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Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Background: It has been established that people with autism spectrum disorder (ASD) often have difficulties understanding spoken language. Understanding reflexive and clitic pronouns is vital to establishing reference‐based inference, but it is as yet unclear whether such constructions pose specific difficulties for those with ASD. Pronoun interpretation seems be connected to the development of pragmatic abilities, and can therefore be considered a plausible marker in the differential diagnosis between ASD and developmental language disorder (DLD). Aims: To establish whether or not there are differences between ASD and DLD in relation to their understanding of pronoun constructions (both reflexive and clitic). The working hypothesis was that although no differences were expected between groups in relation to automatic (online) pronoun processing, the comprehension of reflexive pronouns would constitute a diagnostic marker between the group with ASD and language disorder and the DLD group. Methods & Procedures: The study carried out two experiments with three clinical groups (two with ASD and different levels of language proficiency and one with DLD) and two control groups with typically developing people (with equivalent language levels), analysing their on‐ and offline processing in pronoun resolution tasks. The first experiment uses an online method (eye‐tracking) to record pronoun processing in real time. The second uses an offline method to analyse comprehension accuracy. Outcomes & Results: The results of the two experiments indicated no differences in the way in which the clinical and control groups resolved the tasks, but a shorter reaction time was observed only in the age‐matched control group in comparison with the ASD group without language disorder in the first experiment, perhaps due to the fact that processing pronouns involves a greater cognitive load among the latter group. Conclusions & Implications: The comprehension of reflexive pronouns cannot be considered a diagnostic marker for distinguishing ASD from DLD. What this paper addsWhat is already known on the subjectPrevious studies have found that the performance of children with ASD in the comprehension of personal pronouns is equivalent to youngest control groups, but poorer regarding the interpretation of reflective pronouns. However, children with DLD do not usually have problems with the use of pronouns, which suggests that their pronoun processing is not affected. As pronoun interpretation seems be connected to the development of pragmatic abilities, it could be considered a plausible marker in the differential diagnosis between ASD and DLD.What this paper adds to existing knowledgeThis paper presents the results of two experiments involving pronoun processing by those with ASD (both with and without language disorder) and those with DLD. The design enables us to analyse the reflexive and clitic pronoun processing in people with ASD and DLD, regardless of their language proficiency. One experiment uses an eye‐tracking methodology that allows us to obtain data about how the pronouns are processed in real time. It represents an attempt to identify language markers that may help distinguish between the two groups and adapt the interventions to the specific problems experienced by each one.What are the potential or actual clinical implications of this work?The results indicate that it is not possible to identify any specific impairment in pronoun processing among the clinical groups (ASD and DLD). [ABSTRACT FROM AUTHOR]

What is already known about this subject There is an association between adiposity levels and physical activity guidelines for adolescents., Achieving physical activity recommendations helps adolescents to prevent obesity status., What this study adds This paper presents an association between physical activity levels and obesity status., This paper supports physical activity recommendations to avoid children's obesity levels., This paper emphasizes vigorous physical activity for this matter., Background There is no information about physical activity (PA) recommendations to avoid children's obesity levels and how much of vigorous PA (VPA) is included into the '60 minutes of MVPA 5 days a week' recommendation for children. Objective The aim of this study was to examine the association between PA and adiposity in children and to examine whether the current PA guidelines are associated with a low risk of having excess of body fat in children, with special focus on sex differences, and PA intensity. Methods A sample of 439 Spanish children aged 8-10 years from the European Youth Heart Study participated in the study. The variables measured were anthropometric characteristics (height, weight, body mass index [ BMI], skin-folds and waist circumference) and PA was measured during 6 consecutive days using the GT1M accelerometer. Results Receiver operating characteristic analysis showed significant cut-off points associated with non-overweight: 45 min d−1 of VPA and 67 min d−1 of moderate-to-vigorous physical activity ( MVPA) (using BMI categories); and non-fat: 41 min d−1 of VPA and 67 min d−1 of MVPA (using percentage of body fat) and 38 min d−1 of VPA and 47 min d−1 of MVPA (using waist circumference categories) for boys. For girls, the optimal cut-offs of moderate-to-vigorous activity and MVPA associated with non-overweight were 24 and 57 min d−1, respectively ( BMI). Boys who did not meet 67 min in MVPA had an increased risk of being overweight + obese and overfat + obese (odds ratio [ OR] = 2.48, 95% confidence interval [ CI] = 1.36, 4.53, and OR = 2.56, 95% CI = 1.12, 5.82). Conclusions The findings support current PA recommendations (60 min d−1 of MVPA) to avoid excess of body fat in Spanish children. However, VPA appears to be an important component for the prevention of obesity, and our findings suggest that PA recommendations should specify the dose of VPA required for optimal health. Therefore, public health PA recommendations should incorporate specifically a greater dose of VPA into the total amount of MVPA in 8- to 10-year-old boys. [ABSTRACT FROM AUTHOR]

This paper examines the perceived quality of working life of workers with intellectual disabilities. Specifically, this paper looks at participants' perceptions in relation to perceived job demands and resources and their impact on experienced job satisfaction. In this cross-sectional survey, 507 workers with intellectual disabilities, employed in either sheltered workshops or supported employment, completed questionnaires on the quality of working life through semi-structured interviews. Regression analyses showed that perceived low job demands and elevated social support from coworkers and supervisors predicted higher quality of working life. Common organizational psychology measures can be successfully used with this population to assess quality of working life. This study confirms the multidimensional nature of quality of working life, and the impact of job demands and available resources on perceived satisfaction with job for workers with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4‐year follow‐up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110–130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15–65 µg/L), and normal‐high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5–5 years and the Behaviour Rating Inventory of Executive Function‐Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5–5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal–high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4‐year‐old children. Key messages: Prenatal iron supplementation succeeds in improving maternal haematological outcomes and cognitive performance of children, but few studies have focused on behavioural development.Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4‐year‐old children.Maternal iron stores early in pregnancy should be measured in addition to haemoglobin concentration.These findings contribute greatly to the advancement of public health by giving physicians the tools to prescribe the most appropriate dose of iron supplementation to contribute to better child development. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to test the usefulness of the Cognitive and Language scales Bayley-III in the early assessment of cognitive and language functions in the context of an autism spectrum disorder (ASD) diagnosis. This paper focuses on the application of the Bayley-III and studies the predictive value of the test result in children with ASD with different levels of verbal ability. Method A sample of 135 children (121 boys, 14 girls) with a confirmed ASD diagnosis at age 4 years were assessed with the Bayley-III before 42 months of age ( m = 36.49, s = 4.46) and later with other rating scales of different psychological and psycholinguistic functions as part of a longitudinal study [ McCarthy Scales of Children's Abilities (MSCA) ( n = 48, 90% boys), Kaufman Assessment Battery for Children (K-ABC) ( n = 38, 87% boys) or Illinois Test of Psycholinguistic Abilities (ITPA) ( n = 44, 89% boys)]. Age assessment in months: MSCA ( m = 48.80, s = 3.33), K-ABC ( m = 51.80, s = 7.17) and ITPA ( m = 54.48, s = 3.34). Results Lower scores on the cognitive and language Bayley-III scales before 3.5 years of age predicted lower cognitive and oral language levels at 4 years of age. A significant correlation was found between the Cognitive Bayley-III Scale and the General Cognitive MSCA Scale, and with the Compound K-ABC Mental Processing. An association between the nonverbal cognitive level and oral language level acquired at 4 years of age was found. Conclusions The Bayley-III is a useful instrument in cognitive and language assessment of ASD. [ABSTRACT FROM AUTHOR]

This paper presents a further step in the use and validation of a systematic, functional-analytic method of describing psychologists' verbal behaviour during therapy. We observed recordings from 92 clinical sessions of 19 adults (14women and 5men of Caucasian origin, with ages ranging from 19 to 51 years) treated by nine cognitive-behavioural therapists (eight women and one man, Caucasian as well, with ages ranging from 25 to 48 years). The therapists' verbal behaviourwas codified and then classified according to its possible functionality. A cluster analysis of the data, followed by a discriminant analysis, showed that the therapists' verbal behaviour tended to aggregate around four types of session differentiated by their clinical objective (assessment, explanation, treatment and consolidation). These results confirm the validity of our method and enable us to further describe clinical phenomena by distinguishing psychologists' classes of clinically relevant activities. Specific learningmechanismsmay be responsible for clinical change within each class. These issues should be analysed more closely when explaining therapeutic phenomena and when developing more effective forms of clinical intervention. [ABSTRACT FROM AUTHOR]

Background As future health educators, nursing and physiotherapy students will play an essential role in the prevention of smoking. Aim To determine the prevalence of smoking among students and to analyse their knowledge of and attitudes towards smoking. Method This was a descriptive cross-sectional study using an anonymous questionnaire and conducted in a Spanish Faculty of Health Sciences in 2013. Findings 247 nursing and physiotherapy students (82.33%) participated in the study. The global prevalence of smoking (18.2%) was lower compare with the general population group of the same age. We have observed statistical significance in relation to previous studies. Nursing and physiotherapy students showed a low nicotine dependence. We found a lack of knowledge about the harmful effects of cigarette consumption on health. Statistically significant results were also found in relation to degree courses (p < 0.01) as regards students' opinions about their knowledge of strategies and methods to help patients stop smoking. Conclusion Most students started smoking before commencing their university studies; consequently, interventions should focus on cessation programmes. An analysis of university curricula leading to the award of a degree in the health sciences could serve to identify educational deficiencies in order to implement the necessary modifications. Implications for nursing and health policy This paper presents an update in tobacco use characteristics amongst nursing and physiotherapy students. Those results have showed a need to improve the curricula in order to develop specific programmes to improve knowledge, attitudes and beliefs. Measures to prevent smoking must be taken at school. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Transcatheter aortic valve implantation constitutes an example of a technology introduced into the Galician Health Care System basket and subjected to a post-introduction observational study after coverage. This paper aims to describe the process and results of this experience, illustrating the main challenges and opportunities in using these studies for supporting decision making. Methods The study protocol was developed by a multidisciplinary team consisting of experts from the Galician HTA Agency (avalia-t), interventional cardiologists and cardiac surgeons. Together they agreed on the information that was relevant and feasible for collection, and planned the study design, data collection and analysis of results. Results During the 1-year recruitment period, 94 patients underwent percutaneous aortic valve replacement in the three authorized centres. Implantation rate and prosthesis models differed substantially across the centres. Overall, procedural success rate was 96.8% and hospital mortality was 7.4%. Complications during post-surgical admission were recorded in 40.4% of patients. Moderate residual aortic regurgitation was observed in 10% of patients, and the procedure was associated with a stroke rate of 3.3% at 30 days and 5.3% at 1 year. Conclusions Post-introduction observation has made it feasible to determine the use of this procedure within the SERGAS context and has enabled the assessment of performance in real-life conditions. The proposed strategic actions and interventions have been drawn up based upon the collective judgement of a group of experienced professionals, and have served to establish recommendations on further research that would be required to optimize health benefits. [ABSTRACT FROM AUTHOR]

Purpose To examine the perception of registered nurses and nursing assistants regarding the use of physical restraints with residents of nursing homes located in four of the regions of Spain; and to evaluate the relationship of these perceptions to the staff respondents' level of training. Design Cross-sectional multicenter and correlational study. The research was conducted in 2013 in 19 Spanish nursing homes with 2,940 residential beds. A total of 785 nurses (170 registered nurses and 615 nursing assistants) participated in the study. Methods The Perception of Restraint Use Questionnaire (PRUQ), consisting of 17 of the most cited reasons for using these devices, was used, as was a questionnaire capturing the sociodemographic characteristics and educational or experience level of staff respondents. Findings Nurses reported the most important uses for restraints as prevention of falls and avoidance of medical device interference. As indicated by an average PRUQ score of 3.47, staff respondents supported restraint use, especially nursing assistants (3.59) as compared to registered nurses (3.00). With regard to training: 83.7% had participated in little, if any, training and only 29.2% had read three or more documents related to restraint use; 66.6% believed that their training was inadequate. No correlation was found between the results of the PRUQ and the respondents´ sociodemographic characteristics or participation in training activities. No differences were found among nurses by region. Conclusions In contrast to papers published in other countries, nurses in this study still consider it necessary to apply restraints in everyday practice. The education of nursing staff regarding restraint and knowledge of alternatives is needed; they should at least be aware of international standards of care regarding physical restraint use. Clinical Relevance Most of the staff perceived their training related to the use of these devices as insufficient. Nursing assistants considered the use of restraints more important than did the registered nurses. [ABSTRACT FROM AUTHOR]

Aims To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. Material and Methods Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth ( PPD) and clinical attachment level ( CAL) and most in plaque index (PlI) and/or bleeding on probing ( BOP). Meta-analyses were performed with the data retrieved from the studies fulfilling the inclusion criteria. Results The overall effect of the subgingival application of antimicrobials was statistically significant ( p = 0.000) for both changes in PPD and CAL with a weighted mean difference ( WMD) of −0.407 and −0.310 mm respectively. No significant differences occurred for changes in BOP and PlI. Subgingival application of tetracycline fibres, sustained released doxycycline and minocycline demonstrated a significant benefit in PPD reduction ( WMD between 0.5 and 0.7 mm). The rest of the tested outcomes demonstrated a high heterogeneity. The local application of chlorhexidine and metronidazole showed a minimal effect when compared with placebo ( WMD between 0.1 and 0.4 mm). Conclusions The scientific evidence supports the adjunctive use of local antimicrobials to debridement in deep or recurrent periodontal sites, mostly when using vehicles with proven sustained release of the antimicrobial. [ABSTRACT FROM AUTHOR]

Background: Studies revealed unidirectional associations between frailty and medication‐related problems (MRPs) among older adults. Less is known about the association between frailty and the risk of MRPs. We aimed to assess the bi‐directional association between frailty and the risk of MRPs in community‐dwelling older adults in five European countries. Methods: Participants were 1785 older adults in the population‐based Urban Health Centres Europe project. Repeated assessments were collected at baseline and one‐year follow‐up, including frailty, the risk of MRPs, and covariates. Linear regression analyses were conducted to examine the unidirectional associations. A cross‐lagged panel modeling was used to assess bi‐directional associations. Results: The unidirectional association between frailty at baseline and the risk of MRPs at follow‐up remained statistically significant after adjusting for covariates (β = 0.10, 95%CI:0.08, 0.13). The association between the risk of MRPs at baseline and frailty at follow‐up shows similar trends. The bi‐directional association was comparable with reported unidirectional associations, with a stronger effect from frailty at baseline to the risk of MRPs at follow‐up than reversed path (Wald test for comparing lagged effects: p < 0.05). Conclusion: This longitudinal study suggests that a cycle may exist where older adults with higher frailty levels are more likely to have a higher risk of MRPs, which in turn contributes to developing a higher level of frailty. Further research is needed to validate our findings and explore underlying pathways. [ABSTRACT FROM AUTHOR]

Background A person suffering from dementia needs increasing help from another person, who, in most cases, is a female family member. Times are changing and this traditional role can no longer be maintained. Aim The aim of this research was mainly centred on ascertaining the profile of caregivers and to find out how determinants such as age, sex and educational level and living conditions led people to assume that role. Methods A survey was designed and applied to 925 caregivers (778 of which were analysed) with the collaboration of the Alzheimer's Associations of Andalucía (Spain). Associations gave their ethical approbation for this research prior to the beginning and they informed their members. The participation was entirely voluntary, and caregivers were given the option to withdraw consent. Results Women are the main caregivers in any kind of profile. Males become carers if they are old and the partner of a patient. Males use more external services. Cohabiting and working outside the home increase the use of external support services, and having a higher level of education increases the use of nursing homes. Younger caregivers perceive more intense socio-economic consequences than the general profile. Conclusions Being a caregiver implies limitations to entering the job market and for job promotion. There is a generational gap in the caregiver profile, and more and new support services will be needed. Policymakers should take those into account. [ABSTRACT FROM AUTHOR]

If children in child protection cannot be cared for by their natural parents, should they be adopted or live in foster home? Results from a study of representative samples of populations (n = 12 330), in eight European countries—Austria, England, Estonia, Finland, Germany, Ireland, Norway and Spain—and California, USA, reveal that people would recommend adoption over foster care, if a child in public care cannot grow up with their natural parent(s). There are cross‐country differences between populations, and examining if institutional context such as type of child protection system explains differences, we find that child maltreatment‐oriented systems are more supportive of adoption than other types of systems. Citizens having little confidence in the child protection system were only weakly correlated with preference for adoption. In conclusion, people prefer adoption as placement options for children in care are more than foster homes, and possible this finding reflects a sort of refamalialization of children into the private sphere. [ABSTRACT FROM AUTHOR]

Background: Cannabis use is increasing among Andalusian adolescents, causing health, social and financial problems. School nurses visit schools and provide health promotion to adolescents in Andalusia. In order to better tailor health promotion programs, it is important to understand the sociodemographic and motivational factors related to cannabis use in Andalusian adolescents. Design/Methods: In this cross‐sectional study, 369 students (aged 15–18 years) from secondary schools in Andalusia were involved. An anonymous questionnaire based on the I‐Change Model was self‐administered during school hours. Cannabis users were compared with non‐cannabis users regarding sociodemographic and motivational factors. Contingency tables, mean comparison tests, and logistic regression analyses were conducted. Results: The prevalence of cannabis use in the last year was 21.6%. Non‐cannabis users had a few positive beliefs toward cannabis use (e.g. the ability to relax or medical benefits), as well as users. Users recognized some disadvantages of cannabis use but played down their importance and mentioned more advantages. Moreover, social influence, especially from peers, plays a critical role in cannabis use. Specific social situations and moods seemed to be special risk factors for cannabis use, such as being at a celebration or feeling good. Results of regression analysis showed that cannabis use is mainly associated with age, low family function, low family affluence, high pocket money, perceiving few disadvantages of cannabis use, much social modeling of cannabis use, social norm and pressure favoring cannabis, low self‐efficacy to resist using cannabis and positive intentions to use cannabis. Conclusions: Based on our results, prevention programmes lead by nurses can be tailored to the factors important to prevent cannabis use, focusing on outlining the disadvantages of cannabis use, alternatives for using cannabis when feeling good, increasing salience of healthy social influences and reinforcing self‐efficacy to resist temptations to use cannabis are recommended. Clinical Relevance: Nurses need to know the sociodemographic factors and motivations associated with the use of cannabis in adolescents in order to establish effective preventive interventions at school. [ABSTRACT FROM AUTHOR]

Background and Objectives: First‐line treatment for trigeminal neuralgia (TN) is limited to carbamazepine and oxcarbazepine, and in refractory cases, alternatives are scarce. Lacosamide has been suggested as a valid option. In this study, we describe a series of patients who received oral lacosamide as treatment for TN after first‐line drug failure. Methods: In this retrospective descriptive cohort study, we included patients with refractory TN who attended a tertiary center between 2015 and 2021 and were prescribed oral lacosamide after first‐line treatment failure. The primary endpoints were pain relief and adverse effects. We secondarily analyzed clinical outcomes and compared responders versus nonresponders in the search for potential predictors of response. Results: Eighty‐six patients were included (mean age: 62 [SD 15.6] years; 54/86 [63%] female). The TN etiology was secondary in 16/86 (19%) patients. Concomitant continuous pain was present in 29/86 (34%) patients. The mean number of previous treatments was 2.7 [SD 1.5]. Pain relief was achieved in 57/86 (66%) cases, with 28/86 (33%) patients presenting adverse effects, all of which were mild. No statistically significant differences were observed between responders and nonresponders, but subtle clinical differences suggested potential predictors of response. Conclusion: Lacosamide may be an effective and relatively safe treatment for refractory pain in TN patients after first‐line treatment failure. [ABSTRACT FROM AUTHOR]

The advertisement of food and beverages on television and social media has been widely assessed, evidencing its powerful influence on children's dietary patterns and the development of childhood obesity. However, there is a gap in the evidence about advertisements near schools. The aim of this study was to describe and classify the nutritional quality and information of processed foods and alcoholic and non‐alcoholic beverages advertised near schools in three cities in the north of Spain. A descriptive analysis was performed from September to December 2021 in the cities of Oviedo, Gijón and Avilés in the Principality of Asturias (Spain). The nutritional quality and information of processed foods or beverages advertised within a 500 m radius of schools were assessed. The Nutri‐Score system was used for the classification of the nutritional quality of products and nutritional information, calories, fat, saturated fat, carbohydrates, sugars, protein and salt in 100 g or ml of each product was calculated. A total of 73.5% of the products were classified as "foods to eat less often and in small amounts," and 22.6% and 46.3% were classified as D or E, respectively, according to the Nutri‐Score system. Finally, 57.5%, 56.4% and 78.5% of the products showed a medium to high content of fat, saturated fat and sugar, respectively. In conclusion, the food and drink advertisements surrounding schools in the assessed cities promote many products of low nutritional value, rich in fat, saturated fat and sugars, which have high obesogenic potential. [ABSTRACT FROM AUTHOR]

Transition to adulthood is an accelerated and early process for care leavers that requires intensive preparation, training and support from child welfare services. This study aimed to explore the perceived readiness for independent living of a group of care‐experienced young people preparing for leaving care in Spain and to compare it with the perceptions of their peers from the general population. A sample of 508 youth (50% women) aged 14–21 (M = 16.67; SD = 1.72) took part, of whom 279 were care experienced and 229 belonged to the general population in Spain. Participants' independent living skills, personal autonomy, self‐efficacy and sociodemographic characteristics were assessed through an online survey using standardized instruments. Care‐experienced young people displayed higher levels of life skills and autonomy in self‐care, daily living at home and employment domains, but not related to making daily arrangements in their community. However, their educational level and self‐efficacy levels were lower than in the comparison group. Work experience stood out as a significant predictor of care‐experienced young people's life skills level. These findings support the importance of assessing life skills as an outcome of leaving care preparation services and providing care‐experienced young people with real‐life experiences to develop their life skills. [ABSTRACT FROM AUTHOR]

Background: A culture of shared leadership is widespread among palliative care teams based on a commitment to valuing and including all people equally. As compassion is a core value for end‐of‐life care work, compassionate leadership may be the best way to lead in palliative care. Aims: The aims of this study were twofold: (1) to adapt and validate the Compassionate Leadership Self‐reported Scale in a sample of palliative care professionals; and (2) to study the relation between compassionate leadership and associated concepts of self‐compassion, awareness and self‐care. Methods: A cross‐sectional survey of 296 Spanish end‐of‐life care professionals was conducted. Analyses included descriptive statistics, a confirmatory factor analysis (CFA) with four‐correlated factors, reliability estimates and a structural model. Results: Results suggested there were medium to high levels of compassionate leadership in the sample. The CFA showed an adequate overall fit: χ2(98) = 277.595 (p < 0.001); CFI = 0.986; SRMR = 0.047; RMSEA = 0.088 [0.076, 0.100]. Reliability estimates for four subscales of compassionate leadership (attending, understanding, empathising and helping) were also adequate, ranging from 0.72 to 0.96. Finally, the structural model predicting compassionate leadership suggested that the dimensions of attending and understanding were most highly related to positive self‐compassion and awareness; empathising, to self‐care and awareness; and helping, to positive self‐compassion and self‐care. Conclusion: The Compassionate Leadership Scale has adequate psychometric properties when used to assess compassionate leadership in the context of end‐of‐life care. Our results indicate that self‐compassion, awareness and self‐care are important correlates of such compassionate leadership. [ABSTRACT FROM AUTHOR]

Background: The ABCDE bundle is a set of evidence‐based practices to systematically reduce the risks of sedation, delirium, and immobility in intensive care patients. Implementing the bundle improves clinical outcome. Aims and Objectives: To investigate the association between patient outcomes and compliance with bundle components ABC (analgosedation algorithms), D (delirium protocol), and E (early mobilization protocol). Design: A Spanish multicentre cohort study of adult patients receiving invasive mechanical ventilation (IMV) for ≥48 h until extubation. Methods: The primary outcome was pain level, cooperation to permit Medical Research Council Scale administration, patient days of delirium, and mobility. The secondary outcome was cumulative drug dosing by IMV days. Tertiary outcomes (ICU days, IMV days, bed rest days, ICU mortality, ICUAW) and independent variables (analgosedation, delirium, early mobilization protocols) were also studied. Results: Data were collected from 605 patients in 80 ICUs and 5214 patient days with IMV. Two‐thirds of the ICUs studied applied no protocols. Pain was not assessed on 83.6% of patient days. Patient cooperation made scale administration feasible on 20.7% of days. Delirium and immobility were found on 4.2% and 69.9% of days, respectively. Patients had shorter stays in ICUs with bundle protocols and fewer days of IMV in ICUs with delirium and mobilization bundle components (P = 0.006 and P = 0.03, respectively). Analgosedation protocols were associated with more opioid dosing (P = 0.02), and delirium and early mobilization protocols with more propofol (P = 0.001), dexmedetomidine (P = 0.001), and lower benzodiazepine dosing (P = 0.008). Conclusions: The implementation rate of ABCDE bundle components was very low in our Spanish setting, but when implemented, patients had a shorter ICU stay, more analgesia dosing, and lighter sedation. Relevance to clinical practice: Applying some but not all the bundle components, there is increased analgesia and light sedation drug use, decreased benzodiazepines, and increased patient cooperation and mobility, resulting in a shorter ICU stay and fewer days of IMV. [ABSTRACT FROM AUTHOR]

Objective: To analyze the impact of the foot health and health behavior and the characteristics of outdoor footwear among minority ethnic groups. Design and measures: A cross‐sectional study design using the Foot Health Status Questionnaire: foot pain, foot function, shoe, general foot health, general health, physical activity, social capacity, and vigor. Outcomes included the self‐reported type of outdoor footwear and clinical characteristics by sex were collected in 2019–2020. Sample: A total of 78 Roma participants self‐identified as members of this ethnic minority and 72 participants non‐Roma were assessed (n = 150). Results: The lower score values was recorded in the footwear and general foot health domains in Roma population. General population obtained higher scores in general health domains. The most common outdoor footwear types were running shoes and walking shoes in non‐Roma population, versus flip flops and slippers in Roma population. Clinical characteristics did not show any statistically significant differences (p <.05). Conclusion: Roma people wear flip flops and slippers and non‐Roma people running shoes and walking shoes. These findings reveal cultural differences that make it easier for the Roma population to experience a greater burden of foot health problems. General foot health and foot pain dimensions show statistically significant differences among ethnicity. [ABSTRACT FROM AUTHOR]

Background: Individualising the provided care is mandatory in nursing and is essential in clinical practice. Therefore, there is a need to develop accurate instruments to evaluate the quality of care. Moreover, there is no validated instrument to assess nurses' views of individualised care in Spanish‐speaking countries. Aim: To assess the construct validity and internal consistency of the Spanish version of the Individualised Care Scale‐Nurse. Methods: A cross‐sectional study including 108 nursing professionals (40.84 ± 9.51 years old, 86.1% female) was used to validate the Spanish Individualised Care Scale‐Nurse version. A forward‐back translation method with an expert panel and a cross‐sectional study was used for transcultural adaptation and psychometric validation purposes. Psychometric properties of feasibility, reliability and validity were assessed. Construct validity was examined through a confirmatory factor analysis and fit indices of the overall model were computed. Internal consistency was explored through McDonald's omega and Cronbach's alpha coefficients among other correlation measures. Results: The back‐translation concluded both Spanish and English Individualised Care Scale‐Nurse versions to be equivalent. The original structure of the Individualised Care Scale‐Nurse was verified in the Spanish version through the confirmatory factor analysis (factor loadings >0.3; acceptable fit indices: SRMR ≈ 0.08, CFI ≈ 0.9, RMSEA ≈ 0.09 after posteriori modifications). McDonald's omega exceeded 0.7 for both subscales and complete scales revealing an adequate internal consistency. Conclusions: The Spanish version of the Individualised Care Scale‐Nurse has exhibited good properties of homogeneity and construct validity for its use in practice and research in health care systems. [ABSTRACT FROM AUTHOR]

Introduction: Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. Objectives: The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. Methods: A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25‐item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi‐square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. Results: Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical‐surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). Conclusions: Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence‐based tobacco cessation programs at the organizational‐level, including post‐discharge active quitting smoking support. Clinical relevance: Three‐quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking. [ABSTRACT FROM AUTHOR]

Background: Stronger healthcare models are increasingly sought to address new population needs, health workforce inefficiencies and nursing shortages. One strategy is to focus on employees' strengths to capitalize on their competencies and maximize their scope of practice. Introduction: Globally, there is an exponential demand for advanced practice nursing services. This study aimed to identify the roles and positions of nurses who align with APN defining criteria at all levels of care in Catalonia, Spain. Methods: The first step of the study included the translation and validation to Catalan of the Advanced Practice Nurse Role Delineation Tool (IDREPA) and step 2 comprised a multicentre cross‐sectional study, in which 126 healthcare centres participated: 1209 nurses were included in the study. The STROBE checklist was used to report this study. Results: Transcultural equivalence and validation of the instrument showed a content validity index of 0.958 and the reliability of the questionnaire. The instrument identified 269 nurses who align with international APN defined criteria. They worked in specialized care, mental healthcare and primary and community care, especially in chronic conditions, ageing and end‐of‐life care. Discussion: Most areas of Catalonia have access to nurses practicing at APN defining criteria. These nurses were developed as an optimal resource to respond to patient needs in the context of study. Both recognition and strategic implementation are necessary to apply their full competencies to solve healthcare problems. Conclusion: Understanding the supply of services delivered by nurses practicing at an advanced level and their scope of practice may lay the foundations for effective workforce planning in a dynamic context. Nurses who align with APN defining criteria are working mainly in large acute services without regulation and recognition. Implications for nursing: Advanced practice nurses show the value of their role and activities in healthcare services. Implications for health policy: Promoting the establishment of APN defining criteria that includes credentialing and a regulatory framework within international guidelines should be a priority to make an impact on healthcare policy. [ABSTRACT FROM AUTHOR]

Rationale aims and objectives: The available evidence on the use of heuristics and their relationship with diagnostic error in primary care is very limited. The aim of the study is to identify the use of unknown thought and specifically the possible use of Representativeness, Availability and overconfidence heuristics in the clinical practice of primary care physicians in cases of dyspnoea and to analyse their possible relationship with diagnostic error. Methods: A total of 371 patients consulting with new episodes of dyspnoea in Primary Care centres in Spain were registered. Based on specific operational definitions, the use of unconscious thinking and the use of heuristics during the diagnostic process were assessed. Subsequently, the association between their use and diagnostic error was analysed. Results: In 49.6% of cases, the confirmatory diagnosis coincided with the first diagnostic impression, suggesting the use of the representativeness heuristic in the diagnostic decision process. In 82.3% of the cases, the confirmatory diagnosis was among the three diagnostic hypotheses that were first identified by the general physicians, suggesting a possible use of the availability heuristic. In more than 50% of the cases, the physicians were overconfident in the certainty of their own diagnosis. Finally, a diagnostic error was identified in 9.9% of the recorded cases and no statistically significant correlation was found between the use of some unconscious thinking tools (such as the use of heuristics) and the diagnostic error. Conclusion: Unconscious thinking manifested through the acceptance of the first diagnostic impression and the use of heuristics is commonly used by primary care physicians in the clinical decision process in the face of new episodes of dyspnoea; however, its influence on diagnostic error is not significant. The proposed explicit and reproducible methodology may inspire further studies to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: To determine which nursing interventions are used in individuals with a digestive stoma and the relationships between nursing interventions used and sociodemographic and clinical variables. Methods: The present study is an observational, cross‐sectional, descriptive. Data from 102 individuals in the general surgery unit of a first‐level hospital (University Hospital Complex of Granada, Spain) were analyzed. Data on the use of nursing interventions and sociodemographic and clinical variables were collected. Univariate, bivariate, and multivariate data analyses were conducted. Findings: Interventions: Decision‐Making Support (5250) and Ostomy Care (0480) were the most prevalent interventions in the sample. The period of care (postoperative and follow‐up) was the most common significant variable (p < 0.05) among the interventions observed. Anxiety Reduction (5820), Nutritional Counseling (5246), Self‐Esteem Enhancement (5400), and Body Image Enhancement (5220) were also relevant findings. Conclusions: The present study contributes to determining which nursing interventions are used in individuals with a digestive stoma. Implications for nursing practice: This study could be useful in planning nursing interventions in individuals with a digestive stoma. [ABSTRACT FROM AUTHOR]

Purpose To assess the efficacy of petrolatum jelly for the prevention of diaper rash and to evaluate the relationship between the occurrence of diaper rash and certain treatments and type of nutrition. Design and Methods A randomized clinical trial was carried out with two parallel groups ( n = 213) at the neonatal care unit of Donostia University Hospital in San Sebastián, Guipuzcoa Province, Spain. Results There was a lower incidence of diaper rash in the experimental group with petrolatum jelly (17.1%) than the control group (22.2%), but the difference was not statistically significant ( p =.39). The use of antibiotics and oral 50% glucose as well as an increased number of stools are associated with a higher incidence of diaper rash, while breastfeeding and phototherapy are protective factors. Practice Implications Prevention is strengthened by a better understanding of the risk factors. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore cross‐level mechanisms stimulating employees' innovative behavior in small firms, specifically emotional contagion between small business owners and their employees. Using data from three European countries and applying a multilevel approach, we tested how small business owners' work‐related affect—enthusiasm and comfort—relate to their employees' work‐related affect and innovative work behavior. The sample consisted of 85 small business owners and 711 employees from firms operating in the Netherlands, Poland, and Spain. Controlling for country, the results of multilevel modeling showed that small business owners' work‐related affect was positively related to their employees' work‐related affect. The hypothesized contagion of work‐related affect in small firms was, thus, supported. Employees' work‐related affect, in turn, was positively associated with their innovative behavior. Employees' work‐related affect mediated the relationship between small business owners' work‐related affect and employees' innovative behavior. The results also showed cross‐country differences in the strength of some of the relationships. The study is a step forward in understanding innovation in small firms, extending the insights gained from single‐level investigations. [ABSTRACT FROM AUTHOR]

Objective: Objective of this study is to explore the most prevalent pathologies of the population received in the Spanish coast and to know the nursing prehospital interventions required, as well as the treatments applied and their follow‐ups. Design and Measures: A descriptive and retrospective study. Sample: A total of 481 immigrants cared for by the Red Cross in the study period. Results: Dermatological pathologies were more frequent in men (32.1). In women, the most prevalent pathology was headache (19%). According to age, dermatological pathologies prevail in those over 18 years of age (31.9%) and in children, respiratory pathologies (42.9%). Relationships were found statistically significant between gender and type of disease and between specifying or not nursing interventions (p <.001). Age was also related to the type of diagnosis and the type of nursing interventions to be carried out (p <.001). Conclusion: In general, a good state of health was considered in the migrants, concluding that knowing the pathologies or activities to be carried out according to the sociodemographic variables would help improve the quality of the assistance. [ABSTRACT FROM AUTHOR]

In relative performance evaluation systems, appraisers may choose to adopt stricter or laxer evaluation criteria. When laxer (vs. stricter) criteria are used, higher absolute performance evaluations become easier (vs. harder) to achieve. Thus, each appraisee's absolute performance feedback and the mean of the distribution of absolute performance feedback are shifted upward (vs. downward). Yet, relative performance remains constant. When evaluation outcomes depend solely on relative performance, can the adoption of laxer (vs. stricter) criteria-leading to higher absolute performance feedback but no change in relative performance-influence appraisees' satisfaction with performance? Despite the ubiquity of such systems in organizations, research has not addressed this question. This article points to an important gap between practitioners' beliefs and research findings. We show that while most appraisers believe that higher absolute performance feedback will automatically result in more satisfaction with performance, the opposite may also happen. Specifically, we find that appraisees with a stronger (vs. weaker) chronic or contextual need to engage in social comparison are more satisfied with lower (vs. higher) absolute performance feedback. Overall, we demonstrate why and how feedback interventions in relative performance evaluation systems may backfire, and suggest a set of practical guidelines for maximizing appraisees' satisfaction with performance in such systems. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Prevalence of chronic diseases and multimorbidity is rising, and it remains unclear what the best strategy is for activating people with chronic conditions in their self‐care. We designed a two‐group quasi‐experimental time series trial to examine the effectiveness of a nurse‐led, face‐to‐face, individually‐tailored health coaching (HC) intervention in improving patient activation and secondary outcomes (self‐efficacy, quality of life, anxiety and depression symptoms, medication adherence, hospitalization and emergency visits) among primary care users with chronic conditions. A total of 118 people with chronic conditions were recruited through a primary care center and allocated to either the intervention group (IG) (n = 58) or control group (CG) (n = 60). The IG received a nurse‐led individually‐tailored HC intervention involving 4–6 face‐to‐face multicomponent sessions covering six core activation topics. The CG received usual primary care. Data were collected at baseline, after the intervention (6 weeks after baseline for controls) and at 6 and 12 months from baseline. Compared with controls, the IG had significantly higher patient activation scores after the intervention (73.29 vs. 66.51, p =.006). However, this improvement was not maintained at follow‐up and there were no significant differences in secondary outcomes across the study period. HC may be an effective strategy for achieving short‐term improvements in the activation of primary care users with chronic conditions. Further studies with different methodological approaches are needed to elucidate how HC may improve and sustain changes in patient activation. [ABSTRACT FROM AUTHOR]

Advances in the research of work performance have been due in large part to the conceptualization of performance as a multidimensional construct. Recently, Griffin, Neal, and Parker (2007), have identified three different dimensions of work role performance: proficiency, adaptivity, and proactivity. Social effectiveness constructs (i.e., political skill) have been receiving increased attention in research and there have been recent calls for further research in the area. This study compares the explanatory capacity of political skill, professional experience and intrinsic motivation in the prediction of engineers' proficiency, adaptivity, and proactivity. The relationships were tested with structural equations analysis of 180 supervisor-engineer dyad data. Results indicate that the three dimensions of individual work performance are significantly influenced by political skill and professional experience, but not by intrinsic motivation. The results also indicate that political skill is the strongest predictor. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is to assess the prevalence of visual impairment and visual care practices and its association with socioeconomic conditions in the infant population in Catalonia. Methods: The Catalan Institute of Statistics provided a random sample of 0 to 14‐year‐old non‐institutionalized children whose parents were interviewed in a continuous health survey from 2011 to 2015 in Catalonia. A multistage stratified and random sampling procedure considering age, sex, county and town was followed. All results have been weighted according to the sample design and are presented as the proportion of the condition with its 95% confidence limits. Chi‐square tests were performed to evaluate the association between categorical variables. To study the association of visual care with independent variables, a multiple logistic regression model was used. Results: In 0 to 14‐year‐old children, a 12.9% (95% confidence interval [CI] [11.8–13.9]) prevalence of correctable visual impairment was observed. The prevalence of non‐correctable visual impairment was 0.9% (95% CI [0.6–1.2]). Non‐correctable visual impairment was more prevalent in families with lower education levels, manual professions or unemployed. Of children without visual impairment, 13,5% (95% CI:12.3–14.6) visited a visual care professional in the last 12 months while this proportion was 67.4% (95% CI [63.3–71.5]) among those with correctable visual impairment. When parents have a university degree or non‐manual professions, a higher level of visual care was observed. In children with correctable visual impairment, visual reviews were more frequent when parents are employed in a non‐manual profession. Conclusions: For the first time, indicators related to visual impairment in children in Catalonia have been recorded. There is an association between lower socioeconomic status and having non‐correctable visual impairment, and conversely, having correctable visual impairment was significantly associated with employed parents. More visual care is associated with higher socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) causes high rates of hospital admissions. It is known that disease progression impacts the health‐related quality of life (HRQoL) of both patients and caregivers, yet to date, this finding is based on cross‐sectional studies with limited samples. Objectives: The study aim is to analyze the relationship between HF patients' use of hospital services (a proxy for disease progression) and the HRQoL of their family caregivers. Methods: This work is a multicenter nested case‐control study on a population of patients admitted to hospitals in southern Spain due to heart failure. The sample comprised 530 patient‐caregiver dyads. Hospital admission data were retrospectively collected for the 5 years prior to inclusion in the study. Bivariate analyses and multivariate logistic regression were used to determine associations between patient deterioration and caregivers' quality of life. Results: Patients' use of hospital services was associated with worsened quality of life for family caregivers, with an overall OR of 1.48 (95% CI: 1.23‐1.79). A positive correlation was found between patients' perceptions of their physical health and the perceived mental health of caregivers (r = 0.127, p = 0.004) and between the perceived mental health of both (r = 0.291; p <0.0001). Conclusions: Greater use of hospital services by patients with HF is an independent predictor of deterioration of family caregivers' HRQoL. The physical and mental components of patients' and their family caregivers' HRQoL interact and influence each other. Additional factors, such as the nature and intensity of care provided, also determine the worsening of a family caregiver's HRQoL. Clinical Relevance: These results can be used to identify family caregivers of people with heart failure at risk of suffering a deterioration in their health‐related quality of life. Increased use of hospital services is an independent predictor of the deterioration of the family caregivers' health‐related quality of life. Since clinical nurses are the main provider who gives support and education to family caregivers, they should be alert to this situation and individualize interventions to prevent this deterioration. [ABSTRACT FROM AUTHOR]

Aim: To compare Spanish nursing students' and registered nurses' perception of professional values from the perspective of gender and professional experience. Background: Nursing has traditionally been a female profession; however, the analysis of professional nursing values from a gender perspective has received little attention. The integration of professional values typically begins during academic life and is, thereafter, reinforced during professional activities. Methods: A descriptive cross‐sectional study was conducted with 159 students (97.4% females) and 386 registered nurses (86.8% females) from primary healthcare centres, hospitals and management positions within the public health system. The validated Spanish adaptation of the Nurses Professional Values Scale was used. This instrument measures three dimensions: ethics, commitment and professional mastery. Descriptive statistics were used to analyse the data, together with bivariate analysis using the chi‐squared test. Results: Females granted more importance to professional values. Important gender differences among students were detected. Ethical values were considered to be the most important for both students and nurses, followed by professional mastery and commitment. The importance given to values progressively decreased in the groups under study: students, less‐experienced nurses and expert nurses (in decreasing order). Conclusions: Significant gender differences exist with regard to professional nursing values. The values related to professional commitment and mastery should be integrated and promoted during academic education and specifically focus on male students' perceptions. As professional experience increases, the importance attributed to professional values decreases. Implications for Nursing Policy: Professional nursing values should be promoted among universities, health services and professional organizations, encouraging their dissemination, implementation and evaluation. [ABSTRACT FROM AUTHOR]

Purpose: This study illustrates the huge untapped potential of quantifying the impact of culture in making meaningful comparisons across groups. Our focus is on cross‐national differences in nurses' reports of their relations with physicians, and how the measurement of this complex construct and the evaluation of true differences are related to dimensions of national culture. Design: We examine across 14 European countries the association between indices of national culture from the seminal work of Hofstede and 39,435 nurses' ratings of their relations with physicians. Multilevel confirmatory factor analysis was used to evaluate strong factorial invariance across countries and to examine the influence of power distance and masculinity. Findings: There was wide variation across countries in nurses' reports of their relations with physicians. Strong factorial invariance was shown for a one‐factor model, which confirmed that across countries the seven survey items measure a common factor of physician‐nurse relations. This model showed no country bias for any of the seven survey items, which suggests that differences across countries reflect true differences. These true differences were significantly associated with variation in country values of power distance, which showed a significant negative correlation with physician–nurse relations. Conclusions: Continuously pursuing a better understanding of characteristics that impact the studied indicators, such as national culture, is elementary to better understand the construct under study. In this application, country values of power distance negatively impacted nurse‐reported relations with physicians, which strongly varied across countries. Clinical Relevance: Better nurse‐reported relations between nurses and physicians link to higher nurse job satisfaction, lower emotional exhaustion, better nurse‐perceived quality of care, and lower patient mortality. The Practice Environment Scale of the Nursing Work Index is an excellent instrument to characterize variation in working relations between nurses and physicians as well as physicians' professional posture towards nurses. [ABSTRACT FROM AUTHOR]

Checking whether changes in the perception of the quality of life related to health, after the nursing intervention, influence these patients' motivation to change. This was a two‐staged study undertaken in entertainment‐sector workers in Spain: the first part was transversal and observational, and the second was semi‐experimental. First part undertook in 284 entertainment‐sector workers, selected by non‐probabilistic sampling, while second part undertook in 50 entertainment‐business workers, selected by consecutive sampling from those who consumed substances. A short group‐based motivational intervention session was implemented by nursing staff, and a before and after evaluation was completed. The EuroQol‐5D and Test for the Evaluation of the Quality of Life in Addicts to Psychoactive Substances (TECVASP) were used. The patients' motivation to change was evaluated through the Stages of Change Readiness and Treatment Eagerness Scale. The results analysis showed that the nursing intervention reduced the participants' perceptions of their health‐related quality of life (t = 4.23; P = 0.00009) and of their quality of life in addicts to psychoactive substances (t = 3.38; P = 0.00140). There was an increase in the motivation of 6 workers (12%) to seek treatment of their addiction (χ2 = 13.02; P = 0.0091). The post‐test contemplation stage score was predicted (F = 6.56; P = 0.003; R = 0.46) with post‐test TECVASP score and pre–post difference in TECVASP score. By reducing the patients' perception of their quality of life, this brief nursing intervention facilitated a favourable increase in the motivation for change among these workers and was effective in 12% of cases. [ABSTRACT FROM AUTHOR]

PURPOSE: To validate the content of the NANDA-I diagnosis “death anxiety” (00147). METHODS: Descriptive study using the Fehring model with 202 Spanish nurses who were expert in end-of-life care to explore the adequacy of the components of the NANDA-I diagnosis “death anxiety” (00147) in the Spanish edition. FINDINGS: None of the diagnosis definitions were considered as representative. Furthermore, 5 of the 56 defining characteristics and 5 of the 26 related factors were validated as major. CONCLUSIONS: In general, the components of the diagnosis “death anxiety” (00147) in the Spanish edition are not representative according to experts. IMPLICATIONS FOR NURSING PRACTICE: The results support the need to either exclude the diagnosis from the taxonomy or adjust its content. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study examined the combined influence of gender variables (specifically gender stereotypes, sexism, and genderism/transphobia) as well as racism/xenophobia and attitudes toward bullying roles on gender‐bashing. METHODS: A trans‐cultural sample of 2410 Spanish and Portuguese students participated in the study (mean age = 15.13). Structural equation modeling and multiple group analyses were used to examine the relationships among variables. RESULTS: The model revealed a good fit with the data for the whole sample. Results showed that instrumentality, hostile sexism, genderism/transphobia, racism/xenophobia, and positive attitudes toward the bully were positively correlated with gender‐bashing. An inverse pattern was also observed: expressiveness, benevolent sexism, and positive attitudes toward the defender were negatively correlated with gender‐bashing. Overall, the eight variables explained 48% of the variance of gender‐bashing. Structural relationships among the assessed constructs were equivalent for girls and boys, and for Spain and Portugal. CONCLUSIONS: These results reveal the need to implement inclusive educational policies to improve school health, which promote expressiveness, egalitarian attitudes, and sexual and cultural diversity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Based on Mayer and Salovey's model of emotional intelligence, this study examined whether perceived stress mediates the interplay of emotional intelligence and life satisfaction for girls and boys during early and middle adolescence. METHODS: Using multigroup structural equation modeling with questionnaire data from a sample of Spanish adolescent students (N = 800; MAgeT1 = 14.02, MAgeT2 = 15.00, SD = 1.21) in 2 waves (T1 = March 2015; T2 = December 2015). RESULTS: Results of multigroup structural equation modeling indicated no group differences between boys and girls in early adolescence (7th and 8th grade) and middle adolescence (9th and 10th grade), as stress function as mediator between emotional intelligence and life satisfaction for all groups. However, latent mean comparison indicated that girls not only perceive and understand emotions better than boys, but they also perceive higher amounts of stress at an older age. CONCLUSION: Results indicate the potential risk of perceived stress that might drop the protective effect of emotional intelligence on life satisfaction. These findings have implications for future research and educational practice considering combined prevention programs for adolescent's health and well‐being. [ABSTRACT FROM AUTHOR]

Home‐based tele‐rehabilitation programs are under development and may be a future option for some patients. The objectives of this non‐randomized clinical trial are to design a home‐based multidisciplinary tele‐rehabilitation protocol for patients with hip fracture, and to compare this protocol versus the home‐based usual outpatient rehabilitation protocol. Seventy patients treated for an acute hip fracture, aged 65 years or older, with a high pre‐fracture functional level (Functional Independence Measure score >90), without severe cognitive impairment, absence of terminal disease, discharged to their own home or a relativés home postoperatively, allowed weight‐bearing, and with signed informed consent, will be allocated into a tele‐rehabilitation group (n = 35) or a control group (n = 35). The inclusion criterion for the intervention group will be to have a caregiver with the ability to access the Internet who is willing to perform exercises and activities with the patient at home. The intervention includes a program of physical exercise and occupational therapy (five weekly sessions during 12 weeks), and recommendations for patients and their caregivers, all delivered through a website. The patient's functional level (Functional Independence Measure), quality of life (Euro‐Qol), physical performance (Timed Up and Go), caregiver burden (Zarit Interview), and other descriptive data will be assessed at hospital discharge, 4 weeks, and 12 weeks. This project will add to the knowledge concerning the feasibility of tele‐rehabilitation as an option to promote recovery of the pre‐fracture functional level for some patients with a hip fracture. ClinicalTrials.gov Identifier: NCT02968589NCT. [ABSTRACT FROM AUTHOR]

PURPOSE: To estimate the prevalence of Grieving, risk for Complicated Grieving, and Complicated Grieving in the primary care setting. METHODS: Retrospective epidemiological study, analyzing data from electronic health records (EHR). FINDINGS: A total of 84% of the 9,063 records had diagnostic labels without defining characteristics, related factors, or risk factors. A larger frequency of complicated grieving was found in deceased mourners. CONCLUSIONS: The grieving epidemiology opens new chances for the research using data from EHR. PRACTICE IMPLICATIONS: The adequacy of the records is essential to develop a profile of the patient at risk of complications after the loss. This research is an important step to build an epidemiological basis for nursing diagnosis of grieving in the primary health care setting. [ABSTRACT FROM AUTHOR]

This study examined the types of youth‐led activities performed during the community‐based program "Building My Future" and their impact on personal, problem‐solving, and community competences. At‐risk and non‐at‐risk adolescents (N = 410) participated in 49 groups in the local social services. Different types of pre‐intervention and intervention activities and the meetings held with external resources were associated with pre‐post changes in self‐concept, productive task orientation, connectedness, coping skills, participation, and integration with the community, using cluster analyses. Results showed that adolescents who performed the pre‐intervention activity carried out more modules and performed more intervention activities. Performing group dynamics as a pre‐intervention activity, carrying out creative activities, volunteering, excursions, and games, but no sports, and meeting up with associations were related to the most positive changes in at‐risk groups. Non‐at‐risk groups that mainly participated in amusing activities experienced a decrease in their competence scores. This shows the relevance of the types of self‐selected activities carried out when promoting positive development and can serve as guidance for future community work. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine the prevalence of Ineffective Self‐Health Management (ISHM) (00078) and its related factors in polymedicated patients over the age of 65 years. METHODS: A cross‐sectional, descriptive design was used. A home interview was conducted with each participant (N = 375) for data collection. FINDINGS: The prevalence of ISHM was 37.3%. The risk factors associated were social risk, depression, noncompliance, medication errors, and confusion with medications. CONCLUSIONS: Among polymedicated elderly patients, the prevalence of ISHM is high. The diagnosis is closely connected to the compliance and complexity of the treatment regimen, in addition to those relating strictly to social and emotional factors. IMPLICATIONS: Nursing methodology encompasses instruments that allow nurses in clinical practice to evaluate the issue of compliance. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aims of this study were to (1) examine the reactions of teachers and student teachers to children experiencing pain, (2) identify the most common challenges and potential resources that are associated to dealing with them, and (3) examine whether their responses differed as a function of their experience or sex. METHODS Forty teachers and 318 student teachers completed a survey which included descriptive information, a questionnaire that assesses different responses of participants to children who experience pain, and provides a list of problems and resources that participants might encounter and implement, respectively, when dealing with these children. RESULTS The study participants most often endorsed use of coping and health-promoting responses. Experienced teachers endorsed solicitous responses significantly more often than student teachers. Women reported responding more with solicitous responses than men. Absenteeism and the negative effect of pain on the ability of students to engage in school activities were the most common pain-related challenges mentioned by the study participants overall. CONCLUSIONS The findings emphasize (1) the need for developing guidelines to help teachers to help students experiencing chronic pain, and (2) the importance of including information about pediatric chronic pain in teachers training. [ABSTRACT FROM AUTHOR]

Background Problems with pragmatic aspects of language are well attested in individuals on the autism spectrum. It remains unclear, however, whether figurative language skills improve with language status and whether problems in figurative language are no longer present in highly verbal individuals with autism. Aims To investigate whether highly verbal individuals with autism perform similarly as age-, intelligence- and verbal comprehension-matched controls on the processing of one of the most common types of figurative language, metaphors. The goal was to establish whether the participants with autism are primed similarly to controls by figurative expressions (metaphors) presented in different conditions. Methods & Procedures The experiment was designed as a cross-modal lexical-decision task where metaphors served as primes for target words related to their figurative or literal meaning. Outcomes & Results Our findings show that both ASD and control participants made very few errors in the experimental task. However, the participants with ASD presented with problems in performance on the task, reflected in significantly slower reaction times compared with the typically developing peer groups. The similar response speed observed between the younger typical control children and the adult ASD participants suggests that the mechanisms underlying metaphor processing (e.g., selection of metaphorical versus literal interpretation) are still developing in high-functioning autism, very much like in typical children. Conclusions & Implications These results may suggest that metaphor processing requires more than adequate language competences. The findings are also suggestive of a delay in developing sensitivity to figurative language, rather than sheer inability. This suggests that a timely training programme can be implemented to improve figurative language abilities in ASD. [ABSTRACT FROM AUTHOR]

Objective To compare the effect of two newly formulated chlorhexidine ( CHX) and cetylpyridinium chloride ( CPC) mouthrinses after scaling and root planing ( SRP) in terms of clinical, microbiological, patient-based variables and adverse events, with a positive control with the same active components, already marketed and tested. Methods A pilot, randomized clinical trial, double-blind, parallel design with 1-month follow-up was conducted. Chronic periodontitis patients requiring non-surgical periodontal therapy were enrolled and randomly assigned to: (i) SRP and test-1 (new reformulation: 0.12% CHX and 0.05% CPC); (ii) SRP and test-2 (new formulation: 0.03% CHX and 0.05% CPC); or (iii) SRP and positive control (commercial product: 0.12% CHX and 0.05% CPC). All variables were evaluated at baseline and 1 month after SRP. Quantitative variables were compared by means of anova or Kruskal-Wallis test and qualitative variables by chi-square or McNemar tests. Results Thirty patients (10 per group) were included. After 1 month, there were significant differences among groups in plaque levels ( P = 0.016) as test-1 showed less sites with plaque than test-2 (31.15% [standard error- SE 2.21%] versus 49.39% [ SE 4.60%), respectively). No significant differences were found for global patient perception of the product or in adverse effects. Test groups showed better results in levels and proportions ( P = 0.022) of Capnocytophaga spp. Conclusions Within the limitations of this pilot study, it can be concluded that the newly formulated 0.12% CHX and 0.05% CPC mouthrinse showed larger plaque level reductions, without showing more adverse effects, when compared to the other two mouthrinses, after SRP. [ABSTRACT FROM AUTHOR]

Background Shared decision making is an important component of patient-centred care and decision aids are tools designed to support patients' decision making and help patients with depression to make informed choices. Objective The study aim was to assess the effectiveness of a web-based decision aid for patients with unipolar depression. Design Randomized controlled trial. Setting and participants Adults diagnosed with a major depressive disorder and recruited in primary care centres were included and randomized to the decision aid (n=68) or usual care (n=79). Intervention Patients in the decision aid group reviewed the decision aid accompanied by a researcher. Outcome measures Knowledge about treatment options, decisional conflict, treatment intention and preference for participation in decision making. We also developed a pilot measure of concordance between patients' goals and concerns about treatment options and their treatment intention. Results Intervention significantly improved knowledge ( P<.001) and decisional conflict ( P<.001), and no differences were observed in treatment intention, preferences for participation, or concordance. One of the scales developed to measure goals and concerns showed validity issues. Conclusion The decision aid 'Decision making in depression' is effective improving knowledge of treatment options and reducing decisional conflict of patients with unipolar depression. More research is needed to establish a valid and reliable measure of concordance between patients' goals and concerns regarding pharmacological and psychological treatment, and the choice made. [ABSTRACT FROM AUTHOR]

The attitudes and knowledge of nursing personnel regarding organ and tissue donation can influence the decision to donate. This study aimed to determine these two factors among nurses at a district hospital in Barcelona, Spain. A survey was carried out using a 35 item questionnaire. Results were subjected to descriptive and comparative statistical analyses using bivariate and multivariate analyses to examine the relation between demographic data and attitudes toward donation. The completion rate was 68.2%, with 98.6% of those responding stating that they were in favor of organ donation. The respondents were unsure as to whether the criteria for inclusion in transplant waiting lists were appropriate (57.5%), whereas 72.2% agreed that brain death is equivalent to death. The bivariate analysis revealed a significant association between a positive attitude toward donation and working on permanent night shift no religious beliefs. Attitudes toward donation among nurses were generally positive; a negative attitude, although attitudes towards donation among the nurses participating in the study were generally positive, it should be pointed out that when a negative attitude does exist this affects significant aspects such as belief in the diagnosis of brain death or the criteria for inclusion on the waiting list, amongst others, which reflects that specific training in donation focused on nurses continues to be needed. [ABSTRACT FROM AUTHOR]

Prenatal methyl donor deficiency leads to homocysteine accumulation in the brain and impaired neurodevelopment in rats. We investigated the effect of moderately elevated preconception fasting total plasma homocysteine (tHcy) on child neurodevelopment in a prospective study of 67 and 76 mother-child pairs at 4 months and 6 years of age, respectively. Fasting blood samples at 2-10 weeks preconception, from the cord (nonfasting) and the mother and child 6 years after birth, were collected. Psychomotor and mental development were assessed at 4 months using the Bayley Scale of Infant Development (BSID) and cognitive development at 6 years using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Highest tertile preconception tHcy (≥9.04 µmol/L) was categorized as moderately elevated and low-mid tertile tHcy as normal. Children, born to mothers with moderately elevated compared to normal preconception tHcy, scored lower [mean (95% CI)] in the BSID psychomotor [115 (105, 124) vs. 126 (121, 130), p = 0.03] and mental [101 (93, 109) vs. 113 (107, 119), p = 0.03] development tests. Multiple logistic regression analysis showed that moderately elevated compared to normal preconception tHcy was associated with greater probability, OR (95%CI), of scoring in the lowest tertile for BSID psychomotor development (≤120): 4.0 (1.1, 14.3) and lowest tertiles for WPPSI full (≤111), verbal (≤104) and performance (≤111), intellectual quotient: 6.0 (1.5, 23.7), 3.5 (1.1, 11.2) and 4.1 (1.1, 15.7), respectively. We conclude that moderately elevated preconception tHcy is inversely associated with psychomotor and cognitive development scores in infants and children. [ABSTRACT FROM AUTHOR]