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Background: The present study analyses the design of programming literacy in the sixth grade of Primary Education, starting from the use of simple activities with visual block‐based programming, through Scratch, and progressively linking difficulty to the use of the Unity engine, and the C# language, with simple activities identical to those created in Scratch. Objectives: This research aims to evaluate future teachers' abilities and attitudes regarding programming and its educational possibilities. We intend to evaluate the viability of a teaching proposal that combines a visual block‐based programming environment and a more advanced one, based on C#. Method: In the settings of two public Spanish universities, we analyse the possibilities in the training of future teachers who are studying for a degree in Primary Education Teaching and a degree in Pedagogy. Based on a test and three scales, descriptive data and statistical inference are detailed through a quasi‐experimental design with a Student's t‐test in the first dimension, and a Wilcoxon test in the second dimension. Results: The participants improved their performance and attitudes towards programming with the intervention of the study in the use of coding. Conclusions: It can be concluded that coding is essential in teacher training, and that a greater presence of programming training in higher education is essential. The benefits are visible in the pedagogical approach of coding related to creativity, innovation, motivation, an active approach and interest, highlighting the fact that the implementation of visual block‐based programming by blocks and engines is feasible in Elementary Education. The training proposal—provided by appropriate progression, selection, and sequencing of content—fosters basic and practical teacher training, and this can be defined as an apt training solution. Lay Description: What is already known about this topic: Visual Programming Language (Scratch) provides benefits in educational contextsEducational Technology in classroom provides motivation and encouragement.Active methods and interactions are interesting and beneficial to elementary school students What this paper adds: Visual programming and game engine are feasible in Elementary Education, detailing significant improvements regarding academic outcomesWe found benefits in this pedagogical approach related to creativity, innovation, motivation, active approach and interest. Implications for practice and/or policy: Due to the benefits and positive results obtained in this research it is recommended to implement Visual Programming LanguageWe recommend the introduction to engine in educational settings in 6th grade in primary education though a cross‐curricular implementation.We recommend to apply an active approach, innovation, and learning computational concepts. [ABSTRACT FROM AUTHOR]

Research has drawn attention to the stigma and high rates of victimization among people with intellectual disabilities (ID) and an overlap between bias and non-bias victimization. However, studies of bias events or hate crime involving persons with ID are scarce. Using a self-report measure, we analyze lifetime bias victimization in a sample of 260 adults diagnosed with ID (age M = 41.7, SD = 12.0; 59.2% men), of whom 92 experienced bias victimization (age M = 41.2, SD = 11.9; 54.3% men), and compare the number of different types of victimization and the poly-victimization status between bias and non-bias victims. We also examine the following features: the victim, offender(s), victim–offender relationship, and location. Results show that bias victims experience a higher number of different types of victimization than non-bias victims (M = 7.74 and 4.96, respectively; p <.001, r rb=.37, ξ =.42) and are four times more likely to be poly-victims than non-bias victims (odds ratio [ OR ] = 4.37; 95% CI, p <.001). Most of the victims experienced a number of bias victimization episodes (89.1%; n = 82), and more than a quarter were injured (27.2%, n = 25) as a result of the victimization. All the bias victimizations by strangers were carried out in public places, as were most of the bias victimizations by acquaintances. Schoolmates and work colleagues perpetrated attacks at school and in the workplace, respectively. More than half of the victims, 63% (n = 58), spoke of the experience with someone, but only one reported it to the authorities. The paper provides a valuable descriptive and bivariate analysis of bias victimization of people with ID. The findings will help to understand bias violence against this population, highlighting the need for targeted and effective interventions. [ABSTRACT FROM AUTHOR]

Aim: To examine the influence of health care provider's communication skills on the quality of care perceived by Emergency Department patients. Background: Communication between patients and health care providers in the context of Emergency Department is challenging and can potentially have a negative impact on the quality of care perceived by patients. Design Cross‐sectional descriptive study conducted in the Emergency Department at the University Clinical Hospital Virgen de la Arrixaca of Murcia, Spain. Method: Data were collected from 6 to 9 June 2016. Different instruments were used to evaluate the perception of patients on the communication skills and quality of care at the Emergency Department. Results: The sample was composed of 200 patients, with an average age of 44.1 (SD = 18.3), of which 106 (53%) were men. The multiple linear regression analysis showed the association between communication skills (respect, problem solving, and nonverbal communication) and age with the quality of care perceived by the patients. Conclusions: We found that the communication skills of the health care providers were explanatory variables of the quality of care perceived in an Emergency Department. SUMMARY STATEMENT: What is already known about this topic? The needs of patients and families seeking emergency care differ from those of other care settings.Patient‐health care provider communication in an Emergency Department are a true challenge.Effective communication between emergency professionals and patients/family has been described as a fundamental component of health care. What this paper adds? Health care provider communication skills are explanatory for the quality perceived by Emergency Department patients.Respect, problem solving, and nonverbal aspects are explanatory for the quality of care in an Emergency Department. The implications of this paper: Humanized care, in which patients feel listened to and respected, and which is concerned about their health problems, could increase the quality of care perceived in the Emergency Department.Health care providers in Emergency Departments should be encouraged to increase their level of communication skills. [ABSTRACT FROM AUTHOR]

Despite the importance of the stigma construct for the rehabilitation of people with severe mental illness, there are still no scales that offer a measurement for public stigma in Spanish with good psychometric properties. The aim of this paper is to refine and improve an existing scale to measure public stigma towards people with severe mental illness among the Spanish population. We also intended to decrease the number of items in order to facilitate its applicability. 402 college students (73% women) responded to the attributional questionnaire (AQ27) in two subsamples. Exploratory and confirmatory factorial analysis with high cutoffs were conducted. The convergent validity with the resource allocation questionnaire was also tested. We have obtained a parsimonious tool, with 14 items and four factors, and some reliable psychometric indexes and convergent validity. The factors obtained were dangerousness-fear, lack of solidarity, coercion and avoidance. These results improve the findings from other studies that try to validate the AQ27 in other languages. We discuss the different factors that should be considered in the estimation of public stigma and the necessity to implement programmes to reduce it to enable recovery. Since the public stigma of mental illness is an obstacle to recovery and rehabilitation, reliable instruments are needed to assess it. A parsimonious instrument in Spanish with good psychometric characteristics for measuring public stigma is obtained. Using exploratory and confirmatory factor analysis, a questionnaire of 14 items is obtained. Four factors constitute the instrument: "dangerousness-fear", "coercion", "lack of solidarity", and "avoidance". [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences.AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities.However, the use of AHDs as described above is not yet a reality in Spain. What the paper adds to existing knowledge?: The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice.Although providers had a moderate–low level of knowledge about AHDs, they presented positive attitudes towards them. What are the implications for practice?: The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up‐to‐date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process.More in‐depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation.The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. Introduction: Advance healthcare directives (AHDs) in mental health offer important information regarding service users' preferences. However, whether AHDs are truly understood by providers is questionable. Aim: To survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. Method: We cross‐sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. Results: Participants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing‐care technician was associated with stronger positive attitudes. Discussion: Legal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practice: The Spanish mental healthcare system requires legal and structural changes and must improve healthcare providers' competence in AHDs before they are implemented. [ABSTRACT FROM AUTHOR]

Background: Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases.Methods: This paper describes the protocol for a cluster randomized controlled trial. We will randomly assign 18 primary-care practices per participating region of Spain (Catalonia, Madrid and Canary Islands) to a virtual community of practice or to usual training. The primary-care practice will be the randomization unit and the primary healthcare professional will be the unit of analysis. We will need a sample of 270 primary healthcare professionals (general practitioners and nurses) and 1382 patients. We will perform randomization after professionals and patients are selected. We will ask the intervention group to participate for 12 months in a virtual community of practice based on a web 2.0 platform. We will measure the primary outcome using the Patient-Provider Orientation Scale questionnaire administered at baseline and after 12 months. Secondary outcomes will be the sociodemographic characteristics of health professionals, sociodemographic and clinical characteristics of patients, the Patient Activation Measure questionnaire for patient activation and outcomes regarding use of the virtual community of practice. We will calculate a linear mixed-effects regression to estimate the effect of participating in the virtual community of practice.Discussion: This cluster randomized controlled trial will show whether a virtual intervention for primary healthcare professionals improves attitudes to the empowerment of patients with chronic diseases.Trial Registration: ClicalTrials.gov, NCT02757781 . Registered on 25 April 2016. Protocol Version. PI15.01 22 January 2016. [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]

Background: Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescribing style within and across groups of GPs from six countries. Methods: Cross-sectional study with the inclusion of 457 GPs and 6394 sore throat patients. We describe variation in prescribing antibiotics for sore throat patients across six countries and assess whether variation in “prescribing style” - understood as a subjective tendency to prescribe - has an important effect on variation in prescription of antibiotics by using the concept of prescribing style as a latent variable in a multivariable model. We report variation as a Median Odds Ratio (MOR) which is the transformation of the random effect variance onto an odds ratio; Thus, MOR = 1 means similar odds or strict homogeneity between GPs' prescribing style, while a MOR higher than 1 denotes heterogeneity in prescribing style. Results: In all countries some GPs always prescribed antibiotics to all their patients, while other GPs never did. After adjusting for patient and GP characteristics, prescribing style in the group of GPs from Russia was about three times more heterogeneous than the prescribing style in the group of GPs from Denmark - Median Odds Ratio (6.8, 95% CI 3.1;8.8) and (2.6, 95% CI 2.2;4.4) respectively. Conclusion: Prescribing style is an important source of variation in prescription of antibiotics within and across countries, even after adjusting for patient and GP characteristics. Interventions aimed at influencing the prescribing style of GPs must encompass context-specific actions at the policy-making level alongside GP-targeted interventions to enable GPs to react more objectively to the external demands that are in place when making the decision of prescribing antibiotics or not. [ABSTRACT FROM AUTHOR]

Aim: To provide initial data regarding country‐specific evidence of workplace violence towards nurses working within the health sector in five European countries. Methods: This is a descriptive and cross‐sectional pilot study, conducted in June 2016. The sample consisted of 260 nurses working in selected health care settings in five participating countries (Poland, Czech Republic, Slovakia, Turkey, and Spain). The questionnaire used was adapted from the International Labour Office/International Council of Nurses/World Health Organisation/Public Services International Workplace Violence in the Health Sector Country Case Study—Questionnaire. Results: A large number of participants confirmed that they had been physically attacked or verbally abused in the workplace in the last 12 months. In most cases, the physical and verbal abuse was inflicted by patients and to a lesser degree by relatives of patients, staff members, or managers/supervisors. In the majority of cases, no action was taken to investigate the causes of the incidents. In most cases, participants believed there was no point in reporting the incidents. However, the reasons for not reporting or discussing incidents of workplace violence varied depending on the country. Conclusion: Workplace violence towards nurses is a serious problem internationally, and violence prevention strategies need to be implemented. SUMMARY STATEMENT: What is already known about this topic? The nursing profession is at high risk of workplace violence. However, the problem seems to be severely underreported.What this paper adds? A better understanding of the problem in the social and cultural context, together with data fill information gaps regarding workplace violence in selected European countries.The implications of this paper: On the basis of the data obtained, prevention programmes and recommendations can be established and implemented in nurses' daily lives. Evaluation can also be conducted of the effectiveness of existing programmes and standards. [ABSTRACT FROM AUTHOR]

MANZANO GARCÍA G. & AYALA CALVO J. C. (2011) Emotional exhaustion of nursing staff: influence of emotional annoyance and resilience. International Nursing Review 59, 101-107 Aim: This paper aimed to study the influence of emotional annoyance and resilience on the emotional exhaustion levels of nursing staff. Background: Emotional exhaustion is one of the key factors in understanding both the performance and the quality of care that nurses give to their patients. There is a considerable body of knowledge that has focused on the study of emotional exhaustion in relation to cynicism and professional efficiency. More recently emotional annoyance and resilience have been identified as variables that could help explain levels of emotional exhaustion. Methods: Nine hundred eighty-three nurses who work in five hospitals in the north of Spain were invited to participate in the study. Five hundred questionnaires were distributed, of which 200 were fully completed. The average response rate was 40%. A personal information form, and a questionnaire concerning nurses' emotional annoyance, resilience, professional efficiency and cynicism were used as data collection instruments. To estimate a path model with latent variables, partial least squares was used. Findings: Emotional annoyance and resilience contribute to a better understanding of emotional exhaustion levels of nursing staff. There was a significant association between emotional annoyance and emotional exhaustion (β = 0.26, P = 0.020), while resilience appeared to be protective against emotional exhaustion (β = −0.22, P = 0.004). Conclusion: A more complete explanation and understanding of emotional exhaustion in nursing is achieved when emotional annoyance and resilience is measured in addition elements of burnout, which include professional efficiency and cynicism. [ABSTRACT FROM AUTHOR]