Personal support networks and informal care: differences by sex and place? (CUIDAR-SE II study)

nObjetivo: Comparar la composición y la funcionalidad de apoyo social de redes personales de personascuidadoras de Granada y Gipuzkoa en función del sexo y la provincia.Método: Estudio transversal con metodología de análisis de redes personales. Se seleccionó una muestrade 66 personas cuidadoras segmentada por sexo en cada provincia. Se recogieron variables de compo-sición, funcionalidad de apoyo y contenido relacional de 1650 contactos personales que conforman lasredes estudiadas. Se utilizó el software EgoNet para la recogida, el análisis y la representación gráfica delas redes. Se midió la asociación de las características de la red con el sexo (de las personas cuidadoras yde las que componen sus redes) mediante la prueba de ji al cuadrado. Se analizaron los vínculos dentrode las redes.Resultados: Las redes de las personas cuidadoras de Granada están más feminizadas que las de Gipuzkoa.Las mujeres de Gipuzkoa cuentan con redes compuestas por menos familiares que las de Granada y conmayor número de relaciones entre las personas que las apoyan. Además, cuentan con más apoyo dehombres que de mujeres en todas las tareas analizadas, excepto en atención a la enfermedad. En ambasprovincias, los hombres cuidadores presentan en sus redes más mujeres que ayudan en tareas específicasde cuidado que hombres. Solo en actividades fuera del hogar en Granada hay más hombres que ayudanque mujeres (76,1% vs. 57%; p = 0,026).Conclusión: Se aprecian diferencias según el sexo y entre provincias en la composición de las redes y enel modo en que hombres y mujeres reciben y ofrecen apoyo en el cuidado.tObjective: To compare the composition and functionality of social support of personal networks of care-givers of Granada and Gipuzkoa (Spain) according to sex and province.Method: Cross-sectional study with personal network analysis methodology. A sample of 66 caregiverssegmented by sex in each province was selected. We collected variables of composition, functional andrelational content in social support of 1,650 personal relationships of the networks studied. The EgoNetsoftware was used for the collection, analysis and graphic representation of the networks. The associationof the characteristics of the network with sex (of the caregivers and those who make up their networks)was measured, using Chi-square. The links within the networks were analyzed.Results: The networks of caregivers in Granada are more feminized than those in Gipuzkoa. The women ofGipuzkoa have less familiar networks than those of Granada and with a greater number of relationshipsamong the people who support them. They also have more support from men than women in all the tasksanalyzed, except in attention to the disease. In both provinces, male caregivers show in their networksmore women who help in specific care tasks than men. Only in activities outside the home in Granadathere are more men who help than women (76.1% vs. 57%; p = 0.026).Conclusion: Gender differences between provinces can be seen in the composition of the networks and in the way in which men and women receive and offer support in care

Exploring Changes in Event-Related Potentials After a Feasibility Trial of Inhibitory Training for Bulimia Nervosa and Binge Eating Disorder

In a feasibility trial comparing two forms of combined inhibitory control training and goal planning (i.e., food-specific and general) among patients with bulimia nervosa (BN) and binge eating disorder (BED), we found evidence of symptomatic benefit, with stronger effects among participants receiving a food-specific intervention. The aim of the present study was to examine changes in behavioral outcomes and event-related potentials (ERPs; N2 and P3 amplitudes) from baseline to post-intervention that might suggest the mechanisms underpinning these effects. Fifty-five participants completed go/no-go tasks during two electroencephalography (EEG) sessions, at baseline and post-intervention. The go/no-go task included "go" cues to low energy-dense foods and non-foods, and "no-go" cues to high energy-dense foods and non-foods. Datasets with poor signal quality and/or outliers were excluded, leaving 48 participants (N= 24 BN;N= 24 BED) in the analyses. Participants allocated to the food-specific, compared to the general intervention group, showed significantly greater reductions in reaction time to low energy-dense foods, compared to non-foods, by post-intervention. Commission errors significantly increased from baseline to post-intervention, regardless of stimulus type (food vs. non-food) and intervention group (food-specific vs. general). There were no significant changes in omission errors. P3 amplitudes to "no-go" cues marginally, but non-significantly, decreased by post-intervention, but there was no significant interaction with stimulus type (high energy-dense food vs. non-food) or intervention group (food-specific vs. general). There were no significant changes in N2 amplitudes to "no-go" cues, N2 amplitudes to "go" cues, or P3 amplitudes to "go" cues from baseline to post-intervention. Training effects were only marginally captured by these event-related potentials. We discuss limitations to the task paradigm, including its two-choice nature, ease of completion, and validity, and give recommendations for future research exploring ERPs using inhibitory control paradigms

Gender Differences in Social Support Received by Informal Caregivers: A Personal Network Analysis Approach

Social support is an important predictor of the health of a population. Few studies have analyzed the influence of caregivers? personal networks from a gender perspective. The aim of this study was to analyze the composition, structure, and function of informal caregiver support networks and to examine gender differences. It also aimed to explore the association between different network characteristics and self-perceived health among caregivers. We performed a social network analysis study using a convenience sample of 25 female and 25 male caregivers. A descriptive analysis of the caregivers and bivariate analyses for associations with self-perceived health were performed. The structural metrics analyzed were density; degree centrality mean; betweenness centrality mean; and number of cliques, components, and isolates. The variability observed in the structure of the networks was not explained by gender. Some significant differences between men and women were observed for network composition and function. Women received help mainly from women with a similar profile to them. Men?s networks were broader and more diverse and they had more help from outside family circles, although these outcomes were not statistically significant. Our results indicate the need to develop strategies that do not reinforce traditional gender roles, but rather encourage a greater sharing of responsibility among all parties.Funding: This project has received funding from Consejería de Salud (Junta de Andalucía) (PS-0280–2016) and from Instituto de Salud Carlos III and the European Regional Development Fund (PI16/00207

Cognitive and clinical gender-related differences among binge-spectrum eating disorders: Analysis of therapy response predictors

Objective: This study assessed gender-related differences in executive functions (decision-making, inhibitory control and cognitive flexibility), personality traits and psychopathological symptoms in binge-spectrum eating disorders (EDs). Secondly, we aimed to separately explore the predictive value of gender and executive functions in treatment outcome. Method: A battery of self-reported and neurocognitive measures were answered by a sample of 85 patients (64 females) diagnosed with a binge-spectrum ED (41 BN; 44 binge eating disorder). Results: Data showed gender-related differences in executive functioning, displaying women lower inhibitory control and lower cognitive flexibility than men. Regarding personality traits and psychopathology symptoms, women presented higher reward dependence and cooperativeness, as well as more drive for thinness, body dissatisfaction, bulimia, and somatisation symptoms than men. Finally, worse executive functioning, particularly having lower ability in concept formation seems to predict worse treatment outcomes and dropout in these patients. Conclusions: We described gender specific neuropsychological, personality and psychopathological impairments in patients with binge-spectrum EDs. Moreover, difficulties in executive functioning might have an impact on treatment response, since patients with a lower ability in concept formation are less likely to benefit from treatment. The present results can help improving current treatment approaches by tackling gender and individual differences

High drug resistance prevalence among vertically HIV-Infected patients transferred from pediatric care to adult units in Spain

BACKGROUND: Antiretroviral treatment (ART) has contributed to increased life expectancy of HIV-1 infected children. In developed countries, an increasing number of children reaching adulthood are transferred to adult units. The objectives were to describe the demographic and clinical features, ART history, antiviral drug resistance and drug susceptibility in HIV-1 perinatally infected adolescents transferred to adult care units in Spain from the Madrid Cohort of HIV-1 infected children. METHODS: Clinical, virological and immunological features of HIV-1 vertically infected patients in the Madrid Cohort of HIV-infected children were analyzed at the time of transfer. Pol sequences from each patient were recovered before transfer. Resistance mutations according to the InternationaI AIDS Society 2011 list were identified and interpreted using the Stanford algorithm. Results were compared to the non-transferred HIV-1 infected pediatric cohort from Madrid. RESULTS: One hundred twelve infected patients were transferred to adult units between 1997 and 2011. They were mainly perinatally infected (93.7%), with a mean nadir CD4+-T-cells count of 10% and presented moderate or severe clinical symptoms (75%). By the time of transfer, the mean age was 18.9 years, the mean CD4+T-cells count was 627.5 cells/ml, 64.2% presented more than 350 CD4+T-cells/ml and 47.3% had ≤200 RNA-copies/ml. Most (97.3%) were ART experienced receiving Highly Active ART (HAART) (84.8%). Resistance prevalence among pretreated was 50.9%, 76.9% and 36.5% for Protease Inhibitors (PI), Nucleoside Reverse Transcriptase Inhibitors (NRTI) and Non-NRTI (NNRTI), respectively. Resistance mutations were significantly higher among transferred patients compared to non-transferred for the PI+NRTI combination (19% vs. 8.4%). Triple resistance was similar to non-transferred pediatric patients (17.3% vs. 17.6%). CONCLUSION: Despite a good immunological and virological control before transfer, we found high levels of resistance to PI, NRTI and triple drug resistance in HIV-1 infected adolescents transferred to adult units

Methods and restrictions to increase the volume of resonant rectangular-section haloscopes for detecting dark matter axions

Haloscopes are resonant cavities that serve as detectors of dark matter axions when they are immersed in a strong static magnetic field. In order to increase the volume and improve space compatibility with dipole or solenoid magnets for axion searches, various haloscope design techniques for rectangular geometries are discussed in this study. The volume limits of two types of haloscopes are explored: those based on single cavities and those based on multicavities. In both cases, possibilities for increasing the volume of long and/or tall structures are presented. For multicavities, 1D geometries are explored to optimise the space in the magnets. Also, 2D and 3D geometries are introduced as a first step in laying the foundations for the development of these kinds of topologies. The results prove the usefulness of the developed methods, evidencing the ample room for improvement in rectangular haloscope designs nowadays. A factor of three orders of magnitude improvement in volume compared with a single cavity based on the WR-90 standard waveguide is obtained with the design of a long and tall single cavity. Similar procedures have been applied for long and tall multicavities. Experimental measurements are shown for prototypes based on tall multicavities and 2D structures, demonstrating the feasibility of using these types of geometries to increase the volume of real haloscopes.This work was performed within the RADES group. We thank our colleagues for their support. In addition, this work has been funded by the grant PID2019-108122GB-C33, funded by MCIN/AEI/10.13039/501100011033/ and by “ERDF A way of making Europe”. JMGB thanks the grant FPI BES-2017-079787, funded by MCIN/AEI/10.13039/501100011033 and by “ESF Investing in your future”. Also, this project has received partial funding through the European Research Council under grant ERC-2018-StG-802836 (AxScale)

Executive functions in binge spectrum eating disorders with comorbid compulsive buying

Objective: The aims were to explore if bulimic spectrum disorders (BSD) patients, who also present comorbid compulsive buying (CB), could represent a specific subtype considering its neuropsychological performance; to present a descriptive analysis of different clinical features; and to explore how these variables could influence treatment outcome. It was hypothesised that the comorbid group will present worse neuropsychological performance that will lead to a worse treatment outcome. Method: The study has a longitudinal design. Women (N = 75) diagnosed with BSD, BSD + CB and Healthy Controls (HC); completed an evaluation of: cognitive flexibility, decision making, eating disorder (ED) symptomatology, psychopathological state and personality traits. Results: BSD + CB was the group with the most severe clinical profile, worst treatment outcome and higher neuropsychological impairment, than other groups. Path-analysis evidenced that deficits in decision making were associated with bad treatment outcome, while deficits in flexibility with the presence of the comorbidity. Self-directedness and novelty seeking were associated with the neuropsychological performance and the comorbidity. Conclusion: BSD + CB exhibit a worse clinical and neuropsychological profile that seems to be related with the treatment outcome, which should be taken into account for the establishment of specific treatment approaches

Impulsivity, emotional dysregulation and executive function deficits could be associated with alcohol and drug abuse in eating disorders

Background: Empirical data suggests a high comorbid occurrence of eating disorders (EDs) and substance use disorders (SUDs), as well as neurological and psychological shared characteristics. However, no prior study has identified the neuropsychological features of this subgroup. This study examines the prevalence of alcohol and/or drug abuse (A/DA) symptoms in ED patients. It also compares the clinical features and neuropsychological performance of ED patients with and without A/DA symptoms. Methods: 145 participants (74.5% females) with various forms of diagnosed EDs underwent a comprehensive clinical (TCI-R, SCL-90-R and EDI-2) and neuropsychological assessment (Stroop, WCST and IGT). Results: Approximately 19% of ED patients (across ED subtypes) had A/DA symptoms. Those with A/DA symptoms showed more impulsive behaviours and higher levels of interoceptive awareness (EDI-2), somatisation (SCL-90-R) and novelty seeking (TCI-R). This group also had a lower score in the Stroop-words measure, made more perseverative errors in the WCST and showed a weaker learning trajectory in the IGT. Conclusions: ED patients with A/DA symptoms display a specific phenotype characterised by greater impulsive personality, emotional dysregulation and problems with executive control. Patients with these temperamental traits may be at high risk of developing a SUD

Internet gaming disorder and online gambling disorder: Clinical and personality correlates

Background and aims: The recent growth of Internet use has led to an increase of potentially problematic behaviors that can be engaged online, such as online gambling or Internet gaming. The aim of this study is to better conceptualize Internet gaming disorder (IGD) by comparing it with gambling disorder (GD) patients who only gamble online (online GD). Methods: A total of 288 adult patients (261 online GD and 27 IGD) completed self-reported questionnaires for exploring psychopathological symptoms, food addiction (FA), and personality traits. Results: Both clinical groups presented higher psychopathological scores and less functional personality traits when compared with a normative Spanish population. However, when comparing IGD to online GD, some singularities emerged. First, patients with IGD were younger, more likely single and unemployed, and they also presented lower age of disorder onset. In addition, they displayed lower somatization and depressive scores together with lower prevalence of tobacco use but higher FA scores and higher mean body mass index. Finally, they presented lower novelty seeking and persistence traits. Discussion: GD is fully recognized as a behavioral addiction, but IGD has been included in the Appendix of DSM-5 as a behavioral addiction that needs further study. Our findings suggest that IGD and online GD patients share some emotional distress and personality traits, but patients with IGD also display some differential characteristics, namely younger age, lower novelty seeking scores and higher BMI, and FA scores. Conclusions: IGD presents some characteristics that are not extensive to online GD. These specificities have potential clinical implications and they need to be further studied

Congenital cytomegalovirus, parvovirus and enterovirus infection in Mozambican newborns at birth: A cross-sectional survey

BACKGROUND: Congenital cytomegalovirus (cCMV) infection is the most prevalent congenital infection acquired worldwide, with higher incidence in developing countries and among HIV-exposed children. Less is known regarding vertical transmission of parvovirus B19 (B19V) and enterovirus (EV). We aimed to assess the prevalence of CMV, B19V and EV vertical transmission and compare results of screening of congenital CMV obtained from two different specimens in a semirural Mozambican maternity. METHODS: A cross sectional study was conducted among pregnant mothers attending Manhica District Hospital upon delivery. Information on maternal risk factors was ascertained. Dried umbilical cord (DUC) samples were collected in filter paper for CMV, B19V and EV detection by real-time polymerase chain reaction (RT-PCR), and nasopharyngeal aspirates (NPA) to test for CMV by RT-PCR. Maternal blood samples and placental biopsy samples were also obtained to investigate CMV maternal serology, HIV status and immunopathology. RESULTS: From September 2014 to January 2015, 118 mothers/newborn pairs were recruited. Prevalence of maternal HIV infection was 31.4% (37/118). CMV RT-PCR was positive in 3/115 (2.6%) of DUC samples and in 3/96 (6.3%) of NPA samples obtained from neonates. The concordance of the RT-PCR assay through DUC with their correspondent NPA sample was moderate (Kappa = 0.42 and p<0.001. No differences on cCMV prevalence were found among HIV-exposed and unexposed. All (100%) mothers were seropositive for CMV IgG. RT-PCR of EV and B19V in DUC were both negative in all screened cases. No histological specific findings were found in placental tissues. No risk factors associated to vertical transmission of these viral infections were found. CONCLUSIONS: This study indicates the significant occurrence of vertical transmission of CMV in southern Mozambique. Larger studies are needed to evaluate the true burden, clinical relevance and consequences of congenital infections with such pathogens in resource-constrained settings