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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]

The "hyper-variation" present in rhotic sounds makes them particularly apt for sociophonetic research. This paper investigates the variable realization of the voiced alveolar-trill phoneme /r/ through an acoustic analysis of unscripted speech produced by 80 speakers of Spanish. Although the most common phonetic variant of /r/ contained two lingual constrictions, we find substantial inter-speaker variation in our data, ranging from zero to five lingual contacts. The results demonstrate that the variation in Spanish results from a systematic interaction of factors, deriving from well-documented processes of consonantal lenition (e.g., weakening in unstressed syllables) in addition to processes inherent to the trill's articulation (e.g., high-vowel antagonism). Importantly, speaker sex displayed the strongest effect among all the predictors, which leads us to consider the role of sociolinguistic factors, in addition to possible biomechanical differences, on /r/ production. We contextualize the findings within a literature that theorizes rhotic consonants as a single class of sounds despite remarkable patterns of cross-language and speaker-specific variation. [ABSTRACT FROM AUTHOR]

Descriptive fit indices that do not require a formal statistical basis and do not specifically depend on a given estimation criterion are useful as auxiliary devices for judging the appropriateness of unrestricted or exploratory factor analytical (UFA) solutions, when the problem is to decide the most appropriate number of common factors. While overall indices of this type are well known in UFA applications, especially those intended for item analysis, difference indices are much more scarce. Recently, Raykov and collaborators proposed a family of effect-size-type descriptive difference indices that are promising for UFA applications. As a starting point, we considered the simplest measure of this family, which (a) can be viewed as absolute and (b) from which only tentative cutoffs and reference values have been provided so far. In this situation, this article has three aims. The first is to propose a relative version of Raykov's effect-size measure, intended to be used as a complement of the original measure, in which the increase in explained common variance is related to the overall prior estimated amount of common factor variance. The second is to establish reference values for both indices in item-analysis scenarios using simulation. And the third aim (instrumental) is to implement the proposal in both R language and a well-known non-commercial factor analysis program. The functioning and usefulness of the proposal is illustrated using an existing empirical dataset. [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]

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]

The objective of universal health care systems is to achieve equality in the use of health services at the same level of care need. This study evaluates the relationship of socioeconomic position with the frequency of doctor visits in subjects with and without chronic diseases in Germany and Spain. The dependent variables included number of consultations and if a medical consultation occurred. The socioeconomic factors were income and education. The magnitude of the relationship between socioeconomic position and medical consultation frequency was estimated by calculating the percentage ratio using binomial regression and by calculating the difference in consultations by analysis of the covariance, in the case of number of visits. Statistically significant findings according to education were not observed. The percentage ratio in the medical consultations among those with lower and higher income was 1.03 (95% confidence interval [CI] 1.01-2.88) in Germany and 1.11 (95% CI 1.03-1.20) in Spain among subjects with any of the studied chronic conditions. Also, in Germany the difference in the average number of consultations comparing lower income subjects with higher was 3.98 (95% CI 2.40-5.57) in those with chronic conditions. In both countries, there were no differences in the frequency of doctor visits according to education. However, a pro-inequality trend exists in favor of subjects with lower income. [ABSTRACT FROM AUTHOR]

Objective: It is often claimed that hospitals that are leaders in biomedical research provide higher health care quality, or vice versa. Although several studies have shown a relationship between teaching status and quality of care, none has analysed the association between research output and hospital outcomes. Our aim was to determine whether there is a relationship between bibliometric measures of research output in acute hospitals and hospital mortality for two common cardiac conditions. Methods: A cross-sectional analysis of secondary data of in-hospital risk-adjusted mortality for congestive heart failure and acute myocardial infarction (2002-2004) and several bibliometric measures of publications (1996-2004) in cardiovascular disease. The setting was 50 acute Spanish public hospitals, voluntarily participating in an external quality initiative, with more than 30 medical cases of congestive heart failure and acute myocardial infarction per year, and more than five citable papers in the field of heart disease. Spearman's rho nonparametric correlation coefficient was used to assess association. Results: There was a low-to-moderate negative correlation between the risk-adjusted mortality ratio and the weighted citations ratio: 20.43 (95% CI 20.17 to 20.63) for congestive heart failure and 20.37 (20.10 to 20.59) for acute myocardial infarction. Teaching status and the technological level of the hospital had a stronger correlation with hospital mortality. Conclusions: Measures of research output could be considered for incorporation into comparisons of the quality of hospitals. A weighted citations ratio is the most suitable measure of research output, but more research is needed on the interplay between research and practice as complementary ways of developing medical knowledge. [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 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]

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]

Introduction: Evidence and clinical experience suggest that there are a range of signs of health issues that affect patients who have recovered from acute COVID-19 infection. This condition is commonly referred to as "persistent COVID-19," which is not connected with the severity of the disease. We have identified the prevalence and clinical-epidemiological characteristics of patients with COVID-19 and persistent symptoms treated in primary care centers. This is a descriptive observational study conducted between December 2020 and May 2022, the data were collected from digitized medical records and interviewing 1542 individuals with laboratory-confirmed SARS-CoV-2 infection. These patients were clinically followed for up to 1 year, based on the prevalence of symptoms. When stratifying by the risk of developing persistent COVID-19, 37.09% of the patients exhibited risk factors, with age (over 60 years) and cardiovascular risk factors predominating. The obtained prevalence of persistent COVID-19 at 90 days was 12.39%, with a slight predominance in females (55%) and a mean age of 45.8 years. The most affected systems were the cardiovascular, respiratory, and psychoneurological systems, with predominant symptoms of fatigue (41.88%), dyspnea (32.46%), and headache (14.66%), among others. The average duration of persistent symptoms was 178 days, equivalent to 6 months. In conclusion, over 10% of patients who recover from acute SARS-CoV-2 infection developed long-term consequences. Objective: To measure the prevalence and clinical-epidemiological characteristics of individuals diagnosed with COVID-19 and persistent symptoms treated in primary care centers in Área Sanitaria Sur de Córdoba (Spain) between December 2020 and May 2022. Methods: A retrospective observational study of the population of Área Sanitaria Sur de Córdoba was developed between December 2020 and May 2022. The scope of the study was 1542 individuals, and the prevalence of patients diagnosed with COVID-19 and persistent symptoms was determined based on laboratory-confirmed cases, randomly selected from adults who had progressed beyond the acute phase of the disease. All data were managed by the Área Sanitaria Sur de Córdoba (Spain). Results: The risk factor of exhibiting one or more risk factors associated with developing persistent COVID-19 is 37.09%. The obtained prevalence of persistent COVID-19 at 90 days is 12.39%, it is higher in females (55%) than males and the mean age was 45.8 years. The most affected systems were the cardiovascular, respiratory, and psychoneurological systems, with predominant symptoms of fatigue (41.88%), dyspnea (32.46%), and headache (14.66%), among others. Conclusions: Results confirm that more than 10% of individuals recovering from acute SARS-CoV-2 infection showed long-term consequences and the observed persistent symptom duration was 178 days on average. [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]

For young women, the power imbalance in favor of males in dating relationships has been related to dating violence (DV) victimization. In addition, the use of rumination to cope with DV may increase their psychological distress. The purpose of the current study was to examine whether experiences of DV and rumination mediate the association between power imbalance and suicide risk (SR). The sample comprised 1,216 young women aged between 18 and 28 years from Colombia (n = 461) and Spain (n = 755), in a heterosexual dating relationship, not married or cohabiting with a partner and without children. The following scales were applied: The Sexual Relationship Power Scale-Modified, The Dating Violence Questionnaire–-R (DVQ-R); Cyberdating Abuse Questionnaire, Measure of Affect Regulation Scale (MARS), and The Spanish Suicide Risk Scale. A sequential mediation paths model was tested. Results indicated that power imbalance was associated with DV victimization. Furthermore, DV was associated with more rumination, which was also linked to a greater SR in both countries. Rumination may be a mechanism through which experiences of DV victimization negatively influence mental health in young women and is an important variable related cross-culturally to SR. The findings suggest an equality approach, addressing the power imbalance in dating relationships, empowering girls to prevent DV, and teaching coping strategies for dealing with victimization and its consequences. [ABSTRACT FROM AUTHOR]

This study examined the relationship and degree of predictability that the fluency of writing the alphabet from memory and the selection of allographs have on measures of fluency and accuracy of spelling in a free-writing sentence task when keyboarding. The Test Estandarizado para la Evaluación de la Escritura con Teclado ("Spanish Keyboarding Writing Test"; Jiménez, 2012) was used as the assessment tool. A sample of 986 children from Grades 1 through 3 were classified according to transcription skills measured by keyboard ability (poor vs. good) across the grades. Results demonstrated that fluency in writing the alphabet and selecting allographs mediated the differences in spelling between good and poor keyboarders in the free-writing task. Execution in the allograph selection task and writing alphabet from memory had different degrees of predictability in each of the groups in explaining the level of fluency and spelling in the free-writing task sentences, depending on the grade. These results suggest that early assessment of writing by means of the computer keyboard can provide clues and guidelines for intervention and training to strengthen specific skills to improve writing performance in the early primary grades in transcription skills by keyboarding. [ABSTRACT FROM AUTHOR]

Background: To address the need for standardized, comprehensive chemotherapy/biotherapy education in Latin American and Caribbean (LAC) countries, the Association of Pediatric Hematology/Oncology Nurses (APHON) Pediatric Chemotherapy/Biotherapy Provider and Instructor program courses were culturally adapted, translated to Spanish, and piloted. The process of course adaptation and implementation are described. A Context, Input, Process, Product model outcomes evaluation determined: (a) differences in pass rates by test version and pilot location, (b) predictors of pass rates, (c) course appropriateness for nurses' education and practice levels, and (d) strategies for course improvements. Methods: The Spanish APHON Pediatric Chemotherapy/Biotherapy Provider program was piloted four times and the Instructor program twice with nurses from Mexico, Central America, the Caribbean, South America, and Spain. Statistical analysis identified factors associated with pass rates. Results: Of the 203 students in four Spanish APHON Provider program courses, data from 108 students (three pilots) were analyzed (one unplanned pilot excluded for missing data). Significant predictors of pass rates included: pediatric oncology frontline nurses (OR = 9.86; 95% CI [2.56, 65.23]; p =.004), nurses dedicated to an inpatient or outpatient unit (non-rotating) (OR = 6.79 [1.29, 51.98]; p =.033), and graduation from a 5-year nursing program (OR = 5.92; 95% CI [1.30, 33.15]; p =.028). Discussion: The Spanish APHON Pediatric Chemotherapy/Biotherapy program was determined appropriate for nurses' education and practice levels in LAC countries. Through the APHON Spanish language instructor network, pediatric oncology nurses in LAC countries have increased access to standardized, comprehensive chemotherapy/biotherapy education. [ABSTRACT FROM AUTHOR]

Teen dating violence (TDV) refers to a wide range of partner-directed harmful behaviors among adolescents. Since it was first documented in the 1980s, there is a growing interest in TDV due to its potentially devastating mid- and long-term consequences. Aiming at the early detection of TDV onset with prevention purposes, research has focused on the detection of typologies of perpetrators and/or victims as well as on identifying risk and protective factors for its occurrence. Research with Spanish adolescents, however, is very limited. To fill this gap, we recruited a total of 2,319 adolescents from different regions in Spain, out of which, 1,079 reported having had a romantic partner during the last year. These filled out measures of TDV (perpetration and victimization), school aggression, hostile and benevolent sexism, empathy, assertiveness, psychological inflexibility (general measures), and psychological inflexibility with prejudice thoughts. A cluster analysis revealed that adolescents could be divided into two clusters as a function of their TDV profile: Cluster 1, including close to 76% of the sample (boys and girls), presented low TDV perpetration and victimization; Cluster 2, including 24% of the sample (boys and girls), presented higher TDV perpetration and victimization. Regression analyses revealed that, as compared to those in Cluster 1, adolescents in Cluster 2 were more likely to be older boys who scored high in benevolent sexism, overt and relational school aggression, and personal distress, and low in behavior regulation skills, perspective taking, and practical personal ability. We discuss the implications of these findings for the design of evidence-based TDV prevention campaigns. [ABSTRACT FROM AUTHOR]

Domestic violence has long-term negative consequences on children. In this study, men with a history of partner aggression and a control group of non-offenders were embodied in a child's body from a first-person perspective in virtual reality (VR). From this perspective, participants witnessed a scene of domestic violence where a male avatar assaulted a female avatar. We evaluated the impact of the experience on emotion recognition skills and heart rate deceleration responses. We found that the experience mainly impacted the recognition of angry facial expressions. The results also indicate that males with a history of partner aggression had larger physiological responses during an explicit violent event (when the virtual abuser threw a telephone) compared with controls, while their physiological reactions were less pronounced when the virtual abuser invaded the victim's personal space. We show that embodiment from a child's perspective during a conflict situation in VR impacts emotion recognition, physiological reactions, and attitudes towards violence. We provide initial evidence of the potential of VR in the rehabilitation and neuropsychological assessment of males with a history of domestic violence, especially in relation to children. [ABSTRACT FROM AUTHOR]

As future employers, nurse managers are in a key position to assess the correspondence between the competence of graduating nursing students and work life demands. The aim of the present study was to assess the competence of graduating nursing students from the perspective of managers, and analyze the factors linked to it. Among European managers in six countries, a cross-sectional survey design with a convenience sample was applied. Data were collected using the Nurse Competence Scale. The study was reported using the STROBE guidelines. Managers (n =538, 65.8%) assessed the level of competence of graduating nursing students as good, but there were statistically significant differences between countries. In a multivariable analysis, managers who had a Doctoral/Master’s degree and were dissatisfied with the nursing program in their country assessed the level of competence as lower. Overall, graduating nursing students seem to meet the competence demands of current work life rather well. Further research is needed to confirm the connection between the managers’ competence assessment and their individual background factors. [ABSTRACT FROM AUTHOR]

Violent radicalization continues to be a global problem. One of the main proposals for understanding radicalization and support for political violence is based on social alienation as a trigger. That is, individuals who feel alienated from society try to get out of this situation by using violence, if necessary. However, social alienation alone is not enough to explain radicalization. Therefore, we propose that social alienation interacts with other factors to foster radicalization. Particularly, we propose that obsessive passion, an internal compulsion that leads a person to engage in an activity even when they should not, is one of the interacting factors. Following previous literature, we hypothesized that higher social alienation predicts support for political violence to a greater extent the higher the obsessive passion. To test this hypothesis, we performed two studies in which the cause of passion varied (religion: N = 652 and family: N = 873). Both studies assessed social alienation, harmonious and obsessive passion, and support for political violence. The results showed a significant increase in the effect of social alienation on support for political violence when obsessive passion was higher, even controlling by harmonious passion. These results highlight the importance of considering other variables related to social alienation that could facilitate radicalization processes, particularly maintaining an obsessive passion for a cause when one feels a social disconnection. The theoretical and practical implications of these results are discussed given their contributions to prevention based on work on feelings of social disconnection and harmonization of causes. [ABSTRACT FROM AUTHOR]

Objective: Roll-out of population-based colorectal cancer (CRC) screening with faecal immunochemical test (FIT) is limited by availability of further investigations, particularly colonoscopy and examination of excised lesions. Our objective was to assess whether variation in number of faecal samples and threshold adjustment can optimise resource utilisation and CRC detection rate. Methods: Three different screening strategies were compared for the same FIT threshold using a quantitative FIT system: one FIT, positive when > 20 µg Hb/g faeces; two FIT, positive when either was > 20 µg Hb/g faeces; and two FIT, positive when the mean was > 20 µg Hb/g faeces. We calculated changes in the size of population the provider could invite to screening for an equal number of screening positive results, and CRC and adenoma detected. Results: In our setting, Region of Murcia, south of Spain (not fully rolled out screening programme), changing the usual strategy of two FIT, positive when either to positive when the mean was > 20 µg Hb/g faeces, would increase population invited by 37.81% with the same number of positive results (which would generate a CRC detection rate of 19.2%). In a fully rolled out programme, changing the strategy from one to two FIT (positive when the mean is > 20 µg Hb/g faeces), would increase CRC detection rate by 4.64% with an increase of only 13.34% in positive FIT. Conclusions: In a population-based CRC screening programme, smart use of number of FITs and positivity threshold can increase population invited and CRC detection without increasing the number of colonoscopies and pathological examinations needed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. Design: Single group implementation feasibility study using a pre–posttest design. Setting: Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). Participants: Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. Intervention: A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. Main Measure: Paired t -tests were used to assess pre–post changes and analyses of covariance were used to compare effects based on selected participant characteristics. Results: Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001). Conclusions: Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. Implications for Cancer Survivors: With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan. [ABSTRACT FROM AUTHOR]

The aim of this study was to validate and analyze the psychometric properties of a Spanish version of the Sexual Trafficking Attitudes Scale towards women and girls (STAS). A sample of 204 students from the University of Salamanca (Spain) was used. The exploratory factor analysis and confirmatory factor analysis confirmed a multifactorial structure of six factors (70.1% of variance). The Cronbach's α internal consistency index obtained for the sample was 0.87 and composite reliability was 0.94. Convergent validity was determined between the full scale and the six dimensions, and divergent between subscales. The Spanish version of the instrument consisted of 25 items, proving to be a reliable and parsimonious measure. [ABSTRACT FROM AUTHOR]

This study examines the prevalence and characteristics of sexual victimization experiences suffered by people with intellectual disabilities (ID). The sample consisted of 260 adults with an ID diagnosis (154 men and 106 women), ranging in age from 20 to 71 years (M = 41.69, SD = 12.05). The results showed that 35% of the sample had been sexually victimized at some point in their life. Being a woman, being declared legally incapable, and having comorbid mental health diagnoses were the most relevant characteristics of sexual victims with ID. Fondling was the most reported victimization, and rape showed the greatest gender differences, with a higher risk for women with ID of being raped compared to their male counterparts (odds ratio = 4.28, p <.05). The offender was generally a known male adult, and the percentage of incidents reported to the authorities was very low (7.4%). The psychological consequences of abuse were general distress, anxiety, and depressive symptomatology. Intervention and prevention programs targeting this population, as well as the training of professionals and caregivers, are essential to deal with sexual victimization and to protect and ensure the quality of life of people with ID. [ABSTRACT FROM AUTHOR]

Aims To analyse the cost effectiveness of using the moxibustion technique to correct non-vertex presentation and to reduce the number of caesarean sections performed at term. Method A deterministic model of decision analysis has been developed to analyse the cost of treatment in which heat is applied by moxibustion (the combustion of Artemisia vulgaris) at acupuncture point BL67 for pregnant women with non-vertex fetal position at 33-35 weeks' gestation. This approach was compared with conventional treatment recommendations based on the knee-chest posture technique. The costs were obtained mainly from data provided by the Andalusian Public Health System. Effectiveness data for the baseline analysis were taken from a previous clinical study. A secondary analysis was performed based on a meta-analysis conducted using random effects analysis, by reference to studies published in recent systematic reviews of moxibustion versus conventional treatment, in order to make the results generalisable to other healthcare settings. Deterministic and probabilistic sensitivity analyses were performed under diverse assumptions to assess the uncertainty of the result. Results The baseline analysis shows that the application of moxibustion prevents 8.92% of deliveries with non-vertex presentation compared with conventional treatment, with an average cost saving of €107.11 per delivery, mainly due to the cost saving from avoiding the need for caesarean section. The meta-analysis revealed a relative risk of the version of non-vertex presentation at term of 0.34 (95% CI 0.16 to 0.76). The sensitivity analysis showed that moxibustion can avoid 0.34 caesarean sections, with an incremental cost per delivery ranging from €68 to −€640 for moxibustion versus conventional treatment. Conclusions Moxibustion treatment applied at acupuncture point BL67 can avoid the need for caesarean section and achieve cost savings for the healthcare system in comparison with conventional treatment. [ABSTRACT FROM AUTHOR]

Incarcerated women are at high risk of exposure to traumatic events with subsequent development of post-traumatic stress disorder (PTSD). The present study builds on prior research by adding new findings from Spain on the association between childhood and prison victimization, and negative emotional states with PTSD symptoms during incarceration among women. The study sample (N = 174) included female prison inmates enrolled from two prisons located in Southeast Spain. Participants completed self-report questionnaires including demographic and criminal variables, childhood and prison victimization (including emotional, physical and sexual victimization), negative emotional states (including depression, anxiety, and stress symptoms) and PTSD symptoms. Logistic regression analysis revealed that women screening positive for trauma had significantly greater odds for the assortment of childhood victimization, prison victimization (specifically physical victimization) and depression, anxiety, and stress. Current findings suggest a need to include these construct assessments in the screening and identification of PTSD among incarcerated women in Spain. [ABSTRACT FROM AUTHOR]

Individuals experiencing homelessness—an extreme form of social exclusion—have considerably higher risk of being victims of violence than the general population. We analyze the episodes of violence suffered by 504 individuals experiencing homelessness in Spain, as well as the differences between men and women. The results indicate high levels of violence and suggest that gender (specifically, being a woman) is the primary factor driving exposure to violence among this group. Highlighting the reality of women experiencing homelessness can help social, mental health, and addiction services adjust responses to better address the needs of this group and offer comprehensive care. [ABSTRACT FROM AUTHOR]

Schools are in a position to connect children and adolescents suspected of being victims of violence with an external source of support by making referrals to external agencies. However, several studies have identified obstacles that hinder early reporting among school staff members. Very few studies have applied a mixed-method approach to try to understand this sensitive issue. The current study used this approach to analyze to what extent the students suspected of being victimized match the ones reported by active school staff members in Spain (n = 453, 83.5% females, age: M = 42.23, SD = 9.46). We classified the reasons given for not reporting the potential victimization cases encountered and made comparisons to determine whether there were differences in the level of knowledge, or in the sociodemographic characteristics, of respondents who gave different reasons for not reporting. Although 73.5% of school staff members had detected at least one potential case, 40.8% of them referred it to an external agency. The most common reasons for lack of reporting included deciding not to do so once concerns had been shared within the school and believing that one must be certain or that only serious violence should be reported. The findings of this study may help to further understand the decisions not to report certain suspicions of potential victimization cases to external agencies by school staff. There is an urgent need to raise awareness about the duty to report these concerns to external agencies, even in the absence of agreement from the school management team. Members of school staff need to be strongly encouraged to become familiar with the existing protocols. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of two different exercise-based programs through telerehabilitation in patients with coronavirus disease 2019. Design: Randomized, controlled, parallel, double-blinded, three-arm clinical trial. Setting: Patients' homes through telerehabilitation devices. Subjects: Subjects with coronavirus disease 2019 in the acute phase. Interventions: Subjects were divided into three groups: breathing exercises group, strength exercises group or no treatment/control group. Main measures: We analysed visual analogue scale for fatigue, 6-minute walking test, 30-seconds sit-to-stand test, multidimensional dyspnoea-12 questionnaire and Borg scale at baseline and 14 days later. Results: From 93 subjects recruited, 88 were enrolled, and 77 patients (mean [SD] age 39.40 [11.71]) completed the 14-days intervention and were included in the analysis: 26 in strength exercises group, 29 in breathing exercises group and 22 in control group. The intergroup analysis shows significant differences between the study groups and control group in all variables (p < 0.05); Borg scale, multidimensional dyspnoea-12 questionnaire (pre–post intervention score: strength exercises group: 7.85 [6.82] – 4.54[4.82], breathing exercises group: 11.04 [6.49] – 5.32 [3.63], control group: 10.27 [6.49] – 10.59[6.58]), visual analogue scale for fatigue, 6-minute walking test and 30-seconds sit-to-stand test (pre–post intervention score: strength exercises group: 12.19 [4.42] – 13.58 [5.37], breathing exercises group: 11.18 [3.42] – 12.79 [4.00], control group: 10.45 [2.15] – 9.86[1.88]). The greatest effect sizes were found in the variables Borg Scale (R 2 = 0.548) and multidimensional dyspnoea-12 questionnaire (R 2 = 0.475). Conclusions: Strength exercises group and breathing exercises group obtained significant improvements in fatigue, dyspnoea, perceived effort, and physical state, compared to control group, although the greatest benefits were found for dyspnoea and aerobic capacity in breathing exercises group. [ABSTRACT FROM AUTHOR]

Background: Chronic uncomplicated musculoskeletal pain in the spine (cervical, thoracic or lumbar) is highly prevalent and may severely limit the daily activities of those affected by it. Objective: To evaluate the efficacy and safety of treatment with auriculopressure applied to patients with non-specific spinal pain. Methods: A multicentre randomised controlled trial with two parallel arms (true auriculopressure (TAP) and placebo auriculopressure (PAP)) was performed. The intervention phase lasted 8 weeks and outcomes were measured 1 week after the last intervention (T1) and 6 months after baseline (T2). The primary outcome measure was change in pain intensity according to a 100 mm visual analogue scale (pain VAS) at T1. Secondary outcome measures were the Lattinen index, the McGill Pain Questionnaire and the SF-12 health-related quality of life scale (Spanish version in every case). Results: There were 265 participants (TAP group, n=130; PAP group, n=135). Pain was most frequently located in the upper back (55.1%, n=146), followed by the lower back (25.3%, n=67) and the dorsal area (12.5%, n=33). Nineteen patients (7.2%) reported pain affecting the entire spine. There were statistically significant differences between TAP and PAP in the change in the pain VAS at T1 of 10 mm (95% CI 2.8 to 17.3, p=0.007) and in the change in the pain VAS at T2 of 7.2 mm (95% CI 0.02 to 14.3, p=0.049) in favour of TAP. We also observed a statistically significant difference of 3.4 points in the physical component of the SF-12 in favour of TAP at T2 (95% CI 0.45 to 6.3, p=0.024). No severe adverse effects were detected or reported during treatment. Conclusions: The application of auriculopressure in patients with non-specific spinal pain in primary healthcare is effective and safe, and therefore should be considered for inclusion in the portfolio of primary healthcare services. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities appear to be more vulnerable to victimization. However, few studies have assessed victimization in these groups and those that do exist are highly heterogeneous and tend to focus only on specific forms of violence. This study attempts to shed light on the phenomenon of victimization among adults with intellectual disabilities by assessing victimization and poly-victimization throughout their life course. The sample consisted of 260 adults (154 men and 106 women) with an intellectual disability diagnosis, recruited from the Catalan Federation for People with Intellectual Disabilities (DINCAT) in Spain. They ranged in age from 20 to 71 years (M = 41.69, SD = 12.05). Victimization experiences were assessed by means of an adaptation of the retrospective version of the Juvenile Victimization Questionnaire (JVQ). The results showed that 96.9% of the participants had suffered some kind of victimization throughout their lives. With respect to the types of victimization, the most frequent were common victimization (87.7%), witnessing and indirect victimization (67.3%), victimization by caregivers (59.2%), sexual victimization (35%), and electronic victimization (23.5%). Women and early adults tended to experience higher rates of victimization. The poly-victimized group experienced 13 or more incidents of victimization throughout their lives. This study highlights the elevated rates of lifetime victimization among people with intellectual disabilities. It adds to previous evidence that special protection programs are required to address this issue and emphasizes the need for prevention and intervention measures in this particularly vulnerable group. [ABSTRACT FROM AUTHOR]

Background: Myofascial trigger points (MTrPs) are hypersensitive nodules in a taut band (TB) of skeletal muscle. Dry needling (DN) is an invasive technique recommended for the treatment of MTrPs. However, to our knowledge, no studies have investigated the influence of the DN technique on modification of muscle stiffness and neurophysiological properties of MTrPs. Objective: The objective was to examine the effect of DN on muscle stiffness and motoneuron excitability of a latent medial MTrP (nodule and TB) of the soleus muscle in non-injured subjects. Methods: A double-blinded randomised controlled trial of 46 subjects with latent medial MTrPs of the soleus was conducted, in which all received one session of DN. The intervention group (n = 23) were subjected to DN into the MTrP (the nodule), while the control group (n = 23) were subjected to DN into the TB. Assessment was carried out at baseline (pre-test), after the intervention (post-test) and 1 week after the intervention (follow-up). Biomechanical variables (muscle resistive force at 10°/s and 180°/s, muscle extensibility and strength), as measured with an isokinetic dynamometer, and neurophysiological variables (H-reflex), were recorded. Results: There were no statistically significant differences in biomechanical or neurophysiological assessments between groups. Considering the intra-group analysis, subjects in the intervention group exhibited increased maximal isometric voluntary force to ankle plantarflexion (MIVFp) at both post-intervention and follow-up assessment (p < 0.0125; 0.2 < d < 0.5), while no changes were found in the control group. Conclusion: One session of DN targeting latent MTrPs did not change muscle stiffness, muscle extensibility or motoneuron excitability. Further research on subjects with muscle tone disorders should be considered to better address the impact of DN on muscle tone. Trial registration number: NCT02575586 (ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

Economic recessions can increase socioeconomic inequalities in health. The objective of this study was to analyze socioeconomic inequalities in small-for-gestational-age (SGA) births before and during the Spanish economic crisis. We conducted an ecological study of trends based on 2 periods before the crisis (1999–2003 and 2004–2008) and another during the crisis (2009–2013). The study population was Spanish women resident in 13 cities who had given birth during 1999–2013. The prevalence of SGA was calculated for each census tract. A hierarchical Bayesian model was used to obtain the prevalence ratio (PR) and 95% credible intervals (CI). We analyzed the association between SGA and socioeconomic deprivation in each period for each city and for 3 age groups. The PR was above 1 and statistically significant for all 3 time periods in most of the 13 cities. The differences in PR between periods were only statistically significant for Madrid (PR = 1.56, 95% CI 1.48–1.65 for 1999–2003; PR = 1.28, 95% CI 1.19–1.38 for 2004–2008) and Barcelona (PR = 0.99, 95% CI 0.87–1.12 for 2004–2008; PR = 1.20, 95% CI 1.05–1.36 for 2009–2013). Socioeconomic inequalities in SGA births in small areas (census tracts) of most Spanish cities studied remained stable before and during the economic crisis. [ABSTRACT FROM AUTHOR]

Objectives: To assess screening quality metrics and to describe mortality rates eight years after redesign of breast cancer screening and diagnosis pathways, and the introduction of digital breast tomosynthesis. Setting: Breast Unit of the Toledo Health Area in the region of Castilla-La Mancha (Spain). Methods: We recorded screening metrics and mortality data following the introduction of digital breast tomosynthesis in 2011 for screening and diagnosis pathways. We then compared the mortality between Toledo Health Area and the rest of Castilla-La Mancha, where digital breast tomosynthesis is not available. Results: All screening quality metrics improved following the introduction of digital breast tomosynthesis. The cancer detection rate significantly increased from 2.3 (95% confidence interval (CI): 1.9–3.6) to 4.5 per 1000 women (95% CI: 3.2–5.2) on average between the periods 2005–2009 and 2015–2018, while the recall rate significantly decreased from 7.0% (95% CI: 6.8%–8.2%) to 2.6% (95% CI: 2.0%–3.6%). Comparing breast cancer mortality rates for 2014–2018 in the Toledo Health Area with the rest of Castilla-La Mancha, which had similar cancer treatment access and management protocols but without digital breast tomosynthesis, the crude mortality rate was 17.79 (95% CI: 15.38 -20.19) vs. 24.76 per 100,000 (95% CI: 26.12–23.39), respectively. The cumulative risk of death was also significantly lower for the Toledo Health Area than for Castilla-La Mancha. Conclusion: The introduction of digital breast tomosynthesis improved screening quality indicators. Breast cancer mortality simultaneously decreased with respect to the rest of Castilla-La Mancha. Further research is needed to assess the long-term results, and the role that the redesign may have played in reducing mortality. [ABSTRACT FROM AUTHOR]

Objective: Existing systematic reviews and meta-analyses indicate that acupuncture has similar clinical effectiveness in the prevention of headache disorders (HDs) as drug therapy, but with fewer side effects. As such, examining acupuncture's use in a pragmatic, real-world setting would be valuable. The purpose of this study was to compare the effects of acupuncture and prophylactic drug treatment (PDT) on headache frequency in patients with HDs, under real-world clinical conditions. Methods: Retrospective cohort study of patients with HDs referred to a pain clinic, using electronic health record data. Patients continued with tertiary care (treatment of acute headache attacks and lifestyle, meditation, exercise and dietary instructions) with PDT, or received 12 sessions of acupuncture over 3 months, instead of PDT under conditions of tertiary care. The primary outcome data were the number of days with headache per month, and groups were compared at baseline and at the end of the third month of treatment. Results: Data were analysed for 482 patients with HDs. The number of headache days per month decreased by 3.7 (standard deviation (SD) = 2.9) days in the acupuncture group versus 2.9 (SD = 2.3) in the PDT group (p = 0.007). The proportion of responders was 39.5% versus 16.3% (p < 0.001). The number needed to treat was 4 (95% confidence interval = 3–7). Conclusion: Our study has shown that patients with HDs in tertiary care who opted for treatment with acupuncture appeared to receive similar clinical benefits to those that chose PDT, suggesting these treatments may be similarly effective of the prevention of headache in a real-world clinical setting. [ABSTRACT FROM AUTHOR]

Introduction: Increased migration may lead to an increase in prejudiced attitudes in the host population, which may affect the nursing care provided to this group. Objectives: To identify the attitudes of nursing students toward Moroccan patients and to analyze whether changes in attitude toward this population have taken place after completing a course on cross-culturalism. Method: A quasi-experimental design with a single group and pretest/posttest measurements. The sample consisted of 116 nursing students. Results: There were significant differences after receiving the course on cross-culturalism, with a more positive influence on students who exhibited the most negative attitudes in the pretest phase. Discussion: Nursing students have negative attitudes toward the Moroccan population as do the rest of the host population, but these attitudes improve after their training in the course on cross-culturalism. [ABSTRACT FROM AUTHOR]

Using a sample of 1,190 married Spanish community couples in opposite-sex relationships, this study evaluated a path analytic model exploring the associations between individual and dyadic factors and partner aggression for both males and females. Specifically, the perpetrator's report of their individual mental health symptomatology (borderline and antisocial traits, alcohol use), their report of relationship quality, and their report of perpetration were modeled to predict their partner's victimization. The resultant model exhibited good fit as measured by multiple indices for both male-to-female and female-to-male perpetration. Furthermore, results demonstrated that antisocial and borderline traits were associated with each other, that alcohol use was associated with perpetration, and that one partner's perpetration was associated with his or her partner's victimization for both males and females. However, the pattern of significant pathways between individual pathology and relationship violence differed somewhat for male-to-female and female-to-male aggression. Given the results, policy makers concerned about prevention of partner aggression may consider interventions aimed at symptoms associated with antisocial and borderline traits and substance use, and may identify differential targets for intervention based on the perpetrator's gender. [ABSTRACT FROM AUTHOR]

Victimization—physical, sexual, and emotional—is part of prison life for a sizable proportion of incarcerated people. Research has primarily focused on the prevalence and predictors of physical or sexual victimization inside prisons located in the United States. Very little prison-based victimization research has been conducted in other countries, and even less has examined the clustering patterns of victimization (referred to as polyvictimization), and whether different demographic, behavioral health, and criminal risk factors are associated with polyvictimization. This article explores variation in victimization patterns during incarceration in Spain, and whether there is variation in the demographic, behavioral, and criminal risk factors predicting one type (physical, sexual, or emotional); two types (physical and sexual, physical and emotional, or sexual and emotional); or three types (physical, sexual, and emotional), as well as the number of different types of victimization distinguished by type of perpetrator. Self-report data were collected from 2,484 male inmates housed in eight adult prisons in Spain. More than half the sample reported at least one type of victimization, and one quarter reported two or more types of victimization. Polyvictimization was found to be strongly associated with prior childhood and adulthood victimization experienced in the community. These findings have significant policy and practice implications. [ABSTRACT FROM AUTHOR]

Objective: To assess whether unhealthy behaviors moderated the relationship between allostatic load (AL) and future significant depressive symptoms (SDSs) among 1,789 older Latinos. Method: Longitudinal data included baseline AL, three unhealthy behaviors (UBs), and 2-year follow-up SDS. Multivariable logistic regression analyses, stratified by birthplace (U.S. vs. foreign born), modeled the effects of AL, UB count (range = 0-3), and their interaction on follow-up SDS. Results: Compared with U.S.-born, foreign-born participants engaged in fewer UBs (0.52 vs. 0.60 behaviors, p =.01) and had higher baseline SDS (31% vs. 20%, p <.001). Among foreign-born participants, the effect of AL on future SDS (adjusted odds ratios [aORs]; 95% confidence interval [CI]) significantly increased across UB counts of 0 to 3: 1.06 [0.83, 1.35], 1.46 [1.14, 1.87], 2.00 [1.18, 3.41], and 2.75 [1.18, 6.44], respectively. Discussion: Among foreign-born Latinos, these results were most pronounced for women and adults above age 80, which may represent higher risk groups requiring more intensive screening for depression. [ABSTRACT FROM AUTHOR]

Identifying nutritional strategies to maintain a healthy body weight and reduce the comorbidities associated with obesity is extremely important. We aimed to investigate whether calcium and vitamin D intakes are associated with body composition measurements in a population of children and adolescents. A cross-sectional study was conducted involving 1,060 children and adolescents (65.8% females; 34.2% males) aged 9 to 19 years. Fat mass, percentage of fat mass, and fat-free mass were measured using a body composition analyzer (TANITA BC-418MA®). The mean dietary calcium and vitamin intakes were 829.66 ± 328.34 mg/day and 200.78 ± 400.91 IU/day. Linear regression analysis revealed a lack of significant association between daily calcium and vitamin D intakes and body composition measurements, after adjusting the model for age, sex, maturation status, and energy intake. Dietary calcium and vitamin D intakes do not appear to be associated with higher adiposity measurements in children and adolescents. [ABSTRACT FROM AUTHOR]

Informal employment is an employment condition in which workers are not protected by labor regulations. It has been associated with poor health status in middle- and low-income countries, but it is still a neglected issue in high-income countries. Our aim was to estimate the association between health status and employment profiles in Spain, attending to the role of workplace risk factors. We conducted a cross-sectional study of 8,060 workers from the Seventh Spanish Working Conditions Survey (2011). We defined 4 employment profiles and estimated the associations between them and poor self-perceived health using Poisson regression models. All analyses were stratified by sex. The prevalence of the informal profile was 4% for women and 1.5% for men. Differences in self-perceived health status among employment profiles were negligible. Only women engaged in informal employment had poorer self-perceived health than those in the reference profile. This difference disappeared after adjusting models for psychosocial risk factors. In conclusion, we did not find differences in self-perceived health status between employment profiles, except for women in informal employment. Efforts should be made to improve the psychosocial risk factors in women in informal employment. [ABSTRACT FROM AUTHOR]

Background: I suggest this individualized care is a fundamental principle closely linked to nursing ethics and has important benefits for the patients, however, nurses do not always take into consideration the principles of individualized care. Moreover, there is no validated instrument to assess patients' views of individualized care in Spanish-speaking countries. Objectives: To assess the validity and reliability of the Spanish version of the Individualized Care Scale-patient. Design: A cross-sectional study design was conducted. A questionnaire survey, including the Individualized Care Scale-patient, was used for data collection. Psychometric properties of reliability and validity were assessed. Fit indices of the overall model were computed. Participants and research context: Survey data were collected from a sample of 118 inpatients at a public hospital in Spain. Ethical considerations: Informed consent from participants and ethical approval was obtained from a regional Clinical Research Ethics Committee. Findings: Ordinal Cronbach's alphas were 0.966 for Individualized Care Scale-patient subscale A and 0.969 for Individualized Care Scale-patient subscale B. The polychoric correlation between each item and the subscale ranged between 0.653–0.874 and 0.604–0.916, respectively. The exploratory factor analysis revealed a three-factor solution. Personal life situation explained relatively large amounts of the variance. Goodness of fit index showed a good fit for the model. Discussion: This study confirms three factors underlining the individualized care concept, but some differences were found in the load of the factors, such as the relevance of "personal life situation" subscale, that need further research. Conclusion: The Spanish version of the Individualized Care Scale-patient is reliable, valid, user-friendly, and suitable to be used in Spanish-speaking countries showing satisfactory properties. This instrument may help managers better understand and develop areas in which patients perceive lower individualized care received and the factors influencing it. Such key information will help ensure the right of the patient to be respected as an individual. [ABSTRACT FROM AUTHOR]

The present study measured profit efficiency and its determinants in the hotel sector in Spain from 2010 to 2014, using a Bayesian stochastic frontier approach. This model provides estimates of efficiency and more accurate confidence intervals than the traditional frequentist approach. The results revealed that the hotels are operating with significant profit inefficiencies. These inefficiencies are significantly affected by size, location, occupancy rate by region, customer satisfaction, and whether the hotel is affiliated or independent. Finally, the study points out the strategic implications of these findings, to improve the efficiency of the hotels. [ABSTRACT FROM AUTHOR]

Aims: Overweight and obesity are clinical public-health concerns worldwide. Amongst older adults, the prevalence of overweight and obesity is considered high. The purpose of this study was to provide current data regarding the prevalence and trends of overweight and obesity of adults from 2005 to 2013 in 10 European countries. Methods: The data used in the present study were derived from the first, second, fourth and fifth waves of the Survey of Health, Ageing and Retirement in Europe. The present study includes individuals aged ⩾50 years from 10 European countries. Body mass index (BMI) was calculated from self-reported height and weight (kg/m2). Results: The general prevalence of overweight (BMI ⩾25 kg/m2) was slightly above 60% and remained stable between 2005 (60.1%, 95% confidence interval (CI): 59.3–60.9%) and 2013 (60.3%, 95% CI: 59.7–60.9%). On the other hand, the prevalence of obesity (BMI ⩾30 kg/m2) increased significantly (1.6 points, 95% CI: 0.7–2.6) from 17.5% in 2005 to 19.2% in 2013. Although the prevalence of obesity increased in most countries, the only significant increase was observed in Germany (5.8 points, 95% CI: 1.8–9.9). Spain was the only country where the prevalence of obesity decreased significantly (−4.7 points, 95% CI: −8.8 to −0.5). Sex and age differences are reported. Conclusions: Although the prevalence of overweight was stable, the prevalence of obesity rose. Based on the data currently available for Europe, the prevalence of obesity in European older adults has already reached epidemic proportions, which reinforces the need for the development of effective healthy lifestyle programs. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to determine the functional vision of a sample of older adults living in nursing homes in Galicia in northwestern Spain. The study is aimed at raising the awareness of clinicians, as well as researchers working in the field of vision and the Spanish Social and Equality Services, regarding the need to develop visual screening protocols in nursing homes, which are currently lacking in Spain (Ministry of Health, Social Services and Equality, n.d.). Methods: Presenting visual acuity (visual acuity with current eyeglasses or contact lenses, if worn) was assessed to determine the functional vision of a sample of older adults living in nursing homes. We tested monocular and binocular high-contrast visual acuity using the directional-^ screening test (3.70 scale) for distance vision, and the Rosenbaum near vision chart for near acuity. Visual impairment (distance and near vision) was defined as a binocular presenting visual acuity of less than 6/18 (20/63). Results: The prevalence of visual impairment for distance and near vision reached 23.1% and 16.4%, respectively. We did not find any significant differences in the mean values of presenting visual acuity (far and near vision) between genders. The prevalence of visual impairment for distance vision increased with age (p < 0.01), reaching 25.8% among senior citizens between 80 and 89 years of age, and 50% in the case of nonagenarians. Nevertheless, we did not find any association between age and functional near vision (p > 0.05). Discussion: The findings confirm the high prevalence of visual impairment among this population group. Many of the residents we examined have a level of vision that affects their typical daily activities and quality of life, so it is urgent to develop standard visual screening protocols in nursing homes. Implications for practitioners: Developing visual screening programs in nursing homes would allow for the early detection of visual impairment and help other professionals working in nursing homes--especially clinicians, nurses, and caregivers--to optimize the care of the residents. [ABSTRACT FROM AUTHOR]

Using a nationally representative sample of 10,171 women, this study examines the association between current and previous intimate partner violence and current health status. Current physical or sexual violence was associated with the highest likelihood of reporting health outcomes, followed by current emotional or economic abuse. Current controlling behavior increased the odds of reporting poor health whereas previous controlling behavior has less effect on current health. Controlling behavior alone often is the first expression of mistreatment. If health professionals could identify violence at this early stage, long-term effects on women’s health could be minimized. The implications for health of the cumulative effects of violence and of its timing are discussed. [ABSTRACT FROM AUTHOR]

Multiple victimization, or polyvictimization, is closely related to delinquency and crime, although few studies have studied these experiences in juvenile offenders. Therefore, the aim of this study is to present victimization rates in young offenders from a Southwestern European country. The sample consisted of 101 youth aged between 14 and 17 years, who were mainly recruited from detention centers (77.2%). From a lifetime perspective, the majority had suffered a criminal offense against the person (93.1%), exposure to community violence (95.0%), and peer victimization (86.1%). Prevalence rates for direct and indirect family violence were also high (63.4% and 43.6%). Electronic victimization reached a rate of 40.6% and sexual victimization of 15.8%. Past year experiences showed lower but similar patterns. Based on a community population criterion to define polyvictimization, 65.3% of the sample were considered lifetime polyvictims, while 41.6% were defined as past year polyvictims. Interventions to address multiple, concurrent forms of exposure to violence should be implemented in the justice system as polyvictimization has been revealed as a frequent reality in young offenders, which may result in antisocial behavior. [ABSTRACT FROM AUTHOR]

This study examined whether spelling tasks contribute to the prediction of the handwriting status of children with poor and good handwriting skills in a cross-sectional study with 276 Spanish children from Grades 1 and 3. The main hypothesis was that the spelling tasks would predict the handwriting status of the children, although this influence would decrease with age due to a gradual automatization of handwriting skills. The results confirmed this hypothesis. Another interesting result was that the pattern of pseudoword and irregular word spellings as predictors of handwriting status changed from Grade 1 to Grade 3. In Grade 1, the pseudoword spelling task made a significant contribution, whereas the irregular word spelling task did not. The opposite pattern was found in Grade 3. These results may be a consequence of progressive acquisition of orthographic representations. The orthographic role of the task of writing the alphabet in order from memory in the prediction model was also analyzed. The writing of the alphabet in order from memory task made a significant contribution to the prediction of handwriting status of the children beyond the orthographic influence of spelling tasks. The additional effect of this task on the prediction of handwriting status is presumably due to the fact that this measure is based on fluency. [ABSTRACT FROM AUTHOR]

Arithmetic word problem (AWP) solving is a highly demanding task for children with learning disabilities (LD) since verbal and mathematical information have to be integrated. This study examines specifically how syntactic awareness (SA), the ability to manage the grammatical structures of language, affects AWP solving. Three groups of children in elementary education were formed: children with arithmetic learning disabilities (ALD), children with reading learning disabilities (RLD), and children with comorbid arithmetic and reading learning disabilities (ARLD). Mediation analysis confirmed that SA was a mediator variable for both groups of children with reading disabilities when solving AWPs, but not for children in the ALD group. All groups performed below the control group in the problem solving task. When SA was controlled for, semantic structure and position of the unknown set were variables that affected both groups with ALD. Specifically, children with ALD only were more affected by the place of the unknown set. [ABSTRACT FROM AUTHOR]

We aimed to assess the association of several risk factors for eating disturbances in adolescents. Participants were 448 girls and boys aged 12–15 years. Being female, higher body mass index, internalisation of standard of appearance, perfectionism, body dissatisfaction, number of lifetime addictive behaviours and lower self-esteem were associated with higher eating disturbance scores, whereas frequency of sedentary behaviours and physical activity were not (R2 ⩾ 41%). Findings suggest the need to guide prevention efforts towards the broad spectrum of individual potentially modifiable factors. A non-specific comprehensive perspective may be adequate to prevent problems related to weight, body image and drug use. [ABSTRACT FROM AUTHOR]