attitudes are influenced by different individual, organizational and community factors, and that the supportive attitudes are generally more common among males, and among older and less educated people. This paper presents two cross-sectional studies which aim to obtain a deeper understanding of supportive attitudes towards intimate partner violence against women in a Spanish-speakers context. Results obtained show that the two questionnaires used may be useful for evaluating supporting attitudes towards this violence in Spanish-speaking samples. Thus, the Inventory of Distorted Thoughts about Women and Violence (IPDMV), one of the one of the most widely used tools to this aim among Spanish-speakers, includes information regarding the minimization of this violence and the responsibility of perpetrators, and it seems better able to capture the effect of previous training, which would be consistent with the fact that it was initially designed to detect the effects of interventions; and the Inventory of Beliefs about Intimate Partner Violence (IBIPV), a new tool recently designed to this aim, is more focused on supportive attitudes and seems more effective for capturing differences between men and women in blaming victims and exonerating perpetrators. Additionally, the results obtained allow us to complement previous studies on the effects that factors such as gender, age, or previous training have on supportive attitudes towards intimate partner violence against women.

Perceived Factors of Stress and Its Outcomes among Hotel Housekeepers in the Balearic Islands: A Qualitative Approach from a Gender Perspective.

Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands, e.g., work overload, time pressure, physical burden…, lack of enough resources and little control, derived from role conflict, unexpected events…, were the most important factors explaining HHs' stress. Additionally, this imbalance was perceived as leading to health problems, mainly musculoskeletal disorders. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict, preventing them from enjoying leisure time. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.

Comparing Implicit and Explicit Attitudes Toward Intimate Partner Violence Against Women.

Intimate partner violence against women (IPVAW) is an epidemic social and public health problem. Research has consistently found evidence for a complex etiology of IPVAW resulting from the interaction of many factors, among which gender-related norms and attitudes are among the main drivers of this violence. Public attitudes toward IPVAW are especially important because attitudes rejecting, condoning, or fostering such behavior are social factors that contribute to a climate of tolerance or refusal that can shape the social environment in which such violence takes place. Given the importance of these attitudes, the availability of reliable, valid, and concise measures is critical for both research and intervention purposes. The evidence shows a probable bias of direct or explicit assessment measures of IPVAW attitudes, and it has been suggested that they should be complemented by indirect or implicit measures. In this context, the main aim of this paper was to examine how implicit and explicit attitudes toward IPVAW differ among a Spanish population. An opportunity sample of 693 students took part in this study. Two direct or explicit measures (the Inventory of Distorted Thoughts about Women and Violence, IPDMV, and the Inventory of Beliefs about Intimate Partner Violence, IBIPV) and one indirect or implicit measure [the Gender Violence Implicit Association Test (GV-IAT), a personalized form of the Implicit Association Test (IAT)] were applied. The results obtained show that the psychometric characteristics of the implicit measure used (GV-IAT) are acceptable. Additionally, we obtained significant differences by gender, IPVAW knowledge, IPVAW involvement, and political opinion when we measured IPVAW attitudes by implicit measures. However, when we measured these attitudes by explicit measures, we only obtained significant differences by gender and political opinion. Finally, the results highlight the important differences between the levels of strong IPVAW rejection measured with explicit and implicit measures, confirming the traditional discrepancy between explicit and implicit measures of attitudes. In summary, the results obtained provide additional support for the idea that GV-IAT constitutes a promising assessment tool to complement explicit measures for attitudes toward IPVAW.

Psychosocial Implications of Supportive Attitudes towards Intimate Partner Violence against Women throughout the Lifecycle.

Supportive attitudes towards intimate partner violence against women (IPVAW) normalize and promote these aggressive behaviors. As a result, more and more research is proposing the identification, analysis and intervention of these attitudes. However, the vast majority of this research focuses on students. The main objective of this paper is to analyze these supportive attitudes throughout the lifecycle. An opportunity sample of 200 Spanish participants, by age and sex fixed quotas, took part in this study. Attitudes were measured using the Inventory of Distorted Thoughts about Women and Violence, the Inventory of Beliefs about Intimate Partner Violence and the Gender Violence Implicit Association Test, a personalized form of Implicit Association Test (IAT). The results show that explicitly measured supportive attitudes towards intimate partner violence against women differ between age groups, adopting a U-shape distribution: lower acceptance among middle-aged-adults and young-adults and higher acceptance among adolescents and older adults. However, when these attitudes were implicitly measured, the IPVAW rejection increased with age, which is a counter-intuitive result and inconsistent with previous theoretical evidence. In summary, these results support an age effect that differs according to the measure of attitudes used and highlight some difficulties related to based-on-reaction-time measures among older people. This suggests the need for further research on the topic, especially among the older population.