Borderline Personality Disorder and Intimate Partner Violence: A Systematic Review / Trastorno Límite de Personalidad y Violencia en la Pareja: una Revisión Sistemática

Borderline personality (BPD) features and intimate partner violence (IPV) have been seen associated, focusing the research specially into perpetrators. The achievement of this systematic review is to analyze this relation in both victims and perpetrators, using 17 scientific articles published between 2017 and 2021 from different data bases. Most studies were focused on perpetrators, in which both men and women were equally represented as perpetrators. Instead, studies about victims were focused on women. Throughout this review, different factors observed in people with BPD traits who are victims or perpetrators of IPV are mentioned, finding particularities in each profile. These findings allow increase knowledge about the relationship between BPD and IPV, promoting a greater understanding that impacts positively on clinical intervention in this population.(AU)

Los rasgos límites de personalidad (TLP) se han visto asociados a violencia en la pareja, con investigaciones centradas especialmente en quienes la ejercen. El objetivo de esta revisión sistemática es analizar esta relación tanto en víctimas como en perpetradores, utilizando 17 artículos científicos publicados entre 2017 y 2021 en distintas bases de datos. Los estudios analizados se centraron mayoritariamente en perpetradores, encontrándose tanto hombres como mujeres igualmente representadas. En cambio, los estudios sobre víctimas atendían por lo general a mujeres. A lo largo de esta revisión, se mencionan distintos factores observados en personas que presentan rasgos TLP y ejercen o son víctimas de violencia de pareja, encontrando particularidades en cada perfil. Este trabajo permite incrementar el conocimiento sobre la relación existente entre TLP y violencia de pareja, fomentando una mayor comprensión que repercuta positivamente en la intervención clínica de esta población.(AU)

Leisure Attitude, Self-Rated Health, and Psychological Well-Being in Older Adults: A Moderated Mediation Model.

Purpose: A positive leisure attitude among older adults may have a beneficial effect on psychological well-being, both directly and indirectly by fostering a more positive perception of one's health. This paper presents a correlational design that explores associations among leisure attitude, self-rated health, and psychological well-being, and analyzes the potential moderating role of gender in these relationships. Patients and Methods: The sample was selected using simple random probability sampling (N= 409; 61.9% female; Mean age = 72.9; SD = 8.43¸ Range of age 53 to 93 years). Diverse sociodemographic information was collected, and leisure attitudes, self-perceived health, and psychological well-being (positive affect and emotional ties) were assessed. Results: The results revealed a positive effect of leisure attitude on self-rated health and psychological well-being, with self-rated health fully mediating the association between the behavioral component of leisure attitude and psychological well-being. Furthermore, the moderating effect of gender on the relationship between self-rated health and psychological well-being was stronger among men. Conclusion: Positive cognitive and emotional perceptions of leisure among older adults seem to benefit psychological well-being and improve self-rated health, thereby contributing to healthy ageing.

Adipose Tissue Denervation Blunted the Decrease in Bone Formation Promoted by Obesity in Rats.

The impact of obesity upon bone metabolism is controversial since both beneficial or harmful effects have been reported. Bone remodeling is modulated by the central nervous system through cytokines, hormones and neuromodulators. The present study aimed to evaluate the effects evoked by bilateral retroperitoneal white adipose tissue (rWAT) denervation (Dnx) upon bone mineral metabolism and remodeling in an experimental model of obesity in rats. Male Wistar rats were fed during 18 weeks with high-fat diet (HFD) or standard diet (SD) as controls, and rWAT Dnx or Sham surgery was performed at the 14th week. Biochemical and hormonal parameters, bone histomorphometry, rWAT and hypothalamus protein and gene expression were analyzed. The HFD group presented decreased bone formation parameters, increased serum and bone leptin and FGF23, increased serum and hypothalamic neuropeptide Y (NPY) and decreased serum 1,25-dihydroxyvitamin D3 and PTH. After rWAT Dnx, bone markers and histomorphometry showed restoration of bone formation, and serum and hypothalamic NPY decreased, without alteration in leptin levels. The present study shows that the denervation of rWAT improved bone formation in obese rats mediated by a preferential reduction in neurohormonal actions of NPY, emphasizing the relevance of the adipose tissue-brain-bone axis in the control of bone metabolism in obesity.

Adaptation and Validation of the Spanish Version of Kogan's Attitude toward Older People Scale (KAOP).

It is essential to understand the behavior and attitudes of nurses towards older people to improve clinical practice and quality of care in the gerontological sector. A clearer understanding of the attitudes that drive nurses toward the desire to work with older people would be a good starting point to encourage the development of positive and nurturing attitudes. A cross-sectional study with non-probabilistic sampling and a self-administered questionnaire was conducted among 381 nursing students of the Faculty of Nursing at the University of Castilla La-Mancha to evaluate the psychometric properties of the Spanish Version of the Kogan's Attitudes Towards Older People Scale (KAOP-S). Construct validity, internal consistency, and reliability were assessed. In total, 298 females and 83 males completed the questionnaires. Their mean age was 20.42 years. The results revealed a Cronbach's alpha coefficient of 0.75 for the scale, which is comparable with other published versions of the KAOP Scale. The results of the exploratory factor analysis established that the scale has a two-factor solution and an explained variance of 25% in the sample. The KAOP-S was found to be a reliable and valid tool with good content and construct validity for assessing nursing students' attitudes towards older people.

Attachment, motivational systems and anorexia nervosa: A systematic review and proposed framework for eating disorders.

INTRODUCTION: There is a direct association between patients with insecure attachment style (IAS), behavioural inhibition (BIS) and behavioural activation (BAS) motivational systems, and anorexia nervosa (AN). However, the possible direct relationships between these three variables have not been studied. OBJECTIVE: The main objective of this study is to analyse the relationship between these variables and propose a framework for analysing and understanding these relationships. METHODOLOGY: A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, searching the following terms: 'anorexia', 'attachment' and those related to motivational systems. The final search was limited to publications in English dated between 2014-2022 for 'anorexia and attachment' and 2010-2022 for 'anorexia and BIS/BAS'. RESULTS: Of the 587 articles retrieved, 30 were included in this study for the textual data analysis of the relationship between anorexia and attachment (17), anorexia and motivational systems (10) and anorexia, attachment and motivational systems (3). An association between avoidant IAS, AN and hypersensitivity to punishment of the BIS was observed in the analysis. A relationship was also observed with hyperreinforcement sensitivity of the BAS. After reviewing the articles, a possible relationship between the three factors, along with other mediating factors, was found. DISCUSSION: AN is directly related to the avoidant IAS and to BIS. Similarly, bulimia nervosa (BN) was directly related with anxious IAS and BAS. However, contradictions were found in the BN-BAS relationship. This study proposes a framework for analysing and understanding these relationships.

Different Ventricular Fibrillation Types in Low-Dimensional Latent Spaces.

The causes of ventricular fibrillation (VF) are not yet elucidated, and it has been proposed that different mechanisms might exist. Moreover, conventional analysis methods do not seem to provide time or frequency domain features that allow for recognition of different VF patterns in electrode-recorded biopotentials. The present work aims to determine whether low-dimensional latent spaces could exhibit discriminative features for different mechanisms or conditions during VF episodes. For this purpose, manifold learning using autoencoder neural networks was analyzed based on surface ECG recordings. The recordings covered the onset of the VF episode as well as the next 6 min, and comprised an experimental database based on an animal model with five situations, including control, drug intervention (amiodarone, diltiazem, and flecainide), and autonomic nervous system blockade. The results show that latent spaces from unsupervised and supervised learning schemes yielded moderate though quite noticeable separability among the different types of VF according to their type or intervention. In particular, unsupervised schemes reached a multi-class classification accuracy of 66%, while supervised schemes improved the separability of the generated latent spaces, providing a classification accuracy of up to 74%. Thus, we conclude that manifold learning schemes can provide a valuable tool for studying different types of VF while working in low-dimensional latent spaces, as the machine-learning generated features exhibit separability among different VF types. This study confirms that latent variables are better VF descriptors than conventional time or domain features, making this technique useful in current VF research on elucidation of the underlying VF mechanisms.

Does engagement help to reduce insomnia when workers are emotionally exhausted?

Insomnia is one of the most common problems, affecting more than 35% of the world's population. To achieve a better understanding of this problem the focus of this research is to understand how emotional exhaustion at work may lead to insomnia. To help to combat it, we tested a mediation model including engagement factors. The sample was composed of 823 participants. 38.3% (315 subjects) were male and 61.7% (508 subjects) were female. Mean age was 42.65 years old (9.05 = SD). Main results showed that emotional exhaustion is directly and statistically significant related to insomnia. However, different engagement factors showed different weights in buffering this relationship. Emotional exhaustion showed a statistically significant impact on insomnia. Vigor and absorption helped to buffer the impact of emotional exhaustion over insomnia. Our study has some limitations. First, the sample was acquired by not aleatory processes. Another limitation is that our sample was composed of individuals with decision-making capacity. Lastly, our research is a transversal study. Future research should take these limitations into account and conduct longitudinal research with aleatory sampling procedures.

Reward sensitivity and hazardous alcohol consumption in women: The parallel mediation effect of self-control and impulsivity traits.

Introduction: Little research has been carried out on the associations between several individual factors and hazardous alcohol use in women. The aim of this study was first, to study the relationship between reward sensitivity (RS) and alcohol use in both women with and without hazardous drinking separately. Second, to explore the potential mediating roles of the impulsivity and self-control traits in this relationship. Method: The study was analytical and cross-sectional and included 645 female participants (mean age = 19.14; standard deviation (SD)=1.60). All women were divided into two groups (286, 44.3%, with hazardous drinking, HDW; and 359, 55.7%, with light drinking, LDW). Correlation analyses were carried out to explore the associations between the variables, and parallel mediation analyses were performed to investigate the potential mediating roles of impulsivity and self-control in the RS-alcohol use associations in each group separately. Results: A significant association was observed between RS and alcohol use in HDW, contrary to that observed in their counterparts. In addition, both higher impulsivity and less self-control mediated the association between RS and alcohol use only in HDW. Conclusions: Impulsivity and self-control differently affect alcohol use under the condition of high reward sensitivity, only in HDW, suggesting alterations of the dual top-down and bottom-up mechanisms and a possible imbalance between the competing reflexive and impulsive brain systems. More research is needed regarding the individual factors that affect women's drinking to develop sensitive measures for the assessment of alcohol use and more efficient interventions for women.

Interplay Between Immune and Cancer-Associated Fibroblasts: A Path to Target Metalloproteinases in Penile Cancer.

Extracellular matrix (ECM) remodeling and inflammation have been reported in penile carcinomas (PeCa). However, the cell types and cellular crosstalk involved in PeCa are unexplored. We aimed to characterize the complexity of cells and pathways involved in the tumor microenvironment (TME) in PeCa and propose target molecules associated with the TME. We first investigated the prognostic impact of cell types with a secretory profile to identify drug targets that modulate TME-enriched cells. The secretome analysis using the PeCa transcriptome revealed the enrichment of inflammation and extracellular matrix pathways. Twenty-three secreted factors were upregulated, mainly collagens and matrix metalloproteinases (MMPs). The deregulation of collagens and MMPs was confirmed by Quantitative reverse transcription - polymerase chain reaction (RT-qPCR). Further, the deconvolution method (digital cytometry) of the bulk samples revealed a high proportion of macrophages and dendritic cells (DCs) and B cells. Increased DCs and B cells were associated with better survival. A high proportion of cancer-associated fibroblasts (CAFs) was observed in low-survival patients. Patients with increased CAFs had decreased immune cell proportions. The treatment with the MMP inhibitor GM6001 in CAF cells derived from PeCa resulted in altered cell viability. We reported a crosstalk between immune cells and CAFs, and the proportion of these cell populations was associated with prognosis. We demonstrate that a drug targeting MMPs modulates CAFs, expanding the therapeutic options of PeCa.

Experimental generation of adjustable partially coherent optical vortices from coherent and incoherent light sources.

Adjustable spatial coherence systems allow the possibility to make different intensity distributions using one source. Most common adjustable sources are based on the Collet-Wolf system. However, it is also possible to adjust the spatial coherence of the illumination field from white light sources by spatially filtering the source mutual intensity spectrum. We implement the Collet-Wolf source and the LED-based system to experimentally contrast a variety of partially coherent optical vortices that can be generated with spatial light modulation. We experimentally study the effects of changing the transverse coherence in partially coherent optical vortices, using a proposed metric of vortex contrast depth that quantifies the change of the vortex hollowness. To expand the analysis, we use a Michelson interferometer to reconstruct the spiral wavefronts using phase shifting. We found that the LED system at lower spatially correlated light produces truncated triangular distributions (a 50 µm pinhole is used), and with higher correlated light, it produces partially coherent optical vortices (a 10 µm pinhole is used). The Collet-Wolf system generates partially coherent optical vortices up to 0.5 mm of focal shift in the diffuser. Our results provide an experimental understanding and instrumental methodology capable of steering the optical transverse coherence, producing adjustable partially coherent optical vortices that can be obtained using incoherent and coherent sources.

The Spanish Version of the Eating Habits Questionnaire (EHQ-ES) and Its Links to Symptoms and Concerns Characteristic of Eating Disorders among Young Adults.

The aim of the study was to investigate the psychometric properties (internal consistency, factor structure, and convergent validity) of the Spanish version of the Eating Habits Questionnaire (EHQ-ES) and its links to disordered eating in young adults. Two university student samples with a total of 487 participants (N1age = 21.75 ± 5.10; N2age = 21.17 ± 6.81) participated in the study. They filled out the Eating Habits Questionnaire and the Eating Attitudes Test. Our findings showed that the EHQ-ES demonstrated strong internal consistency, with a Cronbach's α = 0.903 and ω = 0.939. The EHQ-ES consists of 20 items to measure problems associated with healthy eating (α = 0.855, ω = 0.879), knowledge of healthy eating (α = 0.783, ω = 0.826) and feeling positively about healthy eating (α = 0.775, ω = 0.773). In addition, subscales of the EHQ correlated with subscales of the EAT-26, showing that Orthorexia Nervosa is associated with disordered eating in a sample of university students. The current study is the first to describe a Spanish version of the EHQ. This demonstrates that EHQ-ES is a reliable screening tool for Spanish-speaking young adults. Moreover, the EHQ-ES can be a useful instrument for assessing ON in research and clinical practice.

Penile Cancer-Derived Cells Molecularly Characterized as Models to Guide Targeted Therapies.

Penile cancer (PeCa) is a common disease in poor and developing countries, showing high morbidity rates. Despite the recent progress in understanding the molecular events involved in PeCa, the lack of well-characterized in vitro models precludes new advances in anticancer drug development. Here we describe the establishment of five human primary penile cancer-derived cell cultures, including two epithelial and three cancer-associated fibroblast (CAF) cells. Using high-throughput genomic approaches, we found that the epithelial PeCa derived- cells recapitulate the molecular alterations of their primary tumors and present the same deregulated signaling pathways. The differentially expressed genes and proteins identified are components of key oncogenic pathways, including EGFR and PI3K/AKT/mTOR. We showed that epithelial PeCa derived cells presented a good response to cisplatin, a common therapeutic approach used in PeCa patients. The growth of a PeCa-derived cell overexpressing EGFR was inhibited by EGFR inhibitors (cetuximab, gefitinib, and erlotinib). We also identified CAF signature markers in three PeCa-derived cells with fibroblast-like morphology, indicating that those cells are suitable models for PeCa microenvironment studies. We thus demonstrate the utility of PeCa cell models to dissect mechanisms that promote penile carcinogenesis, which are useful models to evaluate therapeutic approaches for the disease.

Frecuentación y motivos de asistencia en el servicio de urgencias tras la ablación de fibrilación auricular con criobalón / Emergency department attendance and reasons for consultation after cryoballoon ablation for pulmonary vein isolation of atrial fibrillation

Introducción y objetivos Existe poca información sobre la frecuentación a urgencias en las semanas siguientes a un procedimiento de aislamiento de venas pulmonares con criobalón. El objetivo del estudio es cuantificar las visitas a urgencias en los primeros 3 meses tras el procedimiento, evaluando los motivos, el diagnóstico final y la actitud terapéutica. Métodos Estudio observacional retrospectivo sobre 330 pacientes sometidos a un primer procedimiento de crioablación de fibrilación auricular. Se realizó un seguimiento de 90 días tras el procedimiento durante el que se registraron las visitas a urgencias con los síntomas que motivaron la consulta, electrocardiograma, actitud terapéutica y diagnóstico final, clasificado como alteración del ritmo, complicación confirmada, complicación posible y sin relación con el procedimiento ni con el trastorno arrítmico. Resultados Un total de 112 pacientes (34%) consultaron en urgencias, 50 de ellos (44,6%) por palpitaciones. En 44 pacientes (39,3%) se documentó una arritmia auricular sostenida. De las 29 consultas (25,9%) por síntomas potencialmente relacionados con complicaciones del procedimiento, 5 fueron complicaciones confirmadas de la punción inguinal, 10 quedaron con diagnóstico no confirmado de posible complicación y 41 visitas no guardaron relación con el procedimiento. El 21,4% del total de consultas fueron por palpitaciones en las que no se tomó ninguna medida terapéutica. Conclusiones Un tercio de los pacientes consultaron en urgencias al menos 1 vez, y los síntomas arrítmicos fueron el motivo más frecuente. Las complicaciones diferidas del procedimiento son raras y, en general, benignas. La disponibilidad de un sistema de teleconsulta con transmisión del ECG a distancia podría evitar hasta un 20% de los desplazamientos a urgencias. (AU)

Introduction and objectives There are few data on emergency visits after cryoballoon-based pulmonary vein isolation. The aim of this study was to quantify emergency department visits during the first 3 months after the procedure and to identify the reasons for consultation, final diagnoses, and the therapeutic approach. Methods Observational, retrospective study of 330 consecutive patients undergoing a first cryoballoon-based ablation procedure. Patients were followed up for 90 days after the procedure. We recorded emergency visits, symptoms, electrocardiographic data, and the therapeutic approach. Final diagnoses were classified as rhythm disorder, confirmed complication, possible complication, and unrelated to the procedure or to the arrhythmic disorder. Results A total of 112 (34%) patients attended the emergency department, 50 (44.6%) for palpitations. Sustained atrial arrhythmias were documented in 44 (39.3%) patients. Among the 29 (25.9%) visits for complications potentially related to the procedure, 5 were confirmed inguinal puncture complications and 10 were classified as unconfirmed possible complications. Forty-one visits were unrelated to the procedure or to the arrhythmic disorder. A total of 21.4% of the visits were due to palpitations requiring no therapeutic action. Conclusions A third of the patients attended the emergency department at least once, with the most frequent reason being arrhythmia-related symptoms. Late complications were rare and generally mild. Up to 20% of emergency visits could potentially be avoided by the availability of a teleconsulting system with remote electrocardiogram transmission. (AU)

Catheter ablation of ventricular arrhythmias in left ventricular noncompaction cardiomyopathy.

BACKGROUND: There are limited data on ventricular arrhythmias (VAs) associated with left ventricular noncompaction (LVNC) cardiomyopathy. OBJECTIVES: This study aims to analyze the clinical and electrocardiographic characteristics of VAs in a group of patients with LVNC. METHODS: Forty-two nonrelated patients with LVNC and VAs were included that were evaluated at the Inherited Cardiac Disease Unit of the University Hospital Virgen Arrixaca (Murcia-Spain) (ERN Guard-Heart Centre, European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart). RESULTS: Thirteen patients (30.9%) had isolated LVNC, 27 (64.3%) had LVNC associated with dilated cardiomyopathy, and 2 (4.8%) had LVNC associated with hypertrophic cardiomyopathy. Among isolated LVNC individuals, 9 (69.2%) had premature ventricular complexes (PVCs)/nonsustained ventricular tachycardias (VTs), and 4 (30.8%) VTs (1 VT degenerating in ventricular fibrillation). In the dilated cardiomyopathy group, 11 (40.7%) patients had PVCs, 14 (51.9%) VTs, and 2 (7.4%) ventricular fibrillation. In the hypertrophic cardiomyopathy group, one patient had PVCs and the other VTs. Endocardial mapping and ablation were performed in 19 patients (45.2%): 7 ventricular outflow tracts (4 right ventricular outflow tract, 1 left coronary cusp, and 2 right coronary cusp), 2 in the left ventricular summit, 5 related to Purkinje potentials at the mid inferoseptal area, and 5 associated with endocardial scar localized in the basal anterolateral and inferolateral segments. Epicardial ablation was performed in 3 cases. CONCLUSION: The substrate of VAs in LVNC cardiomyopathy is heterogeneous, with origin in ventricular outflow tracts, Purkinje system related, and resembling scar patterns in nonischemic cardiomyopathy.

Emergency department attendance and reasons for consultation after cryoballoon ablation for pulmonary vein isolation of atrial fibrillation.

INTRODUCTION AND OBJECTIVES: There are few data on emergency visits after cryoballoon-based pulmonary vein isolation. The aim of this study was to quantify emergency department visits during the first 3 months after the procedure and to identify the reasons for consultation, final diagnoses, and the therapeutic approach. METHODS: Observational, retrospective study of 330 consecutive patients undergoing a first cryoballoon-based ablation procedure. Patients were followed up for 90 days after the procedure. We recorded emergency visits, symptoms, electrocardiographic data, and the therapeutic approach. Final diagnoses were classified as rhythm disorder, confirmed complication, possible complication, and unrelated to the procedure or to the arrhythmic disorder. RESULTS: A total of 112 (34%) patients attended the emergency department, 50 (44.6%) for palpitations. Sustained atrial arrhythmias were documented in 44 (39.3%) patients. Among the 29 (25.9%) visits for complications potentially related to the procedure, 5 were confirmed inguinal puncture complications and 10 were classified as unconfirmed possible complications. Forty-one visits were unrelated to the procedure or to the arrhythmic disorder. A total of 21.4% of the visits were due to palpitations requiring no therapeutic action. CONCLUSIONS: A third of the patients attended the emergency department at least once, with the most frequent reason being arrhythmia-related symptoms. Late complications were rare and generally mild. Up to 20% of emergency visits could potentially be avoided by the availability of a teleconsulting system with remote electrocardiogram transmission.

Understanding the new post-COVID-19 risk scenario: Outlooks and challenges for a new era of tourism.

This paper explores the new travel risk scenario by analysing travel risk perception during the pandemic and proposes measures to improve traveller confidence based on the issue-attention cycle. The study was conducted during two stages of the pandemic. During the initial stage, travellers' decision-making process was studied to learn why travellers chose to maintain or cancel travel plans and what variables influenced their travel risk perception. An online survey was conducted with data collected from 1075 travellers residing in 46 countries (52 nationalities). The second stage of the study started at the beginning of de-escalation in Europe. A qualitative study was conducted in which 28 international hospitality experts were interviewed. They were asked about specific measures to encourage tourism from a global perspective. The results help tourism authorities and companies better understand tourist behaviour and provide concrete measures for restarting tourism.

Menstrual Migraine Among Spanish University Students.

PURPOSE: This study sought to determine the prevalence of menstrual migraine among female university students at the Nursing Faculty of Ciudad Real and to determine possible risk factors. DESIGN AND METHODS: A cross-sectional observational study was performed using a self-report questionnaire. Two hundred and ninety-nine female university students participated in the study; all were enrolled in the 2017/2018 academic year at the Faculty of Nursing. Participants were over the age of 18 years and without any diagnosed gynecological pathology. The main measurement tools were menstrual migraine between days -2 and +3 of the menstrual cycle, over the previous six cycles. RESULTS: The prevalence of menstrual migraine was 45.15%, identifying the following possible risk factors: dysmenorrhea (OR 9.19; 1.62-6.28% CI), use of hormonal contraceptive methods (OR 2.60; 95% CI 1.30-5.20), menstrual irritability (OR 2.34; 95% CI 1.25-4.40), menstrual dizziness (OR 2.05; 95% CI % 1.12-3.75) and daily consumption of cola beverages (OR 1.85; 95% CI % 1.04-3.32). CONCLUSIONS: The prevalence of this problem is high among our population and the approach is complex. PRACTICE IMPLICATIONS: It is necessary to continue to research the pharmacological measures and methods of pharmacological pain relief as well as interventions directed at lifestyle modifications considering the potential risk factors involved in menstrual migraine.

Pathological Preoccupation with Healthy Eating (Orthorexia Nervosa) in a Spanish Sample with Vegetarian, Vegan, and Non-Vegetarian Dietary Patterns.

Orthorexia nervosa (ON) has been defined as an obsessive and pathological attitude towards healthy nutrition. The aim of this study was to compare individuals who followed a vegan, vegetarian, and omnivore diet in terms of ON behaviors and to examine their prime motivations, attitudes, and behaviors towards food. The Spanish version of the ORTO-15 test - ORTO-11-ES - and the Food Choice Questionnaire (FCQ-SP) were used with a demographic questionnaire in an online survey disseminated among the social networks of different vegetarian associations and the general population. Of 466 individuals, 55% followed an omnivore diet, 23.5% were vegetarian and 21.7% were vegan. Results revealed relationships between type of diet and FCQ-SP dimensions for: health and natural content (H = 8.7, p < 0.05), sensory appeal (H = 11.4, p < 0.01), weight control (H = 40.4, p < 0.01), and familiarity (H = 37.3, p < 0.01). Our results confirm the findings of recent studies showing that individuals who follow a vegan or vegetarian diet are more likely to develop a pathological preoccupation with healthy eating versus omnivores. Further studies are required to determine the potential lines of action for the prevention of ON.

Transplantation of a heart donated after circulatory death via thoraco-abdominal normothermic regional perfusion and results from the first Spanish case.

BACKGROUND: Controlled donation after circulatory death (cDCD) has emerged as one of the main strategies for increasing the organ donor pool. Because of the ischemic injury that follows the withdrawal of life-sustaining therapies, hearts from cDCD donors have not been considered for transplantation until recently. The ex-situ perfusion of hearts directly procured from cDCD donors has been used to allow the continuous perfusion of the organ and the assessment of myocardial viability prior to transplantation. Based on our experience with abdominal normothermic regional perfusion in cDCD, we designed a protocol to recover and validate hearts from cDCD donors using thoraco-abdominal normothermic regional perfusion without the utilization of an ex-situ device. CASE PRESENTATION: We describe the first case of a cDCD heart transplant performed with this approach in Spain. The donor was a 43-year-old asthmatic female diagnosed with severe hypoxic encephalopathy. She was considered a potential cDCD donor and a suitable candidate for multiorgan procurement including the heart via thoraco-abdominal normothermic regional perfusion. The heart recipient was a 60-year-old male diagnosed with amyloid cardiomyopathy. Cold ischemia time was 55 min. The surgery was uneventful. CONCLUSIONS: This case report, the first of its kind in Spain, supports the feasibility of evaluating and successfully transplanting cDCD hearts without the need for ex-situ perfusion based on the use of thoraco-abdominal normothermic regional perfusion opening the way for multiorgan donation in cDCD.

Anxiety, perceived stress and coping strategies in nursing students: a cross-sectional, correlational, descriptive study.

BACKGROUND: For many nursing students, clinical training represents a stressful experience. The levels of stress and anxiety may vary during students' educational training, depending on their ability to adopt behavioral strategies for coping with stress, and other factors. This study aimed to investigate the relationship between anxiety, perceived stress, and the coping strategies used by nursing students during their clinical training. METHODS: A cross-sectional correlational descriptive study. The sample consisted of 190 nursing students enrolled in the Nursing Faculty of Ciudad Real University in Spain. Participants provided data on background characteristics and completed the following instruments: the Perceived Stress Scale; the State-Trait Anxiety Inventory and the Coping Behavior Inventory. Relationships between scores were examined using Spearman's rho. RESULTS: The mean age of participants was 20.71 ± 3.89 years (range 18-46 years). Approximately half of the students (47.92%) indicated a moderate level of stress with a mean Perceived Stress Scale score of 22.78 (±8.54). Senior nursing students perceived higher levels of stress than novice students. The results showed a significant correlation for perceived stress and state anxiety (r = 0.463, p < .000) and also for trait anxiety (r = 0.718, p < .000). There was also a significant relationship between the total amount of perceived stress and the following domains of the coping behavior inventory: problem solving (r = -.452, p < .01), self-criticism (r = .408 p < .01), wishful thinking (r = .459, p < .01), social support(r = -.220, p < .01), cognitive restructuring (r = -.375, p < .01), and social withdrawal (r = .388, p < .01). In the current study, the coping strategy most frequently used by students was problem-solving, followed by social support and cognitive restructuring. CONCLUSIONS: Nursing students in our study presented a moderate level of stress, in addition there was a significant correlation with anxiety. Nursing teachers and clinical preceptors/mentors should be encouraged to develop programs to help prepare nursing students to cope with the challenges they are about to face during their clinical placements.