Indifference, Demandingness and Resignation Regarding Support for Childrearing

This article explores the maternal experiences of a heterogeneous group of 26 mothers from Granada (Andalusia, Spain). The aim is to analyse the needs and demands that these women express with regard to childrearing, using a qualitative methodology. The authors conducted in-depth interviews and analysed the discourses of the mothers following the hermeneutical method. The variables used for sample selection and the themes that emerged during the interviews revealed that the discourses of the mothers revolve around three dimensions: indifference, demands and resignation regarding support for childrearing. The lack of paternal involvement in childrearing appears as a transversal dimension. This article shows that the material conditions of existence marked the differences in the responses of the women regarding support for childrearing, while the sexual division of labour and gender inequalities unified their discourses

Estudio comparativo de la recuperación postparto en base a los Patrones de Marjory Gordon

Objective: Analyse if there is any difference in recovery rate according to their puerperium stage depending on perineal lesion.Material and method: Prospective longitudinal descriptive quantitative study, following the Marjory Gordon’s Functional Health Patterns. Data collection will be performed in three phases (immediate, clinical and remote puerperium), through semi-structured interview completed in first instance in a face-to-face interview and phone call interview at 10 and 30 days, respectively. Results: In Spain there is an episiotomy, induction and assisted delivery rate much higher than recommended. Episiotomy technique lead to significant tear (16,7%) in this study. During immediate puerperium, women who were practiced an episiotomy shown mobility difficulties (p=0,0005), elimination (p=0,0007), baby care (p=0,015), rest (p=0,15) and perceived pain (p=0,005), whereas in the clinical puerperium are affected only mobility (p=0,05), elimination (p=0,042) and perceived pain (p=0,006). After 30 days, remote puerperium, there is not statistical significant differences in both groups. More research is needed to confirm these facts as well as provide new knowledge.Conclusions: Episiotomy produce more negative effects than spontaneous tears at the immediate and clinical puerperium of women. Pain produced by this technique as a short, medium and long term limit many daily activities of women.Objetivo: Analizar si existen diferencias en el nivel de recuperación en las distintas fases del puerperio según el tipo de lesión perineal.Material y método: Estudio cuantitativo de tipo descriptivo longitudinal prospectivo, siguiendo los Patrones Funcionales de Salud de Marjory Gordon. La recogida de datos se realiza en tres fases (puerperio inmediato, clínico y tardío), empleando entrevistas semiestructuradas que se completan en un primer momento en una entrevista personal y vía telefónica a los 10 y a los 30 días, respectivamente.Resultados: En España existe un índice de episiotomías, inducciones y partos instrumentales muy superior al recomendado. La técnica de la episiotomía produjo desgarros importantes (16,7%) en este estudio. Durante el puerperio inmediato, las mujeres con episiotomía tienen dificultades en la movilidad (p=0,0005), la eliminación (p=0,007), cuidado del bebé (p=0,015), descanso (p=0,15) y dolor percibido (p=0,005), mientras que en el puerperio clínico están afectados sólo la movilidad (p=0,05), la eliminación (p=0,042) y el dolor percibido (p=0,006). A los 30 días, en el puerperio tardío, no existen diferencias estadísticamente significativas entre ambos grupos. Se necesitan más estudios que reafirmen estos hechos y aporten nuevos conocimientos.Conclusiones: La episiotomía produce más efectos negativos que los desgarros espontáneos en el puerperio inmediato y clínico en la mujer. El dolor que genera esta técnica a corto, medio y largo plazo es el que limita muchas de las actividades cotidianas de estas mujeres

Experiências de partos domiciliares e partos hospitalares de mulheres nos anos 60 e 70 na Espanha

El objetivo principal del estudio es describir la experiencia de las mujeres que vivieron sus partos en el entorno hospitalario y en casa, en España entre los años 60-70. Para las mujeres, el parto es uno de los momentos más especiales de sus vidas, de ahí la importancia de conocer los sentimientos experimentados en este proceso, lo que nos ayudará a mejorar estos cuidados en futuras ocasiones y saber qué es lo que las mujeres realmente valoran a la hora de dar a luz. En este estudio también queda reflejado que los partos en casa, siempre que sean de bajo riesgo y atendidos por personal cualificado, son seguros y que hay que dejar a la mujer que, con toda la información, decida siempre donde quiere dar a luz. Se trata de una investigación cualitativa basada en la Teoría Fundamentada.The main purpose of the study is to describe the experience of women who lived their births in hospitals and at home in Spain between 60’s and 70’s years. For women, childbirth is one of the most special moments of their lives, hence the importance of knowing the feelings experienced in this process, which will help us to improve this care on future occasions and know what women really value when giving birth. This study also reflected that home births, provided they are low risk and serviced by qualified personnel, are safe and we should be left to the woman who, with all the information, decide always where she want to give birth. This is a qualitative research based on Grounded Theory.O principal objetivo do estudo é descrever a experiência de mulheres que viveram suas entregas em hospitais e em casa em Espanha entre 60-70. Para as mulheres, o parto é um dos momentos mais especiais de suas vidas, daí a importância de se conhecer os sentimentos vivenciados neste processo, o que vai nos ajudar a melhorar essa assistência em ocasiões futuras e saber o que as mulheres realmente valor quando o parto. Este estudo também refletiu que partos domiciliares, desde que sejam de baixo risco e servido por pessoal qualificado, são seguros e quais devem ser deixadas para a mulher que, com todas as informações, decidir sempre onde você deseja entregar. Esta é uma pesquisa qualitativa, baseada na Teoria Fundamentada

Game-based learning supported by audience response tools: game proposals and preliminary assessment

[EN] The so-called game-based learning strategies are based on introducing games in the classrooms to improve aspects such as student performance, concentration and effort. Currently, they provide a very useful resource to increase the motivation of university students, generating a better atmosphere among peers and between student and teacher, which in turn is generally translated into better academic results. However, the design of games that successfully achieve the desired teaching-learning objectives is not a trivial task. This work focuses on the design of games that allow the assessment of ICT-related university subjects. Specifically, three different games are proposed, all based on student participation in teams. After undertaking a preliminary evaluation of the different games, and observing the results obtained in different subjects taught by different teachers, the advantages and disadvantages of each game are discussed. This preliminary study will thus serve as an starting point for a more exhaustive study on the designed games, by including an statistical analysis considering the time variable (results in different academic courses).http://ocs.editorial.upv.es/index.php/HEAD/HEAD18Cobos, M.; Arevalillo-Herráez, M.; De Ves, E.; Roger, S.; García-Pineda, M.; Grimaldo, F.; Fuertes, A.... (2018). Game-based learning supported by audience response tools: game proposals and preliminary assessment. Editorial Universitat Politècnica de València. 605-612. https://doi.org/10.4995/HEAD18.2018.8044OCS60561

Diseño e implementación de juegos en el aula utilizando herramientas de respuesta de audiencia

El aprendizaje basado en juegos se basa en introducir el juego en las aulas para mejorar aspectos como el rendimiento, la concentración y el esfuerzo del alumnado. En la actualidad, proporciona un recurso muy útil para incrementar la motivación del alumnado universitario, generando un mejor clima entre compañeros y entre alumno y profesor, el cual en muchas ocasiones se traduce en mejores resultados académicos. Sin embargo, diseñar juegos que consigan con éxito los objetivos de enseñanza-aprendizaje deseados no es una tarea trivial. Este trabajo propone tres juegos basados en la participación por equipos que pueden ser fácilmente implementados utilizando plataformas online existentes. En el diseño de los mismos, se ha tenido en cuenta la experiencia previa de los alumnos en el uso de herramientas de respuesta de audiencia, así como en su participación en juegos en el aula. Tras llevar a cabo los juegos en distintas asignaturas relacionadas con el campo de las TIC, se ha evaluado el impacto de esta actividad mediante encuestas de satisfacción cumplimentadas por el alumnado.The so-called game-based learning strategies are based on introducing games in the classrooms to improve aspects such as student performance, concentration and effort. Currently, they provide a very useful resource to increase the motivation of university students, generating a better atmosphere among peers and between student and teacher, which in turn is generally translated into better academic results. However, the design of games that successfully achieve the desired teaching-learning objectives is not a trivial task. This paper proposes three games based on team participation that can be easily implemented using existing online platforms. The design of these games has taken into account the previous experience of the students in the use of audience response tools, as well as their participation in games in the classroom. After carrying out the games in different ICT-related subjects, we evaluated the impact of this activity using questionnaires collecting students’ assessments.Este proyecto ha sido financiado por la UV (Servei de Formació Permanent i Innovació Educativa) en el contexto del proyecto UV-SFPIE_GER18-848990

Splicing Machinery is Dysregulated in Pituitary Neuroendocrine Tumors and is Associated with Aggressiveness Features

Pituitary neuroendocrine tumors (PitNETs) constitute approximately 15% of all brain tumors, and most have a sporadic origin. Recent studies suggest that altered alternative splicing and, consequently, appearance of aberrant splicing variants, is a common feature of most tumor pathologies. Moreover, spliceosome is considered an attractive therapeutic target in tumor pathologies, and the inhibition of SF3B1 (e.g., using pladienolide-B) has been shown to exert antitumor effects. Therefore, we aimed to analyze the expression levels of selected splicing-machinery components in 261 PitNETs (somatotropinomas/non-functioning PitNETS/corticotropinomas/prolactinomas) and evaluated the direct effects of pladienolide-B in cell proliferation/viability/hormone secretion in human PitNETs cell cultures and pituitary cell lines (AtT-20/GH3). Results revealed a severe dysregulation of splicing-machinery components in all the PitNET subtypes compared to normal pituitaries and a unique fingerprint of splicing-machinery components that accurately discriminate between normal and tumor tissue in each PitNET subtype. Moreover, expression of specific components was associated with key clinical parameters. Interestingly, certain components were commonly dysregulated throughout all PitNET subtypes. Finally, pladienolide-B reduced cell proliferation/viability/hormone secretion in PitNET cell cultures and cell lines. Altogether, our data demonstrate a drastic dysregulation of the splicing-machinery in PitNETs that might be associated to their tumorigenesis, paving the way to explore the use of specific splicing-machinery components as novel diagnostic/prognostic and therapeutic targets in PitNETs

Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU

(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-gamma-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18-20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50-0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66-0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20-22%] vs. 14% [95% CI 13-16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM

A crowdsourcing database for the copy-number variation of the Spanish population

Background: Despite being a very common type of genetic variation, the distribution of copy-number variations (CNVs) in the population is still poorly understood. The knowledge of the genetic variability, especially at the level of the local population, is a critical factor for distinguishing pathogenic from non-pathogenic variation in the discovery of new disease variants. Results: Here, we present the SPAnish Copy Number Alterations Collaborative Server (SPACNACS), which currently contains copy number variation profiles obtained from more than 400 genomes and exomes of unrelated Spanish individuals. By means of a collaborative crowdsourcing effort whole genome and whole exome sequencing data, produced by local genomic projects and for other purposes, is continuously collected. Once checked both, the Spanish ancestry and the lack of kinship with other individuals in the SPACNACS, the CNVs are inferred for these sequences and they are used to populate the database. A web interface allows querying the database with different filters that include ICD10 upper categories. This allows discarding samples from the disease under study and obtaining pseudo-control CNV profiles from the local population. We also show here additional studies on the local impact of CNVs in some phenotypes and on pharmacogenomic variants. SPACNACS can be accessed at: http://csvs.clinbioinfosspa.es/spacnacs/. Conclusion: SPACNACS facilitates disease gene discovery by providing detailed information of the local variability of the population and exemplifies how to reuse genomic data produced for other purposes to build a local reference database

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

Introduction: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT- 2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the The Catalan Government DURSI grant 2009SGR1489

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality