Neural basis of social attention: common and distinct mechanisms for social and nonsocial orienting stimuli.

Social and nonsocial directional stimuli (such as gaze and arrows, respectively) share their ability to trigger attentional processes, although the issue of whether social stimuli generate other additional (and unique) attentional effects is still under debate. In this study, we used the spatial interference paradigm to explore, using functional magnetic resonance imaging, shared and dissociable brain activations produced by gaze and arrows. Results showed a common set of regions (right parieto-temporo-occipital) similarly involved in conflict resolution for gaze and arrows stimuli, which showed stronger co-activation for incongruent than congruent trials. The frontal eye field showed stronger functional connectivity with occipital regions for congruent as compared with incongruent trials, and this effect was enhanced for gaze as compared with arrow stimuli in the right hemisphere. Moreover, spatial interference produced by incongruent (as compared with congruent) arrows was associated with increased functional coupling between the right frontal eye field and a set of regions in the left hemisphere. This result was not observed for incongruent (as compared with congruent) gaze stimuli. The right frontal eye field also showed greater coupling with left temporo-occipital regions for those conditions in which larger conflict was observed (arrow incongruent vs. gaze incongruent trials, and gaze congruent vs. arrow congruent trials). These findings support the view that social and nonsocial stimuli share some attentional mechanisms, while at the same time highlighting other differential effects. Highlights Attentional orienting triggered by social (gaze) and nonsocial (arrow) cues is comparable. When social and nonsocial stimuli are used as targets, qualitatively different behavioral effects are observed. This study explores the neural bases of shared and dissociable neural mechanisms for social and nonsocial stimuli. Shared mechanisms were found in the functional coupling between right parieto-temporo-occipital regions. Dissociable mechanisms were found in the functional coupling between right frontal eye field and ipsilateral and contralateral occipito-temporal regions.

Explicit vs. implicit spatial processing in arrow vs. eye-gaze spatial congruency effects.

Arrows and gaze stimuli lead to opposite spatial congruency effects. While standard congruency effects are observed for arrows (faster responses for congruent conditions), responses are faster when eye-gaze stimuli are presented on the opposite side of the gazed-at location (incongruent trials), leading to a reversed congruency effect (RCE). Here, we explored the effects of implicit vs. explicit processing of arrows and eye-gaze direction. Participants were required to identify the direction (explicit task) or the colour (implicit task) of left or right looking/pointing gaze or arrows, presented to either the left or right of the fixation point. When participants responded to the direction of stimuli, standard congruency effects for arrows and RCE for eye-gaze stimuli were observed. However, when participants responded to the colour of stimuli, no congruency effects were observed. These results suggest that it is necessary to explicitly pay attention to the direction of eye-gaze and arrows for the congruency effect to occur. The same pattern of data was observed when participants responded either manually or verbally, demonstrating that manual motor components are not responsible for the results observed. These findings are not consistent with some hypotheses previously proposed to explain the RCE observed with eye-gaze stimuli and, therefore, call for an alternative plausible hypothesis.

Gaze elicits social and nonsocial attentional orienting: An interplay of shared and unique conflict processing mechanisms.

Subtle to no attentional differences have been broadly observed when using gaze and arrows as orienting cues. However, recent studies have found opposite effects when they are used as targets in spatial interference tasks, with arrows eliciting faster responses when their position is congruent with the indicated direction and gaze producing faster responses in incongruent conditions. In two preregistered experiments aimed at exploring the mechanisms supporting these findings, we examined whether the congruency sequence effects (CSE) elicited by gaze and arrows generalized from one stimulus to another, using an intrablock design where the type of stimuli was manipulated on a trial-by-trial basis. Typical CSE were observed for arrows, with a decrease of congruency effects after incongruent trials, and reversed CSE for gaze, with an increased inversion of congruency effects after incongruent trials. Both patterns occurred independently of the preceding type of target, showing that congruency effects can decrease after positive outcomes (e.g., arrow trials following an incongruent gaze trial), and generalized across different nonsocial and social stimuli as shown in a third experiment. These results are consistent with the coexistence of a shared spatial interference component between gaze and arrow trials, potentially responsible for the CSE obtained in switching target trials, and an additional social dimension, exclusively engaged in gaze trials. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effect of Victimization and Perceived Support on Maintenance of Dating Relationships Among College Students in Guadalajara, Mexico.

This study analyzes the influence of the victimization suffered (sexual, physical, coercion, humiliation, and emotional punishment) and the support network available (as Independent Variables (IIVV)) on the trajectory of young couples (feeling trapped in a relationship, Dependent Variable (DV)). A total of 990 Mexican university students (M = 19.5, SD = 1.82 years) of both sexes (66% women) participated in the study. Family and friends were perceived as providing the greatest support (in over 85% of respondents), while the resources provided by the university (teachers, central resources) were regarded as unhelpful by 40%. A linear regression analysis showed that the feeling of being trapped in the relationship was influenced by all the IIVV (*p < .05), although perceived support proved to be a poor predictor (beta = -.053). A path analysis reflected a negative effect of coercion (regression weight = -.533) and physical violence (-.926) on perceived support, with all forms of victimization being precursors for feeling trapped in a relationship. These results show the negative effect of victimization on expectations of support in young people, which may make it difficult to begin the process of seeking help. They also highlight the need to increase the visibility of resources available in educational settings to provide an early response to intimate partner violence.

Psychometric properties of the Dating Violence Questionnaire, (DVQ-8): A screening tool for educational settings / Propiedades psicométricas del Cuestionario de Violencia de Pareja, versión corta (DVQ-8): una herramienta de evaluación para entornos educativos

Abstract This article provides psychometric information from a screening tool for victimiza tion in young couples: the 8-Item Dating Violence Questionnaire. The first study undertook an exploratory factor analysis with polymorphic correlation matrices and oblimin rotation of 990 Mexican university students with an average age of 19.5, two thirds of whom were women, obtaining a unifactorial structure with high reliability for males and females. The second study, with a sample of 355 participants, provided information on the validity of the instrument, finding a positive relationship between the 8-Item Dating Violence Questionnaire and perceived vic timization. High significance and a large effect size and negative relationship were obtained between the instrument and state of health, with a moderate effect. In conclusion, the DVQ-8 includes reliable, valid indicators for the early detection of victimization in educational settings.

Resumen Este artículo proporciona información psicométrica de un instrumento de screening de victimización en parejas jóvenes: Dating Violence Questionnaire de 8 ítems. Un primer estudio desarrolló un análisis factorial exploratorio con matrices de correlación policóricas y rotación oblimin con 990 jóvenes universitarios mexicanos con edad promedio de 19.5, de las que dos tercios fueron mujeres, obteniendo una estructura unifactorial con alta confiabilidad para varones y mujeres. El segundo estudio, con una muestra de 355 participantes, proporcionó información sobre la validez del instrumento, encontrando una relación positiva entre el Dating Violence Questionnaire de 8 ítems y victimización percibida, se obtuvieron una significación alta y el tamaño del efecto grande y una relación negativa entre el instrumento y estado de salud, con un efecto moderado. En conclusión, el DVQ-8 incluye indicadores confiables y válidos para la detección temprana de victimización en contextos educativos.

Inhibition of Demineralization at Restoration Margins of Z100 and Tetric EvoCeram Bulk Fill in Dentin and Enamel.

Recurrent caries is still considered the main reason restorations need to be replaced. There are different materials available now that promise to reduce the possibility of recurrent caries by releasing fluoride and inhibiting restoration marginal caries. The purpose of this in vitro study was to evaluate the demineralization inhibition potential of a non-fluoride-releasing resin (Z100TM 3M, St. Paul, MN, USA) and a glass containing resin-based composite (Tetric EvoCeram Bulk Fill, Ivoclar/Vivadent AG, Schaan, Liechtenstein), which contains fluoride. Class V preparations were placed on 22 premolars; the gingival margin was below the cementoenamel junction and the occlusal margin was placed above the cemento-enamel junction. Ten teeth were randomly selected to be restored with Z100 while the other 10 were restored with Tetric EvoCeram Bulk Fill. Both groups were restored following manufacturer's instructions. All teeth had an acid resistant varnish placed within one millimeter of the preparation margins. Both groups were placed in artificial caries challenge solution (pH 4.4). At the end of the 4 days; 100 µm buccolingual sections were obtained for each tooth; these were photographed under polarized light microscopy and the demineralized areas adjacent to the restorations were measured and quantified. The mean (±S.D.) area (µm2) of demineralization from the occlusal margin (enamel) and dentin margin were: Z100 2781.889 ± 1045.213; 3960.455 ± 705.964 and for Tetric EvoCeram Bulk Fill 1541.545 ± 1167.027; 3027.600 ± 512.078. Student's t-test indicated that there was significantly less enamel and dentin demineralization adjacent to Tetric EvoCeram Bulk Fill compared to Z100; there was significantly less demineralization in enamel compared to dentin in both Tetric EvoCeral Bulk Fill and Z100. Tetric EvoCeram Bulk Fill performed better inhibiting demineralization at restoration margins when compared to Z100 and provided better demineralization inhibition in enamel than cementum/dentin.

Are eyes special? Electrophysiological and behavioural evidence for a dissociation between eye-gaze and arrows attentional mechanisms.

It has been proposed that attention triggered by eye-gaze may represent a unique attentional process, different from that triggered by non-social stimuli such as arrows. To investigate this issue, in the present study we compared the temporal dynamics of the conflict processing triggered by eye-gaze and arrow stimuli. We investigated the electrophysiological activity during a task in which participants were required to identify the direction of laterally presented eye-gaze or arrow targets. Opposite behavioural effects were observed: while arrows produced the typical effect, with faster responses when they were congruent with their position, eye-gaze targets produced a reversed effect with faster responses when they were incongruent. Event-related potentials showed common and dissociable congruency modulation: whereas eye-gaze and arrows showed similar effects on earlier ERP components (P1 and N1), they led to opposite effects in later components such as N2 and P3. This represents the first electrophysiological demonstration of both early shared and later dissociable congruency effects for eye-gaze and arrow stimuli.

Cost-effectiveness analysis of sensor-augmented pump therapy with low glucose-suspend in patients with type 1 diabetes mellitus and high risk of hypoglycemia in Spain / Análisis coste-utilidad del sistema integrado con suspensión en hipoglucemia en pacientes con diabetes tipo 1 y alto riesgo de hipoglucemias en España

Objective: To compare the cost-effectiveness of sensor-augmented pump therapy (SAP) [continuous subcutaneous insulin infusion (CSII) plus real-time continuous glucose monitoring (RT-CGM)] with low glucose suspend (MiniMed(TM) Veo(TM)) and CSII alone in patients with type 1 diabetes mellitus (T1DM) at high risk of hypoglycemia in Spain. Methods: The IQVIA CORE Diabetes Model was used to estimate healthcare outcomes as life-years gained (LYGs) and quality-adjusted life years (QALYs), and to project lifetime costs. Information about efficacy, resource utilization, and unit costs (€2016) was taken from published sources and validated by an expert panel. Analyses were performed from both the Spanish National Health System (NHS) perspective and the societal perspective. Results: From the NHS perspective, SAP with low glucose suspend was associated to a €47,665 increase in direct healthcare costs and to increases of 0.19 LYGs and 1.88 QALYs, both discounted, which resulted in an incremental cost-effectiveness ratio (ICER) of €25,394/QALY. From the societal perspective, SAP with low glucose suspend increased total costs (including direct and indirect healthcare costs) by €41,036, with a resultant ICER of €21,862/QALY. Considering the willingness-to-pay threshold of €30,000/QALY in Spain, SAP with low glucose suspend represents a cost-effective option from both the NHS and societal perspectives. Sensitivity analyses confirmed the robustness of the model. Conclusions: From both the Spanish NHS perspective and the societal perspective, SAP with low glucose suspend is a cost-effective option for the treatment of T1DM patients at high risk of hypoglycemia

Objetivo: Evaluar la relación coste-utilidad del sistema integrado (MiniMed(R) Veo(R)) con suspensión en hipoglucemia frente a la infusión subcutánea continua de insulina (ISCI) en el tratamiento de pacientes con diabetes tipo 1 (DM1) y alto riesgo de hipoglucemias en España. Métodos: Se utilizó el modelo de diabetes IQVIA CORE para estimar los resultados en salud expresados como años de vida ganados (AVG) y años de vida ajustados por calidad (AVAC) y los costes a lo largo de la vida de los pacientes. La información sobre la eficacia, el consumo de recursos y los costes unitarios (2016€) fue obtenida de fuentes publicadas y validadas por un panel de expertos. En el escenario principal se consideró la perspectiva del Sistema Nacional de Salud (SNS) y, en un escenario alternativo, la de la sociedad en general. Resultados: Bajo la perspectiva del SNS el tratamiento con el sistema integrado con suspensión en hipoglucemia se asoció con mayores costes sanitarios directos (47.665€) y un incremento de 0,19 AVG y 1,88 AVAC, resultando en un ratio coste-utilidad incremental (RCUI) de 25.394€/AVAC. Considerando la perspectiva de la sociedad, los costes totales (sanitarios directos e indirectos) se incrementaron en 41.036€, siendo el RCUI resultante de 21.862€/AVAC. Los análisis de sensibilidad confirmaron la robustez de los resultados en todos los escenarios evaluados. Conclusión: Considerando el umbral de máxima disposición a pagar para España de 30.000€/AVAC, el sistema integrado con suspensión en hipoglucemia representa una opción eficiente en comparación con la ISCI tanto desde la perspectiva del SNS como de la sociedad en su conjunto

Budget impact analysis of demineralized bone matrix in combination with autograft in lumbar spinal fusion procedures for the treatment of lumbar degenerative disc disease in Spain.

OBJECTIVE: To estimate the budget impact (BI) of introducing local autograft (LA) combined with demineralized bone matrix (LA + DBM) in lumbar spinal fusion (LSF) procedures to treat lumbar degenerative disc disease (LDDD) in Spain. METHODS: A decision tree model was developed to evaluate the 4-year BI associated with introducing LA + DBM putty to replace currently available grafting methods, including iliac crest bone graft (ICBG), LA alone, and LA combined with beta-tricalcium phosphate (LA + ceramics), with 30%, 40%, and 30% market shares, respectively. The analysis was conducted for a hypothetical cohort of 100 patients with LDDD receiving LSF, assuming LA + DBM would replace 100% of the standard of care mix. The fusion rates extracted from the literature were validated by an expert panel. Costs (€2017) were obtained from different Spanish sources. Budget impact and incremental cost per successful fusion were calculated from the perspective of the Spanish National Health System (NHS). RESULTS: Over 4 years, replacing currently available options with LA + DBM for 100 patients resulted in an additional cost of €12,330 (€123/patient), and an additional 14 successful fusions, implying a cost of €881 per additional successful fusion. When costs of productivity loss were included, the introduction of LA + DBM resulted in cost savings of €70,294 (€703/patient). LIMITATIONS: The lack of high-quality, homogeneous, head-to-head research studying the efficacy of grafting procedures available to patients undergoing LSF, in addition to a lack of long-term follow-up in existing studies. Therefore, the number of fusions occurring within the model's time horizon may be underestimated. CONCLUSIONS: Acquisition costs of DBM were partially offset by costs of failed fusions, adverse events and reoperation when switching 100 hypothetical LDDD patients undergoing LSF procedures from standard of care grafting methods to LA + DBM from the perspective of the Spanish NHS. DBM cost was entirely offset when costs of lost productivity were considered.

Cost-effectiveness analysis of sensor-augmented pump therapy with low glucose-suspend in patients with type 1 diabetes mellitus and high risk of hypoglycemia in Spain.

OBJECTIVE: To compare the cost-effectiveness of sensor-augmented pump therapy (SAP) [continuous subcutaneous insulin infusion (CSII) plus real-time continuous glucose monitoring (RT-CGM)] with low glucose suspend (MiniMed™ Veo™) and CSII alone in patients with type 1 diabetes mellitus (T1DM) at high risk of hypoglycemia in Spain. METHODS: The IQVIA CORE Diabetes Model was used to estimate healthcare outcomes as life-years gained (LYGs) and quality-adjusted life years (QALYs), and to project lifetime costs. Information about efficacy, resource utilization, and unit costs (€2016) was taken from published sources and validated by an expert panel. Analyses were performed from both the Spanish National Health System (NHS) perspective and the societal perspective. RESULTS: From the NHS perspective, SAP with low glucose suspend was associated to a €47,665 increase in direct healthcare costs and to increases of 0.19 LYGs and 1.88 QALYs, both discounted, which resulted in an incremental cost-effectiveness ratio (ICER) of €25,394/QALY. From the societal perspective, SAP with low glucose suspend increased total costs (including direct and indirect healthcare costs) by €41,036, with a resultant ICER of €21,862/QALY. Considering the willingness-to-pay threshold of €30,000/QALY in Spain, SAP with low glucose suspend represents a cost-effective option from both the NHS and societal perspectives. Sensitivity analyses confirmed the robustness of the model. CONCLUSIONS: From both the Spanish NHS perspective and the societal perspective, SAP with low glucose suspend is a cost-effective option for the treatment of T1DM patients at high risk of hypoglycemia.

Targeting the MAPK and PI3K pathways in combination with PD1 blockade in melanoma.

Immunotherapy of advanced melanoma with CTLA-4 or PD-1/PD-L1 checkpoint blockade induces in a proportion of patients long durable responses. In contrast, targeting the MAPK-pathway by selective BRAF and MEK inhibitors induces high response rates, but most patients relapse. Combining targeted therapy with immunotherapy is proposed to improve the long-term outcomes of patients. Preclinical data endorsing this hypothesis are accumulating. Inhibition of the PI3K-Akt-mTOR pathway may be a promising treatment option to overcome resistance to MAPK inhibition and for additional combination with immunotherapy. We therefore evaluated to which extent dual targeting of the MAPK and PI3K-Akt-mTOR pathways affects tumor immune infiltrates and whether it synergizes with PD-1 checkpoint blockade in a BRAFV600E/PTEN-/--driven melanoma mouse model. Short-term dual BRAF + MEK inhibition enhanced tumor immune infiltration and improved tumor control when combined with PD-1 blockade in a CD8+ T cell dependent manner. Additional PI3K inhibition did not impair tumor control or immune cell infiltration and functionality. Analysis of on-treatment samples from melanoma patients treated with BRAF or BRAF + MEK inhibitors indicates that inhibitor-mediated T cell infiltration occurred in all patients early after treatment initiation but was less frequent found in on-treatment biopsies beyond day 15. Our findings provide a rationale for clinical testing of short-term BRAF + MEK inhibition in combination with immune checkpoint blockade, currently implemented at our institutes. Additional PI3K inhibition could be an option for BRAF + MEK inhibitor resistant patients that receive targeted therapy in combination with immune checkpoint blockade.

Tolerance of abuse within Mexican adolescent relationships

Violence in interpersonal relationships in young people has been the subject of several studies in recent years. Studies of dating violence show that one of the resources available for the young to help perceive and distinguish abusive or violent behaviour is an indicator which increases the ability to recognise as well as confront the reality of abuse. Certain violent behaviour however can be perceived as non-abusive, where the victim and the aggressor can share an abnormal view of the relationship in which possession, jealousy and exclusivity are considered significant elements within the relationship. The objective of this study is to understand and establish the levels of aggravation (degree of tolerance) towards violent behaviour in relationships of engaged adolescent Mexicans affected by abuse, by considering gender and level of perception of abuse as variables. The sample was formed of 3304 young Mexican students between the ages of 13 and 22, containing 1432 boys and 1872 girls, 1383 pursuing university studies, whereas the remaining 1921 were pre-university students. CUVINO was administered in order to determine the abusive conduct and levels of discomfort (tolerance), which allowed us to observe that the highest levels of discomfort, greater than those caused by any other kind of abuse, are experienced by women, especially regarding sexual victimization within the category of those non-abused women that presented a lower level of tolerance. This finding led us to identify, as a major risk factor, those men and women with a high level of tolerance, who did not perceive themselves as having been abused. (AU)

Rol del apoyo social en la reincorporación de penados: un estudio del Sistema de Postpenitenciario de Jalisco, México / Role of social support in the social prisioners: Study of the Postpenitentiary System of the State of Jalisco, Mexico

Este artículo es resultado de un estudio cuantitativo que tiene como objetivo el definir el perfil de las redes de apoyo formales e informales en relación con la reincorporación social de los usuarios del programa de la Dirección del Sistema Postpenitenciario y Atención a Liberados del Estado de Jalisco, México. La muestra esta integrada por 260 usuarios de este sistema, quienes accedieron a participar en la evaluación y a realizar una entrevista de seguimiento a los seis meses. Los análisis realizados ofrecen unos resultados que constatan una alta satisfacción de los usuarios con respecto al programa y al sistema de apoyo formal de reincorporación social; a su vez, el abandono del programa no correlaciona con el apoyo formal, siendo de resaltar que el apoyo informal presenta una correlación positiva con este de acuerdo con las figuras y la adaptación social de estas. Se discuten las implicaciones de los resultados para afrontar la reinserción social de los penados.

This paper results from a quantitative study, which aims to define the profile of the networks of formal and informal support in relation to social reintegration program users of the Postpenitentiary System Office and The Attention of the Released Bureau of the State of Jalisco, Mexico. The sample consists of 260 users of this system, who agreed to participate in the evaluation and make a follow up interview at six months. The analysis give results where a high user satisfaction regarding the program and the formal support system of social reintegration, in turn, leaving a program does not correlate with the formal support, being noted that the informal support show a positive correlation with this according to the figures and their social adaptation. Implications of the results to address the social reintegration of prisoners are discussed.

Estudio exploratorio de relación entre la percepción de apoyo social instrumental y la modificación de roles familiares en mujeres con cáncer de mama / An exploratory study about instrumental social support perception and familiar role modification in woman with breast cancer

Objetivo: Explorar la relación entre las fuentes y el tipo de apoyo instrumental brindado a las mujeres con Cáncer de Mama (CM) con la modificación de roles y actividades cotidianas en las pacientes y sus allegados. Método: Se realizó un estudio cualitativo centrado en la etnografía de 9 pacientes con CM. A través del software MAXQDA v10, se hizo un análisis temático del discurso para posteriormente elaborar tablas cruzadas para el análisis de las variables en estudio. Resultados: Para estas mujeres, la familia nuclear constituye la principal fuente de apoyo instrumental, al mismo tiempo que son quienes suelen modificar más sus actividades cotidianas y roles sociales. Las mujeres con CM expresan dificultad para delegar principalmente actividades del hogar debido a 3 razones: la responsabilidad de madre, la sensación de utilidad y una ideología tradicional de género Conclusiones: El impacto del cáncer en la mujer tiene consecuencias únicas, debido al papel central que ellas asumen en la vida familiar. Los movimientos funcionales, afectivos y relacionales que ocurren en la familia ante un diagnóstico de CM parece ser un hecho frecuente y de gran trascendencia, que ha sido poco estudiado en nuestra población. Estos aspectos deben ser considerados como un elemento importante en la comprensión y el soporte que se debe otorgar a las mujeres con CM y a sus familias

Objective: To explore the relationship between the sources and types of instrumental support provided to women with breast zancer, with changes in roles and daily activities in patients and their relatives. Methods: Qualitative study focused on the ethnography of 9 patients with nreast cancer. Through MAXQDA v10 software, we did a thematic analysis of discourse and developed cross tables for the analysis of the study variables. Results: For these women, the nuclear family is the main source of instrumental support, also are who often modify their daily activities and social roles. Women with breast cancer expressed difficulty delegating household chores, principally due to three reasons: Her mother's responsibility, a sense of usefulness and traditional gender ideology. Conclusions: The impact of cancer in women has unique consequences, because they assume central role in family life. Functional, affective and relational movements occurring in the family with breast cancer diagnosis, seems to be frequent and with important implications, which has been little studied in our population. These aspects should be considered as an important element in the understanding and support given to Breast Cancer patients and their families

Cost-effective PKHD1 genetic testing for autosomal recessive polycystic kidney disease.

BACKGROUND: Genetic diagnosis of autosomal recessive polycystic kidney disease (ARPKD) is challenging due to the length and allelic heterogeneity of the PKHD1 gene. Mutations appear to be clustered at specific exons, depending on the geographic origin of the patient. We aimed to identify the PKHD1 exons most likely mutated in Spanish ARPKD patients. METHODS: Mutation analysis was performed in 50 ARPKD probands and nine ARPKD-suspicious patients by sequencing PKHD1 exons arranged by their reported mutation frequency. Haplotypes containing the most frequent mutations were analyzed. Other PKD genes (HNF1B, PKD1, PKD2) were sequenced in PKHD1-negative cases. RESULTS: Thirty-six different mutations (concentrated in 24 PKHD1 exons) were detected, giving a mutation detection rate of 86%. The screening of five exons (58, 32, 34, 36, 37) yielded a 54% chance of detecting one mutation; the screening of nine additional exons (3, 9, 39, 61, 5, 22, 26, 41, 57) increased the chance to 76%. The c.9689delA mutation was present in 17 (34%) patients, all of whom shared the same haplotype. Two HNF1B mutations and one PKD1 variant were detected in negative cases. CONCLUSIONS: Establishing a PKHD1 exon mutation profile in a specific population and starting the analysis with the most likely mutated exons might significantly enhance the efficacy of genetic testing in ARPKD. Analysis of other PKD genes might be considered, especially in suspicious cases.

Adaptación del Inventario de Estrategias de Afrontamiento (CSI) a la población penitenciaria de Mexico / Adaptation of the Coping Strategies Inventory (CSI) for the Mexican prison population

El objetivo del estudio es adaptar el CSI - Inventario de Estrategias de Afrontamiento - al contexto penitenciario. La muestra - 261 penados, 97% varones (n=253) - del Sistema Postpenitenciario y Atención a Liberados (DSPAL) del Estado Jalisco, México. Los instrumentos utilizados: Ficha Penitenciaria de Historia de Vida y el Inventario CSI. Los resultados refieren una estructura de primer orden casi idéntica a la obtenida para la población general, con niveles de consistencia interna satisfactorios, al mismo tiempo que la interpretación de segundo orden no confirma la estructura de segundo y tercer orden. Se discuten las implicaciones de los resultados para intervención penitenciaria. (AU)

The aim of the present study is to adapt the Coping Strategies Inventory (CSI) to the prison context. The sample consisted of 261 prisoners, 97% were male (n = 253) from Sistema Postpenitenciario y Atención a Liberados (DSPAL) of Jalisco, Mexico. The instruments used were Record of Prison Life History and the CSI. The results reported a first-order structure almost identical to that obtained for the general population with satisfactory levels of internal consistency whereas the results of second-order interpretation do not confirm the original structure of second and third order. The implications of the results for prison intervention are discussed. (AU)

Clinical profile of patients diagnosed with leptospirosis after a typhoon: a multicenter study.

This study described the clinical features and complications of leptospirosis among patients seen at nine tertiary hospitals from September 28 to November 30, 2009 after a heavy rainfall typhoon. The clinical findings of the confirmed cases were compared with the previous clinical studies on seasonal leptospirosis in the Philippines. Risk factors for complicated disease were also identified. Confirmed cases were based on any of the following: positive leptospiral cultures of blood or urine, single high leptospira microscopic agglutination test (MAT) titer of 1:1,600, a fourfold rise in MAT, and/or seroconversion. Of 670 patients with possible leptospirosis, 591 were probable by the WHO criteria, 259 (44%) were confirmed. Diagnosis was confirmed by MAT 176 (68%), by culture 57 (22%), and by MAT and culture 26 (10%). The mean age of the confirmed cases was 38.9 years (SD 14.3). The majority were males (82%) and had a history of wading in floodwaters (98%). The majority of the patients presented with nonspecific signs, with fever as the most common (98.5%). Other findings were myalgia (78.1%), malaise (74.9%), conjunctival suffusion (59.3%), oliguria (56.6%), diarrhea (39%), and jaundice (38%). Most of the patients presented with a moderate-to-severe form of leptospirosis (83%). Complications identified were renal failure (82%), pulmonary hemorrhage (8%), meningitis (5%), and myocarditis (4%). Mortality rate was 5%, mostly due to pulmonary hemorrhage. This study emphasizes the importance of public awareness and high index of suspicion among clinicians of leptospirosis during the monsoon months when flooding is common. Early recognition and detection of the disease should decrease morbidity and mortality.

La red de apoyo en mujeres víctimas de violencia contra la pareja en el estado de Jalisco (México) / Support networks of women victims of partner violence in Jalisco (Mexico)

El objetivo de este trabajo es identificar las características del apoyo social informal otorgado a la mujer maltratada por su pareja íntima, quiénes lo aportan, así como el tipo de apoyo percibido por las entrevistadas. Es un estudio cuantitativo realizado en Guadalajara, Jalisco, en el que se aplicó el Cuestionario de Apoyo Social Percibido de las Fuentes de Apoyo (Gracia & Herrero, 2004) a 204 mujeres maltratadas por su pareja. Los resultados del análisis de cluster mostraron que el tipo más frecuente de red de apoyo presentaba a los amigos como principal fuente de apoyo. Otros tipos de red de apoyo encontradas en este estudio fueron: familia de origen, compuesta principalmente por padre, madre y hermanos(as) y pareja e hijos (que incluía en algunas mujeres al agresor como fuente de apoyo).

The main goal of the present research is to identify the support networks of women victims of partner violence paying attention to both sources and type of support provided. Information about network support from 204 participants living in Guadalajara (Jalisco, México) was obtained using the Relationship-specific Perceived Social Support (Gracia & Herrero, 2004). Cluster analysis revealed that the most frequent type of support network included friends as the main source of social support. Two other types of network support were found in this study: family of origin support (mother and sisters, mainly) and partner and offspring's support (in some cases the batterer was also included in this support network).

Violencia y temor por la vida en mujeres jaliscienses violentadas por su pareja íntima / Violence and fear for life seen in women from Jalisco who are abused by their partners

Introducción Los datos relativos a la atención de las necesidades de las víctimas de violencia de género en las relaciones interpersonales con su pareja íntima, en general no toman en cuenta las variables que inciden en el problema del servicio. Estos aspectos se encuentran definidos, a su vez, en la ley General de Acceso a una Vida Libre de Violencia, donde un primer paso sería conocer y no ignorar la realidad. Objetivos Presentar los aspectos relacionados con la violencia por parte de la pareja en las relaciones interpersonales y la petición de ayuda, en un grupo de mujeres que habita en la zona metropolitana de Guadalajara, Jalisco, México. Métodos La investigación es cuantitativa de corte transversal. El instrumento utilizado fue una entrevista semiestructurada a 204 mujeres que manifestaron que habían sido violentadas por su pareja íntima. Resultados La violencia de tipo psicológica en el 98 por ciento de mujeres fue la predominante y la agresión verbal, en el 97,1 por ciento, la más frecuente. Un alto porcentaje de las mujeres victimas de violencia física, independientemente del medio coercitivo utilizado, temieron por sus vidas. El 65,7 por ciento de las mujeres no solicitó ayuda ni hizo denuncia. Conclusiones En la zona metropolitana de Guadalajara existe un grupo importante de mujeres atemorizadas en su convivencia interpersonal dentro de sus hogares, a las cuales les han faltado apoyo y recursos personales para salir del núcleo maltratante y denunciar. Los servicios asistenciales, policiales y de salud tienen que mejorar las prestaciones a esta población.

Introduction Data on the attention paid to the needs of the victims of gender violence in their personal relationships with their partners do not take generally into account the variables affecting the service. These aspects have been defined in the General Law of Access to Violence-Free Life where the first step would be to learn about rather than to ignore the realities. Objectives To present the aspects of violence on the part of a sexual partner in the personal relationships of a couple and the request for help in a group of women living in the metropolitan area of Guadalajara, Jalisco, Mexico. Methods A cross-sectional quantitative study was conducted. The instrument was semi-structured interview made to 204 women who went to several institutions of the metropolitan area to state that they had been abused by their partners. Results Psychological violence prevailed in 98 percent of women whereas oral aggression was more frequent in 97.1 percent. A high percentage of battered women, regardless of the coercitive means used by the partner, feared for their lives. Additionally, 67.7 percent of women neither asked for help nor reported the violent action. Conclusions In the metropolitan area of Guadalajara, there exists a significant number of women who feared for their personal relationships in their houses; they have lacked support and personal resources to get out of their abusive environment and to report these actions. This violence also brings about more health problems for the females, in terms of physical condition, integration and social adaptation.

El proceso enfermero en la administración de vacunas / The nursing process in the administration of vaccines

Objetivo: identificar los elementos del proceso enfermero (diagnósticos de Enfermería, criterios de resultado NOC, intervenciones de Enfermería NIC) relacionados con la administración de vacunas con el propósito de elaborar una guía clínica que además facilite el uso de registros informatizados. Método: búsqueda bibliográfica en bases de datos en castellano, con las palabras clave: proceso & atención & enfermera & vacuna; atención &enfermería & vacuna; vacunación & NIC & NOC, o NIC & NOC &plan de cuidados & vacunación o plan de cuidados & vacunación. Elaboración de un listado de posibles diagnósticos enfermeros usando la clasificación NANDA, elección de los criterios de resultados (NOC) e intervenciones de Enfermería (NIC) asociados. Elaboración de parrilla aunando diagnósticos NANDA con criterios de resultados (NOC) e intervenciones de Enfermería (NIC).Resultados: cuando la actitud del usuario es positiva hacia el acto vacunal, los planes de cuidados para este proceso pueden agruparse en el diagnóstico Disposición para mejorar el estado de inmunización (00186). A partir de los diagnósticos, y para cada uno de ellos, se desarrollan los criterios de resultados (NOC) y las intervenciones de Enfermería (NIC) pertinentes. Conclusiones: la utilización de planes de cuidados estandarizados, al contemplar los diagnósticos, resultados e intervenciones enfermeras, facilitan que el profesional tenga una visión general de los cuidados a prestara cada usuario, facilitando a focalización y potenciando la individualización al tener en cuenta la idiosincrasia de cada persona (AU)

Objective: identify the elements of nursing process (nurse diagnoses, NOC nursing outcomes, NIC nursing interventions) related to vaccine administration in order to develop a clinical guideline which also facilitates the use of computerized records. Method: bibliographic search in databases in Spanish, with key words: process & attention & nurse & vaccine; attention & nursing & vaccine; vaccination & NIC & NOC, or NIC & NOC & care plan & vaccination or care plan & vaccination. Elaboration of a list of possible nursing diagnoses using the NANDA classification, selection of outcome criteria (NOC) and associated nursing interventions (NIC). Elaboration of a table template grouping NANDA diagnoses with outcome criteria (NOC) and nursing interventions (NIC).Results: when the attitude of the user is positive towards the act of vaccination, care plans for this process may be grouped under “Disposition/Readiness” to improve the state of immunization (00186). Using the diagnoses as the start point, and for each of these diagnoses, outcome criteria (NOC) and the pertinent nursing interventions (NIC) will be developed. Conclusions: the utilisation of standardised care plans when assessing diagnoses, outcomes and nursing interventions make it possible for the professional to have a general vision of the care to be given to each user, facilitating focalisation and enhancing individualisation by taking into account the idiosyncrasy of each individual (AU)