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Obstetric violence appears to be a worldwide concern and is defined as a type of gender-based violence perpetrated by health professionals. This violence undermines and harms women's autonomy. In Spain, 38.3 % of women have identified themselves as victims of this type of violence. To explore current information and knowledge about obstetric violence within the Spanish healthcare context, as well as to develop a theoretical model to explain the concept of obstetric violence, based on the experiences of healthcare professionals (midwives, registered nurses, gynaecologists and paediatricians) and nursing students. A constructivist grounded theory study was conducted at Jaume I University in Spain between May and July 2021, including concurrent data collection and interpretation through constant comparison analysis. An inductive analysis was carried out using the ATLAS.ti 9.0 software to organise and analyse the data. Twenty in-depth interviews were conducted, which revealed that healthcare professionals and students considered obstetric violence a violation of human rights and a serious public health issue. The interviews allowed them to describe certain characteristics and propose preventive strategies. Three main categories were identified from the data analysis: (i) characteristics of obstetric violence in the daily routine, (ii) defining the problem of obstetric violence and (iii) strategies for addressing obstetric violence. Participants identified obstetric violence as structural gender-based violence and emphasised the importance of understanding its characteristics. Our results indicate how participants' experiences influence their process of connecting new information to prior knowledge, and they provide a connection to specific micro- and macro-level strategic plans. Despite the lack of consensus, this study resonates with the established principles of women and childbirth care, but also generates a new theoretical model for healthcare students and professionals to identify and manage obstetric violence based on contextual factors. The term 'obstetric violence' offers a distinct contribution to the growing awareness of violence against women, helps to regulate it through national policy and legislation, and involves both structural and interpersonal gender-based abuse, rather than assigning blame only to care providers. Obstetric violence is the most accurate term to describe disrespect and mistreatment as forms of interpersonal and structural violence that contribute to gender and social inequality, and the definition of this term contributes to the ongoing awareness of violence against women, which may help to regulate it through national policy and legislation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effect of empagliflozin on diastolic function in a nondiabetic heart failure with reduced ejection fraction (HFrEF) scenario and on the pathways causing diastolic dysfunction. This group demonstrated that empagliflozin ameliorates adverse cardiac remodeling, enhances myocardial energetics, and improves left ventricular systolic function in a nondiabetic porcine model of HF. Whether empagliflozin also improves diastolic function remains unknown. Hypothetically, empagliflozin would improve diastolic function in HF mediated both by a reduction in interstitial myocardial fibrosis and an improvement in cardiomyocyte stiffness (titin phosphorylation). HF was induced in nondiabetic pigs by 2-h balloon occlusion of proximal left anterior descending artery. Animals were randomized to empagliflozin or placebo for 2 months. Cardiac function was evaluated with cardiac magnetic resonance (CMR), 3-dimensional echocardiography, and invasive hemodynamics. In vitro relaxation of cardiomyocytes was studied in primary culture. Myocardial samples were obtained for histological and molecular evaluation. Myocardial metabolite consumption was analyzed by simultaneous blood sampling from coronary artery and coronary sinus. Despite similar initial ischemic myocardial injury, the empagliflozin group showed significantly improved diastolic function at 2 months, assessed by conventional echocardiography (higher e′ and color M-mode propagation velocity, lower E/e′ ratio, myocardial performance Tei index, isovolumic relaxation time, and left atrial size), echocardiography-derived strain imaging (strain imaging diastolic index, strain rate at isovolumic relaxation time and during early diastole, and untwisting), and CMR (higher peak filling rate, larger first filling volume). Invasive hemodynamics confirmed improved diastolic function with empagliflozin (better peak LV pressure rate of decay (–dP/dt), shorter Tau, lower end-diastolic pressure-volume relationship (EDPVR), and reduced filling pressures). Empagliflozin reduced interstitial myocardial fibrosis at the imaging, histological and molecular level. Empagliflozin improved nitric oxide signaling (endothelial nitric oxide synthetase [eNOS] activity, nitric oxide [NO] availability, cyclic guanosine monophosphate (cGMP) content, protein kinase G [PKG] signaling) and enhanced titin phosphorylation (which is responsible for cardiomyocyte stiffness). Indeed, isolated cardiomyocytes exhibited better relaxation in empagliflozin-treated animals. Myocardial consumption of glucose and ketone bodies negatively and positively correlated with diastolic function, respectively. Empagliflozin ameliorates diastolic function in a nondiabetic HF porcine model, mitigates histological and molecular remodeling, and reduces both left ventricle and cardiomyocyte stiffness. [ABSTRACT FROM AUTHOR]

There are currently no studies available about the possible use of gamification in the evaluation of nursing students' clinical skills. The purpose of this study was to understand the gameful experience and satisfaction of nursing students in the evaluation of their clinical skills using an escape room. A quasiexperimental study was carried out. The participants were divided into an experimental group (escape room) and a control group. The experimental group had higher than average scores in all dimensions of the gameful experience scale, except in the dimension of negative effects. Escape rooms are a useful tool for the evaluation of nursing students compared with using the objective structured clinical evaluation. • Studies show that the design of nursing evaluations is important, as well as the environment and the form in which the evaluator interacts and communicates with the nursing students. • Implementing gamification into an educational setting has proved to have many positive results, including making the student an active part of their own learning. • Escape room is a team-based activity in which participants are closed in a room and given a scenario in which they must solve puzzles and use clues to complete the activity. • Escape rooms can help incorporate simulation into students' learning using the game setting. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the clinical performance of observers interpreting head CT images from patients with symptoms of acute stroke with a medical workstation or a smartphone or laptop reading system.Materials and Methods: Our institutional review board approved this retrospective study and waived the requirement for informed consent. We employed a factorial design including 2,256 interpretations (188 patients × 4 neuroradiologists × 3 reading systems). Accuracy equivalence tests, at a threshold of 5% and 10%, were performed for the following variables: detection of imaging contraindications for intravenous recombinant tissue-type plasminogen activator administration (eg, hemorrhagic lesions), ischemic lesions, hyperdense arteries, and acute ischemic lesions. For each clinical variable, the sensitivity, specificity, and receiver operating characteristic (ROC) curves were evaluated.Results: For each variable, the shapes of the ROC curves were very similar for all of the reading systems, indicating similar observer performance with different specificities and sensitivities. For all the clinical variables, the areas under the ROC curves were equivalent for all of the reading systems at a 10% threshold and were equivalent at a 5% threshold for hemorrhagic lesions, hyperdense middle cerebral artery, and acute ischemic lesion in the middle cerebral artery territory. There was no more than 30 seconds of difference between the reading time of the mobile devices compared with that for the medical workstation.Conclusion: The results of this pilot study showed equivalent diagnostic accuracy when using smartphone and laptops compared with medical monitors to interpret head CT images of patients with symptoms of acute stroke. [ABSTRACT FROM AUTHOR]

The Forensic Resource/Reference on Genetics-knowledge base (FROG-kb) web site was introduced in 2011 and in the five years since the previous publication ongoing research into how the database can better serve forensics has resulted in extensive redesign of the database interface and functionality. Originally designed as a prototype to support forensic use of single nucleotide polymorphisms (SNPs), FROG-kb provides a freely accessible web interface that facilitates forensic practice and can be useful for teaching and research. Based on knowledge gained through its use, the web interface has been redesigned for easier navigation through the multiple components. The site also has functional enhancements, extensive new documentation, and new reference panels of SNPs with new curated data. FROG-kb focuses on single nucleotide polymorphisms (SNPs) and provides reference population data for several published panels of individual identification SNPs (IISNPs) and several published panels of ancestry inference SNPs (AISNPs). For each of the various marker panels with reference population data, FROG-kb calculates random match probabilities (RMP) and relative likelihoods of ancestry for a user-entered genotype profile (either completely or partially specified). Example genotype profiles are available and the User’s Manual presents interpretation guidelines for the calculations. The extensive documentation along with ongoing updates makes FROG-kb a comprehensive tool in facilitating use of SNPs in forensic practice and education. An overview of the new FROG-kb with examples and material explaining the results of its use are presented here. [ABSTRACT FROM AUTHOR]

• No clinical relapses were noted in our study cohort following COVID-19 vaccination. • The spectrum of the SE experienced by MS patients following vaccination is similar to that of the general population studies. • COVID-19 vaccination in MS patients, regardless of concomitant disease modifying therapy, carries a very low risk of triggering severe SE, acute relapses, or temporary exacerbation of MS symptoms. The coronavirus disease 2019 (COVID-19) pandemic created an urgency for an effective vaccine. The FDA approved vaccines offered by Pfizer-BioNTech (BNT162b2), ModernaTX (mRNA-1273) and Janssen/Johnson & Johnson (Ad26.COV2.S) have shown minimal side effects (SE) in general population studies. Multiple sclerosis (MS) patients were not specifically represented in the above studies. The MS community is interested in how these vaccines behave in people with MS. In this study, we compare the SE experienced by MS to that of the general population after SARS-CoV-2 vaccination and evaluate their risk of relapses or pseudo-relapses. A retrospective, single-site, cohort study of 250 MS patients who received the initial cycle of FDA approved SARS-CoV-2 vaccines with 151 of whom also received an additional booster dose. SE resulting immediately after COVID-19 vaccination were collected as part of the standard clinical care during patient visits. Out of the studied 250 MS patients, 135 received the first and second doses of BNT162b2 with less than 1% and 4% pseudo-relapses respectively and 79 received the third BNT162b2 dose with a pseudo-relapse rate of 3%. 88 received the mRNA-1273 vaccine with a pseudo-relapse frequency of 2% and 5% after the first and second doses respectively. 70 patients had the mRNA-1273 vaccine booster with a 3% pseudo-relapse rate. 27 received the Ad26.COV2.S first dose, 2 of whom received a second Ad26.COV2.S booster dose, with no reports of MS worsening. No acute relapses were reported in our patient population. All patients experiencing pseudo-relapse symptoms returned to baseline within 96 h. COVID-19 vaccine is safe in patients with MS. Cases of temporary worsening of MS symptoms following SARS-CoV-2 are rare. Our findings support those reported by other recent studies and the CDC recommendation for MS patients to receive the FDA-approved COVID-19 vaccines, including the boosters. [ABSTRACT FROM AUTHOR]

We report two cases of hemoglobin Sendagi in a Romanian family residing in Spain: a four-year-old boy and his mother, who had been previously diagnosed with another type of congenital hemolytic anemia and had undergone splenectomy in her country during childhood. The unstable hemoglobin variant, hemoglobin Sendagi, is characterized by decreased oxygen affinity caused by replacement of one of the critical amino acid residues, phenylalanine beta 42 (CD1) of the beta-chain, with valine in the heme pocket, resulting in methemoglobin formation. As a result of migratory movements in Europe, new disease-causing hemoglobin variants are emerging in our country. Here, capillary electrophoresis enabled the identification of the variant and a molecular study was used to establish an accurate diagnosis. [ABSTRACT FROM AUTHOR]

to explore nursing students' experiences with the use of RCA technique in patient safety-related incidents during clinical placements. A secondary descriptive qualitative content analysis Patient safety education for nursing students is an international priority. While early detection and intervention strategies, such as the root cause analysis technique, have been found to be effective for near misses and errors, little is known about how these strategies facilitate nursing students understand how patient safety incidents happen. A secondary qualitative content analysis was conducted as part of a larger patient safety research project. Data were collected from nursing students at [ Hidden for blinding purposes ]. This study included 108 third-year undergraduate nursing students enroled in the Care Management in the Socio-Health Care Settings for the academic years 2017–2018 and 2018–2019. During hospital clinical placements, nursing students were asked to do a coursework describing a patient safety incident and using the root cause analysis technique for its analysis. A content analysis was used to provide an in-depth analysis of the collected data. Two main themes were identified after the data analysis process: (i) patient safety incident as learning events: highlights how these incidents were turned into learning opportunities and how the root cause analysis guided them in identifying and addressing critical incidents to prevent similar situations in the future; and (ii) strategies for improving patient safety culture: depicts how nursing students realised that following protocols and evidence-based practice reduces incidents related to patient safety and the value of reporting errors in avoiding and minimising the recurrence of similar mistakes. The root cause analysis technique is a versatile and flexible learning resource for nursing students that can help them understand complex patient safety incidents while also fostering critical and problem-solving thinking, teamwork and systematic communication. [ABSTRACT FROM AUTHOR]

Several algorithms have been developed in the literature to solve regression problems. We propose a novel methodology based on Bayesian networks (BNs) to deal with regression problems in environmental research. To demonstrate its capabilities and strength, we compare a BN model with 3 other methods commonly used to solve regression tasks, in terms of their root mean squared error (RMSE). The errors were depicted on error maps, providing information about the reliability of the predictions in each observation. The results show that BNs are competitive with other popular methods. [ABSTRACT FROM AUTHOR]

Microaggressions, stigma and minority stress still occur among sexual and gender minorities on an individual, interpersonal, and structural level. Cultural immersion may therefore be an effective strategy in order to find potential healthcare approaches and foster more comprehensive, critical, intersectional, and inclusive care practices. The aim of this study was to develop insight into the experiences of LGBTQ+ community members to obtain in-depth perceptions of microaggressions and an understanding of their healthcare needs to provide a culturally safe and sensitive care. A qualitative descriptive study was conducted between September to November 2021. This study was conducted at the University of Almeria with LGBTQ+ community members. Twenty-one LGBTQ+ individual participated in this study, aged between 18 and 56 years old. Participants were recruited using a purposive sampling. Responses from semi-structured interviews were studied using a thematic analysis. Methods and findings are reported in line with Standards for Reporting Qualitative Research recommendations. Three themes emerged from the qualitative analysis: (i) experiences to understand the impact of a heteronormative society, (ii) perceptions of engaging with health education and promotion, and (iii) healthcare access, use and experiences within the LGTBQ+ community. This study yields findings about the difficulties that LGBTQ+ community members face in the healthcare system in order to ensure equal care for vulnerable communities and integrate a culturally safe care approach into nursing practice. Certain microaffirmation strategies against social determinants of health such as school-based nursing strategies can help to raise awareness and knowledge among heterosexual peers and reduce cultural invisibility, microaggressions, stigma and minority stress. In order to provide culturally safe care, educators might also explore the inclusion of gender and sexual minority care content in both in-faculty education and ongoing continuing education for nurse practitioners. • Heteronormative social attitudes have a biopsychosocial impact in the LGBTQ+ community. • Microaggressions and marginalisation of the LGBTQ+ community can be avoided by changing social determinants. • Culturally sensitive care can help to break down institutional barriers in the healthcare system. • Nursing social justice can transform heteronormative societies through microaffirmations strategies. • LGBTQ+-related content is required in higher education and ongoing nursing to provide inclusive diversity practices. [ABSTRACT FROM AUTHOR]

Abstract: This paper investigates the different patterns of occupational gender segregation in the hospitality industry in Andalusia. The methodology is based on the segregation curve and different segregation measures. The results show that cleaning jobs, customer service and jobs with less responsibility in the area of administration are dominated by women, whereas maintenance, jobs with a high level of responsibility in the areas of kitchen, restoration, and administration are dominated by men. Occupational segregation increases as the age of the workers and size of the establishment increase, but decreases with level of education and is less common among workers with training contracts, whereas it is greater among part-time and seasonal workers. Horizontal segregation is more marked than vertical segregation in the hotel industry, but horizontal and vertical segregation is similar in restaurants. Finally, vertical segregation decreases with the size of the establishment, whereas horizontal segregation increases. [Copyright &y& Elsevier]

Anatomy is an important part of health science education. In teaching anatomy, new teaching strategies have been studied in comparison with traditional-based approaches. In this manner, strategies such as the escape room-based approach have been used as an innovative learning approach in nursing education, but little is known about its application in an Anatomy module. To evaluate the effectiveness of the escape room for anatomy-related knowledge retention in nursing and the perceived value of the game. In the first semesters of the academic years 2017–2018 and 2018–2019, a comparative cross-sectional study was conducted. This study took place at the University of Almeria with students enrolled in the Anatomy module. A total of 248 first-year nursing students took part in the study. The study included two groups: an experimental group (EG) that participated in an escape room in the final session of their Anatomy module, and a control group (CG) that received a traditional-based teaching approach in their final lesson. Students enrolled in the Anatomy module were randomly assigned to either the experimental (EG, n = 128) or control groups (CG, n = 120). The escape room was conducted in groups of four and lasted no more than 15 min. In terms of satisfaction with the escape room, EG scored above the mean. The item "I enjoyed playing" received the highest score (4.88 ± 0.35). Taking the final scores of each group into account, the EG had a final average score of 8.94 ± 0.96, while the CG had a final average score of 7.70 ± 1.25 (p = 0.001). According to the findings, the "Anatomy Escape Room" is a game-based approach that motivates students and constitutes a down-to-earth resource for anatomy learning in healthcare students. • Escape room-based approach constitutes a down-to-earth resource for anatomy educators. • This experience demonstrates to be a motivating learning experience in nursing. • Findings showed efficacy for evaluating anatomy and knowledge retention in students. • This game-based method can be captivating and promotes creativity in students. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed significant challenges around the world, affecting over 1.5 billion students in 191 countries. This situation has forced faculties and health-related degrees in particular to be innovative, flexible, and agile when transitioning to online or blended learning. The aim of this study was to explore nursing students' experiences and perceptions of the use of game elements in two full-nursing subjects using a blended-learning teaching strategy. A qualitative study was conducted through sixteen focus group interviews between November 2020 and January 2021. This study took place at the Jaume I University with students enrolled in Adult and Elderly Health Programmes and Chronic Processes in their second and third year, respectively. One hundred forty-nine second- and third-year undergraduate nursing students took part in the focus group interviews. A blended-learning teaching approach with game elements was developed for two full-undergraduate nursing subjects. Focus groups using a semi-structured interview protocol were conducted after delivering the teaching content. A content analysis was used to analyse the focus group interview data. The qualitative analysis revealed four major themes: (i) teaching transition in the COVID-19 pandemic scenario, (ii) game elements to retain student attention and learning, (iii) gameful designs for competency-based team training, and (iv) blended learning vs face-to-face learning including gamification. This study yields, for the first time, findings about the use of game elements in blended learning. This strategy was shown to be useful for teaching other key clinical or teamwork-related skills such as creativity, innovation, team-based communication, and responsibility, in addition to supporting the use of this innovative teaching strategy to reduce online fatigue and stress and increase student engagement in online classes. • The gameful blended-learning experience demonstrated efficacy in reducing online class-related stress. • The use of game elements in blended-learning showed an impact on psychological well-being and academic performance. • Game elements and team-based learning was effective in developing teamwork skills and communication, among others. • The rapid shift to digital learning has highlighted the need to be a priority for faculty members. [ABSTRACT FROM AUTHOR]