Inflammatory Determinants and Associated Morbidity in Hemodialysis Patients.

Hemodialysis deteriorates patients' physical, metabolic, and mental status. Clinical outcomes derived from inflammation determine a worse status but are less frequently identified. The objective of the study was to identify inflammatory determinants and the effect of SNP-related serum IL-6 and IL-10 levels on associated morbidity in hemodialysis. A sample of hemodialysis patients at IMSS Regional Hospital No.46 in Guadalajara (n = 85) were tested using the Malnutrition Inflammation Score (MIS) and Patient Health Questionnaire-9 (PHQ-9) to assess the associated morbidity. Serum cytokine levels were quantified by enzyme-linked immunosorbent assay (ELISA). The restriction fragment length polymorphism (RFLP) technique was used for analysis of IL-6-572C/G and IL-10-1082A/G. Using data visualization methods, we identified relevant determinants of inflammation. A simple regression model was constructed between predictors and targets with genotypes as covariates. Results showed malnutrition in 85.9% of patients and depressive symptoms in 50.6%. IL-10 was the most relevant inflammatory determinant, with regression coefficients (R2) between 0.05 and 0.11. The GG genotype of IL-10-1082 A/G evinced small effect on both clinical outcomes (δ of 0.35 and 0.37, respectively). Hemodialysis increases the associated morbidity, cytokines act as inflammatory determinants, and genetic variability contributes to the severity of clinical outcomes. Further studies need to refine the causal relationship between inflammation and CKD.

Bioinformatic Analysis of the Effect of Silver Nanoparticles on Colorectal Cancer Cell Line.

Colorectal cancer (CRC) is the most diagnosed cancer with the highest mortality rate each year globally. Although there are treatments for CRC, the development of resistance to therapies decreases the success of treatments. In vitro studies using the Caco-2 cell line have revealed the anticancer properties of silver nanoparticles (AgNPs) as a possible treatment for this disease. This study considered four researches that evaluated the proteomic profiles of cells of the Caco-2 line exposed to AgNPs. We performed a bioinformatics analysis to predict protein-protein interaction, hub genes, Gene Ontology (molecular function, biological process, and cellular components), KEGG pathways, analysis of expression, and immune cell infiltration. For these analyses, the STRING, DAVID, UALCAN, GEPIA2, and TISIDB databases were used. The results in Gene Ontology show that AgNPs cause a deregulation of genes related to cell-cell adhesion, the cytoplasm, the centriole, and carbon metabolism. Hub genes were identified, including GADPH, ENO1, EEF2, and ATP5A1, which showed differential expression in patients with adenocarcinoma of the colon and rectum. Additionally, the expression of the hub genes and immune cells was correlated. It was found that ATP5A1 and ENO1 were positively correlated with the infiltration of CD4+ T lymphocytes in colon adenocarcinoma and a negative correlation between GADPH and PDIA3 with the infiltration of NK cells and CD4+ T lymphocytes in rectal adenocarcinoma, respectively. In conclusion, the administration of AgNPs causes an alteration of biological processes, cellular components, metabolic pathways, deregulation of hub genes, and the activity of immune cells leading to a potential anticancer effect.

Psychometric properties of the Jefferson Empathy Scale in four nursing student faculties.

OBJECTIVE: To evaluate the psychometric properties of the Jefferson Medical Empathy Scale, Spanish version (JSE-S), its factorial structure, reliability, and the presence of invariance between genders in the behavior of empathy levels among Chilean nursing students. METHOD: Instrumental research design. The JSE-S was applied to 1,320 nursing students. A confirmatory factor analysis was used. An invariance study between genders was carried out. Descriptive statistics were estimated. Between genders, Student's T distribution was applied alongside a homoscedasticity analysis. The level of significance was α ≤ 0.05. RESULTS: The confirmatory factor analysis determined the existence of three dimensions in the matrix. The statistical results of the invariance tests were significant, and allowed comparison between genders. Differences were found between mean empathy values, as well as in some of its dimensions between genders. CONCLUSION: The factor structure of empathy data and its dimensions is in correspondence with the underlying three-dimensional model. There are differences in empathy levels and their dimensions between genders, with the exception of the compassionate care dimension, which was distributed similarly. Women were more empathetic than men.

Psychometric properties of the Jefferson Empathy Scale in four nursing student faculties / Propriedades psicométricas da Jefferson Empathy Scale em quatro faculdades de estudantes de enfermagem / Propiedades psicométricas de la Jefferson Empathy Scale en cuatro facultades de estudiantes de enfermería

ABSTRACT Objective To evaluate the psychometric properties of the Jefferson Medical Empathy Scale, Spanish version (JSE-S), its factorial structure, reliability, and the presence of invariance between genders in the behavior of empathy levels among Chilean nursing students. Method Instrumental research design. The JSE-S was applied to 1,320 nursing students. A confirmatory factor analysis was used. An invariance study between genders was carried out. Descriptive statistics were estimated. Between genders, Student's T distribution was applied alongside a homoscedasticity analysis. The level of significance was α ≤ 0.05. Results The confirmatory factor analysis determined the existence of three dimensions in the matrix. The statistical results of the invariance tests were significant, and allowed comparison between genders. Differences were found between mean empathy values, as well as in some of its dimensions between genders. Conclusion The factor structure of empathy data and its dimensions is in correspondence with the underlying three-dimensional model. There are differences in empathy levels and their dimensions between genders, with the exception of the compassionate care dimension, which was distributed similarly. Women were more empathetic than men.

RESUMO Objetivo Avaliar as propriedades psicométricas da Jefferson Medical Empathy Scale , versão em espanhol (JSE-S), sua estrutura fatorial, confiabilidade e a presença de invariância entre os sexos no comportamento dos níveis de empatia entre estudantes de enfermagem chilenos. Método Desenho de pesquisa instrumental. O JSE-S foi aplicado a 1.320 estudantes de enfermagem. Uma análise fatorial confirmatória foi usada. Foi realizado um estudo de invariância entre os gêneros. Estatísticas descritivas foram estimadas. Entre os gêneros, a distribuição T de Student foi aplicada juntamente com uma análise de homocedasticidade. O nível de significância adotado foi α ≤ 0,05. Resultados A análise fatorial confirmatória determinou a existência de três dimensões na matriz. Os resultados estatísticos dos testes de invariância foram significativos e permitiram a comparação entre os gêneros. Foram encontradas diferenças entre os valores médios de empatia, bem como em algumas de suas dimensões entre os gêneros. Conclusão A estrutura fatorial dos dados de empatia e suas dimensões está em correspondência com o modelo tridimensional subjacente. Existem diferenças nos níveis de empatia e suas dimensões entre os gêneros, com exceção da dimensão do cuidado compassivo, que se distribuiu de forma semelhante. As mulheres eram mais empáticas do que os homens.

RESUMEN Objetivo Evaluar las propiedades psicométricas de la Jefferson Medical Empathy Scale , versión en español (JSE-S), su estructura factorial, confiabilidad y la presencia de invariancia entre géneros en el comportamiento de los niveles de empatía entre estudiantes de enfermería chilenos. Método Diseño de investigación instrumental. La JSE-S se aplicó a 1.320 estudiantes de enfermería. Se utilizó un análisis factorial confirmatorio. Se realizó un estudio de invariancia entre géneros. Se estimaron estadísticas descriptivas. Entre los géneros, la distribución T de Student se aplicó junto con el análisis de homocedasticidad. El nivel de significancia fue α ≤ 0,05. Resultados El análisis factorial confirmatorio determinó la existencia de tres dimensiones en la matriz. Los resultados estadísticos de las pruebas de invariancia fueron significativos y permitieron la comparación entre géneros. Se encontraron diferencias entre los valores medios de empatía, así como en algunas de sus dimensiones entre géneros. Conclusión La estructura factorial de los datos de empatía y sus dimensiones está en correspondencia con el modelo tridimensional subyacente. Existen diferencias en los niveles de empatía y sus dimensiones entre géneros, a excepción de la dimensión de cuidado compasivo, que se distribuyó de manera similar. Las mujeres eran más empáticas que los hombres.

Empatia, género y declinacion empática en estudiantes de enfermería / Empathy, gender and empathie declination in nursing students

RESUMEN Objetivo: Determinar los niveles de empatía en estudiantes de enfermería. Material y métodos: Estudio exploratorio, transversal. Se estudió una muestra de 479 estudiantes. Se utilizó la Escala de Empatía de Jefferson. Se analizaron las diferencias en la empatía y sus componentes. Resultados: No hubo diferencias significativas en el factor año académico de los estudiantes, pero sí en el factor género. Se observó un aumento de la empatz'a en el género femenino; en el género masculino se observó un decremento a partir del segundo año. Hubo diferencias entre los géneros. Conclusiones: Los niveles de empatía en las mujeres se comportan de forma "plana" a través de los cursos, pero con valores mayores que los del promedio general de los datos observados. Los niveles de empatía en los hombres se comportan con una tendencia a la declinación empática.

SUMMARY Objective: To determine the empathy in nursing students. Material and methods: Exploratory, cross-sectional study. A sample of 479 students was studied. The Jefferson Empathy Scale was used. Empathy and its components were analyzed. Results: There were no significant differences in the academic year factor of the students. However in the gender factor they were found. An increase in empathy was observed in the female gender; in the masculine gender a decrease is observed from the second year. There were differences between the genders. Conclusions: The empathy in women behave "flat" through the courses, but with values higher than the general average of the observed data. The empathy in men behave with a tendency to empathic decline.

Efectos de la experiencia clínica en las actitudes de estudiantes de enfermería hacia las personas con discapacidad psiquiátrica / Effects of clinical experience in the nursing student attitudes toward people with psychiatric disabilities

RESUMEN En la formación del estudiante de pregrado de Enfermería se hace fundamental la elección de experiencias de aprendizaje significativas. Objetivo: Determinar el efecto de la experiencia clínica en servicios de psiquiatría, en las actitudes de estudiantes de Enfermería hacia las personas con discapacidad psiquiátrica. Material y método: Diseño cuasi experimental de pre y postest. La muestra incluyó un total de 84 estudiantes de Enfermería de tercer año de dos universidades de Santiago de Chile. El total de la muestra completó la "Escala de Actitudes hacia las Personas con Discapacidad" (EAPD) forma G. Se consideró como intervención las estrategias usadas en las asignaturas clínicas de enfermería psiquiátrica en ambas universidades. Se realizó prueba t de student para muestras relacionadas. Resultados: Se encontró diferencia estadísticamente significativa (p< 0,05) en el postest, lo que está relacionado con las experiencias de aprendizaje que consideran el contacto con personas con discapacidad psiquiátrica, en diferentes dispositivos de la red de psiquiatría y el acompañamiento docente directo. Conclusión: Estos hallazgos validan la importancia de la elección de experiencias clínicas, en los currículos de formación de Enfermería, como instancias que disminuyen las actitudes negativas como la estigmatización.

ABSTRACT The choice of meaningful learning experiences becomes essential in basic Nursing education programs. The purpose of this study is to determine the effect of clinical experience in psychiatric services in Nursing students' attitudes towards people with mental illnesses. A quasi-experimental design method of pre-test and post-test was used. The sample was made up of 84 third-year-nursing students from two universities in Santiago, Chile. All of the participants completed the Scale of Attitudes Toward Disabled Persons (SADP)-G. The strategies used in subjects of psychiatric nursing at both universities were regarded as intervention. Student t test for related samples was performed. Results: Respondents reported statistically significant difference (p <0.05) in the post test, which is associated with learning experiences that consider contact with people with mental illness in any of the different psychiatry network nodes and direct educational support. Conclusion: Validate the importance of including the clinical experience in the nursing training curriculum as a way of reducing negative attitudes of Nursing students, such as stigmatization, towards people with mental illnesses.

The cost and cost-effectiveness of gender-responsive interventions for HIV: a systematic review.

INTRODUCTION: Harmful gender norms and inequalities, including gender-based violence, are important structural barriers to effective HIV programming. We assess current evidence on what forms of gender-responsive intervention may enhance the effectiveness of basic HIV programmes and be cost-effective. METHODS: Effective intervention models were identified from an existing evidence review ("what works for women"). Based on this, we conducted a systematic review of published and grey literature on the costs and cost-effectiveness of each intervention identified. Where possible, we compared incremental costs and effects. RESULTS: Our effectiveness search identified 36 publications, reporting on the effectiveness of 22 HIV interventions with a gender focus. Of these, 11 types of interventions had a corresponding/comparable costing or cost-effectiveness study. The findings suggest that couple counselling for the prevention of vertical transmission; gender empowerment, community mobilization, and female condom promotion for female sex workers; expanded female condom distribution for the general population; and post-exposure HIV prophylaxis for rape survivors are cost-effective HIV interventions. Cash transfers for schoolgirls and school support for orphan girls may also be cost-effective in generalized epidemic settings. CONCLUSIONS: There has been limited research to assess the cost-effectiveness of interventions that seek to address women's needs and transform harmful gender norms. Our review identified several promising, cost-effective interventions that merit consideration as critical enablers in HIV investment approaches, as well as highlight that broader gender and development interventions can have positive HIV impacts. By no means an exhaustive package, these represent a first set of interventions to be included in the investment framework.

CrowdOutAIDS: crowdsourcing youth perspectives for action.

To develop a strategy for how to better engage young people in decision-making processes on AIDS, UNAIDS launched the participatory online policy project CrowdOutAIDS in 2011. A total of 3,497 young people aged 15-29 from 79 countries signed up to nine online forums, and volunteers recruited through the online platform hosted 39 community-based offline forums with an additional 1,605 participants. This article describes the participatory approach of using social media and crowdsourcing solutions to integrate youth perspectives into strategy and policy processes. In these forums, youth consistently identified the need to change the way sex and relationships are dealt with through changing how sex is talked about, putting comprehensive sexuality education in place, and overcoming social and cultural taboos. The outcome document recommended three major priorities: dispel taboos surrounding sex and sexuality, eliminate stigma and discrimination against young people living with HIV, and remove social and legal barriers. Six strategic actions were also recommended: strengthen young people's skills for effective leadership, ensure full youth participation in the AIDS response, increase access to HIV-related information, strengthen strategic networks, increase UNAIDS's outreach to young people, and increase young people's access to financial support. Through leveraging social media and crowdsourcing, it is possible to integrate grassroots perspectives from across the globe into a new model of engagement and participation, which should be further explored for community empowerment and mobilization.

Teenage sexuality and rights in Chile: from denial to punishment.

While Chile sees itself as a country that has fully restored human rights since its return to democratic rule in 1990, the rights of teenagers to comprehensive sexuality education are still not being met. This paper reviews the recent history of sexuality education in Chile and related legislation, policies and programmes. It also reports a 2008 review of the bylaws of 189 randomly selected Chilean schools, which found that although such bylaws are mandatory, the absence of bylaws to prevent discrimination on grounds of pregnancy, HIV and sexuality was common. In relation to how sexual behaviour and discipline were addressed, bylaws that were non-compliant with the law were very common. Opposition to sexuality education in schools in Chile is predicated on the denial of teenage sexuality, and many schools punish sexual behaviour where transgression is perceived to have taken place. While the wider Chilean society has been moving towards greater recognition of individual autonomy and sexual diversity, this cultural shift has yet to be reflected in the government's political agenda, in spite of good intentions. Given this state of affairs, the Chilean polity needs to recognise its youth as having human rights, or will continue to fail in its commitment to them.