Objectives: understand the structure and content of the maternal representations of Mexican teenagers during their first pregnancy. Methods: a study was carried out with qualitative methodology based on the concept of maternal representation and the theory of social representations with 30 adolescents who attended prenatal control at the Civil Hospital of Guadalajara "Fray Antonio Alcalde", in Jalisco, Mexico. The participants were interviewed with the consent of their tutors. Classical content analysis techniques were used to obtain codes and thematic categories to develop a conceptual map that explains maternal representations. Results: the maternal representation was identified: "Pregnant but reunited, a legitimated bad decision", which was composed of social meanings towards adolescent pregnancy, family dynamics, expectations towards motherhood, and the feelings experienced by the adolescent during the pregnancy. The content of the representations was heterogeneous for most of the identified categories; however, it is identified that the desire for pregnancy guides the expectations of the adolescent about her future way of being as a mother. Conclusions: the desire of women for pregnancy, the level of participation of the couple, and the social meanings of adolescent pregnancy, have an outstanding role in the development of models of maternal representations.
Background. Myostatin is a regulator of muscle size. To date, there have been no published studies focusing on the relation between myostin levels and myopenia in rheumatoid arthritis (RA). Objective. Evaluate the value of serum myostatin as a biomarker of cachexia and low skeletal muscle mass (LSMM) in RA patients, along with whether high serum myostatin is associated to these conditions after adjusting for potential confounders. Methods. This cross-sectional study included 161 female RA patients and 72 female controls. In the RA group, we assessed several potential risk factors for LSMM and rheumatoid cachexia. Dual-energy X-ray absorptiometry was used to quantify the skeletal muscle mass index (SMMI) (considering
LSMM
≤
5.5
kg/m2) and the presence of rheumatoid cachexia (a fat-free mass
index
≤
10
percentile and fat mass
index
≥
25
percentile of the reference population). Serum myostatin concentrations were determined by ELISA. To identify a cut-off for high serum myostatin levels, we performed ROC curve analysis. Multivariable logistic regression analysis was used to identify the risk factors for LSMM and rheumatoid cachexia. The risk was expressed as odds ratios (ORs) and their 95% confidence intervals (95% CIs). Results. Compared to the controls, the RA group had a higher proportion of LSMM and exhibited high serum myostatin levels (
p
<
0.001
). ROC curve analysis showed that a myostatin
level
≥
17
ng/mL was the most efficient cut-off for identifying rheumatoid cachexia (sensitivity: 53%, specificity: 71%) and LSMM (sensitivity: 43%, specificity: 77%). In the multivariable logistic regression, RA with high myostatin levels (≥17 ng/mL) was found to increase the risk of cachexia (
OR
=
2.79
, 95% CI: 1.24-6.29;
p
=
0.01
) and LSMM (
OR
=
3.04
, 95% CI: 1.17-7.89;
p
=
0.02
). Conclusions. High serum myostatin levels increase the risk of LSMM and rheumatoid cachexia. We propose that high myostatin levels are useful biomarkers for the identification of patients in risk of rheumatoid cachexia and myopenia.
Diabetics' nutritional practices reflect the culture and human behavior of social groups; they also show how the diabetic faces health-sickness. This study's aim was to compare the nutritional practices in two geographic medical zones and to relate the value of metabolic control to age, sex, educational level, and length of the disease. The sample consisted of 404 cases chosen by systematic random sampling of 10 units of family medicine in the state of Jalisco, Mexico (five of them in metropolitan Guadalajara and five outside). Using 13 structured questions, validated, codified, and quantified according to Likert scale, nutritional practices were estimated with a range from 0–70 points. The results show that 20.54% of the diabetics have adequate nutritional practices (> 31 points). Of this figure, 80.72% are in the metropolitan zone and 19.27%, outside the metropolitan zone, showing a statistically significant difference ( p = 0.04). When relating the value of the practices with the educational level, there is a significant statistical difference shown between both medical zones ( p = 0.001). The simple regression between the value of the practices and metabolic control demonstrated that 8.2% and 1.5% of type-2 diabetics in the metropolitan zone and outside respectively account for metabolic control through high level nutritional practices.
La pandemia por el nuevo coronavirus (SARS-CoV-2) como reto de salud pública ha implicado múltiples desafíos en los sistemas de salud y generó contextos estresantes que afectaron la salud mental de los trabajadores de la salud por lo cual el objetivo de este trabajo fue revisar la literatura existente sobre el burnout en el personal de enfermería durante la pandemia por COVID - 19, para lo cual se realizó una revisión panorámica de la literatura basados en la metodología propuesta por Arskey y O´Malley utilizando los siguientes descriptores: Profesional Burnout, Nursing personnel, nursing staff, pandemic y COVID - 19 en las bases de datos PubMed, Scielo y Google Académico con lo cual se recuperaron 25 artículos que cumplieron con los criterios de inclusión. Resultados: Se identificaron 41 variables relacionadas con la presencia de burnout en el personal de enfermería y se organizaron en 5 categorías principales. Discusión: La pandemia por COVID – 19 generó factores estresantes en el personal de enfermería; múltiples variables de tipo sociodemográfico, laborales y factores sociales se identificaron como influyentes para el desarrollo de burnout en el personal de enfermería. Conclusiones: Es necesario planear programas de atención a la salud mental del personal de enfermería basados en la evidencia proporcionada por los estudios empíricos.
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