Aims
The objective of this study is to describe and understand the experiences of sexuality amongst heterosexual women with morbid obesity (MO) who are in a bariatric surgery program.
Background
...Morbid obesity is a chronic, metabolic disease that affects women's physical, psychological and sexual health. MO is associated with anxiety, depression and body image disorders. Bariatric surgery is a reliable method for weight loss in people with MO.
Design
A qualitative descriptive study research design was adopted.
Methods
Twenty‐one heterosexual women with MO in a bariatric surgery program were recruited through purposive sampling. Data collection included individual semi‐structured interviews conducted between November 2018 and May 2019. Interviews were audio recorded, transcribed verbatim and analysed using a computer‐assisted qualitative data.
Findings
Three main themes emerged from the analysis: (1) trapped in a body that limits my sexuality; (2) between neglect and hope and (3) the partner as a source of support for sexuality in women with MO.
Conclusion
Women hide a body that they do not accept and ignore their own sexuality, focusing on that of their partner. Although the women have doubts about their partners’ desire for them, they share the decision‐making process with them whilst waiting for bariatric surgery, on which they place all of their hopes for improved sexuality and quality of life.
Impact
The findings highlight the importance of exploring the experiences and sexual issues faced by heterosexual women with MO in a bariatric surgery program. Bariatric nurses have a privileged position to assess these women's sexuality, recommend alternatives to sexual intercourse or refer them to sexologists. As part of the multidisciplinary team, nurses can contribute to managing the expectations of women with MO and their partners in relation to the improvement of their sex lives following bariatric surgery.
Accommodation disorders and nonstrabismic binocular dysfunctions affect patients’ binocular system and visual performance. These visual disorders could be associated with musculoskeletal discomfort ...in the neck and shoulder area. The purpose of this systematic review and meta‐analysis was to ascertain the relationship between visual system disorders and the musculoskeletal system of the neck. The review protocol is available in PROSPERO (CRD42018112771). All articles selected examined the relationship between neck conditions (chronic neck pain and whiplash) and the visual system in adult populations. Studies with optometric or physiotherapeutic measurements were included. Bias risk was evaluated with the modified Cochrane Collaboration Tool and Study Quality Assessment Tool. To provide complete quality assessment evidence, the authors applied the GRADEpro Guideline Development Tool. The literature search was conducted in November 2018 and yielded 745 studies among all the databases. Out of these studies, 21 were finally included. Most of the studies presented a moderate methodological quality. Only one high‐quality trial was found. Based on a qualitative assessment, our systematic review and meta‐analysis revealed that all included studies established a relationship between the visual system and musculoskeletal system of the neck. However, the methods for the measurement of the visual system lacked uniformity.
Accommodation disorders and nonstrabismic binocular dysfunctions affect patients’ binocular system and visual performance. These visual disorders could be associated with musculoskeletal discomfort in the neck and shoulder area. The purpose of this systematic review and meta‐analysis was to ascertain the relationship between visual system disorders and the musculoskeletal system of the neck.
Macrophages present different Notch receptors and ligands on their surface. Following macrophage activation by LPS or other TLR ligands, Notch1 expression is upregulated. We report here that Notch ...signaling increases both basal and LPS-induced NF-κB activation, favoring the expression of genes implicated in the inflammatory response, such as the cytokines TNF-α and IL-6, or enzymes, such as iNOS. Delta4 seems to be the most effective ligand to induce Notch activation and increasing NF-κB transcriptional activity in macrophages. We show that Notch1 signaling promotes NF-κB translocation to the nucleus and DNA binding by increasing both phosphorylation of the IκB kinase α/β complex and the expression of some NF-κB family members. Treatment of macrophages with the γ-secretase inhibitor DAPT, which prevents the cleavage and activation of Notch receptors, inhibits all these processes, diminishing NF-κB activity following LPS stimulation. Additionally, we show that the active intracellular Notch fragment can directly interact with TNF-α and iNOS promoters. Our results suggest that Notch signaling results in an amplification of the macrophage-dependent inflammatory response by enhancing NF-κB signaling.
Aims
Physical and psychiatric comorbidities are common in cancer patients and could impact their treatment and prognosis. However, the evidence base regarding the influence of comorbidities in the ...management and health service use of patients is still scant. In this research we investigated how physical comorbidities are related to the mental health and help‐seeking of cancer patients.
Methods
Data were obtained from the representative National Health Survey of Spain (2017). Participants were respondents who reported a cancer diagnosis (n = 484). These were also matched with controls without cancer history (n = 484) based on age, gender, and region. Four alternative physical comorbidities indices were created based on information regarding 28 chronic conditions. Outcomes of interest were psychological distress and having consulted a mental healthcare professional in the year before the survey.
Results
Thirty percent of cancer patients reported significant psychological distress but only 10% had consulted a professional. After adjusting for sociodemographic variables, among cancer patients each additional comorbidity was associated with 9% higher odds of reporting high psychological distress (odds ratio OR = 1.09, 95% confidence interval CI: 1.01–1.16) and 21% higher odds of having consulted a mental healthcare professional (OR = 1.21, 95% CI: 1.09–1.34). The effects of comorbidities depended on the type of index and were different in controls without cancer history.
Conclusion
Physical comorbidities in cancer patients are associated with higher risk of psychological distress and higher demand for mental health services. We encourage further research on this issue as it could improve mental health screening and management in oncologic care.
During the Holocene (last ~11,700 years), societies have continuously modified the landscape of the Mediterranean Basin through changes in land-use, exerting extraordinary pressures onto the ...environment and adding variability to the climate. Despite its importance to current land management, knowledge of how past land-use practices have impacted the regional climate of the Basin remains largely in the scientific sphere. Thereby, this work aims to inform non-scientific actors and practitioners about the environmental effects of past land-use changes on the hydrologic cycle of the Mediterranean Basin. For this purpose we: i) summarize fundamental observed interactions between land-use change and the environment, identified through a semi-systematic review of 23 scientific case-studies from around the Basin; ii) reflect on the consequences to the Mediterranean environment (atmosphere, biosphere, lithosphere, and hydrosphere) in a synthesized and integrated way; iii) argue the need for taking into account the impact of local land-use practices from a regional-scale perspective; iv) highlight the importance of recognizing historical factors, such as past land-use changes, for developing protective strategies in the rural areas of the Basin. With this work, we provide a synthesized and more integrated understanding of the effects of past and local land-use changes in the regional Mediterranean environment, assisting to bridge the gap between scientific findings, Mediterranean watersheds stakeholders, and regional policy-makers.
Display omitted
•Collects specific case-studies and displays identified effects using a network map•Highlights the importance of historical practices for developing adaptation strategies•Argues the need for regional coordinated action within the Mediterranean Basin•Assists in bridging the gap between scientific findings and policy-makers' knowledge
Breast cancer ranks first in women, and is the second cause of death in this gender. In addition to genetics, the environment contributes to the development of the disease, although the factors ...involved are not well known. Among the latter is the influence of microorganisms and, therefore, attention is recently being paid to the mammary microbiota. We hypothesize that the risk of breast cancer could be associated with the composition and functionality of the mammary/gut microbiota, and that exposure to environmental contaminants (endocrine disruptors, EDCs) might contribute to alter these microbiota.
We describe a case-control clinical study that will be performed in women between 25 and 70 years of age. Cases will be women diagnosed and surgically intervened of breast cancer (stages I and II). Women with antecedents of cancer or advanced tumor stage (metastasis), or who have received antibiotic treatment within a period of 3 months prior to recruitment, or any neoadjuvant therapy, will be excluded. Controls will be women surgically intervened of breast augmentation or reduction. Women with oncological, gynecological or endocrine history, and those who have received antibiotic treatment within a period of 3 months prior to recruitment will also be excluded. Blood, urine, breast tissue and stool samples will be collected. Data regarding anthropometric, sociodemographic, reproductive history, tumor features and dietary habits will be gathered. Metabolomic studies will be carried out in stool and breast tissue samples. Metagenomic studies will also be performed in stool and breast tissue samples to ascertain the viral, fungal, bacterial and archaea populations of the microbiota. Quantitation of estrogens, estrogen metabolites and EDCs in samples of serum, urine and breast tissue will also be performed.
This is the first time that the contribution of bacteria, archaea, viruses and fungi together with their alteration by environmental contaminants to the risk of breast cancer will be evaluated in the same study. Results obtained could contribute to elucidate risk factors, improve the prognosis, as well as to propose novel intervention studies in this disease.
ClinicalTrials.gov NCT03885648 , 03/25/2019. Retrospectively registered.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background. Trait emotional intelligence (trait EI or trait emotional self‐efficacy) refers to individuals’ emotion‐related self‐perceptions (Petrides, Furnham, & Mavroveli, 2007). The children's ...trait EI sampling domain provides comprehensive coverage of their affective personality. Preliminary evidence shows that the construct has important implications for children's psychological and behavioural adjustment.
Aims. This study investigates the associations between trait EI and school outcomes, such as performance in reading, writing, and maths, peer‐rated behaviour and social competence, and self‐reported bullying behaviours in a sample of primary school children. It also examines whether trait EI scores differentiate between children with and without special educational needs (SEN).
Sample. The sample comprised 565 children (274 boys and 286 girls) between the ages of 7 and 12 (M(age)= 9.12 years, SD= 1.27 years) attending three English state primary schools.
Method. Pupils completed the Trait Emotional Intelligence Questionnaire‐Child Form (TEIQue‐CF), the Guess Who peer assessment, the Peer‐Victimization Scale, and the Bullying Behaviour Scale. Additional data on achievement and SEN were collected from the school archives.
Results. As predicted by trait EI theory, associations between trait EI and academic achievement were modest and limited to Year 3 children. Higher trait EI scores were related to more nominations from peers for prosocial behaviours and fewer nominations for antisocial behaviour as well as lower scores on self‐reported bulling behaviours. Furthermore, SEN students scored lower on trait EI compared to students without SEN.
Conclusions. Trait EI holds important and multifaceted implications for the socialization of primary schoolchildren.
Purpose: This study aims to address the pressing need for accurate forecasting of healthcare resource demands during the COVID-19 pandemic. It presents a novel approach that combines a stochastic ...Markov model and a discrete event simulation model to dynamically predict hospital admissions and daily occupancy of hospital and ICU beds.Design/methodology/approach: The research builds upon existing work related to predicting COVID-19 spread and patient influx to hospital emergency departments. The proposed model was developed and validated at San Juan de Alicante University Hospital from July 10, 2020, to January 10, 2022, and externally validated at Hospital Vega Baja. The model involves an admissions generator based on a stochastic Markov model, feeding data into a discrete event simulation model in the R programming language. The probabilities of hospital admission were calculated based on age-stratified positive SARS-COV-2 results from the health department's catchment population. The discrete event simulation model simulates distinct patient pathways within the hospital to estimate bed occupancy for the upcoming week. The performance of the model was measured using the median absolute difference (MAD) between predicted and actual demand.Findings: When applied to data from San Juan hospital, the admissions generator demonstrated a MAD of 6 admissions/week (interquartile range IQR 2-11). The MAD between the model's predictions and actual bed occupancy was 20 beds/day (IQR 5-43), equivalent to 5% of total hospital beds. For ICU occupancy, the MAD was 4 beds/day (IQR 2-7), constituting 25% of ICU beds. Evaluation with data from Hospital Vega Baja showcased an admissions generator MAD of 2.42 admissions/week (IQR 1.02-7.41). The MAD between the model's predictions and actual bed occupancy was 18 beds/day (IQR 19.57-38.89), approximately 5.1% of hospital beds. The ICU occupancy MAD was 3 beds/day (IQR 1-5), making up 21.4% of ICU beds.Practical implications: The dynamic predictions of hospital admissions, ward beds, and ICU occupancy for COVID-19 patients proved highly valuable to hospital managers, facilitating early and informed planning of resource allocation. Additionally, this study underscores the importance of utilizing simulation techniques to predict and manage hospital occupancy levels, thereby enhancing decision-making in hospital bed management, not only during pandemics but also during regular periods.Originality/value: This study introduces a novel hybrid approach that combines stochastic modeling and discrete event simulation to forecast healthcare resource demands during the COVID-19 pandemic. The methodology's effectiveness in predicting admissions and bed occupancy contributes to improved resource planning and situational awareness.
Purpose
To evaluate the effect of different non-osteoporotic drugs on the increase or decrease in the risk of incident fragility fractures (vertebral, humerus or hip) in a cohort of patients ...diagnosed with osteoporosis on active anti-osteoporotic therapy.
Methods
For this retrospective longitudinal study, baseline and follow-up data on prescribed non-osteoporotic treatments and the occurrence of vertebral, humerus or hip fractures in 993 patients from the OSTEOMED registry were analyzed using logistic regression models. The drugs evaluated with a possible beneficial effect were thiazides and statins, while the drugs evaluated with a possible harmful effect were antiandrogens, aromatase inhibitors, proton pump inhibitors, selective serotonin reuptake inhibitors, benzodiazepines, GnRH agonists, thyroid hormones, and oral and inhaled corticosteroids.
Results
Logistic regression analyses indicated that no treatment significantly improved fracture risk, with the only treatments that significantly worsened fracture risk being letrozole (OR = 0.18,
p
-value = 0.03) and oral corticosteroids at doses ≤ 5 mg/day (OR = 0.16,
p
-value = 0.03) and > 5 mg/day (OR = 0.27,
p
-value = 0.04).
Conclusion
The potential beneficial or detrimental effects of the different drugs evaluated on fracture risk are masked by treatment with anabolic or antiresorptive drugs that have a more potent action on bone metabolism, with two exceptions: letrozole and oral corticosteroids. These findings may have important clinical implications, as patients receiving these treatments are not fully protected by bisphosphonates, which may imply the need for more potent anti-osteoporotic drugs such as denosumab or teriparatide.
Inhibition of Leishmania infantum trypanothione disulfide reductase (LiTryR) by disruption of its homodimeric interface has proved to be an alternative and unexploited strategy in the search for ...novel antileishmanial agents. Proof of concept was first obtained by peptides and peptidomimetics. Building on previously reported dimerization disruptors containing an imidazole-phenyl-thiazole scaffold, we now report a new 1,2,3-triazole-based chemotype that yields noncompetitive, slow-binding inhibitors of LiTryR. Several compounds bearing (poly)aromatic substituents dramatically improve the ability to disrupt LiTryR dimerization relative to reference imidazoles. Molecular modeling studies identified an almost unexplored hydrophobic region at the interfacial domain as the putative binding site for these compounds. A subsequent structure-based design led to a symmetrical triazole analogue that displayed even more potent inhibitory activity over LiTryR and enhanced leishmanicidal activity. Remarkably, several of these novel triazole-bearing compounds were able to kill both extracellular and intracellular parasites in cell cultures.
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