Development and Validation of a Bangladeshi Pediatric Silhouette Scale (BPSS)

There is no culturally congruent children\u27s silhouette scale to understand how Bangladeshi mothers perceive their children\u27s body sizes and weight categories. The purpose of this study was to develop and validate an ethnic congruent Bangladeshi Pediatric Silhouette Scale (BPSS) and a facial feature scale to assess the mothers\u27 perceptions of their children\u27s body sizes, weight categories and facial features. The study methodology was a quantitative, descriptive design with scale content validation. The sample was comprised of 29 Bangladeshis mothers ages 25-40 and their four-five year old children living in London, England and New York City. The Mola Facetool analyses revealed that the gender set preference consensus was achieved in 13 of 14 facial features which were statistical non-significant. The hair variable revealed a significant difference with conditions; t (27) = -2.42, p = .02. The BPSS was validated by the analyses of three gender set sequences of A, B and C silhouette scales from thinnest to heaviest ordering and weight classifications assignments. The Cronbach alpha coefficients were significant for the samples. The independent sample t tests and paired t test revealed no differences between the samples with the ordering and weight classification of sequences A and B scales, achieving a p \u3e .05. There was a significant difference between the samples in the scores of identifying correct weight classification of sequence C silhouettes scale, boys with shorts, with the conditions; t (8) = 2.44, p = .04. The BPSS has provided a cultural congruent adiposity risk tool in the Bangladeshi community

Cerebral vasoreactivity in response to a headof-bed position change is altered in patients with moderate and severe obstructive sleep apnea

Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA. Furthermore, we have monitored the effect of two years of continuous positive airway pressure (CPAP) treatment on the cerebral vasoreactivity.Peer ReviewedPostprint (published version

Confiabilidad y validez de constructo del FFMQ en un grupo de meditadores y no meditadores

En la presente investigación se analiza la confiabilidad y validez de constructo del Five Facet Mindfulness Questionnaire (FFMQ, Baer et al., 2008) en una muestra compuesta por 55 meditadores y 55 no meditadores adultos con educación superior de Lima Metropolitana. La prueba y sus factores mostraron una elevada consistencia interna y todos los ítems lograron discriminar entre bajos y altos puntajes, lo que certificó la confiabilidad de la prueba. La validez de constructo fue demostrada al encontrar diferencias grupales significativas consistentes con la teoría, los meditadores puntuando más alto que los no meditadores en el puntaje total y en tres de los cinco factores de la prueba: Observación, Descripción y Ausencia de Reactividad. Dicha validez fue reforzada al encontrar relaciones consistentes con la teoría entre el FFMQ y la experiencia de meditación, pues esta correlacionó positivamente con el puntaje total y los tres factores antes mencionados. El FFMQ no pudo validarse del todo pues en dos de sus factores los resultados no fueron los esperados. Además, sólo en la muestra de meditadores los factores mostraron intercorrelaciones entre sí. Se discuten los resultados en base a la revisión teórica, los trabajos previos sobre la validez de constructo del FFMQ, aspectos metodológicos, las características demográficas de ambas muestras y las particularidades de la experiencia en meditación en el grupo de meditadores.Tesi

Cerebral vasoreactivity in response to a head-of-bed position change is altered in patients with moderate and severe obstructive sleep apnea

Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA. Furthermore, we have monitored the effect of two years of continuous positive airway pressure (CPAP) treatment on the cerebral vasoreactivity. CBF was measured at different head-of-bed position changes (supine to 30° to supine) in sixty-eight patients with OSA grouped according to severity (forty moderate to severe, twenty-eight mild) and in fourteen control subjects without OSA. A subgroup (n = 13) with severe OSA was measured again after two years of CPAP treatment. All patients and controls showed a similar CBF response after changing position from supine to 30° (p = 0.819), with a median (confidence interval) change of -17.5 (-10.3, -22.9)%. However, when being tilted back to the supine position, while the control group (p = 0.091) and the mild patients with OSA (p = 0.227) recovered to the initial baseline, patients with moderate and severe OSA did not recover to the baseline (9.8 (0.8,12.9)%, p < 0.001) suggesting altered cerebral vasoreactivity. This alteration was correlated with OSA severity defined by the apnea-hypopnea index, and with mean nocturnal arterial oxygen saturation. The CBF response was normalized after two years of CPAP treatment upon follow-up measurements. In conclusion, microvascular CBF response to a head-of-bed challenge measured by diffuse correlation spectroscopy suggests that moderate and severe patients with OSA have altered cerebral vasoreactivity related to OSA severity. This may normalize after two years of CPAP treatment

Calidad de vida de los profesionales en el modelo de gestión clínica de Asturias

ResumenObjetivoAnalizar la calidad de vida profesional en el modelo de gestión clínica de Asturias y comprobar si hay diferencias en los centros donde el modelo lleva implantado más tiempo o en función del ámbito asistencial (atención primaria o especializada).MétodosSe aplicó el CVP-35 (35 preguntas), anónimo y autocumplimentado, con tres preguntas adicionales. Se realizó un análisis descriptivo, univariado y bivariado, de las preguntas por separado y según las subescalas «Apoyo directivo» (AD), «Cargas de trabajo» (CT) y «Motivación intrínseca» (MI), siendo las principales variables independientes el ámbito asistencial y el tiempo como unidad o área de gestión clínica.ResultadosDe la población de estudio, 2572 profesionales, respondieron 1395 (54%) (el 67% en primaria y 51% en especializada). El 87% llevaba 5 años o más en su puesto. Para el 33% era su primer año en gestión clínica. El ítem con mayor puntuación fue la capacitación para el trabajo (8,39±1,42) y el más bajo los conflictos con los compañeros (3,23±2,2). Primaria obtiene resultados más altos en AD y calidad de vida en el trabajo, y especializada en CT. Respecto a la gestión clínica, las mejores puntuaciones se obtienen en las de 3 años y las peores en las de primer año. Las diferencias son especialmente favorables a la gestión clínica en especializada: las que más tiempo llevan perciben menos CT y más MI y calidad de vida.ConclusionesLlevar más tiempo en el modelo de gestión clínica se asocia con mejores percepciones en la calidad de vida profesional, sobre todo en atención especializada.AbstractObjectiveTo evaluate professional quality of life in our clinical governance model by comparing differences according to the time since the model's implementation (1-3 years) and the setting (primary or hospital care).MethodsA cross-sectional descriptive study was performed. The 35-item, anonymous, self-administered Professional Quality of Life Questionnaire, with three additional questions, was applied. A minimum sample size for each clinical governance unit/area (CGU/CGA) was calculated. Descriptive, univariate and bivariate analyses were performed using the 35 items separately. The subscales of «management support», «workload» and «intrinsic motivation» were used as dependant variables, and the setting and time since implementation of the CGU/CGA as independent variables.ResultsOf the study population of 2572 professionals, 1395 (54%) responded (67% in primary care and 51% in hospital care). A total of 87% had been working for 5 years or more in their positions. Thirty-three percent had worked for less than a year in clinical governance. The item with the highest score was job training (8.39±1.42) and that with the lowest was conflicts with peers (3.23±2.2). Primary healthcare professionals showed better results in management support and quality of life at work and hospital professionals in workload. The clinical governance model obtained the best scores at 3 years and the worst at 1 year. These differences were especially favorable for clinical governance in hospitals: professionals working longer perceived a lower workload and more intrinsic motivation and quality of life.ConclusionsA longer time working in the clinical governance model was associated with better perception of professional quality of life, especially in hospital care

Characterization of the microvascular cerebral blood flow response to obstructive apneic events during night sleep

Altres ajuts: This work was funded by the "Severo Ochoa" Programme for Centres of Excellence in R&D (Grant No. SEV-2015-0522), the Obra Social "la Caixa" Foundation (Grant Nos. LlumMedBcn, Programa de Matemàtica Col·laborativa), LASERLABEUROPE IV (Grant No. EU-H2020 654148), Marie Curie initial training network (Grant No. OILTEBIA 317526), Societat Catalana de Pneumologia (SOCAP), and Sociedad Española de Neumología y Cirugía Torácica (SEPAR).Obstructive apnea causes periodic changes in cerebral and systemic hemodynamics, which may contribute to the increased risk of cerebrovascular disease of patients with obstructive sleep apnea (OSA) syndrome. The improved understanding of the consequences of an apneic event on the brain perfusion may improve our knowledge of these consequences and then allow for the development of preventive strategies. Our aim was to characterize the typical microvascular, cortical cerebral blood flow (CBF) changes in an OSA population during an apneic event. Sixteen patients (age , 75% male) with a high risk of severe OSA were measured with a polysomnography device and with diffuse correlation spectroscopy (DCS) during one night of sleep with 1365 obstructive apneic events detected. All patients were later confirmed to suffer from severe OSA syndrome with a mean of apneas and hypopneas per hour. DCS has been shown to be able to characterize the microvascular CBF response to each event with a sufficient contrast-to-noise ratio to reveal its dynamics. It has also revealed that an apnea causes a peak increase of microvascular CBF () at the end of the event followed by a drop () similar to what was observed in macrovascular CBF velocity of the middle cerebral artery. This study paves the way for the utilization of DCS for further studies on these populations

Intervención educativa sobre abuso sexual infantil en trabajadores del Hospital Pediátrico “Hermanos Cordové”

Introduction: child sexual abuse is a form of child maltreatment; it has become an alarmingly increasing problem.Objective: to evaluate the effectiveness of an educational intervention on child sexual abuse in workers from “Hermanos Cordové” Pediatric Hospital.Method: a quasi-experimental before-and-after study was conducted without a control group in workers from “Hermanos Cordové” Pediatric Hospital in the period between September and December 2018. The target group comprised 28 participants.Results: among the participants, female sex predominated (68 %), age group between 25 and 35 years (64 %). The predominant level of schooling was pre-university (46 %). A low level of knowledge predominated for both sexes before applying the intervention (female: 74 %; male: 67 %). After the application of the educational intervention, a high level of knowledge predominated (females: 52,6 %; males: 55,6 %).Conclusions: the application of the educational intervention had a favorable impact on the level of knowledge about child sexual abuse in the community, guaranteeing a greater perception of risk and providing tools in order to prevent, to identify and manage it.Introducción: el abuso sexual infantil constituye una forma de maltrato infantil; ha llegado a ser un problema que se incrementa en forma alarmante.Objetivo: evaluar la efectividad de una intervención educativa sobre abuso sexual infantil en trabajadores del Hospital Pediátrico “Hermanos Cordové”.Método: se realizó un estudio cuasiexperimental de tipo antes y después sin grupo de control en trabajadores del Hospital Pediátrico “Hermanos Cordové”, en el período comprendido entre septiembre y diciembre del 2018. El universo estuvo compuesto por 28 participantes.Resultados: entre los participantes predominó el sexo femenino (68 %), el grupo de edades entre 25 y 35 años (64 %). El nivel de escolaridad que predominó fue el preuniversitario (46 %). Predominó un bajo nivel de conocimientos para ambos sexos antes de aplicar la intervención ( femenino: 74 %; masculino: 67 %). Luego de aplicada la intervención predominó un alto nivel de conocimientos (féminas: 52,6 %; varones 55,6 %).Conclusiones: la aplicación de la intervención educativa tuvo un impacto favorable sobre el nivel de conocimiento sobre abuso sexual infantil de la comunidad, garantizando una mayor percepción del riesgo y brindando herramientas para prevenirla, identificarla y manejarla

Factors associated with mortality in a neonatal intensive care unit

Aims: To describe the factors associated with mortality of newborns hospitalized in a Neonatal Intensive Care Unit in the period from 2012 to 2015. Methods: This was a descriptive, quantitative study of secondary data, correlated with the causes of death and hospitalization according to classification by ICD-10.&nbsp; The categorical variables were presented in absolute and relative frequencies, with measurements of central tendency and dispersion. Evaluation of the factors associated with neonatal death was made by the logit model of analysis with correction of robust errors by the statistical program Stata 12.0, considering values of p&lt;0.05 and interval of confidence of 95%.&nbsp; Results: Of the 563 newborns, 58.6% were of the male sex; 89.0% were early newborns, 73.0% were premature. 181 newborns died (32.3%). The main causes of hospitalization were: difficulties during birth, conditions of birth and immaturity (45.0%), pathologies associated with the respiratory system (21.1%), congenital malformations (9.7%). The main causes of death were: septicemia of the NB (40.4%), respiratory discomfort of the NB (22.4%). The significant associations for mortality were the use of ventilatory supports: Mechanical Ventilation (p=0.001), Hallo (p=0.000), CPAP (p=0.000), VNI (p=0.005). Conclusions: The major risk factors for neonatal mortality were associated with septicemia and use of mechanical ventilation