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Coral-reef ecosystems of the central Mexican Pacific have been routinely affected by both moderate and severe El Niño–Southern Oscillation (ENSO) events over the past 20 years. Such conditions are associated with abnormally high (1997–1998, 2002–2003, 2009–2010, and 2015–2016; 'El Niño') and low (1999–2000, 2008–2009, and 2010–2011; 'La Niña') seawater temperatures. Because few studies have documented how ENSO events affect both corals and key coral competitors such as macroalgae, we evaluated the short- and long-term changes in the cover of three reef coral genera, namely, Pocillopora , Pavona and Porites , as well as four coral competitors, namely, macroalgae, turf algae, coralline algae (CCA) and sponges, over a multi-year period that encapsulated two strong ENSO events: the 2010–2011 La Niña and the 2015–2016 El Niño. Such temperature anomalies caused a short-lived decrease in coral cover, alongside a concomitant increase in CCA. The communities eventually returned to their coral-dominated states within several months of the ENSO events, suggesting that these reef habitats can recover from such episodes of anomalous seawater temperatures. Coral-reef ecosystems have been continuously affected by stress conditions, causing bleaching and death, allowing other competitors from the reef to use such space. We evaluated the short- and long-term changes in the cover of three reef coral genera over multi-year periods, some with abnormal temperature. Results showed that anomalies caused an ephemeral decrease in coral cover, with a remarkable presence of coralline algae. However, the communities eventually returned to their coral-dominated state, suggesting that these reef habitats are resilient to such episodes of abnormal seawater temperature. [ABSTRACT FROM AUTHOR]

Background: Irradiation of intraocular tumors requires dedicated techniques, such as brachytherapy with (106)Ru plaques. The currently available treatment planning system relies on the assumption that the eye is a homogeneous water sphere and on simplified radiation transport physics. However, accurate dose distributions and their assessment demand better models for both the eye and the physics.Methods: The Monte Carlo code PENELOPE, conveniently adapted to simulate the beta decay of (106)Ru over (106)Rh into (106)Pd, was used to simulate radiation transport based on a computerized tomography scan of a patient's eye. A detailed geometrical description of two plaques (models CCA and CCB) from the manufacturer BEBIG was embedded in the computerized tomography scan.Results: The simulations were firstly validated by comparison with experimental results in a water phantom. Dose maps were computed for three plaque locations on the eyeball. From these maps, isodose curves and cumulative dose-volume histograms in the eye and for the structures at risk were assessed. For example, it was observed that a 4-mm anterior displacement with respect to a posterior placement of a CCA plaque for treating a posterior tumor would reduce from 40 to 0% the volume of the optic disc receiving more than 80 Gy. Such a small difference in anatomical position leads to a change in the dose that is crucial for side effects, especially with respect to visual acuity. The radiation oncologist has to bring these large changes in absorbed dose in the structures at risk to the attention of the surgeon, especially when the plaque has to be positioned close to relevant tissues.Conclusion: The detailed geometry of an eye plaque in computerized and segmented tomography of a realistic patient phantom was simulated accurately. Dose-volume histograms for relevant anatomical structures of the eye and the orbit were obtained with unprecedented accuracy. This represents an important step toward an optimized brachytherapy treatment of ocular tumors. [ABSTRACT FROM AUTHOR]

OBJECTIVE:This study was conducted to elucidate whether antagonistic targeting of the histamine H3 receptor increases hypothalamic histamine levels, in parallel with decreases in food intake and body weight.METHODS:The competitive antagonist potency of a recently synthesized histamine H3 receptor antagonist, NNC 38-1049, was studied in intact HEK293 cells expressing human or rat histamine H3 receptor, in which NNC 38-1049 was allowed to antagonize the effect of the H3 receptor agonist R-α-methylhistamine on isoprenaline-induced accumulation of cAMP. The affinity of NNC 38-1049 for a number of variants of the histamine receptor was also determined. Following single dosing of normal rats with NNC 38-1049, hypothalamic histamine levels were assessed by means of microdialysis. Plasma and brain levels of NNC 38-1049 and acute effects on food intake and energy expenditure were followed after oral doses of 3–60 mg/kg. Potential side effects were examined with rat models of behaviour satiety sequence (BSS), pica behaviour and conditioned taste aversion (CTA). Intakes of food and water together with body weight were recorded for 15 days during daily dosing of dietary obese rats.RESULTS:NNC 38-1049 was found to be a highly specific and competitive antagonist towards both human and rat histamine H3 receptors, and measurable amounts of NNC 38-1049 were found in the plasma of rats following single oral doses of 3–60 mg/kg and in the brain after 15–60 mg/kg. Following single intraperitoneal injections of NNC 38-1049 (20 mg/kg), significant increases in extracellular histamine concentrations were observed. The same dose did not change BSS or pica behaviour acutely, nor did it induce CTA following repeated administration for 7 days. Reductions in food intake were seen very soon after administration, and occurred in a dose-dependent fashion. Energy expenditure was unchanged, but the respiratory quotient (RQ) tended to decrease at higher doses, indicating an increase in lipid oxidation. Twice daily administration of 20 mg/kg of NNC 38-1049 in old and dietary obese rats resulted in sustained reduction of food intake throughout a 2-week study, and was associated with a highly significant (P<0.01) decrease in body weight compared with controls (−18.4±3.4 vs +0.4±2.7 g). The same dose of NNC 38-1049 produced an acute decrease of water intake, but 24 h intakes were not significantly changed.CONCLUSIONS:The results of this study strongly support the idea that an increase in the hypothalamic concentration of histamine produces a specific reduction of food intake and that this effect can be translated into a decrease in body weight.International Journal of Obesity (2005) 29, 1402–1412. doi:10.1038/sj.ijo.0803036; published online 6 September 2005 [ABSTRACT FROM AUTHOR]

The symbiotic relationship between the crab Trapezia spp. and pocilloporid corals has been characterized as obligate. Although this relationship is considered common and has been widely registered within the distribution areas of these corals, the initiation of this symbiotic relation and its potential persistence throughout the life cycle of the crustacean is still poorly described. To understand the Trapezia–Pocillopora symbiosis, determining the time and conditions when Trapezia recruits a coral colony and the factors influencing this process are key. Thus, in the present study, healthy, small and unrecruited coral fragments were attached to the substrates (using cable ties) of nearby adult Pocillopora colonies. All fragments were monitored for two years to measure their growth and size at the first evidence of Trapezia crab recruitment, as well as the abundance and permanence of the crabs on the coral fragments. Results showed a relation between the space available (coral volume) and crab recruitment as an increase in substrate complexity is required to provide protection for the crabs and hence maintain the symbiosis, while abiotic conditions such as sea temperature and the distance of the fragments from the adult coral colonies seemingly did not affect the recruitment process. In addition, crabs are able to move between colonies, thus discarding the theory that once recruited, crabs are obligate residents on this specific colony. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology but associated with HLA-B27. In our laboratory we have previously reported that AS patients show lymphoproliferative response to the HSP60 from Klebsiella pneumoniae. On the other hand, we have also reported in the HSP60 sequence a nonapeptide (residues 117-125) that have high affinity for B2705. In order to know the role of this nonapeptide in AS, we separated by inmunomagnetics beads CD4 and CD8 T lymphocytes from PBMC of AS B27+ patients and healthy subjects. Subpopulations were analyzed by flow cytometry to verify purity. CD4 T lymphocytes were sensitized with 6 micrograms of peptide for 24 hours in AIM-V medium at 37°C in a CO2 atmosphere. Afterwards these cells were washed and adjusted to be use as target cells. CD8 T lymphocytes were used as effectors cells. Target and effectors cells were mixed in a 1:1 ratio, in a final volume of 200 microliters in AIM-V medium and incubated 24 hours at 37°C in CO2 atmosphere. Then 20 microliters of alamar blue were added and incubated 24 hours more in the same conditions. Flourescence was determined and % of dead target cells was calculated. In all subjects analyzed, subpopulations purity was up to 95%. 5/10 AS patients and 0/6 healthy subjects showed citotoxic activity, suggesting that the 117-125 peptide could be a target for CD8 T lymphocytes in B27 positive AS patients. [ABSTRACT FROM AUTHOR]

The explanatory value of four hypotheses for geographic variation in total species richness and species richness was evaluated per family in coral and fish communities in the North Sector of the Mesoamerican Barrier Reef System (NS-MBRS). The four hypotheses emphasize different reefscape attributes that are important for coral and fish: reef area (RA), live coral cover (LCC), habitat complexity (HC), and coral richness itself and for fish. For both coral and fish communities, we estimated the total number of species and number of species per family on 11 coral reefs along a 400-km section of NS-MBRS. Hard coral cover and HC were quantified using line and chain transects, respectively, and RA was estimated using Landsat TM images and a geographic information system. We used multiple regression and canonical redundancy analysis to study the fish-environment and coral-environment relationships. The three reefscape features (RA, LCC, and HC) in combination were much stronger explanatory variables for the observed biogeographic patterns of fish and coral biodiversity than they were singly. Coral and fish species richness were strongly correlated. Indicators of functional diversity (fish trophic groups and coral morphofunctional groups) followed the same biogeographic patterns as species richness. Reefscape attributes (RA, LCC, and HC) were shown to be good proxies for critical coral reef biodiversity values. This means that simple reefscape attributes can be used to predict more complex biodiversity values of different reef areas. Such predictions can provide an invaluable guide for regional biodiversity assessments, the extrapolation of these results to unsurveyed areas, and guidance for ecoregionalization within large reef tracts where data are sparse. [ABSTRACT FROM AUTHOR]

Background: Mindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on extreme psychological trauma caused by the coronavirus disease 2019 (COVID-19) pandemic is largely unknown. The aim of this paper was to systematically review empirical studies of MBIs for HCPs carried out during the COVID-19 pandemic, to evaluate them and their effectiveness in different areas of mental health., Methods: The electronic databases searched were Web of Science, Scopus, PubMed, and PsycINFO. The date when each database was last searched was September 15, 2023. Randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and non-randomized non-controlled trials (NRNCTs) focused on MBIs for health care staff who were working in healthcare centers during the COVID-19 pandemic were included. All of them employed standardized measures of mental health. The review followed the best practices and reported using PRISMA guidelines. A data collection form, adapted from the Cochrane handbook for systematic reviews of interventions, was used to extract and synthesize the results. The methods used to assess the risk of bias in the included studies were the Cochrane Risk of Bias Tool and the ROBINS-I Tool., Results: Twenty-eight studies were included in the systematic review. Overall, the methodological quality of the studies was moderate. The results showed the effectiveness of MBIs in improving levels of stress, mindfulness, and mental well-being. However, no conclusive results were found regarding the effectiveness of MBIs in improving the levels of burnout, anxiety, depression, sleep quality, and resilience of HCPs., Conclusions: The MBIs for HCPs carried out during the COVID-19 pandemic have mainly contributed to improving stress, mindfulness, and mental well-being at a time of serious health emergency. However, more robust studies at a methodological level would have been desirable., Systematic Review Registration: PROSPERO CRD42021267621., (© 2024. The Author(s).)

Objective: The aim is to examine whether the addition of Virtual Reality (VR) meditation training to a standard 8-week Mindfulness-Based Health Care Program (MBHC-VR) results in a significantly increased improvement in occupational, mental health, and psychological functioning versus MBHC-only in university students., Materials and Methods: A randomized controlled clinical trial with three arms (MBHC, MBHC-VR, Control Group), four assessment time points (pre-intervention, inter-session, post-intervention, and 3-month follow-up), and mixed methodology will be proposed. University students (undergraduate, master, or doctoral) interested in participating and who meet the inclusion/exclusion criteria will be included over two years. Data will be collected from different ad hoc questionnaires, several standardized tests, and an Ecological Momentary Assessment. We will use R software to carry out descriptive analyses (univariate and bivariate), multilevel modeling, and structural equation models to respond to the proposed objective. The qualitative analysis will be carried out using the MAXQDA program and the technique of focus groups., Discussion: It is expected that with the proposed intervention university students will learn to relate in a healthier way with their mental processes, so as to improve their occupational balance (OB) and their psychological well-being., Trial Registration: ClinicalTrials.gov Identifier NCT05929430., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lillo-Navarro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aim: The objective of this study was to identify the key dimensions of transformational leadership that influence the promotion of engagement and structural empowerment in a population of nurses from different care settings., Method: A cross-sectional survey study asking about engagement, leadership style and structural empowerment was used. Descriptive and correlational statistics were applied followed by hierarchical regression. 131 nurses were recruited from a Spanish health organisation using random sampling., Results: Individualised consideration and intellectual stimulation were predictors of structural empowerment in a hierarchical regression of transformational leadership dimensions controlled by demographic variables (R 2 =0.467). In addition, intellectual stimulation was a predictor of engagement (R 2 =0.176)., Conclusion: The results are the starting point for the design of an organisationwide educational intervention to increase the engagement of nurses and staff development., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

An increasing number of drugs that consist of a therapeutic peptide or protein linked to an albumin-binding structure are being approved. In this perspective, the pharmacokinetic data of currently marketed drugs of this type will be presented. Acylation with fatty acids or fatty α,ω-dicarboxylic acids has been used successfully to prepare long-acting analogs of insulin, GLP-1, and other peptides but not of larger proteins. With a tetrazole-sulfonylamide fatty acid bioisostere, it has now been possible to prepare a long-acting analog of human growth hormone (191 amino acids), which is suitable for once-weekly administration.

Physical activity and exercise are relevant behaviors for fibromyalgia health outcomes; however, patients have difficulties undertaking and maintaining an active lifestyle. With a cross-sectional design, this study explored the role of pain-related worrying and goal preferences in the walking persistence of women with fibromyalgia. The sample included 111 women who attended a tertiary health setting. We adapted the Six-Minute Walk Test where participants decided either to stop or continue walking in five voluntary 6 min bouts. Women who were categorized higher in pain-related worrying reported higher preference for pain avoidance goals ( t = -2.44, p = 0.02) and performed worse in the walking task (LongRank = 4.21; p = 0.04). Pain avoidance goal preference increased the likelihood of stopping after the first ( OR = 1.443), second ( OR = 1.493), and third ( OR = 1.540) 6 min walking bout, and the risk of ending the walking activity during the 30 min task ( HR = 1.02, [1.0-1.03]). Influence of pain-related worrying on total walking distance was mediated by goal preferences ( ab = -3.25). In interventions targeting adherence in physical activity and exercise, special attention is needed for women who are particularly worried about pain to help decrease their preference for short-term pain avoidance goals relative to long-term goals such as being active through walking.

(1) Background: Partner violence prevention programmes do not produce the expected behavioural changes. Accordingly, experts suggest applying evidence-based behavioural models to identify the determinants of abusive behaviours. In this research, we applied the reasoned action approach (RAA) to predict the performance (boys) and acceptance (girls) of abusive behaviours in adolescents. (2) Method: We designed a questionnaire based on the RAA and performed a cross-sectional study. We analysed the predictive capacity of the RAA constructs on intentions with the sample of single adolescents ( n = 1112). We replicated the analysis only with those who were in a relationship ( n = 587) and in addition analysed the predictive capacity of intention on future behaviour (3 months later). (3) Results: The hierarchical regression analysis performed with the sample of single adolescents showed that the model explained 56% and 47% of the variance of boys' intentions to perform the controlling and devaluing behaviours, respectively; and 62% and 33% of girls' intention to accept them. With those in a relationship, the model explained 60% and 53% of the variance of boys' intentions to perform the controlling and devaluating behaviour, respectively, and 70% and 38% of girls' intention to accept them. Intention exerted direct effects on boys' performance of controlling and devaluing behaviours (31% and 34% of explained variance, respectively) and on girls' acceptance (30% and 7%, respectively). (4) Conclusions: The RAA seems useful to identify the motivational determinants of abusive behaviours, regardless of adolescents´ relationship status, and for their prediction. Perceived social norms emerge as a relevant predictor on which to intervene to produce behavioural changes with both sexes.

Objectives: Avoidance, persistence, and pacing are activity patterns that have different adaptive effects in chronic pain patients. Some inconsistent findings have been explained from a contextual perspective that underlines the purpose of the activity. In this way, avoidance, persistence, and pacing are multidimensional constructs, nuanced by their goals. This multidimensionality has been supported with a new instrument, the Activity Patterns Scale, in heterogeneous chronic pain samples. Owing to the clinical implications of this conceptualization, the complexity of the activity patterns and their relationships with health outcomes in fibromyalgia (FM), our aim was to explore the construct validity of this scale in this pain problem, testing its internal structure and the relationships with other constructs., Materials and Methods: The sample included 702 women with diagnosis of FM from tertiary (53.3%) and community settings (46.7%). Confirmatory factor analysis was conducted to test different factor structures of the activity patterns and Pearson correlation to explore the relationships with health outcomes and psychosocial variables., Results: A 6-factor structure showed acceptable fit indices (standardized root mean square residual=0.062; root mean-square error of approximation=0.066; comparative fit index=0.908). The highest significant relationships for health outcomes was between activity avoidance and FM impact (r=0.36) and excessive persistence and negative affect (r=0.41)., Discussion: Avoidance and persistence activity patterns are shown as multidimensional constructs but not pacing. The ongoing pain in these women may make it difficult to regulate their activity taking into account other goals not contingent on pain fluctuations., Competing Interests: This work was supported by Ministerio de Economía y Competitividad (grant reference PSI2016-79566-C2-1-R) and by Fondo de Investigación en Salud from the Instituto de Salud Carlos III cofinanced by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER) (grant reference PI17/00858), Spain. The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Being physically active has positive effects on fibromyalgia functioning. However, promoting an active lifestyle in these patients continues to be a relevant clinical challenge. Our aim was to test a motivational model to explain light (LPA) and moderate-vigorous physical activity (MVPA). A cross-sectional prospective study was conducted at a tertiary level of care. Participants completed sociodemographic, clinical, motivational (physical activity self-efficacy and goal preferences) and behavioral measures (activity avoidance). LPA and MVPA were measured with triaxial accelerometers, starting the same day of the aforementioned assessment. Out of 211 women, 183 completed this measure. Structural models were performed. Our results show that the best fit indices (CFI = 0.97, SRMR = 0.04) showed a model with direct influence of PA self-efficacy on MVPA ( p < 0.01) and indirect influence on LPA ( p < 0.001). LPA received the influence of PA self-efficacy mainly through activity avoidance ( p < 0.01). Clinical variables did not have any effect on PA intensities. Thus, the motivational variables showed different paths to explain two PA intensities. Targeting PA self-efficacy in rehabilitation settings is needed to enhance both daily LPA and MVPA intensities.

The objective of this study is to test the efficacy of a group motivational plus implementation intentions intervention in promoting adherence to an unsupervised walking program recommended for fibromyalgia, compared to an implementation intentions condition and to an active control condition. A triple-blind, randomized, longitudinal study with measures at baseline, short (seven weeks post-intervention), mid (12 weeks) and long-term (36 weeks) is performed. Data are analyzed using multilevel longitudinal growth curve two-level modelling. Participants are 157 women with fibromyalgia. In the short-term, adherence to the minimum and to the standard walking program (primary outcome measures) is explained by time (both p <.001), motivational plus implementation intentions intervention (both p <.001) and by their interaction (both p <.001). Regarding the secondary outcomes, only physical function is explained by time ( p <.001), motivational plus implementation intentions intervention ( p <.05) and by their interaction ( p <.05). Motivational plus implementation intentions intervention achieve the promotion of walking as an exercise in the short-term; furthermore, physical function of the women in this condition is better than in the other two intervention groups, which is a relevant outcome from a rehabilitation point of view. However, more studies are needed to maintain the exercise at mid and long-term.

Mild and selective nickel-catalyzed trifluoromethylation and perfluoroalkylation reactions of alkenes were developed to provide fluorinated olefins, including natural products, pharmaceuticals, and variety of synthetic building blocks in good to excellent yields (38 examples). Control experiments, kinetic measurements and in situ EPR studies reveal the importance of radical species and the formation of 1,2-adducts as intermediates.

Background: During their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses., Objectives: To identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses., Design: This study uses descriptive, correlational, two-level design with repeated measures., Settings: Wards of two University hospitals., Participants: A random cohort of 113 nurses was studied., Methods: An ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships., Results: Different momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task., Conclusions: The choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping., Competing Interests: The authors have declared that no competing interests exist.

Nurses experience significant stress and emotional exhaustion, leading to burnout and fatigue. This study assessed how the nurses' mood and fatigue evolves during their shifts, and the temporal factors that influence these phenomena. Performing a two-level design with repeated measures with moments nested into a person level, a random sample of 96 nurses was recruited. The ecological momentary assessment of demand, control, effort, reward, coping, and nursing tasks were measured in order to predict mood and fatigue, studying their current, lagged, and accumulated effects. The results show that: (1) Mood appeared to be explained by effort, by the negative lagged effect of reward, and by the accumulated effort, each following a quadratic trend, and it was influenced by previously executing a direct care task. By contrast, fatigue was explained by the current and lagged effect of effort, by the lagged effect of reward, and by the accumulated effort, again following quadratic trends. (2) Mood was also explained by problem-focused and emotion-focused coping strategies, indicative of negative mood, and by support-seeking and refusal coping strategies. (3) Fatigue was also associated with direct care and the prior effect of documentation and communication tasks. We can conclude that mood and fatigue do not depend on a single factor, such as workload, but rather on the evolution and distribution of the nursing tasks, as well as on the stress during a shift and how it is handled. The evening and night shifts seem to provoke more fatigue than the other work shifts when approaching the last third of the shift. These data show the need to plan the tasks within a shift to avoid unfinished or delayed care during the shift, and to minimize accumulated negative effects.

Competing Interests: Competing interests: None declared.

Some motivational models understand health behavior as a result of the interaction between goal preferences and mood. However, this perspective has not been explored in fibromyalgia. Furthermore, in chronic pain, it has only been explored with regard to negative affect. Thus, our aims were: (1) to develop a Spanish version of the Goal Pursuit Questionnaire (GPQ); (2) to explore the relationships between goal preferences and health outcomes, testing the moderator role of affect and the mediating role of chronic pain activity patterns. We conducted two cross-sectional studies. In Study 1, after a double translation/back-translation process, we interviewed 94 women attending the Fibromyalgia Unit of the Community of Valencia in order to identify the cultural feasibility and the content validity of the GPQ. Study 2 comprised 260 women. We explored the GPQ structure and performed path analyses to test conditional mediation relationships. Eight activities from the original GPQ were changed while maintaining the conceptual equivalence. Exploratory factor analysis showed two factors: 'Pain-avoidance goal' and 'Mood-management goal' (37 and 13% of explained variance, respectively). These factors refer to patients' preference for hedonic goals (pain avoidance or mood-management) over achievement goals. Robust RMSEA fit index of the final models ranged from 0.039 for pain to 0.000 for disability and fibromyalgia impact. Pain avoidance goals and negative affect influenced pain mediated by task-contingent persistence. They also affected disability mediated by task and excessive persistence. Pain avoidance goals and positive affect influenced fibromyalgia impact mediated by activity avoidance. We also found a direct effect of negative and positive affect on health outcomes. Preference for pain avoidance goals was always related to pain, disability and fibromyalgia impact through activity patterns. Affect did not moderate these relationships and showed direct and indirect paths on health outcomes, mainly by increasing persistence and showing positive affect as an asset and not a risk factor. Intervention targets should include flexible reinforcement of achievement goals relative to pain avoidance goals and positive affect in order to promote task-persistence adaptive activity patterns and decreased activity avoidance.

Background: The previous psychosocial evaluation of the potential living kidney donors (PLKD) requires a detailed understanding of the psychosocial benefits and the possible damages of the act of donation., Objective: The aim was to create clusters by using the clinical patterns of personality and to evaluate their influence on psychopathological variables., Methods: Observational, analytical and cross-sectional study that included the PLKD from February 2009 to March 2017. The patients were referred to the Hospital Psychology Unit by the Transplant Coordination Unit. The total sample was composed of 100 participants. The socio-demographic characteristics, the relationship with the recipient and the Millon Clinical Multiaxial Inventory were included., Results: The final sample was composed by 100 PLKD. The mean age of the participants was 45.70, and most were women (70%). The analysis showed a final result of 3 personality clusters that best represented the data, in agreement with the DSM-5 classification. The PLKD from cluster 3 obtained greater scores in all the clinical syndromes., Conclusions: The personality evaluation of the PLKD could help with the planning of monitoring protocols of the participants who were classified to cluster 3, in order to improve their post-transplant psychosocial adjustment. This result makes us consider the usefulness of the psychosocial evaluation to preserve the psychological health of the PLKD., Competing Interests: The authors have declared that no competing interests exist.

Aim: To identify and analyse the 100 most cited papers on stress in nurses published in nursing journals., Background: The number of citations an article receives is an index of its impact on the scientific community. An analysis of the most cited articles on stress in nursing would allow us to identify the most important articles and to obtain information about this area of knowledge., Design: A retrospective bibliometric analysis., Data Sources: In 2016, 111 journals belonging to the "nursing" category were identified in the Science and Social Science Citation Index. A search was performed of the Science Core Collection Website for articles on stress published in these journals., Review Methods: The topic, type of article, publishing journal, countries and institutions of origin and year of publication were extracted from the articles. The impact factor, immediacy index, journal country and publisher and h index were collected from the Institute for Scientific Information. The citation density, citation tendency and Bradford's law were calculated., Results: They identified articles were mostly empirical quantitative studies with a transversal design, published from 1975 - 2011 in 23 journals. They were signed by 233 authors, most of whom are English-speaking from the USA and UK. The core distribution of the publications comprises a single journal, the Journal of Advanced Nursing., Conclusion: The study of stress in nursing has shown increased visibility and recognition each decade. The most recent articles have the highest number of citations, are the highest in rank and have the higher citation densities., (© 2018 John Wiley & Sons Ltd.)

Competing Interests: Competing interests: None declared.

Background: Work-related stress is a prevalent condition in the nursing profession, and its influence may vary according to changeable individual and situational factors. It is, therefore, important to investigate the real-time momentary changes in these factors and their relationship to emotional exhaustion experienced by nurses., Objectives: We aim to analyse how their perceptions of demand, control, effort and reward change according to the task performed through real-time assessment and interact with the emotional exhaustion level of ward nurses., Design: The research design was longitudinal., Method: A three-level hierarchical model with a repeated measures design was used to assess the momentary self-reports of 96 hospital ward nurses, completed using a smartphone programmed with random alarms., Results: Findings show that demand, effort, and control appraisals depend on the task performed. The task appraised as most demanding, effortful, and controllable was direct care. Reward appraisal depends on the task performed and personal variables, i.e. emotional exhaustion. The situations perceived as more rewarding were rest and direct care. Momentary hedonic tone can be explained by the task performed, demand, reward, emotional exhaustion and by the interaction between emotional exhaustion and demand appraisal. Momentary fatigue can be explained by the task performed, demand, reward, and the emotional exhaustion., Conclusions: This study highlights the importance of using momentary measures to understand complex and changeable inter-relationships. While also clarifying the targets of intervention programmes aimed at preventing burnout within the nursing profession., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

How does the experience of flow among nurses influences their health? This question is addressed on the basis of a model of flow, stress, burnout, and coping. The results indicate that promoting flow can be a way to enhance the health of ward nurses in a hospital work context.

Objective: To identify common issues of nurses with high engagement to enable us to develop the construct as it applies to nursing in more depth., Method: Based on the constructivist paradigm and with a phenomenological approach, a qualitative content analysis was conducted using an inductive approach. Participants were nurses working in direct care in different healthcare areas. The sample size was determined by data saturation and 15 participants were interviewed., Results: The units of meaning were grouped into 11 subcategories, and then into 7 categories termed vigour, dedication, reward, autonomy, social support, conciliation and attributes of nurses. Then these categories were grouped into 3 major themes: job characteristics, characteristics of organizations, and individual characteristics., Conclusions: Having high engagement does not mean ignoring the negative aspects of work and organizations. Nurses who maintain high engagement are also affected by the negative aspects, however the assessment of positive aspects such as enjoying the work, the meaning of being a nurse, reward and autonomy enable the process of depletion of engagement to be overcome. In view of the findings, we propose reconceptualising the construct, taking the features of nursing into account., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)