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Background: The aim of the research was to translate, culturally adapt and validate the Caring Behaviors Assessment (CBA) tool in Spain, ensuring its appropriateness in the Spanish cultural context. Methods: Three-phase cross-cultural adaptation and validation study. Phase 1 involved the transculturation process, which included translation of the CBA tool from English to Spanish, back-translation, and refinement of the translated tool based on pilot testing and linguistic and cultural adjustments. Phase 2 involved training research assistants to ensure standardized administration of the instrument. Phase 3 involved administering the transculturally-adapted tool to a non-probabilistic sample of 402 adults who had been hospitalized within the previous 6 months. Statistical analyses were conducted to assess the consistency of the item-scale, demographic differences, validity of the tool, and the importance of various caring behaviors within the Spanish cultural context. R statistical software version 4.3.3 and psych package version 2.4.1 were used for statistical analyses. Results: The overall internal consistency of the CBA tool was high, indicating its reliability for assessing caring behaviors. The subscales within the instrument also demonstrated high internal consistency. Descriptive analysis revealed that Spanish participants prioritized technical and cognitive aspects of care over emotional and existential dimensions. Conclusions: The new version of the tool proved to be valid, reliable and culturally situated, which will facilitate the provision of objective and reliable data on patients beliefs about what is essential in terms of care behaviors in Spain. Key points: • This paper provides a culturally translated, adapted, and validated version of the Caring Behaviors Assessment tool in the Spanish context, which can be used to obtain reliable and culturally adapted data on essential aspects of patient care. • The findings of this study contribute to the wider global clinical community by demonstrating the importance of considering cultural factors when assessing and evaluating patient care from patients' own perspective, and also emphasizes the need for culturally sensitive approaches in healthcare settings. • This validated instrument facilitates the measurement of caring behaviors in the Spanish context, allowing for objective evaluation and improvement. Use of the Caring Behaviors Assessment tool could thus serve as a valuable resource for both future research and clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to study the influence of leisure-time physical activity on depression crises and the difficulty in performing light household tasks. Design/methodology/approach: A population-based cross-sectional study was conducted using data from the 2020 European Health Survey in Spain. A total of 1,076 individuals diagnosed with depression were selected. ANOVA, chi-square, Fisher's exact test and Mann–Whitney U test were applied, and a simple moderation analysis was conducted using the SPSS PROCESS 4.0 macro. Findings: Women had higher percentages of some or much difficulty in performing domestic activities (p = 0.007). Differences were found between experiencing a crisis in the past 12 months versus not having one (p < 0.001): less physical activity was performed, perceived health was worse and difficulty in performing domestic activities increased. The moderation analysis confirmed the moderating effect of physical activity on the relationship between experiencing a crisis and having difficulty with domestic activities (p = 0.017). Research limitations/implications: The usual limitation of descriptive cross-sectional studies, which cannot establish causal relationships, must be added to low sample sizes in some categories. Practical implications: The analysis with gender differentiation, promoting gender-specific adapted practices, considering age and personal circumstances of the patient, appropriate exercise prescription, as well as its evaluation and follow-up, are areas where specialist nurses need to delve deeper to enhance the quality of care. Originality/value: Leisure-time physical activity moderates the relationship between experiencing a crisis and having difficulty with light household tasks: those who engage in occasional physical activity have less difficulty compared to those who do not engage in it. [ABSTRACT FROM AUTHOR]

Background: Many caregivers are insufficiently prepared, and little is known about measures that can be employed to enhance their preparedness. Aim: The aim of this study was to explore the factors associated with caregiver preparedness and establish a predictive model including the relationship between preparedness, burden, resilience and anxiety. Design: A cross‐sectional design was used. Methods: The sample included 172 family caregivers who were selected from one private hospital and daytime nursing centres. Caregivers were recruited from 2018 to 2019; they completed assessments for caregiver preparedness, anxiety, resilience and burden. A multiple linear regression analysis was performed to identify the factors associated with preparedness. Results: Preparedness was significantly associated with high levels of resilience and a low level of burden, while it was not associated with anxiety. Caregivers' gender, experience and cohabitation status were the main predictors. Resilience is an explanatory factor for caregiver preparedness in the predictive model. Conclusion: The demographic variables related to preparedness can be used to guide efforts to meet the needs of vulnerable caregivers. A caregiver's preparedness depends on their level of burden and resilience. Nursing interventions focused on these aspects could make the caregiver's role easier and improve the quality of care provided. Summary statement: What is already known about this topic? Many caregivers are inadequately prepared for this role, and ensuring adequate preparedness is important for family caregivers.Preparedness and factors predictive of this in Spanish family caregivers have not been well‐documented.Resilience, burden and anxiety affect caregivers, but the degree to which they influence caregivers' preparation levels is unknown. What is the contribution of this paper? Specific factors influence the preparedness of family caregivers. Men and caregivers who do not cohabit in the same household with the care‐dependent person may present greater deficits in preparedness. Moreover, poor health and lack of experience in caring can result in inadequate caregiving performance.Readiness, resilience and burden are significantly related, and the best predictor of family caregivers' preparedness is resilience.Resilience leads to greater preparedness in caregivers, and better‐prepared caregivers experience a lighter burden. What are the implications of this paper? Knowing the factors associated with preparedness in advance will allow health‐care professionals to prevent deficits in vulnerable family caregivers.Resilience is a decisive factor which prevents negative consequences such as low preparedness. A resilient coping style can diminish the burden and promote successful adaptation in caregivers. [ABSTRACT FROM AUTHOR]

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]

Active citizen participation in research is important to generate societal impact of outcomes. Even so, many times, the community input in these processes is limited or non-existent, and co-creation processes are often not documented. This paper describes a structured and systematised protocol to co-create a nature-based social prescribing intervention addressed to face loneliness in urban deprived neighbourhoods. As a result, a nature-based social prescription menu was co-developed with stakeholders from health, social prescription, nature, associative, and research sectors. The menu consists of open spaces and nature activities and will be offered to the participants of a randomised controlled trial to test actions for social prescribing in natural spaces. [ABSTRACT FROM AUTHOR]

Simple Summary: Patients with multiple myeloma (MM) who become refractory to three or more lines of therapy (RRMM patients) have few valid therapeutic alternatives. Among them, drugs directed against the BCMA antigen expressed in plasma cells are very appealing. Belantamab-mafodotin (belamaf) is the first antibody-drug conjugate against BCMA ready for clinical use. In this paper, we report the Spanish experience of belamaf monotherapy in 156 patients with RRMM. The overall response rate was 41.8%, with 39.8% of patients achieving a partial response or better. Median progression-free survival was 3.61 months, but interestingly, it increased to 14.47 months in patients achieving a minimal response or better. Treatment was well tolerated, ocular events being the most reported toxicity (87.9%; grade ≥ 3, 33.7%), but only two patients discontinued treatment due to side effects. Overall, our results confirm the safety and efficacy of belamaf in this poor prognosis subset of patients. Belantamab-mafodotin (belamaf) is a novel antibody-drug conjugate targeting B-cell maturation antigen that showed anti-myeloma activity in patients with relapsed and refractory multiple myeloma (RRMM). We performed an observational, retrospective, and multicenter study aimed to assess the efficacy and safety of single-agent belamaf in 156 Spanish patients with RRMM. The median number of prior therapy lines was 5 (range, 1–10), and 88% of patients were triple-class refractory. Median follow-up was 10.9 months (range, 1–28.6). The overall response rate was 41.8% (≥CR 13.5%, VGPR 9%, PR 17.3%, MR 2%). The median progression-free survival was 3.61 months (95% CI, 2.1–5.1) and 14.47 months (95% CI, 7.91–21.04) in patients achieving at least MR (p < 0.001). Median overall survival in the entire cohort and in patients with MR or better was 11.05 months (95% CI, 8.7–13.3) and 23.35 (NA-NA) months, respectively (p < 0.001). Corneal events (87.9%; grade ≥ 3, 33.7%) were the most commonly adverse events, while thrombocytopenia and infections occurred in 15.4% and 15% of patients, respectively. Two (1.3%) patients discontinued treatment permanently due to ocular toxicity. Belamaf showed a noticeably anti-myeloma activity in this real-life series of patients, particularly among those achieving MR or better. The safety profile was manageable and consistent with prior studies. [ABSTRACT FROM AUTHOR]

Various barriers make recruiting a difficult task for researchers, especially when recruiting people living with HIV (PLWH) or conducting longitudinal studies. Effective recruitment is crucial to the validity of studies, and in this regard, social media can come to aid, although researchers usually rely on paid advertisements. This paper describes the free social media strategies used for participant recruitment in two studies carried out with PLWH in Spain and Latin America. Study 1 was a cross‐sectional study on the validation of two stigma scales with a 1‐month retest. Study 2 was a longitudinal study exploring the mental health of newly diagnosed PLWH, with a second assessment after 6 months. Facebook posts, Twitter mentions, and discussion forums were used in both studies. Study 2 also recruited participants through a healthcare centre. In Study 1, 5‐month recruitment yielded a sample of 458 PLWH, averaging 91.6 surveys/month and a 43% retention rate. In study 2, recruitment took 16 months, yielding a final sample of 145 newly diagnosed PLWH, 92 from the healthcare centre (5.75 surveys/month) and 53 from social media (3.31 surveys/month), with 95% and 60% retention rates, respectively. Participants in Study 2 did not differ in sociodemographic characteristics by recruitment method, except for the region of origin and financial difficulty (more diverse origin and greater difficulty emerged in social media participants). Greater psychological distress and lower personal and social resources were also found in social media participants. These data indicate that free social media recruitment is a feasible and effective tool for the recruitment of Spanish‐speaking PLWH, although it is best used in combination with traditional methods for newly diagnosed PLWH and longitudinal studies. [ABSTRACT FROM AUTHOR]

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Introducing continental European approaches to UK child welfare practice raises a problem of comparison: to what extent are the problems and issues similar to or different from one country compared to another. Social pedagogues trained in continental Europe and working in English residential care services often encountered the phrase ‘our young people are worse’ from their English colleagues, with the implication that the social pedagogic approach was not suitable for the client group. This paper examines two propositions: (1) that in the context of introducing the continental European approach of social pedagogy into children's residential care services in England, young people are ‘different’ in England compared to other European countries and (2) that the placement options and practices for young people living away from their birth parents in continental European countries differ from those in England. Using data from a five nation study of young people from public care backgrounds, the paper argues that while family backgrounds are remarkably similar there are marked differences in the child welfare systems that might account for the perception that young people in care are ‘worse’ in England. [ABSTRACT FROM AUTHOR]

Background: Work stress is a common problem among the health personnel of the Spanish National Health System. The objective of this paper is to assess the state of mindfulness among Spanish primary care providers and to evaluate its potential relationship with work stress and basic labor and sociodemographic characteristics. Methods: Cross-sectional, multi-centric study. Primary care nurses, teachers, teaching collaborators and residents assigned to six Spanish Family Medicine/Family and Community Care Departments were invited to participate (n = 475). A template was designed in Google Forms, including sociodemographic and work-related variables. The state of mindfulness was measured with the Five Facet Mindfulness Questionnaire (FFMQ), while work-related stress was measured using an ordinal scale ranging from 0 to 10 points. Descriptive and inferential statistical analyses were carried out, as well as bivariate and multivariate statistics. Results: The mean age of participants was 40,14 ± 13.12 (range:23–65 years); 66.9% were women, 42.5% internal medicine residents, 29.3% family physicians, and 20.2% nurses. More than half (54.5%) knew about mindfulness, with 24.0% have received training on it, and 22.5% were usual practitioners. The average level of mindfulness was 127.18 ± 15.45 (range: 89–177). The average score of stress at work was 6.00 ± 2.44; 49.9% (range: 0–10). 49.9% of participants scored 7 or more on the stress at work scale. There was an inverse correlation between the levels of mindfulness (FFMQ total score) and work-related stress (Spearman's r = − 0.155, p = 0.003). Significant relationships between the mindfulness practice and the level of mindfulness (F = 29.80, p < 0.001), as well as between the mindfulness practice and the level of work-related stress (F = 9.68, p = 0.042), were also found. Conclusions: Levels of mindfulness in primary care health providers were in line with those levels observed in other groups of health professionals. Half of all of the primary care providers suffered from a high degree of stress. Although weak, inverse relationships were observed between levels of mindfulness and stress at work, with lower values of stress at work among those who practiced mindfulness. Trial registration: NCT03629457. [ABSTRACT FROM AUTHOR]

To assist higher education institutions in meeting the challenge of limited student engagement in the implementation of Learning Analytics services, the Questionnaire for Student Expectations of Learning Analytics (SELAQ) was developed. This instrument contains 12 items, which are explained by a purported two‐factor structure of "Ethical and Privacy Expectations" and "Service Feature Expectations." As it stands, however, the SELAQ has only been validated with students from UK university, which is problematic on account of the interest in Learning Analytics extending beyond this context. Thus, the aim of the current work was to assess whether the translated SELAQ can be validated in three contexts (an Estonian, a Spanish, and a Dutch University). The findings show that the model provided acceptable fits in both the Spanish and Dutch samples, but was not supported in the Estonian student sample. In addition, an assessment of local fit is undertaken for each sample, which provides important points that need to be considered in future work. Finally, a general comparison of expectations across contexts is undertaken, which are discussed in relation to the General Data Protection Regulation (2018). Lay Description: What is currently known about the subject matter: Accounting for student expectations allows for a service that is meaningful.SELAQ measures student expectations towards Learning Analytics services.The 12 items of the SELAQ can be explained by a two‐factor structure (Ethical and Privacy Expectations and Service Feature Expectations). What their paper adds to this: Validation of the SELAQ in three contextsA discussion of localized sources of strainAn assessment of measurement quality in each contextA general comparison of student expectations across contexts The implications of study findings for practitioners: SELAQ can be used with Spanish and Dutch students.SELAQ responses provide a much needed input from end‐users in Learning Analytics implementations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Newborns in neonatal intensive care units (NICUs) are in contact with a variety of medical products whose production might include synthetic chemicals with hormonal activity. OBJECTIVES: Our aim was to assess the content of bisphenol A (BPA) and parabens (PBs) and the hormone-like activities of a subset of medical products commonly used in NICUs in prolonged intimate contact with NICU newborns. METHODS: Fifty-two NICU items were analyzed, determining the concentrations of BPA and PBs [methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butylparaben (BuP)] and using the E-Screen and PALM-luciferase assays to measure the in vitro (anti-)estrogenic and (anti-)androgenic activity, respectively, of the extracts. Items found to have elevated BPA/PB content or hormone-like activities were further extracted using leaching methodologies. RESULTS: BPA was found in three-fifths and PBs in four-fifths of tested NICU items, and ~25% and ~10% of extracts evidenced estrogenic and anti-androgenic activity, respectively. The highest BPA content was found in the three-way stopcock (>7.000 ng/g), followed by patterned transparent film dressing, gastro-duodenal feeding tubes, sterile gloves, single-lumen umbilical catheters, and intravenous (IV) infusion extension sets (concentrations ranged from 100 to 700 ng/g BPA). A total PB concentration (?PPBs) >100 ng/g was observed in several items, including light therapy protection glasses, patterned transparent film dressing, winged IV catheters, IV infusion extension sets, and textile tape. The highest estrogenic activity [>450 pM estradiol equivalent (E2eq)] was found in small dummy nipples, three-way stopcocks, and patterned transparent film dressing and the highest anti-androgenic activity [>5 mM procymidone equivalent units per gram (Proceq/g)] in small dummy nipples and three-way stopcocks. DISCUSSION: According to these findings, neonates might be exposed to multiple sources of BPA and PBs in NICUs via inhalation, dermal, oral, and IV/parenteral routes. There is a need to address the future health implications for these extremely vulnerable patients and to adopt precautionary preventive measures as a matter of urgency. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, clinical diagnosis, and treatment lines in cancer patients, with the goal of improving understanding and management of this debilitating symptom to enhance patient care and quality of life. Methods: This study employed an observational, cross-sectional, and descriptive approach to investigate patients with oncological disease at the University Hospital of Salamanca between March 2021 and April 2024. A convenience sample was selected, including patients over 18 years old with a pathological diagnosis of cancer, experiencing any degree of dyspnea, and who consented to participate by signing the informed consent. Exclusion criteria included lack of consent and clinical conditions that prevented an interview. The studied variables encompass sociodemographic (age, gender, diagnosis, tumor stage, number of treatment lines) and clinical aspects (daily activities, degree of dyspnea, functional capacity, physical performance), evaluated using the Barthel Index, the mMRC Dyspnea Scale, the ECOG Scale, and the Short Physical Performance Battery (SPPB). Data were collected through semistructured interviews and medical records, and analyzed using specialized software. This research has ethical approval CEiM Code 2023 12 1472, Reference 2024/01. Results: The mean age was 66.82 years. Lung cancer was predominant (60.2%), with most patients in stage 3 (65.7%) and receiving three treatment lines (68.7%). Higher age, advanced disease stage, and more treatment lines correlated with lower Barthel and SPPB scores, and higher ECOG and mMRC scores, indicating worse functionality, physical performance, and greater dyspnea. No significant correlations were found between gender or pathological diagnosis and the studied variables. Conclusions: Advanced age, higher disease stage, and more treatment lines are associated with decreased functionality, poorer physical performance, and increased dyspnea in cancer patients. Gender and specific cancer diagnosis do not significantly affect these relationships. Addressing dyspnea is crucial to improving the quality of life and physical performance in this population. Future studies should explore additional factors like treatment types and nutritional status. [ABSTRACT FROM AUTHOR]

High school students with better knowledge about back care have fewer problems, but conceptual errors can hinder the acquisition of essential knowledge necessary for developing healthy habits. This study analyzed secondary school students' declarative knowledge and misconceptions related to back care in daily activities. An exploratory cross-sectional study was conducted with 80 girls and 89 boys aged 14–18 years (M = 15.68, SD = 2.12). The Health Questionnaire on Back Care Knowledge in Activities of Daily Living was used to evaluate knowledge using the true answer model (TAM) and the misconception model (MM). Using the test–retest method, both models' reliability was confirmed (TAM = 0.75; MM = 0.77), while only a minimal measurement error was identified (TAM = −0.01; MM = −0.07). The average scores were 6.23 for the TAM and 2.29 for the MM. The results showed no significant differences in both models. The analysis indicated that students had the most accurate knowledge of the location and function of the spine, whereas misconceptions regarding anatomical understanding and body posture usage were common. An analysis of the results under Reassumption Theory emphasizes the significance of comprehending concepts such as load transmission and spinal stability to maintain back health, thus highlighting the need for improved education in these areas to address misconceptions and enhance overall back-care knowledge. [ABSTRACT FROM AUTHOR]

Background Egalitarianism and altruism are two ways in which people may have attitudes that go beyond the narrowly defined selfish preferences. The theoretical constructs of egalitarianism and altruism are different from each other, yet there may be connections between the two. This paper explores the empirical relationship between egalitarianism and altruism, in the context of health. Methods We define altruism as individual behaviour that aims to benefit another individual in need; and egalitarianism as a characteristic of a social welfare function, or a meta-level preference. Furthermore, we specify a model that explains the propensity of an individual to be egalitarian in terms of altruism and other background characteristics. Individuals who prefer a hypothetical policy that reduces socioeconomic inequalities in health outcomes over another that does not are regarded 'egalitarian' in the health domain. On the other hand, 'altruism' in the health context is captured by whether or not the same respondents are (or have been) regular blood donors, provided they are medically able to donate. Probit models are specified to estimate the relationship between egalitarianism and altruism, thus defined. A representative sample of the Spanish population was interviewed for the purpose (n = 417 valid cases). Results Overall, 75% of respondents are found to be egalitarians, whilst 35% are found to be altruists. We find that, once controlled for background characteristics, there is a statistically significant empirical relationship between egalitarianism and altruism in the health context. On average, the probability of an altruist individual supporting egalitarianism is 10% higher than for a non-altruist person. Regarding the other control variables, those living in high per capita income regions have a lower propensity and those who are politically left wing have a higher propensity to be an egalitarian. We do not find evidence of a relationship between egalitarianism and age, socioeconomic status or religious practices. Conclusion Altruist individuals have a higher probability to be egalitarians than would be expected from their observed background characteristics. [ABSTRACT FROM AUTHOR]

Purpose: Research-supported family programmes are proven to be effective in reducing dysfunctional behaviours in youth. A fundamental role is played by professionals with high competence levels and a positive attitude to evidence-based practice (EBP). The aim of the study was to assess the efficacy of prior training for the facilitators of the PCF-AFECT, in order to ascertain whether it led to improvements in their competence levels and whether favourable attitudes to evidence-based practice were associated with higher competence levels. Method: A quantitative method was used, with a sample of professionals from Spain (N = 150). Results: Results showed that the training was effective in the case of four categories of professional competencies. Favourable attitudes to EBP were associated with clusters of professionals with higher competencies. Discussion: Both findings contribute scientifically to the identification of the core components or gold standards of training that are needed for the facilitators of research-supported family programmes. [ABSTRACT FROM AUTHOR]

The Mar Menor, Europe's largest saltwater lagoon in the Mediterranean basin (Murcia, southeastern Spain), is an ecosystem facing severe pollution, anoxia events, and marine biodiversity loss. This exploratory study examines the association between residential proximity to the Mar Menor and childhood cancer incidence in Murcia from 2000 to 2018. In our case–control study of 594 cancer cases and 3564 controls, matched by birth year and sex, participants were categorized by proximity to the lagoon (G1 ≥ 20 km, G2 = 10–20 km, G3 = 2–10 km, G4 = ≤ 2 km). Odds ratios (ORs) and 95% confidence intervals (95%CI) were adjusted for sociodemographic and environmental covariates. Analysis of distance as a continuous variable indicated a decrease both in all types of cancer and lymphoid acute leukemia risk with greater distance (OR = 0.99; 95% CI 0.98–0.99), while as a categorical variable, it revealed a non-linear pattern. Specifically, the risk did not increase for those living within 2 km of the lagoon (OR = 0.87; 95% CI 0.52–1.37), whereas increased risks were observed in the 2–20 km range within Campo de Cartagena (G2; OR = 1.32; 95% CI 1.01–1.73 and G3; OR = 1.43; 95% CI 1.00–2.02). This suggests modulating factors near the lagoon may counterbalance risks from broader environmental contamination. These findings highlight the complexity of environmental health dynamics and the importance of detailed research to guide public health strategies and urban planning for environmental and child health protection. [ABSTRACT FROM AUTHOR]

Emergency medical services (EMSs) face critical situations that require patient risk classification based on analytical and vital signs. We aimed to establish clustering-derived phenotypes based on prehospital analytical and vital signs that allow risk stratification. This was a prospective, multicenter, EMS-delivered, ambulance-based cohort study considering six advanced life support units, 38 basic life support units, and four tertiary hospitals in Spain. Adults with unselected acute diseases managed by the EMS and evacuated with discharge priority to emergency departments were considered between January 1, 2020, and June 30, 2023. Prehospital point-of-care testing and on-scene vital signs were used for the unsupervised machine learning method (clustering) to determine the phenotypes. Then phenotypes were compared with the primary outcome (cumulative mortality (all-cause) at 2, 7, and 30 days). A total of 7909 patients were included. The median (IQR) age was 64 (51–80) years, 41% were women, and 26% were living in rural areas. Three clusters were identified: alpha 16.2% (1281 patients), beta 28.8% (2279), and gamma 55% (4349). The mortality rates for alpha, beta and gamma at 2 days were 18.6%, 4.1%, and 0.8%, respectively; at 7 days, were 24.7%, 6.2%, and 1.7%; and at 30 days, were 33%, 10.2%, and 3.2%, respectively. Based on standard vital signs and blood test biomarkers in the prehospital scenario, three clusters were identified: alpha (high-risk), beta and gamma (medium- and low-risk, respectively). This permits the EMS system to quickly identify patients who are potentially compromised and to proactively implement the necessary interventions. [ABSTRACT FROM AUTHOR]

(1) Background: To analyze the prevalence of physical activity (PA) according to the presence of overweight or obesity and other sociodemographic factors in the Spanish adult population. (2) Methods: Cross-sectional study using the European Health Interview Surveys for Spain from 2014 and 2020. (3) Results: In overweight and obese people, the percentage of those who reported not performing any type of PA remained constant between 2014 and 2020, while a statistically significant increase was observed in the percentage of people who walked for 10 min a day and exercised at least 2 days a week. The probability of being obese with respect to normal weight was higher in individuals who reported not engaging in PA during leisure time (OR 1.42; 95% CI 1.31–1.53), those who did not walk 10 min a day at least 2 days a week (OR 1.25; 95% CI 1.15–1.35), and those who did not exercise at least 2 days a week (OR 1.42; 95% CI 1.32–1.53). The probability of being overweight was higher in individuals who reported not performing PA during leisure time (OR 1.07; 95% CI 1.02–1.15) and in those who did not exercise at least 2 days per week (OR 1.15; 95% CI 1.09–1.22). (4) Conclusions: Small increases in PA have been observed in both overweight and obese individuals from 2014 to 2020. [ABSTRACT FROM AUTHOR]

In recent decades, disappointing poverty trends and welfare state limitations in many European countries – including constraints on minimum income benefits – have paved the way for a larger role of the third sector. An interesting but controversial form of third-sector in-kind support is food aid provision. In Europe, food aid is, so far, a non-rights-based practice displaying worrisome discretionary and stigmatizing characteristics. Yet, the phenomenon of food aid in Europe has spread, professionalized, and penetrated the institutions of the welfare state. This raises the question if, how and to what extent food aid plays a role in bypassing structural constraints on minimum income protection. This article applies an exploratory case study approach to estimate the monetary value of food aid in relation to statutory minimum incomes in four EU-countries. We use cross-nationally comparable food reference budgets to price food aid packages in Belgium, Finland, Hungary and Spain. The results show that food aid, although not sufficient to close the at-risk-of-poverty gap, is non-trivial for some European households. In Spain and Belgium food aid packages can reach up to €100 a month (expressing 7% to 11% of respective minimum income benefit levels). Importantly, we perceive (formalized) cooperation and interaction between local welfare agencies and food charities in all countries, suggesting that welfare state actors use non-rights-based food aid for filling gaps in the social safety net. The large between- and within-country variation of the monetary values of food aid packages points, however, to food aid as a problematic discretionary practice. [ABSTRACT FROM AUTHOR]

Simple Summary: A 90-day mortality predictive model for curative gastric cancer resection based on the Spanish EURECCA Esophagogastric Cancer database was externally validated using the GASTRODATA registry. The externally validated model showed a modestly worse performance compared to the original model, nevertheless maintaining its discriminating ability in clinical practice. Background: Radical gastrectomy remains the main treatment for gastric cancer, despite its high mortality. A clinical predictive model of 90-day mortality (90DM) risk after gastric cancer surgery based on the Spanish EURECCA registry database was developed using a matching learning algorithm. We performed an external validation of this model based on data from an international multicenter cohort of patients. Methods: A cohort of patients from the European GASTRODATA database was selected. Demographic, clinical, and treatment variables in the original and validation cohorts were compared. The performance of the model was evaluated using the area under the curve (AUC) for a random forest model. Results: The validation cohort included 2546 patients from 24 European hospitals. The advanced clinical T- and N-category, neoadjuvant therapy, open procedures, total gastrectomy rates, and mean volume of the centers were significantly higher in the validation cohort. The 90DM rate was also higher in the validation cohort (5.6%) vs. the original cohort (3.7%). The AUC in the validation model was 0.716. Conclusion: The externally validated model for predicting the 90DM risk in gastric cancer patients undergoing gastrectomy with curative intent continues to be as useful as the original model in clinical practice. [ABSTRACT FROM AUTHOR]

This study explored the association between parental employment status and education level and the prevalence of sensory reactivity (SR) in population-based sample of school-aged children. SR was assessed in 495 children using the parent-reported Short Sensory Profile (SSP) questionnaire. Children with SR were identified based on probable or definitive differences in total SSP and subscales. Association between parental employment and education level were explored using multiple Poisson regression models with robust variance, adjusted for potential confounders. The main findings showed that a mother's unemployment status was associated with higher prevalence of SR for the taste/smell sensitivity subscale (PR = 1.66, 95%CI: 1.08–2.56), and the low energy/weak (PR = 2.18, 95%CI: 1.31–3.49) subscale. A lower education level of a father was also associated with a higher prevalence of sensory problems on the tactile sensitivity subscale (PRprimary education = 2.68, 95%CI: 1.27–5.61; PRsecondary education = 1.96, 95%CI: 1.004–3.66) and the low energy/weak subscale (PRsecondary education = 1.95, 95%CI: 1.02–3.73). This study underscores the impact of parental employment and education on SR in school-aged children, offering insights for interventions and support systems aimed at improving their sensory functioning and overall well-being. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice, in conjunction with optimum care quality, improves patients' clinical outcomes. However, its implementation in daily clinical practice continues to present difficulties. The aim of this study was to identify the strategies applied by Advanced Practice Nurses (APNs) to foster adherence to clinical practice guideline recommendations. Methods: An exploratory qualitative study was conducted with six focus groups at three public hospitals belonging to the Balearic Islands Health Care Service (Spain). The study participants were 32 ward nurses and 5 advanced practice nurses working routinely with inpatients at these hospitals. The study was conducted from November 2020 to January 2021, using thematic analysis, based on the COREQ checklist. Results: Four major themes related to the facilitation process were identified either by RNs and APNs: the context of the project, APN contribution to nursing team management, healthcare provision on the ward, and the acquisition and application of knowledge. Conclusions: The APNs adapted their actions to the characteristics and needs of the local context, employing strategies aimed at improving teamwork, healthcare, and knowledge management. Each of these contributions enhanced the sustainability of the changes made. [ABSTRACT FROM AUTHOR]

Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations. [ABSTRACT FROM AUTHOR]

Objective: To evaluate therapeutic footwear expectations and usability of individuals with diabetes and foot complications. Design: A prospective multicenter study was conducted on participants with a high risk of developing a diabetic foot ulcer. Setting: Participants were enrolled in 11 different specialized diabetic foot units in Spain between March 2022 and June 2023. Subjects: Patients with diabetes at moderate to high risk of foot ulceration receiving first therapeutic footwear prescription. Interventions: All the patients included in the research were prescribed with their first pair of therapeutic footwear. Main measures: Primary outcome measures were MOS-pre and MOS-post questionnaires evaluating use and usability of prescribed therapeutic footwear. Secondary outcome measures aimed to evaluate footwear clinical efficacy as ulceration rate and self-reported perceived walking distance per day. Results: The use of therapeutic footwear exceeded the patient's pre-provision prediction of their anticipated use in 94% of people (n = 126). Based on the visual analogic satisfaction scale, the median satisfaction of daily wearing their therapeutic footwear was 7 points, Interquartile Range (IQR) [5–8.25]. During the follow-up period, 39 participants (29.1%) experienced diabetic foot ulcer. Perceived walking distance participants reported an improvement in their perceived walking ability during various daily life activities. Conclusions: Diabetes patients at moderate to high risk of diabetic foot ulcer improved their perception of walking ability after therapeutic footwear prescription. Adherence to the therapeutic footwear prescription resulted in less ulcerations. [ABSTRACT FROM AUTHOR]

Background:The European Disability Strategy (2010–2020) seeks to significantly raise the proportion of people with disabilities working in the open labour market. The ERGO WORK project is a collaboration of academic and industrial partners in six European countries, focused on understanding and tackling barriers to workplace inclusion for workers with disabilities. Methods:This study sought to explore the perceptions and needs of stakeholders in terms of workplace adaptation to the needs of employees with disabilities. An exploratory online survey was completed by 480 participants across six countries. Results:The analysis suggests that workplaces could be further improved to meet the needs of employees with considerable scope for training within companies to raise awareness about employees’ needs, employers’ obligations and workplace adaptation. Conclusions:This snapshot suggests there is still a gap between intent and reality in workplace inclusion and further strategies are needed to improve the opportunities for employees with disabilities. The paper argues that ergonomics may have a key role to play in tackling these challenges and adapting the workplace environment and job design to suit the needs of individual employees.Implications for rehabilitationThis study suggests there is considerable scope for workplace adaptation and improvements to meet the needs of employees with disabilities.Employers need and want further specialist practitioner guidance to facilitate workplace inclusion and support adaptation to individual needs.Organisations would benefit from training to raise awareness about potential solutions and approaches that would support more widespread employment of people with disabilities. [ABSTRACT FROM PUBLISHER]

(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing's role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences. [ABSTRACT FROM AUTHOR]

Background. Nurses are one of the largest and costliest groups in healthcare organizations; therefore, it is important to comprehend their scope of practice. Aim. To contribute to the improvement of nursing resource management in medical-surgical and Intensive Care Units by identifying factors that influence the scope of nursing practice. The hypothesis was that the activities carried out by nurses in medical-surgical units and intensive care units are influenced by individual and job-related factors, with job characteristics having an additive and moderating effect on individual characteristics. Materials and Methods. Cross-sectional correlational design to test the relationship between the individual and job characteristics on the nursing scope of practice measured by the Actual Scope of Nursing Practice (ASCOP) questionnaire. The sample consisted of 270 nurses. Linear mixed effects models analysis (LME) was used with the aleatory effect of the intensive care unit (ICU). Results. Belonging to the ICU decreased the scope of practice of nurses. We found a statistically significant effect of psychological demand, practice environment, role ambiguity, and growth need strength on the scope of nursing practice. The models explained a variance up to 24%. Conclusions. Although the survey results revealed the existence of broader scope of practice levels in Spanish hospital units than in the original Canadian study, the use of scope of nursing practice remains suboptimal. Higher levels on the psychological demand, the practice environment and in the individual growth need strength were related with a broader scope of practice. Otherwise, role ambiguity negatively affected the scope of practice. Implications for Nursing Management. This article provides an analysis of the impact of individual and job-related characteristics on the nursing scope of practice. It serves as a valuable resource for both managers and nurses, offering insights to improve nurses' working conditions and obtain more efficient workforces. [ABSTRACT FROM AUTHOR]

The well-being of people is a key aspect of the field of psychology. Hence, it is important to analyse the variables that are related to life satisfaction and happiness as perceived by individuals and that, therefore, increase their overall well-being. The main objective of this study was to analyse the predictive capacity of emotional intelligence and perceived social support on both the level of life satisfaction and perceived happiness. A total of 380 psychology students completed the Trait Meta Mood Scale, the Multidimensional Scale of Perceived Social Support, the Satisfaction with Life Scale, and the Subjective Happiness Scale. The results show that both emotional intelligence and social support are related to and predictive of subjective happiness and life satisfaction. The importance of developing the components of emotional intelligence and promoting an adequate social network in young people is highlighted. [ABSTRACT FROM AUTHOR]

Background. Few studies have analyzed the negative outcomes of disruptive behaviors in the nurse-physician relationship in patient care and their impact on patient safety. These multicausal studies significantly relate to organizational, institutional, and professional attitudinal risk factors. Aim. Analyze healthcare professionals' perceptions of disruptive behavior and factors associated with patient safety climate in the nurse-physician relationship at the hospital level. Methods. A multicenter cross-sectional study was conducted with a sample of 370 nurses and physicians assigned to different public hospitals in the Murcia/Spain region, applying the adapted and validated Spanish version of the Nurse-Physician Relationship Scale: Impact of Disruptive Behavior on Patient Care. The analysis used proportions or means (standard deviation (SD)), univariate and multivariate linear regression models, and the chi-square test. Results. Disruptive behavior was more prevalent in the ICU (81.6%) and the emergency department (67.8%). Professionals indicate that fear of reprisals is the main barrier to the reporting system. Likewise, stress and frustration are more associated with disruptive behavior and influence the safety climate. Conclusion. Professionals indicate that disruptive behaviors can have a negative impact on clinical outcomes. Age and type of service were identified as the most relevant socio-occupational factors. Stress, frustration, and communication problems are the factors that most influence the safety climate. [ABSTRACT FROM AUTHOR]

Background: Malnutrition, sedentary lifestyle, cognitive dysfunction and poor psychological well‐being are often reported in patients on haemodialysis (HD). Aims: We aimed to explore needs, barriers and facilitators—as perceived by patients, their carers, and healthcare professionals (HCPs) for increasing the adherence to the diet, to physical activity and cognition and psychological well‐being. Methods: This is an observational cross‐sectional study following the STROBE statement. This study is part of an ERASMUS+ project, GoodRENal—aiming to develop digital tools as an educational approach to patients on HD. For that, the GoodRENal comprises HD centers located in four Belgium, Greece, Spain and Sweden. Exploratory questionnaires were developed regarding the perceived needs, barriers and facilitators regarding the diet, physical activity, cognition and psychological well‐being from the perspective of patients, their carers and HCPs. Results: In total, 38 patients, 34 carers and 38 HCPs were included. Nutrition: For patients and carers, the main needs to adhere to the diet included learning more about nutrients and minerals. For patients, the main barrier was not being able to eat what they like. Physical activity: As needs it was reported information about type of appropriate physical activity, while fatigue was listed as the main barrier. For Cognitive and emotional state, it was perceived as positive for patients and carers perception but not for HCPs. The HCPs identified as needs working as a team, having access to specialised HCP and being able to talk to patients in private. Conclusions: Patients and their carers listed as needs guidance regarding nutrition and physical activity but were positive with their cognitive and emotional state. The HCPs corroborated these needs and emphasised the importance of teamwork and expert support. [ABSTRACT FROM AUTHOR]

This document analyzes a survey conducted in three geographical areas in Spain, focusing on centers for individuals with cerebral palsy (CP). The study aims to determine the adherence rate to recommended physical activity guidelines, assess if there is a decline in interest in physical activity over time, identify the stage at which this decline occurs, and explore potential mechanisms, tools, or strategies to sustain long-term engagement in regular physical activity for this population. The 36-item questionnaire comprises multiple-choice, open-ended, and Likert scale-type questions. Data were collected on physical activity frequency and duration, daily living activities, and demographics. Statistical analysis identified patterns and relationships between variables. Findings reveal that only a 17.6% meets the World Health Organization (WHO) recommendations regarding regular physical activity (RPA), decreasing in frequency or number of days a week, (3.7 d/w to 2.9 d/w; p < 0.01) and duration (50.5 min/d to 45.2 min/d; p < 0.001) with age, especially for those with higher Gross Motor Function Classification System (GMFCS) mobility levels. Obesity slightly correlates with session duration (ρ = −0.207; p < 0.05), not mobility limitations. Gender has no significant impact on mobility, communication, or physical activity, while age affects variables such as body mass index (BMI) and engagement (p < 0.01). A substantial proportion follows regular physical activities based on health professionals' advice, with interest decreasing with age. To improve adherence, focusing on sports-oriented goals, group sessions, and games is recommended. These findings emphasize the importance of personalized programs, particularly for older individuals and those with greater mobility limitations. [ABSTRACT FROM AUTHOR]

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics. [ABSTRACT FROM AUTHOR]

Background. Simulation-based education has been incorporated into nursing curricula as an educational strategy. However, its implementation has not yet been standardized in different regions. Purpose. The aim of this study is to describe simulation-based education in the nursing curricula in Catalonia and Andorra. Methods. An exploratory cross-sectional study was conducted in 2019 in which 16 universities participated. Results. The median dedication to clinical simulation in the nursing studies was 287.5 hours, with variations between universities (ranging from 24 to 516 hours). The dedication for the low-medium fidelity simulation was 89.4 hours (SD ± 58.3) and 26 hours (SD ± 17) for the high-fidelity simulation. All the universities had qualified teaching staff and facilities. Conclusions. There is variability in the implementation and use of simulation-based education among universities. However, there is consensus on its usefulness in nursing curricula. To integrate simulation training into the nursing curriculum, it is necessary to establish convergent simulation standards in higher education. [ABSTRACT FROM AUTHOR]

Objective: The main objective of this study was to estimate the prevalence of molar incisor hypomineralisation (MIH), an alteration of tooth enamel with an estimated worldwide prevalence rate of 14%, among children using primary care services in the Community of Madrid, Spain. Materials and methods: This was a descriptive, cross-sectional and multicentre study. After calibrating all researchers and following the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD), children aged between 8 and 16 years who were users of the dental services at 8 primary oral health units of the Madrid Health Service (SERMAS) were included. The children underwent a dental examination, and the parents were asked to complete a questionnaire. Results: The prevalence of MIH was 28.63% (CI: 24.61–32.65%). The age cohorts most affected by MIH were 8 years (21.4%) and 11 years (20.7%). The presence of MIH was greater among girls (85; 60.71%) than among boys (55; 39.28%). The mean number of affected teeth per patient was 4.46 ± 2.8. The most frequently affected molar was the upper right first molar (74.3%), and the upper left central incisor was the most affected incisor (37.85%). Opacities were the defects most frequently recorded (63.57%). Conclusions: The prevalence of MIH in this study is the highest of all relevant studies conducted in Spain. [ABSTRACT FROM AUTHOR]

Aim: To psychometrically assess the Spanish version of the Self‐Care of Chronic Illness Inventory (SC‐CII‐Sp) in community‐dwelling older adults with chronic multimorbidity. Design: A methodological study. Method: A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC‐CII‐Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC‐CII‐Sp and their scores on the Spanish Chronic Disease Self‐Efficacy scale (SCD‐SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC‐CII‐Sp's reliability was tested by computing the Cronbach's alpha. Results: The SC‐CII‐Sp showed good content and convergent validity. The CFA showed that the SC‐CII‐Sp has three sub‐scales. The 8‐item Self‐Care Maintenance sub‐scale has good internal consistency and is comprised of two dimensions: illness‐related and health‐promoting behaviour. The Self‐Care Monitoring sub‐scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6‐item Self‐Care Management sub‐scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour. Conclusion: The Spanish version of SC‐CII is a valid and reliable instrument to be used in the assessment of self‐care behaviours amongst Spanish‐speaking, community‐dwelling older adults with chronic multimorbidity. Implications for the Profession: Nurses need valid and reliable tools to assess self‐care behaviours in Spanish‐speaking community‐dwelling older adults with chronic multimorbidity. This study provides a 19‐item tool that allows for the comprehensive evaluation of self‐care behaviours in healthy and ill states. Impact: Using the SC‐CII‐Sp in clinical or research settings could help nurses to examine the effects of different interventions on self‐care behaviours amongst Spanish‐speaking, community‐dwelling older adults with chronic multimorbidity. Patient or Public Contribution: None to be reported. [ABSTRACT FROM AUTHOR]

Background: The widespread adoption of mobile devices by adolescents underscores the potential to harness these tools to instill healthy habits into their daily lives. An exemplary manifestation of this initiative is the Healthy Jeart app, crafted with the explicit goal of fostering well-being. Methodology: This study, framed within an applied investigation, adopts an exploratory and descriptive approach, specifically delving into the realm of user experience analysis. The focus of this research is a preliminary examination aimed at understanding users' perceived usability of the application. To glean insights, a comprehensive questionnaire was administered to 101 teenagers, seeking their evaluations on various usability attributes. The study took place during 2022. Results: The findings reveal a considerable consensus among users regarding the evaluated usability aspects. However, the areas for improvement predominantly revolve around managing the information density, particularly for a subset of end users grappling with overwhelming content. Additionally, recommendations are put forth to streamline the confirmation process for user suggestions and comments. Conclusion: This analysis illuminates both the strengths of the app and areas ripe for refinement, paving the way for a more user-centric and efficacious Healthy Jeart application. [ABSTRACT FROM AUTHOR]

Craniofacial growth and development have been shown to be influenced by various environmental factors that impact child development. This study aims to analyze the different patterns of feeding during early childhood, starting from birth, and assess the variability of nutrition during the first stage of childhood, along with the habits developed, to study their impact on jaw development. The study was conducted on a sample of twenty-five patients aged 3 to 5, following approval from the ethics committee of the Catholic University of Valencia. Informed consent was obtained from the fathers, mothers, and/or legal guardians, who were administered surveys on habits and diet. Cephalometric measurements within the parameters of ideal occlusion were subsequently taken. While previous studies examined this subject, the findings are challenging to evaluate. However, this study identified significant associations (p = 0.001) between clinical measurements and children's eating habits. The growth and development of the craniofacial cavity are influenced by multiple factors, including a child's diet and habits. Nonetheless, further research is required to determine whether diet can be considered a determining factor in proper jaw growth. [ABSTRACT FROM AUTHOR]

Accessible summary The burnout syndrome contributes to the deterioration in the quality of personal life as well as lower quality practice in healthcare personnel. Researchers have been concerned about the psychometric limitations of some previous questionnaires designed to evaluate burnout. The Spanish Burnout Inventory was developed to address the problems associated with other instruments, but it has not yet been validated in staff nurses., This study provides evidence that the Spanish Burnout Inventory has adequate psychometric properties to estimate burnout in staff nurses., The Spanish Burnout Inventory offers a theoretical proposal to explain the different components of burnout., The Spanish Burnout Inventory provides researchers and practitioners with an expanded conceptualization of the burnout syndrome, which can facilitate the diagnosis and treatment of nursing professionals., Abstract Researchers have been concerned about the psychometric limitations of the some previous questionnaires designed to evaluate burnout. To address these problems associated with previous instruments, the Spanish Burnout Inventory ( SBI) was developed. The instrument has not yet been validated in staff nurses. The purpose of this paper was to evaluate the psychometric properties of the SBI. The sample consisted of 720 staff nurses from two Spanish general hospitals. The instrument is composed of 20 items distributed in four dimensions: Enthusiasm towards the job (five items), Psychological exhaustion (four items), Indolence (six items) and Guilt (five items). Data were subjected to confirmatory factor analysis. To assess the factorial validity of the SBI, four alternative models were tested. Results show that the four-factor model of the SBI has adequate psychometric properties for the study of burnout in staff nurses. This model fitted the data better than the alternative models. The study provides evidence of the adequate psychometric properties of a measure to evaluate burnout in nursing professionals. The SBI proposes a theoretical explanation for the different types of burnout, facilitating the diagnosis and treatment of staff nurses. [ABSTRACT FROM AUTHOR]

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This study aimed to explore the family profile of adolescent-to-parent abuse cases. Concretely, this paper examines whether or not there is a different family profile of parent-abuse offenders compared with other types of offenders and with non-offender adolescents. The sample included 90 adolescents who were clustered into three groups (parent-abuse offenders, other type of offenders, and non-offender adolescents). Participants completed measures of quality of communication with parents and parents' educational styles. They were also evaluated using a brief interview with questions about family structure. Results indicate offenders who assault their parents have a different family structure and dynamics. Differences were found concerning the type of household, family size, and family incomes. In addition, parent-abuse offenders reported a lower quality of communication with both parents perceiving them as less warm, more rejecting, and less inductive than did the other groups. [ABSTRACT FROM AUTHOR]

Introduction: The psychometric properties of the Satisfaction With Life Scale (SWLS) have been evaluated across numerous languages and population groups, primarily from a factor analysis perspective. In some studies, inconsistencies in structural invariance have been identified. Objective: This study aims to analyze the properties and gender invariance of the SWLS from a network analysis perspective. Method: A total of 857 Spanish university students were obtained through a stratified random cluster sampling method in a cross-sectional survey design study. Descriptive analysis of the items, partial-correlation network, Bayesian network model estimation, and invariance analysis by gender were conducted. Results: The instrument did not exhibit any floor or ceiling effects. Each item can be considered univariately normally distributed, and all items clustered in a single and stable community. The partial-correlation network model and centrality measures were stable in the full sample and invariant across genders. Item 3 emerged as the most central node in the network with the highest predictability. The Bayesian network indicated that items 2 and 4 initiate the process, while item 5 acts as the sink, and items 1 and 3 act as mediators. Conclusions: The SWLS can be used as a unidimensional measure, and the total score and relationships among items are stable and reliable. Any potential differences among genders cannot be associated with the functioning of the instrument. The predictability of every item was high, and the Bayesian network clearly identified different roles among the items. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality is prevalent in older people and impairs their quality of life. Various studies show an association between sleep disorders and altered levels of inflammatory cytokines. The cytokine IL-1β has been shown to display both somnogenic and insomnia-promoting effects in experimental animals. Objectives: to evaluate the relationship between insomnia and salivary IL-1β concentration and the role of associated factors such as the symptoms of depression, use of hypnotics, intake of caffeinated beverages, smoking, and alcohol use in older individuals. An analytical, cross-sectional, observational research was carried out with a population of community-dwelling individuals over 60 years of age in Valencia (Spain). Sleep quality was measured with the Athens insomnia scale (AIS) and depressive symptoms with Geriatric Depression Scale (GDS). Results: 287 individuals participated in the study (mean age 74.08 years (76.7% women). 41.5% of the participants had insomnia, 36.9% took drugs for sleep problems, and 32.4% had relevant depressive symptoms. There was a significant inverse correlation between the IL-1β and total AIS score (rho = −0.302, p < 0.001), the sleep difficulty subdomain (rho = −0.259, p < 0.001), and the daytime sleepiness subdomain (rho = −0.322, p < 0.001). No significant correlation was observed between GDS and salivary IL-1β concentration. The IL-1β concentration was significantly lower in individuals taking drugs for sleeping compared with those not taking those drugs (1.11 ± 0.09 and 1.48 ± 0.08, respectively; p = 0.001). Regarding the AIS score, there was no significant difference in marital status, smoking, or the number of cups of tea or cola drinks, but there was a significant association with alcohol intake (p = 0.019) and in the number of daily intakes of coffee (p = 0.030). The receiver operating characteristic (ROC) curve analysis of IL-1β for diagnosis of moderate-severe insomnia showed an area under the curve (AUC) value of 0.78 (95% confidence interval 0.71–0.85). At the cut-off of 0.83 pg/µL of Il-1β, it had a sensitivity of 70.3% and a specificity of 69.8%. [ABSTRACT FROM AUTHOR]

Purpose: The main aim of this research was to explore experiences of care during the lockdown of the first wave of COVID-19 syndemic in Spain Methods: This is a qualitative and explorative study using self-photo-elicitation as a data collection method. Fifteen participants (Twelve women and three men) shared 25 photographs and one video between the June 18 and August, 2020. Participants' photographs and texts were collected online. Data were analysed based on Thematic Analysis. Results: Three emerging categories were constructed: 1) the deconstruction of care: self-care and collective care 2) the crisis of care and gendered care, 2) beyond anthropocentrism: animalism and ecology. Findings indicate the need to understand "care" in terms of social reproduction, including self-care, care towards other humans and non-human animals, and collective care. Also, the need to care for planetary health and to be in contact with nature as a form of self-care and social care. Conclusions: Care in a period of social and health crisis puts human relationships and also non-human life at the centre. Care requires adopting taking an ecological one-health perspective. [ABSTRACT FROM AUTHOR]

Background: In order to be used safely, accurately and reliably, measuring instruments in the health field must first be validated, for which the study of their psychometric properties is necessary. The Short Physical Performance Battery (SPPB) tool is a widely used clinical assessment test that has been approved for usage across several nations, languages and demographics. Finding SPPB's psychometric properties for a sample of institutionalized older individuals is the aim of this research. Methods: This is a multicenter, retrospective and observational study of the psychometric properties of the Short Physical Performance Battery tool with a convenience sample of 194 institutionalized older adults. Reliability (internal consistency) and validity (construct validity and convergent validity) tests were performed. Results: The results show a very good internal consistency, construct validity and convergent validity. In addition, the factorial structure of the SPPB is provided, which reflects that it is a unidimensional scale. Conclusions: In conclusion, the Short Physical Performance Battery is a valid and reliable tool for use with institutionalized older adults. Its use is recommended as part of the Comprehensive Geriatric Assessment for the evaluation of the physical or functional sphere. This study was not registered. [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]

Objectives Lipoatrophy is a long-term adverse effect of some antiretrovirals that affects quality of life, compromises adherence and may limit the clinical impact of HIV treatments. This paper explores the effect of tenofovir/emtricitabine ( TDF/ FTC) on the amount of limb fat in patients with virological suppression. Methods A randomized, prospective clinical trial was performed to compare continuation on a zidovudine/lamivudine ( ZDV/3TC)-based regimen with switching to a TDF/ FTC-based regimen in terms of the effect on limb fat mass as assessed by DEXA over a 72-week period. Results Eighty patients were included (39 in the TDF/ FTC arm and 41 in the ZDV/3 TC arm) and 73 completed the study (37 and 36, respectively). In the switch arm, limb fat increased by a median of 540 g from baseline ( P = 0.022), while in the ZDV/3TC arm it decreased by a median of 379 g ( P = 0.112; p between groups = 0.007). Subjects with baseline limb fat ≤ 7200 g, previous time on ZDV > 5 years or a body mass index > 25 kg/m2 experienced higher limb fat gains than other subjects, and these differences were statistically significant. Haemoglobin increased by a median of 1.0 g/d L in the TDF/ FTC arm ( P < 0.001) and remained unchanged in the ZDV/3TC arm (p between groups = 0.0002). There were no significant differences between groups in other secondary endpoints (body weight, total body and trunk fat content, total body bone mineral density, laboratory parameters, CD4 cell count and viral load). Conclusions Switching from a ZDV/3TC-based to a TDF/ FTC-based regimen led to a statistically significant improvement in limb fat, in contrast to the progressive loss of limb fat in subjects continuing ZDV/3TC. [ABSTRACT FROM AUTHOR]

This paper aims to identify the inter-relationships between the social factors that influence epidemiological patterns in the city neighbourhood of Casablanca, Zaragoza (Spain). Data for a cross-sectional survey were collected between January 2008 and April 2008 from a representative random sample of 1032 residents aged more than 15 years. The study interview contained information scales on healthcare behaviours, treatment evaluation, the number of medical consultations in the weeks pervious to the interview and the perceived health status of the respondents, using The Health Perception Questionnaire. The global index (continuous variable) allowed inferences to be made on the individual's perception of his/her own health. The assessment of social vulnerability was based on the occupational, educational and economic conditions of the interviewees. An individual was considered to belong to a vulnerable subeconomic group if he/she had a personal income of 6000 euros or less; or had no formal education or had been educated up to primary school level only; or was not in paid employment at the time of the interview. A descriptive and comparative analysis of the vulnerable and non-vulnerable population groups for perceived and diagnosed health variables was undertaken using parametric and non-parametric tests. A total of 550 interviewees (53.3%) were considered vulnerable people. Low level of instruction (primary or no education) was the main characteristic of this group (356 subjects, 64.7% of those identified as vulnerable). Binary logistic regression was used to analyse the association between belonging to the vulnerable group and a number of health variables adjusted for gender, age and area of residence. The vulnerable group had worse levels of perceived health even when controlled for gender and area of residence. In Casablanca, the place of residence is an important social stratification indicator reflected in the characteristics of the vulnerable population group and its perceived health. [ABSTRACT FROM AUTHOR]

Background: Very few studies have assessed the association between COVID-19 infection and the rates of exclusive breastfeeding (EBF) upon discharge following the first waves of the pandemic and after initiation of vaccination. The primary objective of this study is to compare the rates of EBF since birth upon discharge in mothers diagnosed with COVID-19 infection at the time of the delivery versus a group of non-infected mothers in maternity hospitals with Baby Friendly Hospital Initiative (BFHI) accreditation. The secondary objectives include determining the rates of any breastfeeding at three and six months of life in both groups, as well as determining the possible factors associated with EBF rates observed upon discharge. Methods: An observational, Spanish multi-center hospital, prospective cohort study conducted from 1 to 2021 to 31 March 2022 and with follow-up during the first six months of life. Follow-up was performed via telephone contact with calls performed at three and six months. A multivariate logistic regression analysis model was used to identify the factors related to a lower probability of EBF upon discharge. Results: 308 mother-infant pairs participated in the study, 111 in the cohort of women with COVID infection and 197 in the comparison group. EBF upon discharge was 62.7% in the COVID group vs. 81.2% in the comparison group (p = 0.002); at three months; 52.4% vs. 57.0% (p = 0.33) were performing EBF, with the rates of EBF at six months being 43.0% vs. 39.3% (p = 0.45), respectively. Exposure to COVID-19 at delivery (AOR 5.28; 95% CI 2.01, 13.86), not practicing BF previously (AOR 36.3; 95% CI 7.02, 187.74), birth via Cesarean section (AOR 5.06; 95% CI 1.62, 15.79) and low birth weight of the newborn (AOR 1.01; 95% CI 1.01, 1.01) were associated with a greater risk of not performing EBF upon discharge. Conclusions: Mothers with a mild or asymptomatic COVID-19 infection at the time of the delivery were less likely to have exclusively breastfed during their hospital stay than other mothers in these BFHI-accredited hospitals. However, there were no differences in breastfeeding rates between the groups at three and six months postpartum. [ABSTRACT FROM AUTHOR]

Aims and objective: To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID‐19 pandemic (May–June 2020). Background: As other healthcare professionals, nursing students who worked during the first COVID‐19 wave suffered from dysfunctional mental health symptoms. Design: Sequential, mixed‐method, multicentre study. Methods: The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi‐structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting. Results: The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned. Conclusion: The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members. Relevance to Clinical Practice: In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience. [ABSTRACT FROM AUTHOR]