Our multivariate analysis suggests that TSH concentrations are higher in SGA infants than they are in AGA infants, and this should be taken into account when establishing a reference interval appropriate for this population. The clinical relevance remains unknown, but lines of research are opened that may allow a better understanding of the long-term morbidities in these newborns.

The objective was to explore obese adolescents' perceptions about obesity among students in the seventh to ninth grade of a public school in Tamaulipas, Mexico. This is a qualitative study. Participants were 24 adolescents with a body mass index equal to or greater than the 95th percentile. Semistructured interviews were conducted until data saturation was reached and the meaning was understood. The adolescents defined obesity according to standards of measurement. They identified the hereditary factor as the main obesity cause, tended to underestimate obesity and had low self-esteem. They reported problems to do physical exercise and get clothes in order to improve their image, and feel rejected by their peers in school. It was identified that these adolescents have psychological defense mechanisms against obesity and that some of them are making efforts to lose weight.Obesity entails social and psychological health implications for persons suffering from this problem. Interventions should be put in practice.Descriptors: Adolescent; Obesity; Body Weight; Self Concept. para subestimar a obesidade e a ter baixa autoestima, apresentan problemas quando realizam atividade física e para conseguirem roupas para melhorar a própria imagen, são rejeitados pelos seus pares ou iguais, na escola. Identificou-se, também, que possuem mecanismos psicológicos de defesa ante a obesidade e alguns deles estão realizando ações para diminuir o peso. A obesidade tem implicações na saúde, no aspecto psicológico e social de quem a padece, recomenda-se, aqui, implementar intervenções.Descritores: Adolescente; Obesidade; Peso Corporal; Auto-imagem. Percepciones de la obesidad de adolescentes obesos estudiantes del 7º al 9º grado residentes en Tamaulipas, MéxicoEl objetivo de esta investigación fue explorar las percepciones de la obesidad de adolescentes obesos estudiantes del 7º al 9º grado de una institución pública en Tamaulipas, México. Se trata de un estudio cualitativo en el cual participaron 24 adolescentes que tenían un índice de masa corporal superior al percentil 95. Se realizaron entrevistas semiestructuradas hasta obtener la saturación de los datos y la comprensión del significado. Los adolescentes definieron la obesidad de acuerdo a los estándares de medición, identificaron como causa principal el factor hereditario, tendieron a subestimar la obesidad y presentaron baja autoestima, relataron problemas cuando realizan actividad física y para conseguir ropa que pudiese mejorar su imagen, y se sienten rechazados por sus pares o iguales en la escuela. Se identificó que cuentan con mecanismos psicológicos de defensa ante la obesidad y algunos de ellos están realizando acciones para disminuir el peso. La obesidad tiene implicaciones en la salud, también en los aspectos psicológico y social de quienes la padecen. Se recomienda implementar intervenciones.

The manufacturer has introduced the new EBT2 film model so as to improve its predecessor, the EBT radiochromic film model. According to the manufacturer, some of its main advantages include a higher tolerance to light exposure and it can correct non-uniformity of the active layer thickness using a marker dye. However, the equivalence in uniformity between both models was questioned by some authors, and the asymmetrical configuration of layers of the EBT2 film model produces a new dependence on the film side being scanned (front and back orientation). In this study, the EBT2 radiochromic film model was compared with the EBT model and the new marker dye feature was assessed. We also compared this correction method with a pre-irradiated pixel value correction method. An Epson Expression 10000XL scanner in transmission mode was used to scan the films and the red channel response was analyzed. We confirmed the lower-measured signal dependence on the visible light exposure of the EBT2 film model. Differences in pixel values remained below 0.5% for a minimum of 15 days. In regard to the uniformity, similar results for EBT2 and EBT film models were obtained; in both cases inhomogeneity was found to be less than 1%, in relative pixel value from the mean. However, we found that the signal-to-noise ratio was reduced for low doses by 37% for old EBT2 batch and by 21% for new EBT2 batch compared to signal-to-noise ratio for EBT. The EBT2 film model's pixel value difference for the front and back orientation reached up to 1.0% in the red channel. Our results did not show a clear advantage between to use a pre-irradiated pixel value correction and to use the manufacturer's correction.

The inconsistent use of hormonal contraceptive methods can result, during the first year of use, in one in twelve women still having an undesired pregnancy. This may lead to women experiencing fear of becoming pregnant (FBP). We have only found one study examining the proportion of FBP among women who used hormonal contraceptives. To gather further scientific evidence we undertook an observational, cross-sectional study involving 472 women at a Spanish university in 2005–2009. The inclusion criteria were having had vaginal intercourse with a man in the previous three months and usual use for contraception of a male condom or hormonal contraceptives, or no method of contraception. The outcome was FBP. The secondary variables were contraceptive method used (oral contraceptives; condom; none), desire to increase the frequency of sexual relations, frequency of sexual intercourse with the partner, the sexual partner not always able to ejaculate, desire to increase the partner’s time before orgasm, age and being in a stable relationship. A multivariate logistic regression model was used to determine the associated factors. Of the 472 women, 171 experienced FBP (36.2%). Factors significantly associated (p < 0.05) with this FBP were method of contraception (condom and none), desire to increase the partner’s ability to delay orgasm and higher frequency of sexual intercourse with the partner. There was a high proportion of FBP, depending on the use of efficient contraceptive methods. A possible solution to this problem may reside in educational programmes. Qualitative studies would be useful to design these programmes.

Background. Little research exists on the impact of paid work on academic performance of students of health sciences. No research exists on this subject for students in Colombia.Objectives. This paper seeks to analyze the impact of paid work on academic performance among nursing students. Design, settings and participants: cross-sectional research, involving 430 of nursing students from the National University of Colombia (N = 566). Methods. Variables analyzed: sex, age, work activity, attendance, current semester, degree subjects studied and unavailable, lost credits, grades during the second semester of 2013, and delayed semesters. Subgroups analyzed: (i) according to labor activity: do not work, work up to 20 h and work more than 20 h per week; (ii) Grade point average: failing is considered as less than 3.0 and passing 3.0 or above out of 5.0. Percentage of delayed semesters were calculated. Qualitative and quantitative variables were analyzed for groups by work activity. The percentage and probability of students getting a grade point average less than 3.0 and delaying semesters were calculated by multivariate logistic regression. Results. A total of 219 of the students work (50.9%), the main reason is socioeconomic, of which 99 (45.2%) work more than 20 h per week and have an increased risk of failing, which is higher in the first semester. They also get lower grades, lose more credits and take longer to finish the degree. The logistic bivariate regressions of success (grade point average, credits gained, courses gained and not having delayed semesters) reduce with work, above all in those who work more than 20 h per week and increase as the number of semesters completed increases, independent of sex. Conclusion. A high percentage of nursing students work more than 20 h per week. The compatibility of paid work with studies in university nursing students has a negative impact on academic performance, more so when they work more than 20 h per week. This negative impact diminishes as the student completes semesters, irrespective of the sex of the students.

AimsTo determine out-of-hospital cardiac arrest mortality in the province of Alicante (Spain) and its associated factors.MethodsCross-sectional observational study of all patients who received cardiopulmonary resuscitation (CPR) by the Emergency Medical Services (EMS) (n = 422) in the province of Alicante in 2013. To determine associated factors, a binary logistic regression model was constructed. Primary outcome: death before arriving at the hospital. Predictive variables: gender, age, artificial respiration, prior functional status, asystole, cardiogenic aetiology, bystander CPR, time from the cardiac arrest to the arrival of the EMS and location of cardiac arrest.ResultsThere were 337 deaths (79.9%; 95% CI: 76.0–83.7%). Factors independently associated (p<0.05) with death were: male gender (OR = 2.11; 95% CI: 1.20–3.72; p = 0.010), asystole (OR = 1.99, 95% CI: 1.17–3.39; p = 0.012), cardiac arrest at home (OR = 2.44; 95% CI: 1.42–4.18; p = 0.001) and an increased time between arrest and EMS arrival (OR = 1.05, 95% CI: 1.01–1.09, p = 0.009). Having a worse prior functional status had a tendency towards significance (OR = 0.56, 95% CI: 0.31–1.02, p = 0.059).ConclusionsMortality was high. The associated factors were: male gender, asystole, worse prior functional status, longer time from the cardiac arrest to the arrival of the EMS and having the cardiac arrest at home. The clearly negative impact of experiencing a cardiac arrest at home necessitates modifying training policies in Spain. These policies should be focused on providing information about CPR in schools in order to decrease the mortality of these events.

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Nearly 50-60% of cancer patients will undergo radiotherapy at some point in their treatment. Around 85% of the world's population live in developing countries served by approximately 30% of the world's radiotherapy facilities. It has been suggested that 1 megavoltage unit is required for every 500 new treatment courses per year, while others estimate that 1 megavoltage unit is needed for every 300 new treatments. However, these numbers do not necessarily take into account the development of new technologies and treatment modalities, which are more time- and resource-intensive. The International Commission on Radiological Protection has emphasised that 'purchasing new equipment without a concomitant effort on education and training and on a programme of quality assurance is dangerous', and 'the decision to implement a new technology for radiation therapy should be based on a thorough evaluation of the expected benefits, rather than being driven by the technology itself'. It is estimated that the rate of serious mistakes could be as high as 0.2%, which is several orders of magnitude higher than the rate reported for commercial aviation. So, how safe is safe? It can be stated that the development of a culture of safety is critical and requires efforts in education and training, which could prove difficult in overloaded departments.