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Abstract Question In people who have undergone surgical carpal tunnel release, do sensorimotor-based exercises performed on the touchscreen of a tablet device improve outcomes more than a conventional home exercise program prescribed on paper? Design Randomised, parallel-group trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants Fifty participants within 10 days of surgical carpal tunnel release. Intervention Each participant was prescribed a 4-week home exercise program. Participants in the experimental group received the ReHand tablet application, which administered and monitored exercises via the touchscreen. The control group was prescribed a home exercise program on paper, as is usual practice in the public hospital system. Outcome measures The primary outcome was functional ability of the hand, reported using the shortened form of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Secondary outcomes were grip strength, pain intensity measured on a 10-cm visual analogue scale, and dexterity measured with the Nine-Hole Peg Test. Outcomes were measured by a blinded assessor at baseline and at the end of the 4-week intervention period. Results At Week 4, functional ability improved significantly more in the experimental group than the control group (MD –21, 95% CI –33 to –9) on the QuickDASH score (0 to 100). Although the mean estimates of effect on the secondary outcome also all favoured the experimental group, none reached statistical significance: grip strength (MD 5.6 kg, 95% CI –0.5 to 11.7), pain (MD –1.4 cm, 95% CI –2.9 to 0.1), and dexterity (MD –1.3 seconds, 95% CI –3.7 to 1.1). Conclusion Use of the ReHand tablet application for early rehabilitation after carpal tunnel release is more effective in the recovery of functional ability than a conventional home exercise program. It remains unclear whether there are any benefits in grip strength, pain or dexterity. Trial registration ACTRN12618001887268. [ABSTRACT FROM AUTHOR]

Objectives: To explore the rate of NUPs and associated factors in the PED of the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain) using Andersen's Behavioural Model. Methods: We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain). Results: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions: The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice: Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method: This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This paper aims to examine the satisfaction and depressed mood experienced by nursing home workers during the COVID‐19 pandemic and associated variables. Specifically, to analyse the factors that may contribute to nursing home workers developing adaptive behaviours that promote satisfaction or, on the contrary, show characteristics associated with a negative mood. Background: Nursing homes have faced unprecedented pressures to provide appropriately skills to meet the demands of the coronavirus outbreak. Design: A cross‐sectional survey design using the STROBE checklist. Methods: Professionals working in nursing homes (n = 165) completed an online survey measuring sociodemographic and professional characteristics, burnout, resilience, experiential avoidance, satisfaction with life and depression. Data were collected online from April to July 2021, the time in which Spain was experiencing its fifth wave of COVID‐19. Two multiple linear regression models were performed to identify salient variables associated with depressive mood and satisfaction. Results: Resilience, personal accomplishment and satisfaction had a significant and negative relationship with depression and emotional exhaustion, depersonalisation and experiential avoidance had a positive relationship with depression. However, emotional exhaustion, depersonalisation and experiential avoidance had a negative and significant relationship with satisfaction and personal accomplishment, and resilience had a positive and significant relationship with satisfaction. In addition, it was found that accepting thoughts and emotions when they occur is beneficial for developing positive outcomes such as satisfaction. Conclusions: Experiential avoidance was an important predictor of the effects that the COVID‐19 pandemic can have on nursing home workers. Relevance to Clinical Practice: Interventions focusing on resources that represent personal strengths, such as acceptance, resilience and personal accomplishment, should be developed. No Patient or Public Contribution: The complex and unpredictable circumstances of COVID's strict confinement in the nursing home prohibited access to the centres for external personnel and family members. Contact with the professionals involved could not be made in person but exclusively through online systems. However, professionals related to the work environment have subsequently valued this research positively as it analyses 'How they felt during this complicated process'. [ABSTRACT FROM AUTHOR]

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

Objective: To examine the moderating role of alcohol-related risk perception and perceived vulnerability to alcohol consequences in the relationship between descriptive drinking norms and personal alcohol use, and to determine if this moderation was, in turn, moderated by gender Methods: 538 college students (78.0% women, mean age = 21.2) from three Spanish universities completed a paper-and-pencil questionnaire. Simple moderation and moderated moderation analyses were conducted Results: Risk perception and perceived vulnerability moderated the relationship between drinking norms and alcohol use. This relationship weakened as perceived vulnerability and risk perception increased. High levels of risk perception and perceived vulnerability nullified the effect of perceived peer drinking on drinking quantity among both men and women, but higher values were necessary to nullify these effects among men Conclusions: Risk perception and perceived vulnerability appear to be useful in identifying specific subgroups more vulnerable to the effects of drinking norms and might be effective strategies for weakening its impact on alcohol use, with such strategies being more beneficial for women than men. These variables could thus be incorporated into norm-based interventions as they may improve their effectiveness. Our findings highlight the importance of designing gender-specific interventions to reduce the potential negative impact of alcohol consumption. [ABSTRACT FROM AUTHOR]

Nurses' lifestyle habits play a key role in promoting healthy lifestyles; although, they may not always be entirely healthy and can be influenced by working conditions. This paper aims to analyze the influence of doing shift work on nurses' lifestyle habits. Participants (n = 219) were recruited from 27 primary health care centres in Spain. Data were collected on socio-demographic characteristics, working conditions and lifestyle behaviour, assessed by use of an adhoc questionnaire including validated measures. Descriptive analysis and logistic regression models were performed. A total of 95% of the nurses reported having an adequate diet; 45.2% did not engage in any type of physical activity; and 85.8% did not smoke, especially women. A total of 60.3% did shift work, especially the younger ones (80.8%; p < 0.001), these nurses being the ones with the worst food habits (81.8%). In contrast, nurses who did shift work, exercised more days a week (69.5%; p < 0.001). The dietary habits of the nurses were adequate. Low tobacco consumption and low adherence to physical activity were observed, especially among women. Shift work harmed eating habits and obesity rates, but was a protective factor in terms of adherence to physical exercise. [ABSTRACT FROM AUTHOR]

Background Multimorbidity is influenced in an interconnected way, both in extent and nature, by the social determinants of health. We aimed at implementing an intersectional approach to analyse the association of multimorbidity with five important axes of social inequality (i.e. gender, age, ethnicity, residence area and socioeconomic class). Methods We conducted a cross-sectional observational study of all individuals who presented with at least one chronic disease in 2019 (n=1086948) from the EpiChron Cohort (Aragon, Spain). Applying intersectional analysis, the age-adjusted likelihood of multimorbidity was investigated across 36 intersectional strata defined by gender, ethnicity, residence area and socioeconomic class. We calculated odds ratios (OR) 95% confidence interval (CI) using high-income urban non-migrant men as the reference category. The area under the receiver operator characteristics curve (AUC) was calculated to evaluate the discriminatory accuracy of multimorbidity. Results The prevalence of multimorbidity increased with age, female gender and low income. Young and middle-aged low-income individuals showed rates of multimorbidity equivalent to those of high-income people aged about 20 years older. The intersectional analysis showed that low-income migrant women living in urban areas for >15 years were particularly disadvantaged in terms of multimorbidity risk OR=3.16 (95% CI=2.79-3.57). Being a migrant was a protective factor for multimorbidity, and newly arrived migrants had lower multimorbidity rates than those with >15 years of stay in Aragon, and even non-migrants. Living in rural vs. urban areas was slightly protective against multimorbidity. All models had a large discriminatory accuracy (AUC=0.7884-0.7895); the largest AUC was obtained for the model including all intersectional strata. Conclusions Our intersectional approach uncovered the large differences in the prevalence of multimorbidity that arise due to the synergies between the different socioeconomic and demographic exposures, beyond their expected additive effects. [ABSTRACT FROM AUTHOR]

Background: This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2–14. Methods: Parents or guardians reported the weight and height of participants, used to calculate body mass index (BMI) and BMI z-scores according to the International Obesity Task Force standards. Participants were categorized into "overweight/obesity" and "no overweight/obesity" and further into "obesity" and "no obesity". The rate of poverty rate was determined using data from the National Statistics Institute of Spain, defining it as the percentage of people with income below 60% of the national median. SES was based on the head of household's occupation and categorized into low, medium, and high levels. Results: Adjusted multilevel models showed participants with medium or high SES had lower odds of overweight/obesity compared to those with low SES (medium SES: odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.54–0.73; high SES: OR: 0.59, 95% CI: 0.49–0.70). Participants in the high-poverty group had higher odds of having overweight/obesity (OR: 1.40, 95% CI: 1.13–1.74) compared to the low-poverty group. Conclusions: The study highlights significant socioeconomic disparities in childhood overweight/obesity, emphasizing the potential impact of SES and poverty on health outcomes in Spanish children and adolescents. [ABSTRACT FROM AUTHOR]

Background: One of the main drawbacks of tunneled central venous catheters (CVCs) is catheter-related bloodstream infections (CRBSIs). Antibiotic lock therapy (ALT) can be combined with systemic antibiotics to achieve catheter salvage. Our objectives are to describe cases of CRBSI and our experience with ALT in a pediatric oncology–hematology ward. Methods: a retrospective descriptive study of pediatric CRBSI cases in a Spanish oncology–hematology unit from 2007 to 2017 was conducted. We collected demographic, clinical, and microbiological data from all patients. Results: fifty-eight CRBSIs were diagnosed in thirty-nine patients; 72.9% of these patients were male, with a median age of 42.1 months. The main underlying diseases were leukemia/lymphoma (51.7%) and solid tumors (32.7%). Thirty-five (60.3%) CRBSIs were caused by Gram-positive cocci, of which 70.6% were coagulase-negative Staphylococci, and sixteen (27.6%) were caused by Gram-negative bacilli. We treated 41/58 (71%) cases with ALT. A total of 12/17 (71%) CVCs that were not treated with adjunctive ALT were removed, compared with 13/41 (32%) that were treated with ALT (relative risk (RR), 0.449; confidence interval (CI), 95%: 0.259–0.778, p = 0.004). Major reasons to remove the CVC in the CRBSI-ALT group were local insertion/pocket site infection (23%), persistent symptoms (23%), and infectious' relapses (15%). Conclusions: ALT was shown to be an effective approach to keeping the CVC in place, with no added adverse effects. [ABSTRACT FROM AUTHOR]

Suicidal behavior has become an important public health problem, correlating with stress and emotional deficits in recent research. This study examined the relationship between perceived stress and suicidal behavior risk, testing the mediating roles of cognitive emotion regulation and impulsivity, and the moderating role of problematic alcohol use in stress-suicidal behavior association in a sample of 121 Spanish adolescents surveyed online. Results showed positive and significant associations between perceived stress and suicidal behavior risk, as well a mediation role of adaptive cognitive emotion regulation strategies and a moderation role of problematic alcohol use between perceived stress and suicidal behavior risk, supporting stress as an influential factor in suicidal behavior. Our findings emphasize adaptive emotional regulation strategies in stressful situations, as well as the importance of promoting responsible alcohol consumption to decrease suicide risk in adolescents. Additionally, they contribute to effective educational suicide prevention programs for young people. [ABSTRACT FROM AUTHOR]

Background:The primary purpose of this paper is to examine youth addiction and other justifications for adolescent smoking, and how they affect the level of consumption.Methods:Data from the Spanish ‘State Survey on Drug Use among High School Students’ aged between 14 and 18 years old were used in this paper. To account for the nature of the cigarette consumption data, several count data models were estimated in order to select the one that best fits adolescent smoking consumption.Results:Most adolescent smokers smoke because it relaxes them, and about a quarter of them recognize that they are addicted. Moreover, the latter group smoke 44% more cigarettes than the rest (IRR = 1.444), revealing the strong addictive nature of tobacco, even at early ages. Moreover, parents’ smoking increases the probability of smoking and has an impact on the level of consumption.Conclusions:The implications of these findings offer insight for parents, researchers, educators, and cessation interventionists, as awareness of self-reported and other predictors held by smoking youth creates a vantage point to facilitate changes in smoking behavior. [ABSTRACT FROM PUBLISHER]

This paper reports new evidence on students’ evaluation of a first-year induction experience programme and examines the relationship between gender and perceptions. The programme was provided to 610 business studies students at the University of Granada (Spain). The programme includes individual and group sessions providing psychosocial and instrumental support. Gender differences were investigated using nonparametric techniques. Structural equation models were used to test relationships between variables of overall satisfaction with the programme and its activities and the moderating effects of gender. The results obtained show that gender significantly influences enrolment and satisfaction with the programme and with the individual sessions. Satisfaction with group and individual activities is directly related to overall satisfaction with the programme. Gender has a moderating effect on the relation of overall satisfaction with individual sessions. [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]

(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]

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]

Introduction: Teledermatology is the practice of dermatology through communication technologies. The aim of this study is to analyze its implementation in a Spanish health area during its first two years. Methods: Cross-sectional descriptive study. It included interconsultations between dermatologists and family physicians in the Salamanca Health Area (Spain) after the implementation of the non-face-to-face modality over a period of two consecutive years. A total of 25,424 consultations were performed (20,912 face-to-face and 4,512 non-face-to-face); 1000 were selected by random sampling, half of each modality. Main measures: referral rate, response time and resolution time, type of pathology, diagnostic concordance, and quality of consultation. Results: The annual referral rate was 42.9/1000 inhabitants (35.3 face-to-face and 7.6 non-face- to-face). The rate of face-to-face referrals was higher in urban areas (37.1) and the rate of non- face-to-face referrals in rural areas (10.4). The response time for non-face-to-face consultations was 2.4 ± 12.7 days and 56 ± 34.8 days for face-to-face consultations (p < 0.001). The resolution rate for non-face-to-face consultations was 44%. Diagnostic concordance, assessed by the kappa index, was 0.527 for face-to-face consultations and 0.564 for non-face-to-face consultations. Greater compliance with the quality criteria in the non-attendance consultations. Conclusions: Teledermatology appears to be an efficient tool in the resolution of dermatological problems, with a rapid, effective, and higher quality response for attention to skin pathologies. Registry: ClinicalTrials.gov Identifier: NCT05625295. Registered on 21 November 2022 (https://clinicaltrials.gov/ct2/show/ NCT05625295). [ABSTRACT FROM AUTHOR]

Aim: The study explores the experiences of women with low‐risk pregnancies and no complications who planned a home birth. Design: A cross‐sectional study was conducted using an online questionnaire. Methods: The questionnaire included socio‐demographic, obstetric and perinatal variables. Birth satisfaction was evaluated via the Spanish version of the childbirth experience questionnaire. The study group comprised home‐birthing women in Catalonia, Spain. Data were collected from 1 January 2019 to 31 December 2021. Statistical analysis was performed using SPSS. Results: A total of 236 women responded. They reported generally positive experiences, with professional support and involvement being the most highly rated dimensions. Better childbirth experiences were associated with labour lasting less than 12 h, no perineal injuries, no intrapartum transfers to hospital, euthocic delivery and the presence of a midwife. Conclusions: Women's positive home birth experiences were linked to active participation and midwife support. Multiparous women felt safer. Medical interventions, especially transfers to hospitals, reduced satisfaction, highlighting the need for improved care during home births. Implications for the Profession and Patient Care: Home births should be included among the birthplace options offered by public health services, given the extremely positive feedback reported by women who gave birth at home. Impact: Home birth is not an option offered under Catalonia's public health system only as a private service. The experience of home‐birthing women is unknown. This study shows a very positive birth experience due to greater participation and midwife support. The results help stakeholders assess home birth's public health inclusion and understand valued factors, supporting home‐birthing women. Reporting Method: The study followed the STROBE checklist guidelines for cross‐sectional studies. Public Contribution: Women who planned a home birth participated in the pilot test to validate the instrument, and their contributions were collected by the lead researcher. The questionnaire gathered the participants' email addresses, and a commitment was made to disseminate the study's results through this means. [ABSTRACT FROM AUTHOR]

Background: Women report a heightened concern of (breast) cancer, relative to other chronic conditions. This experimental study investigated whether such heightened concern may be a function of availability bias. Methods: participants (N = 750; 100% female) were randomly assigned to one of two experimental conditions: in the recall condition, they were asked to name the health condition they feared most; in the recognition condition, they picked the disease they feared most out of a list of chronic conditions. Results: The probability of selecting cancer as the most frightening disease varied as a function of experimental condition χ2 (10) = 112.13, p < 0.001. Participants in the recall condition were almost twice as likely to select cancer as the most frightening disease (N = 240, 59.10%) as those in the recognition condition (N = 121, 35.20%), who most frequently selected neurological diseases as the most threatening. The majority of participants believed that cancer was the disease receiving the most media attention (86.27%) (prior to the COVID-19 pandemic), and the one accounting for the highest number of deaths among Spanish females (63.50%). Conclusions: altogether, these results provide experimental evidence that availability bias may partly account for misperceptions and a heightened fear of cancer, which may narrow the scope of women's information-seeking and health-preventive behaviors. [ABSTRACT FROM AUTHOR]

The use of electronic cigarettes (ECs) is a major problem globally. Susceptibility and curiosity are important factors that develop prior to the onset of substance use, such as ECs, and are therefore considered as predictors. Both factors are used to obtain an extended index of susceptibility (ESIe-c), which allows the identification of adolescents who are at risk of starting to use these devices. The aim of this study was to determine the prevalence of EC consumption and to assess the association of possible predictors with susceptibility to use and experimentation with ECs among adolescents. A cross-sectional study was carried out in 377 adolescents (53.0% female). Participants were compared according to their experimentation with ECs. A total of 45.9% had already used electronic cigarettes, and 20.8% were current users. Among those who had not tried electronic cigarettes, 43.3% had a medium-high susceptibility to EC initiation. Consumption among close friends, receiving offers of consumption and alcohol consumption were associated with initiation. There was an inverse association between a medium susceptibility index electronic cigarette score and the consumption of cigarettes and positive affect; on the other hand, the lack of premeditation was associated with a higher susceptibility index score. Intrapersonal factors and social factors seem to influence the ESIe-c and onset of EC use, respectively. The main conclusion in this study is that susceptibility is influenced by intrapersonal factors such as affectivity and impulsivity through the lack of premeditation, and by social factors such as EC consumption by best friends. [ABSTRACT FROM AUTHOR]

Background: The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission. Aim: To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days). Research Design and Setting: A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR. Results: A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital‐acquired pressure ulcers. Conclusions: Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital‐acquired ulcers at hospital discharge. Relevance to Clinical Practice: Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation. No Patient or Public Contribution: No direct patient contact was made during the data collection. [ABSTRACT FROM AUTHOR]

Fundamental movement skills (FMS), considered as building blocks of movement, have received growing interest due to their significant impact on both present and future health. FMS are categorized into locomotor, object control and stability skills. While there has been extensive research on assessing the proficiency and reliability of locomotor and object control skills, stability skills have received comparatively less attention. For this reason, this study aimed to assess the test–retest, intrarater and interrater reliability of five stability skills included in the Alfamov app. The performance of eighty-four healthy primary school children (60.8% girls), aged 6 to 12 years (mean ± standard deviation of 8.7 ± 1.8 years), in five stability skills was evaluated and scored by four raters, including two experts and two novices. The Alfamov tool, integrating various process-oriented tests, was used for the assessment. Reliability analyses were conducted through the computation of the intraclass correlation coefficient (ICC) along with the corresponding 95% confidence intervals. Good-to-excellent intrarater reliability, excellent interrater reliability and moderate-to-good reliability in the test–retest were achieved. The results proved that Alfamov is a robust test for evaluating stability skills and can be suitable for use by different professionals with less experience in assessing children's motor competence. [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]

A large body of literature shows the link between inadequate housing conditions and poor physical and mental health. The aim of this paper is to summarize the research on the impact of local housing policies on health inequalities, focusing on the issues of access to housing and fuel poverty as studied in the SOPHIE project. Our case studies in Spain showed that people facing housing insecurity, experienced intense levels of mental distress. We found that access to secure and adequate housing can improve the health of these populations, therefore, public policies that address housing instability and their consequences are urgently needed. Housing conditions related to fuel poverty are associated with poorer health and are unevenly distributed across Europe. We found possible positive effects of façade insulation interventions on cold-related mortality in women living in social housing; but not in men. Policies on housing energy efficiency can reduce the health consequences of fuel poverty, but need to be free to users, target the most vulnerable groups and be adaptable to their needs. [ABSTRACT FROM AUTHOR]

The Chronic Disease Self-Management Program (CDSMP) focuses on a health promotion perspective with a salutogenic approach, reinforcing the pillars of self-efficacy. The aim of this study was to assess the impact of the CDSMP on Self-perceived Health (SPH) in disadvantaged areas of Asturias, España. The study included vulnerable adults with experience of chronic diseases for over six months, along with their caregivers. The intervention consisted of a six-session workshop led by two trained peers. SPH was evaluated by administering the initial item of the SF-12 questionnaire at both baseline and six months post-intervention. To evaluate the variable "Change in SPH" [improvement; remained well; worsening/no improvement (reference category)], global and disaggregated by sex multivariate multinomial logistic regression models were applied. There were 332 participants (mean = 60.5 years; 33.6% were at risk of social vulnerability; 66.8% had low incomes). Among the participants, 22.9% reported an improvement in their SPH, without statistically significant sex-based differences, while 38.9% remained in good health. The global model showed age was linked to decreased "improvement" probability (RRRa = 0.96), and the "remaining well" likelihood drops with social risk (RRRa = 0.42). In men, the probability of "remaining well" decreased by having secondary/higher education (RRRa = 0.25) and increased by cohabitation (RRRa = 5.11). Women at social risk were less likely to report "remaining well" (RRRa = 0.36). In conclusion, six months after the intervention, 22.9% of the participants had improved SPH. Age consistently decreased the improvement in the different models. [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]

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]

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]

The aim of this study was to analyze the technical-tactical performance profile of the serve for various age groups and categories of competition in men's volleyball. The sample comprised 13,262 serves performed by 986 players in 299 sets observed in various categories of competition (U-14, U-16, U-19, national senior, and international senior). An observational design was used. The variables studied were category of competition, type of execution, and serve performance. The results showed that for higher age groups (senior categories), there were significantly fewer jump serves and poorer serve performance, regardless of players' maturity and training development. The use of the jump serves increased the serve risk while attempting to hinder the organization of the opponent attack. This paper discusses the serve evolution and the implications on the training process at the different age groups in men's volleyball. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND This study describes the perceived impact of H1N1 influenza and the adoption of the recommended measures to address the pandemic in schools. METHODS A cross-sectional self-reported survey was conducted in 433 schools in Barcelona addressed to the school principal or the H1N1 influenza designated person. A descriptive analysis was performed, stratifying by educational level and type of school. A logistic regression analysis also was conducted. RESULTS Around 70% of the respondents reported that there had been H1N1 influenza cases among students, being this percentage significantly higher among those schools offering primary education (74.4%) (p < .05). The main measures (single-use paper towels, availability of sanitizer solutions and 15 minutes ventilation per day of enclosed spaces) were implemented in most of the centers. However, the correct adoption of the main measures took place in around 30% of the schools, being the percentage lower in those offering only secondary education (Odds ratio [OR]: 0.518; 95% confidence interval [CI]:0.272-0.986) and those located in medium (OR: 0.438, 95% CI: 0.234-0.811) or low socioeconomic status (SES) districts (OR: 0.321, 95% CI: 0.159-0.649). CONCLUSIONS Despite the climate of social alarm, the perceived impact of H1N1 influenza in most schools was moderate. In future potential threats, the educational level and the SES of the school should be considered, especially when measures requiring purchasing any product are recommended but not provided. [ABSTRACT FROM AUTHOR]

Objective: This paper examines the transmission of smoking in-home across three generations in Spain. Methods: Multilevel logistic regression is used to assess the significance and magnitude of intergenerational transmissions of smoking in-home. We use the survey data “Encuesta Estatal Sobre Uso De Drogas en Estudiantes de Enseñanzas Secundarias (ESTUDES)” corresponding to year 2010. This survey with 32 234 students constitutes a representative survey of Spanish students between 14 and 18 years of age. Results: Estimates reported show a significant association of students’ smoking with mothers’ smoking (OR = 1.41; 95% CI = 1.31–1.51), fathers’ smoking (OR = 1.25; 95% CI = 1.16–1.35) and grandparents’ smoking (OR = 1.30; 95% CI = 1.07–1.57). Our results also suggest that, although mothers’ and parents’ smoking impacts sons’ and daughters’ smoking, grandparents’ smoking significantly increases grandsons’ smoking but does not influence granddaughters’ smoking. Conclusions: Parents and grandparents could reduce adolescents’ smoking by quitting smoking themselves, a decision that would have beneficial effects for parents, grandparents and, indirectly, for adolescents. [ABSTRACT FROM PUBLISHER]

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

The aim of this study was to assess the agreement between deaf children's and adolescents' self-ratings of health-related quality of life (HRQoL) and their parents' proxy reports. This observational cross-sectional study included 114 deaf 8- to 18-years-old students and proxy family members. HRQoL was measured using the KIDSCREEN-27 questionnaire, which was adapted to Spanish sign language for children, with a written version for parents. Respondents completed a selfadministered paper questionnaire. Parents' and children's mean scores differences were not significant, except for the “Autonomy and Parents” and “Peers and Social Support” dimensions. Children aged 8-11 years scored higher in some domains of QoL compared to those aged 12-18 years. The level of agreement between children/adolescents' and parents/ proxies' responses was acceptable, except for the dimension “Autonomy and Parents.” Overall, deaf children/adolescents' self-ratings of HRQoL did not differ from their parents' proxy reports; however, differences were found in the dimensions that explored the quality of the interaction of children/adolescents and parents, the perceived level of autonomy, and social relations and support. [ABSTRACT FROM AUTHOR]

This paper focusses on coping strategies employed by children and adolescents with diagnosed short stature, assesses the impact of socio-demographic and clinical characteristics on coping, examines the relationship between coping and health related quality of life (QoL) and investigates the role of coping strategies in mediating the relationship between height and QoL. Coping with a disease (CODI) and quality of life in short stature youth (QoLISSY-QoL) questionnaires were completed by 137 short-statured children and adolescents between 8 and 18 years, participating in the crosssectional European QoLISSY study. Clinical and socio-demographic data were collected to examine differences in coping via variance and regression analyses, associations between CODI and QoLISSY were inspected using correlation and mediation analyses. Most frequently employed coping strategies in the CODI were 'Acceptance' and 'Wishful Thinking', with 'Emotional Reaction' used least. Significant effects of age, diagnosis and treatment status on coping strategies were detected. CODI scales 'Acceptance' and 'Distance' were associated with higher QoLISSY-QoL scores, 'Emotional Reaction' and 'Wishful Thinking' with lower scores. Coping strategies predicted 60 % of the QoLISSY-QoL variance. Relationships between height deviation and QoLISSY-QoL were mediated by the coping strategies of 'Wishful Thinking' and 'Distance'. Findings suggest that coping efforts vary with socio-demographic and clinical characteristics, that protective coping strategies in terms of QoL can be identified and that coping mediates the relationship between short stature and QoL. Future longitudinal research should focus on the adaptive function of coping in relation to QoL over time. [ABSTRACT FROM AUTHOR]

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. An expansion of morbidity, as indicated by disease, has appeared in Europe and other developed regions. It is likely that better treatment, preventive measures, and increases in education levels have contributed to the declines in mortality and increments in life expectancy. This paper examines whether there has been an expansion of morbidity in Catalonia (Spain). It uses trends in mortality and morbidity and links these with survival to provide estimates of life expectancy with and without diseases and mobility limitations. We use a repeated cross-sectional health survey carried out in 1994 and 2011 for measures of morbidity, and information from the Spanish National Statistics Institute for mortality. Our findings show that at age 65 the percentage of life with disease increased from 52 to 70 % for men, and from 56 to 72 % for women; the expectation of life with mobility limitations increased from 24 to 30 % for men and from 40 to 47 % for women between 1994 and 2011. These changes were attributable to increases in the prevalence of diseases and moderate mobility limitation. Overall, we find an expansion of morbidity along the period. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population. Higher prevalence of health problems can lead to greater pressure on the health care system and a growing burden of disease for individuals. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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

Aim and Objectives: To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID‐19 among Spanish nurses by comparing two assessment points: before and after the COVID‐19 vaccination campaign. Background: The COVID‐19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID‐19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential. Design: A repeated cross‐sectional design was carried out with a time‐lapse of 12 months. Methods: A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID‐19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies. Results: The fear of COVID‐19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID‐19 and BO (r =.44, p ≤.001; r =.41, p ≤.001) and also between fear of COVID and CF (r =.57, p ≤.001; r =.50, p ≤.001). Negative correlations between fear and CS were also found (r = −.16, p =.001; r = −.22, p ≤.001). Relevance to Clinical Practice: Programmes to reduce fear of COVID‐19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care. Patient or Public Contribution: The nurses collaborated by participating in the present study anonymously and disinterestedly. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Coronavirus disease 2019 (COVID-19) was declared as a pandemic and public health emergency on 11 March 2020 by the World Health Organization. Different clinical trials on the efficacy of mRNA vaccination have excluded pregnant women, leading to a lack of empirical evidence on the efficacy of the vaccine in this population. The aim of the study was to examine the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at birth and adverse perinatal outcomes in infected and non-infected women from a university hospital in Spain. Methods: The data were obtained from electronic health records from 1 March 2020 to 28 February 2022. A bivariate descriptive analysis was performed, comparing women with and without confirmed SARS-CoV-2 infection during pregnancy using the chi-square test. A multivariate logistic regression was complementarily conducted to determine whether SARS-CoV-2 infection increases the risk of adverse obstetric and perinatal outcomes. Results: A total of 2676 women were divided into two groups: non-infected with SARS-CoV-2 (n = 2624) and infected with SARS-CoV-2 (n = 52). Infected women were primarily multiparous (p < 0.03) and had received an incomplete vaccination regimen (p < 0.001). A greater incidence of premature rupture of membranes (p < 0.04) was observed among the non-infected women. Pertaining to perinatal outcomes, there was a notable rise in NICU admissions (p < 0.014), coupled with an extended duration of stay (p < 0.04), for neonates born to infected mothers in comparison to their non-infected counterparts. Conclusion: Although SARS-CoV-2 infection may pose significant risks to pregnant women and their infants, adverse obstetrical/puerperal outcomes do not significantly differ between women infected and non-infected to SARS-CoV-2 in our study. NICU admissions were higher for neonates born to infected mothers. Additionally, coronavirus disease 2019 vaccination during pregnancy is not associated with severe adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Aims Obesity levels have increased worldwide with serious public health concerns. However, weight status is related to socioeconomic status (SES), which may also influence health-related lifestyles. Here, we study the association between SES and obesity mediated by diet and physical activity. Methods and results Using cross-sectional data from 2006, 2011, 2014, and 2017 Spanish health surveys (the final sample consisted of 61 768 adults aged between 18 and 64 years), we conducted a latent class analysis to estimate health-related lifestyle clusters (based on dietary patterns and physical activity) and mediation analyses to evaluate the association of SES and obesity through the clustering of health-related lifestyles. In both men and women, SES was inversely related to obesity (P<0.001) and positively related to healthier lifestyle classes (P< 0.001). Obesity was inversely related to healthier lifestyle classes (P<0.001). A small--although significant--proportion mediated by the clustering of lifestyles was found as follows: 4.9%, 95% CI (6.6%, 3.2%) in men and 2.3%, 95% CI (3.4%, 1.3%) in women for educational attainment, 5.3%, 95% CI (7.2%, 3.6%) in men and 2.0%, 95% CI (2.9%, 1.1%) in women for occupational social class, and 4.9%, 95% CI (6.5%, 3.1%) and 1.9%, 95% CI (2.9%, 1.1%) combining the above two SES indicators. Conclusions SES is related to obesity through clustering health-related lifestyles, with greater emphasis on men. However, the complex relationship between SES and weight status also suggests other indicators that contribute to the social gradient of obesity. [ABSTRACT FROM AUTHOR]

The objective of this longitudinal study carried out with the same participants, with two repeated measurements, the first taken in March 2020 (M1) and the second measurement in March 2021 (M2), is to investigate the impact of the COVID-19 pandemic throughout one year on the levels of Affect, Psychological Well-being, Depression and Mental and Physical Health, as well as to learn about the evolution of those levels from M1 to M2. Comparison of the mean scores of the variables analyzed between the two measurements (M1 and M2) show significant differences in the following scales: Positive Affect (PANAS), with lower scores at M2; Total Depression (BDI-II) and the two Cognitive-Affective and Somatic-Motivational factors, with higher scores at M2; the physical and mental health scales (SF-36) of Physical Functioning, Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health, and the two Physical and Mental Health components, with lower scores at M2 in all of them; and the Purpose in Life (PWB) scale, with a lower score at M2. We can conclude that the one-year pandemic situation has affected all the variables analyzed in this work, showing a decrease in positive affect, an increase in the score of the depression inventory, worse physical and mental health, and less psychological well-being. Throughout the pandemic year, the results show that age has a moderation effect on the Somatic-Motivational factor and on the Total Depression, Physical Functioning, Vitality, and Role Emotional scales. Gender shows no moderation effect on any of the four variables analyzed. [ABSTRACT FROM AUTHOR]

Simple Summary: Metastatic colorectal cancer is common and complicated to treat. The first choice of treatment is guided by the genetics of the patients (RAS mutation status) and the location of their primary tumor. However, real-world information on what treatments are actually being used and the survival benefits of these patient-guided treatments in Spain is lacking, so we aimed to determine this. We found that, in general, treatment choice was guided by primary tumor location and mutation status, with mutation status being the more influential characteristic. In addition, non-mutated RAS or left-sided tumors were predictive of longer survival times. We hope the results of this study may serve as a useful benchmark for future studies and assist practicing oncologists in selecting appropriate treatments for their patients. The retrospective, observational RWD-ACROSS study analyzed disease characteristics, systemic treatment, and survival in patients with metastatic colorectal cancer (mCRC) in Spain. In total, 2002 patients were enrolled (mean age 65.3 years; 62.7% male). Overall median overall survival (OS) was 26.72 months, and was longer in patients with left-sided tumors (28.85 vs. 21.04 months (right-sided tumors); p < 0.0001) and in patients receiving first-line anti-epidermal growth factor receptor (EGFR) treatment (31.21 vs. 26.75 (anti-vascular endothelial growth factor (VEGF) treatment) and 24.45 months (chemotherapy); p = 0.002). Overall median progression-free survival (PFS) was 10.72 months and was longer in patients with left-sided tumors (11.24 vs. 9.31 months (right-sided tumors); p < 0.0001), and in patients receiving either first-line anti-EGFR or anti-VEGF (12.13 and 12.00 vs. 8.98 months (chemotherapy); p < 0.001). PFS was longer with anti-VEGF treatment in patients with right-sided tumors and wild-type RAS (11.24 vs. 8.78 (anti-EGFR) and 7.83 months (chemotherapy); p = 0.025). Both anti-EGFR and anti-VEGF produced longer PFS in patients with left-sided tumors and wild-type RAS than chemotherapy alone (12.39 and 13.14 vs. 9.83 months; p = 0.011). In patients with left-sided tumors and mutant RAS, anti-VEGF produced a longer PFS than chemotherapy alone (12.36 vs. 9.34 months; p = 0.001). In Spain, wild-type RAS or left-sided mCRC tumors are predictive of longer survival times. [ABSTRACT FROM AUTHOR]

Aim: To describe transitions in smoking status and their determining factors among nursing students between baseline (2015–2016) and follow‐up (2018–2019). Design: Observational prospective longitudinal study of 4381 nursing students in Catalonia (Spain). Methods: We examined transitions in smoking status from: (i) current smokers to recent quitters, (ii) never smokers to new smokers and (iii) former smokers to quitters who relapsed. We fitted logistic regression models to assess the predictors of quitting smoking. Results: The proportion of current smokers decreased from 29.7% at baseline to 23.6% at follow‐up, with a cumulative incidence rate of quitting of 28.3% during follow‐up. Nondaily smokers were more likely to quit than daily smokers. Of those who were never smokers at baseline, 4.6% were smokers at follow‐up, and 23.2% of former smokers at baseline had relapsed at follow‐up. Conclusions: Nondaily smokers were more likely to have quit smoking at follow‐up among this cohort of nursing students. The early implementation of a comprehensive tobacco control program that includes tobacco‐free campus policies, tobacco prevention interventions and cessation support during college years may decrease tobacco use among nursing students. Impact: Nursing students' tobacco use is concerning, as they are the future workforce of nurses who have a key role in tobacco product use prevention and cessation. During college years, nursing students have a greater likelihood of experimenting with several smoking status changes as well as to consolidate smoking behaviors. This is the first longitudinal study to highlight the factors associated with quitting smoking among a cohort of Spanish nursing students. Being a nondaily smoker at baseline predicted quitting at follow‐up. Our findings support the early implementation of a comprehensive tobacco control program that includes tobacco‐free campus policies, tobacco prevention interventions and tobacco cessation support during college years to decrease tobacco product use prevalence among nursing students. Reporting Method: We have adhered to STROBE guidelines. No Patient or Public Contribution. This observational study has not been registered. [ABSTRACT FROM AUTHOR]

A randomized pilot study was conducted involving 69 third-year nursing students (ClinicalTrials.gov ID: NCT05270252). Students were randomly assigned to the CG (n = 34) or the intervention group (n = 35), using computer-generated randomization. The CG completed the third-year nursing, and the intervention group received in addition the Learning & Care educational intervention. The aim of this study was to determine the effectiveness, feasibility, and acceptability of the Learning & Care for students to acquire the knowledge, skills, and attitudes necessary to care for survivors and their families. The intervention group significantly improved in knowledge (p =.004; −1.15, 95% confidence interval [CI] [−1.94, −0.37]), skills (p ≤.0001; −13.51, 95% CI [−15.19, −11.83]), and attitudes (p =.006; −5.61, 95% CI [−8.81, −2.42]). The students' satisfaction was found to be high (93.75%). Offering a family nursing approach improves students' competence to care for long-term cancer survivors and their families. [ABSTRACT FROM AUTHOR]

Context: Knee injury prevention is a critical aspect in sport rehabilitation sciences, and taping is a widely used technique in this field. Nevertheless, the role and effectiveness of a long-term application of Kinesio Taping (KT) on knee function, disability, and injury prevention remain unclear. Objective: To determine the effect of KT, alone or in combination with balance exercises (BE), on dynamic and static knee balance and flexibility. Design: Randomized trial design. Setting: University of Valencia (Spain). Participants: Forty-eight male amateur soccer players. Intervention: Participants were assigned to 3 groups: Sham KT (sKT) + BE, KT + BE, and KT in isolation. The intervention period lasted 4 weeks. Three evaluations were performed: at baseline (pre), at 2 weeks (mid), and at 4 weeks posttreatment (post). Main outcome measures: Y Balance Test, unipedal stance test, the toe touch test, and the Knee Injury and Osteoarthritis Outcome Score. Results: Both sKT + BE and KT + BE groups achieved significant pre-post improvements in SEBT, unipedal stance test, and toe touch test. The KT group only showed significant intragroup differences in the left and right unipedal stance test variable (P < .05, d = 0.76, d = 0.62, respectively). The sham KT group obtained the strongest results in all physical variables. Regarding the Knee Injury and Osteoarthritis Outcome Score, pre-post significant changes were found in the sham group (P < .05, d = 0.28). Conclusions: Both sham and real KT in combination with BE achieved significant improvements on all physical variables, and these differences were significantly greater compared with those found in the KT in the isolation group, suggesting that benefits in knee function are due to the BE. Level of evidence: Therapy level 1b. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to assess the effect of the FreeStyle Libre device implantation in adult type 1 diabetics in a Health Area of Castilla La Mancha (Spain) during the COVID‐19 pandemic. Background: FreeStyle Libre is a so‐called mHealth device that supports health care. During COVID‐1 confinement, diabetic patients could have improved their glycaemic monitoring thanks to these devices, although health care in these patients may have been limited due to confinement. Methods: A 12‐month longitudinal study in which a total of 206 type I diabetics participated, belonging to a single health area. Sociodemographic and analytical data and the Self Care Inventory Revised questionnaire (SCI‐R) were collected. STROBE checklist was followed. Results: The analysis showed differences related to the use of the sensor. After the study period, patients obtained better levels of basal glucose, glycosylated haemoglobin, creatinine, cholesterol, triglycerides and LDL. In addition, a significant increase in the total score of the SCI‐R questionnaire was observed after the use of the monitor (MD −7.77; 95% CI −10.43, −8.29). The same occurred with different SCI‐R items such as diet (MD ‐2.995; 95% CI −3.24, −2.57), glucose determination (MD −3.21; 95% CI −3.52, −2.91), medication administration (MD −2.58; 95% CI −2.53, −1.96) and hypoglycaemic episodes (MD −1.07; 95% CI −1.21, −0.93). In the analysis by groups, worse values of glycosylated haemoglobin and adherence to treatment (p <.05) were observed in overweight/obese subjects versus those with normal weight after one year of study. Conclusion: The use of flash monitoring is related to better adherence to most of the recommended habits in diabetes. Nevertheless, there seems to be no relationship with an improvement in physical exercise and preventive aspects of diabetes. A good nursing intervention to support physical exercise and the use of mHealth devices could improve the control of diabetic patients. Relevance to clinical practice: The use of this mHealth device has shown positive results and reduced complications. Despite less contact with healthcare facilities due to the pandemic, type 1 diabetic patients have improved their blood results and adherence after using the device for one year. Nursing staff should focus on promoting physical activity and routine disease care in type 1 diabetics. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1D) is a chronic disease that is usually diagnosed in childhood, underscoring the importance of early disease control for overall wellbeing. Our aim was to design an explanatory model of subjective emotional wellbeing in children and adolescents with T1D. A longitudinal study was conducted at the Reina Sofia University Hospital in Cordoba (Spain). A total of 151 patients (mean age = 14.50, SD = 2.67; 41.1% girls) participated at T1, while 97 participated at T2 (mean age = 14.93, SD = 2.56; 39.2% girls). Participants completed a self-report questionnaire. Descriptive, reliability, correlation, path, and mediation analyses were performed. The explanatory model showed excellent fit indices [χ2 (10) = 8.62, p = 0.57, RMSEA = 0.00, 95% [0.00, 0.10], CFI = 1.00, GFI = 0.98, AGFI = 0.93, and TLI = 1.01]. The results showed significant and positive relationships between family social support and subjective emotional wellbeing and improved self-care skills. Self-efficacy presented a mediating role between family social support and subjective emotional wellbeing. Given that self-efficacy is a self-regulatory mechanism and a determinant of health, it is argued that future psychoeducational interventions could aim to improve self-efficacy to manage chronic diseases, to achieve greater emotional wellbeing in children and adolescents with T1D. [ABSTRACT FROM AUTHOR]

Objective: To identify the flow charts and discriminators of the Manchester Triage System that are most likely to identify the onset of delirium in older people. Background: Delirium is an underdiagnosed geriatric syndrome, and up to 80% of all cases of delirium go undetected in emergency departments. Patient triage seeks to manage clinical risk with a view to safely and appropriately managing patient flows. Design: A case–control study was performed according to the STROBE checklist. Setting: The emergency department of a secondary hospital. Participants: Older adults aged ≥65 years and admitted from 1 January to 31 December 2020. Methods: Older patients were identified from the emergency department research database. Cases were defined as patients diagnosed with delirium (n = 128), excluding cases of delirium due to alcohol or substance abuse. Controls were randomised from the remaining patients (n = 128). Results: A total of 29.35% of the subjects admitted to the emergency department were older adults with an incidence of delirium of 0.7%. The flow charts with the highest probability of delirium were 'unwell adult' [OR = 3.04 (95%CI:1.82–5.1)] and 'behaving strangely' [OR = 16.06 (95%CI:3.72–69.29)], and the discriminators were 'rapid onset' [OR = 3.3 (95%CI:1.85–5.88)] and 'new neurological deficit less than 24 h old' [OR = 4.76 (95%%CI:1.01–22.5). The area under the curve for 'unwell adult' in the presence of dementia, previous stroke and fall in the previous 30 days was 0.73 (95%CI: 0.67–0.79), and that for 'behaving strangely' in the presence of diabetes was 0.75 (95%CI: 0.69–0.81). Conclusions: Knowing which flow charts, discriminators and risk factors are most likely to predict delirium allows the identification of the older population at risk for triage screening in emergency departments. Relevance to clinical practice: Risk factors such as diabetes, dementia, previous stroke and recent fall among 'unwell adult' or 'behaving strangely' triaged older persons should be assessed for the probable presence of delirium. [ABSTRACT FROM AUTHOR]