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Background: Shortages of mechanical ventilation have become a constant problem in Emergency Departments (EDs), thereby affecting the timely deployment of medical interventions that counteract the severe health complications experienced during respiratory disease seasons. It is then necessary to count on agile and robust methodological approaches predicting the expected demand loads to EDs while supporting the timely allocation of ventilators. In this paper, we propose an integration of Artificial Intelligence (AI) and Discrete-event Simulation (DES) to design effective interventions ensuring the high availability of ventilators for patients needing these devices. Methods: First, we applied Random Forest (RF) to estimate the mechanical ventilation probability of respiratory-affected patients entering the emergency wards. Second, we introduced the RF predictions into a DES model to diagnose the response of EDs in terms of mechanical ventilator availability. Lately, we pretested two different interventions suggested by decision-makers to address the scarcity of this resource. A case study in a European hospital group was used to validate the proposed methodology. Results: The number of patients in the training cohort was 734, while the test group comprised 315. The sensitivity of the AI model was 93.08% (95% confidence interval, [88.46 − 96.26%]), whilst the specificity was 85.45% [77.45 − 91.45%]. On the other hand, the positive and negative predictive values were 91.62% (86.75 − 95.13%) and 87.85% (80.12 − 93.36%). Also, the Receiver Operator Characteristic (ROC) curve plot was 95.00% (89.25 − 100%). Finally, the median waiting time for mechanical ventilation was decreased by 17.48% after implementing a new resource capacity strategy. Conclusions: Combining AI and DES helps healthcare decision-makers to elucidate interventions shortening the waiting times for mechanical ventilators in EDs during respiratory disease epidemics and pandemics. [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]

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

Background: Decision making is a pivotal component of nursing education worldwide. This study aimed to accomplish objectives: (1) Cross-cultural adaptation and psychometric validation of the Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM©) scale from English to Spanish; (2) Comparison of nursing student groups by academic years; and (3) Analysis of the impact of work experience on decision making. Methods: Cross-sectional comparative study. A convenience sample comprising 301 nursing students was included. Cultural adaptation and validation involved a rigorous process encompassing translation, back-translation, expert consultation, pilot testing, and psychometric evaluation of reliability and statistical validity. The NASC-CDM© scale consists of two subscales: self-confidence and anxiety, and 3 dimensions: D1 (Using resources to gather information and listening fully), D2 (Using information to see the big picture), and D3 (Knowing and acting). To assess variations in self-confidence and anxiety among students, the study employed the following tests: Analysis of Variance tests, homogeneity of variance, and Levene's correction with Tukey's post hoc analysis. Results: Validation showed high internal consistency reliability for both scales: Cronbach's α = 0.920 and Guttman's λ2 = 0.923 (M = 111.32, SD = 17.07) for self-confidence, and α = 0.940 and λ2 = 0.942 (M = 80.44, SD = 21.67) for anxiety; and comparative fit index (CFI) of: 0.981 for self-confidence and 0.997 for anxiety. The results revealed a significant and gradual increase in students' self-confidence (p =.049) as they progressed through the courses, particularly in D2 and D3. Conversely, anxiety was high in the 1st year (M = 81.71, SD = 18.90) and increased in the 3rd year (M = 86.32, SD = 26.38), and significantly decreased only in D3. Work experience positively influenced self-confidence in D2 and D3 but had no effect on anxiety. Conclusion: The Spanish version (NASC-CDM-S©) was confirmed as a valid, sensitive, and reliable instrument, maintaining structural equivalence with the original English version. While the students' self-confidence increased throughout their training, their levels of anxiety varied. Nevertheless, these findings underscored shortcomings in assessing and identifying patient problems. [ABSTRACT FROM AUTHOR]

Background: The association between socioeconomic status and depression is weaker in older adults than in younger populations. Loneliness may play a significant role in this relationship, explaining (at least partially) the attenuation of the social gradient in depression. The current study examined the relationship between socioeconomic status and depression and whether the association was affected by loneliness. Methods: A cross-sectional design involving dwelling and nursing homes residents was used. A total of 887 Spanish residents aged over 64 years took part in the study. Measures of Depression (GDS-5 Scale), Loneliness (De Jong-Gierveld Loneliness Scale), Socioeconomic Status (Education and Economic Hardship), and sociodemographic parameters were used. The study employed bivariate association tests (chi-square and Pearson's r) and logistic regression analyses. Results: The percentage of participants at risk of suffering depression was significantly higher among those who had not completed primary education (45.5%) and significantly lower among those with university qualifications (16.4%) (X2 = 40.25;p <.001), and respondents who could not make ends meet in financial terms faced a higher risk of depression (X2 = 23.62;p <.001). In terms of the respondents who experienced loneliness, 57.5% were at risk of depression, compared to 19% of those who did not report loneliness (X2 = 120.04;p <.001). The logistic regression analyses showed that having university qualifications meant a 47% reduction in the risk of depression. This risk was 86% higher among respondents experiencing financial difficulties. However, when scores for the loneliness measure were incorporated, the coefficients relating to education and economic hardships ceased to be significant or were significantly reduced. Conclusion: Loneliness can contribute to explaining the role played by socioeconomic inequalities in depression among older adults. [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]

Pelvic floor dysfunction comprises various disorders, including urinary incontinence, fecal incontinence, pelvic organ prolapse, and chronic pelvic pain. This study aimed to evaluate health-related quality of life (HRQoL), anxiety, depression, sleep disturbance, and sexual functioning in women with pelvic floor dysfunction of colorectal etiology compared with control women. Patients were recruited from a specialized colorectal unit and controls were selected from among the patients' friends and relatives. Sociodemographic and clinical data were collected. Pelvic floor dysfunction distress and impact, HRQoL, depression, anxiety, insomnia, and sexual functioning were assessed using the following validated questionnaires: Short-Form Pelvic Floor Distress Inventory (PFDI-20), Short Form Pelvic Floor Impact Questionnaire (PFIQ-7), 36-Item Short-Form Health Survey (SF-36), Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), and Changes in Sexual Functioning Scale (CSFQ). Statistical analyses included Welch's t-test, Fisher's exact test, and Spearman's correlation coefficients. Eighty-four patients and 57 controls were included. Compared with controls, patients were more likely to be obese or overweight, have had higher numbers of deliveries, more vaginal deliveries, more frequent use of forceps, and have had more associated comorbidities, mainly in the urinary, neurological, and psychiatric domains. As expected, patients scored significantly higher than controls on both the PFDI-20 and PFIQ-7 and their respective sub-scales, with the highest mean values in the patient group on the sub-scales related to the colorectal–anal domain. QoL, depression, anxiety, insomnia, and sexual functioning were significantly worse in patients than in controls (p < 0.0001 in every case). In patients, PFIQ-7 scores correlated significantly with HRQoL (p < 0.001 for the physical component and p < 0.01 for the mental component), depression (p < 0.001), anxiety (p < 0.001), insomnia (p < 0.05), and sexual functioning scores (p < 0.05). Colorectal pelvic floor dysfunction had a markedly deleterious impact on the HRQoL, depression, anxiety, sleep disturbance, and sexual functioning of patients. It is concluded that colorectal pelvic floor dysfunction exerts a considerable burden on patients' lives. Addressing these issues in clinical settings could significantly improve patients' well-being. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

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

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]

Background: The display of compassionate care by palliative care professionals is of the utmost importance to the patients, their families, and even to their own professional well-being. Lately and, especially due to the emergence of the COVID-19 pandemic, palliative care professionals have been subjected to greater pressures stemming from their work environment, organizational standpoint, and emotional sense of view. Not only have these factors made it harder for professionals to deliver compassionate care to their patients, but they have also decreased their overall well-being. The aim is to study how sociodemographics, workplace characteristics, internal resources, and the COVID-19 pandemic-derived pressures have affected the professionals' capacity to perform compassionate care and their well-being while at the same time exploring the relationship between compassionate care and well-being. Methods: This study used a cross-sectional design with data gathered from Spanish palliative care professionals. The final sample was formed by 241 participants. They were surveyed about compassion, professional quality of life, well-being, sociodemographic data, working conditions, self-care, and coping with death competence, and the impact of the COVID-19 pandemic. The analyses used were descriptive statistics, bivariate tests, and the construction of a structural equation model. Results: Compassion was predicted by the ability to control their workload and the ability to cope with death. Burnout was predicted by age, workload, workload control, self-care, material resources, and changes in teamwork. Moreover, compassion, age, workload control, and changes in teamwork and self-care were shown to significantly predict compassion satisfaction. When it comes to compassion fatigue, different variables were shown to predict it, those being compassion, control over the workload, social self-care, and the ability to cope with death. Conclusions: Having a healthy lifestyle and an adequate social support system is key to maintaining professional well-being in the case of palliative care professionals. Inner resources such as the ability to perform self-care and the capacity to cope with death are of vital importance to taking care of these professionals. Thus, it would be beneficial to establish training programs focused on these aspects in the myriad of sanitary centers that perform these tasks, as these abilities are necessary to withstand the work-related pressures and, at the same time, be able to provide compassionate care for patients. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is currently the most prevalent malignancy among women. Psychological resilience is an important factor that diminishes the stress-related emotional and psychosocial disturbances triggered when receiving the diagnosis. Furthermore, resilience appears to be associated with cortisol, the hormonal end-product of the hypothalamic-pituitary-adrenal axis; however, further studies are needed due to the mixed results reported. Thus, we aim to examine the predictive role of social support and cortisol in resilience among breast cancer patients. Methods: A total of 132 women with primary breast cancer completed the Medical Outcomes Study-Social Support Survey (MOS-SSS) and the Resilience Scale (RS-14) and provided four salivary samples for the estimation of participants' total daily cortisol production, for which the formula of the area under the curve with respect to the ground (AUCg) was applied. Moderation analyses were performed to study the influence of social support and AUCg on psychological resilience levels. Results: The regression analyses showed a direct significant effect for the emotional support subscale of MOS-SSS on resilience and the interaction between emotional support and AUCg was also found to be statistically significant. Specifically, the conditional effect of emotional support on resilience was found to be significant at middle (M = 3.08; p <.05) and low levels (M =.59; p <.001) of AUCg. Conclusions: Our results suggest that newly diagnosed breast cancer women with middle and low diurnal cortisol profiles may benefit more from emotional support based-interventions while women with high diurnal cortisol may need more individualized therapies. [ABSTRACT FROM AUTHOR]

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