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Background: There is a clear predominance of programmes aimed at improving aspects related to language production in pupils with developmental language disorder (DLD). However, programmes aimed at improving their receptive skills are limited. Aims: The main aim was to assess the effectiveness of an intervention programme for oral language comprehension skills in preschoolers with typical development (TD) and pupils with DLD. Methods & Procedures: Participants were 99 five‐year‐old pupils, with and without DLD, divided into four groups: two control groups (TD‐C = 25; DLD‐C = 25) and two experimental groups (TD‐T = 24; DLD‐T = 25), from schools on the Spanish island of Tenerife. The study used, as pre‐ and post‐measures, the receptive language subtests of the CELF‐4‐Spanish: Concepts and Following Directions, Word Classes—Receptive and Sentence Structure, as well as two tasks assessing comprehension of paragraphs and narratives. Due to the strong link between oral comprehension skills and executive functions, working memory and semantic fluency are included in this research. The Backward Digit Span subtest of the Wechsler Intelligence Scale for Children (WISC‐IV) and Semantic Fluency subtest of the Controlled Oral Word Association Test (COWAT) were used to assess working memory and semantic fluency, respectively. The intervention programme followed a multitiered system of support (MTSS) model, with 95 sessions lasting 60 min each delivered jointly by teachers and speech and language therapists, and focused on lexical–semantic, morphological, syntactic and narrative skills; inferences; verbal working memory; and semantic fluency. Outcomes & Results: The results showed, as expected, that pupils diagnosed with DLD initially performed worse on oral language comprehension and executive functions than pupils with TD. Further, the DLD‐T and TD‐T groups showed greater gains following the programme, especially in word classes—receptive, sentence structure, verbal working memory and semantic fluency. Finally, a significant positive correlation was found between the gains obtained by the participants in verbal working memory and semantic fluency, with the gains obtained in the three CELF‐4‐Spanish subtests. Conclusions & Implications: An intervention programme applied at an early age fosters oral language comprehension skills and executive functions in pupils with DLD and TD. The intervention organized at different levels of support, following an MTSS model, showed clear progress of the DLD and TD groups in oral language comprehension and executive functions. What this paper adds: Pupils with DLD present deficits in linguistic comprehension and executive functions. There are many intervention programs focused on improving language production skills. It is also necessary to consider the skills underlying language problems in pupils with DLD. Oral language, inference, working memory and semantic fluency activities improve comprehension. A collaborative and inclusive intervention of teachers and speech language therapists. Psycholinguistic and neuropsychological skills training should become part of the academic curriculum as early as preschool age. What is already known on the subject: Pupils with DLD show problems related to both comprehension and production language. However, there is a clear predominance of programs just aimed at improving aspects related to language production. Clinical implications of this study: An intervention program applied at an early age fosters oral language comprehension skills and executive function in pupils with DLD. The intervention organized at different levels of support, following an adaptation of the Response Tier Intervention models, showed clear progress of the DLD in comprehension oral language and executive functions. [ABSTRACT FROM AUTHOR]

Background: This paper determines longitudinal changes in the time Spanish adolescents devote to moderate-to-vigorous physical activity (MVPA) and screen media activity (SMA). Moreover, it examines the displacement hypothesis between time spent on SMA and MVPA. Methods: A cohort of 755 adolescents participated in a prospective cohort study over a three-year period. Repeated measures ANOVA to highlight interaction effects among all variables and Structural Equation Modeling (SEM) techniques were employed. Results: Age and gender-related variations in longitudinal changes in time spent on MVPA and SMA evolved in the inverse direction (decreased on MVPA/increased on SMA) according to the ANOVA. The potential displacement between time spent on SMA and MVPA from Wave I to Wave II was analysed via SEM. The first model, estimated in the overall sample, showed no evidence for the displacement hypothesis. Subsequently, a multigroup sequence of panel models was performed and a partial displacement was observed only in boys. Hence, boys who spent more time on SMA were more likely to devote less time to MVPA three years later. Conclusion: This study confirms the opposite trend on the time spent on MVPA and SMA over a three-year period, being clearly higher in SMA. Further SEM analyses reveal a deferred displacement hypothesis between SMA and MVPA only in boys. This partial gendered displacement may be linked to the different uses adolescents make of screen media. The incursion of new technological devices (smartphones or tablets) and their wide range of possibilities for social networking or gaming could explain this displacement [ABSTRACT FROM AUTHOR]

This paper examines the perceived quality of working life of workers with intellectual disabilities. Specifically, this paper looks at participants' perceptions in relation to perceived job demands and resources and their impact on experienced job satisfaction. In this cross-sectional survey, 507 workers with intellectual disabilities, employed in either sheltered workshops or supported employment, completed questionnaires on the quality of working life through semi-structured interviews. Regression analyses showed that perceived low job demands and elevated social support from coworkers and supervisors predicted higher quality of working life. Common organizational psychology measures can be successfully used with this population to assess quality of working life. This study confirms the multidimensional nature of quality of working life, and the impact of job demands and available resources on perceived satisfaction with job for workers with intellectual disabilities. [ABSTRACT FROM AUTHOR]

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

Rationale, aims and objectives Transcatheter aortic valve implantation constitutes an example of a technology introduced into the Galician Health Care System basket and subjected to a post-introduction observational study after coverage. This paper aims to describe the process and results of this experience, illustrating the main challenges and opportunities in using these studies for supporting decision making. Methods The study protocol was developed by a multidisciplinary team consisting of experts from the Galician HTA Agency (avalia-t), interventional cardiologists and cardiac surgeons. Together they agreed on the information that was relevant and feasible for collection, and planned the study design, data collection and analysis of results. Results During the 1-year recruitment period, 94 patients underwent percutaneous aortic valve replacement in the three authorized centres. Implantation rate and prosthesis models differed substantially across the centres. Overall, procedural success rate was 96.8% and hospital mortality was 7.4%. Complications during post-surgical admission were recorded in 40.4% of patients. Moderate residual aortic regurgitation was observed in 10% of patients, and the procedure was associated with a stroke rate of 3.3% at 30 days and 5.3% at 1 year. Conclusions Post-introduction observation has made it feasible to determine the use of this procedure within the SERGAS context and has enabled the assessment of performance in real-life conditions. The proposed strategic actions and interventions have been drawn up based upon the collective judgement of a group of experienced professionals, and have served to establish recommendations on further research that would be required to optimize health benefits. [ABSTRACT FROM AUTHOR]

Aims To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. Material and Methods Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth ( PPD) and clinical attachment level ( CAL) and most in plaque index (PlI) and/or bleeding on probing ( BOP). Meta-analyses were performed with the data retrieved from the studies fulfilling the inclusion criteria. Results The overall effect of the subgingival application of antimicrobials was statistically significant ( p = 0.000) for both changes in PPD and CAL with a weighted mean difference ( WMD) of −0.407 and −0.310 mm respectively. No significant differences occurred for changes in BOP and PlI. Subgingival application of tetracycline fibres, sustained released doxycycline and minocycline demonstrated a significant benefit in PPD reduction ( WMD between 0.5 and 0.7 mm). The rest of the tested outcomes demonstrated a high heterogeneity. The local application of chlorhexidine and metronidazole showed a minimal effect when compared with placebo ( WMD between 0.1 and 0.4 mm). Conclusions The scientific evidence supports the adjunctive use of local antimicrobials to debridement in deep or recurrent periodontal sites, mostly when using vehicles with proven sustained release of the antimicrobial. [ABSTRACT FROM AUTHOR]

Introduction: This paper aimed to analyse the predictive ability of a self-determination theory (SDT) based model describing competitive sport dropout, and variance as a function of age and gender. Variables included in the model were: psychological need satisfaction, self-determined motivation, perceived conflict between sport and study, intention to practise sport, and dropout. Methods: A prospective study was performed over a period of 19 months. Variables considered as predictors of sport dropout were measured initially, and after 19 months persistence or dropout was assessed. The sample consisted of 857 athletes aged 11–19 (mean value 15.3; standard deviation = 1.77), 680 males and 177 females. Results: Structural equation modelling illustrated support for an “alternative” model that incorporated a direct relationship between psychological need satisfaction and intention to practise sport. Analysis of invariance showed that the model was consistent as a function of age and gender, i.e. no differences were found in regression weights. MANOVA, however, revealed some group differences with respect to the dependent variables. Specifically, in terms of engagement, although assessed at the start of the study, those athletes who persisted at 19 months demonstrated greater need satisfaction, self-determined motivation and intention to practise sport than those who dropped out. Age related differences were also identified: with increased age self-determined motivation and intention to practise sport decreased, while there were no differences in need satisfaction or perceived conflict between sport and study. There were no differences related to gender. Discussion: The results support previous studies that had used SDT to predict sport dropout, specifically those that had reported an inverse relationship between self-determined motivation and perceived conflict between activities. Further, it suggests that other variables (emotional) may play a specific role in predicting intention to continue engagement with sport. Conclusion: The major contribution of the study is in validating a motivational model predicting sport dropout which incorporates perceived conflict and the direct effect of psychological need satisfaction on the intention to practise sport. The invariance of regression weights between age and gender groups suggests that the relationships proposed in the model are universal. [ABSTRACT FROM PUBLISHER]

Generalised variance function (GVF) models are data analysis techniques often used in large-scale sample surveys to approximate the design variance of point estimators for population means and proportions. Some potential advantages of the GVF approach include operational simplicity, more stable sampling errors estimates and providing a convenient method of summarising results when a high number of survey variables is considered. In this paper, several parametric and nonparametric methods for GVF estimation with binary variables are proposed and compared. The behavior of these estimators is analysed under heteroscedasticity and in the presence of outliers and influential observations. An empirical study based on the annual survey of living conditions in Galicia (a region in the northwest of Spain) illustrates the behaviour of the proposed estimators. [ABSTRACT FROM AUTHOR]

Patent citations added by examiners are often used as indicators of technological impact and knowledge flows, despite various criticisms. In this study we analyze the distribution of examiner patent citations according to patent characteristics in order to show their limitations. According to our findings, the number of applicant citations included is dependent on the science-base of the technology. However, this gets masked by the citations added by patent examiners, who smooth the distribution of citations across technology classes and include the same number of citations regardless of whether applicants cite any references. Some researchers have called for the use of applicant rather than examiner patent citations as indicators of technology impact and knowledge flows. Nevertheless, we show that the former also have important caveats, because applicants may increase the number of citations in international patents and when there are coapplicants. The implication is that analysts should consider a context-driven use of citation-based indicators. [ABSTRACT FROM AUTHOR]

Background A readiness assessment for identifying and measuring variables that can facilitate evidence-based nursing (EBN) is important. Attitude towards EBN is one of its components. However, questionnaires that exclusively measure attitude to EBN do not exist in Spanish-speaking contexts. Aim This paper is a report of the development and psychometric testing of a Spanish-language assessment tool: the Evidence-Based Nursing Attitude Questionnaire (EBNAQ). Methods The questionnaire was developed in three phases: item generation through a review of scientific literature and focus groups; item selection through an expert review; content and construct validity testing, and internal consistency reliability testing. The instrument was validated in terms of construct validity by a factorial analysis and content validity by grouping the items into the three categories of attitude: cognitive, affective and behavioural. Data were collected from May to November of 2008. Results The questionnaire was validated in a sample of 219 Spanish community nurses, who had a mean age of 43.21 (SD 10.3) years, and 64.5% (141) were women. A total of 54.3% (121) had been working in the community for more than 10 years. The questionnaire consisted of 15 items grouped into the three factors that make up the concept of attitude. Cronbach's alpha was 0.853 for the entire questionnaire. The factor solution explained 54.70% of the variance. Conclusions The EBNAQ is brief, making it a user-friendly tool. It is the first Spanish-language questionnaire that exclusively measures attitude towards EBN in nurses who work in the community. The EBNAQ can be used efficiently in research and practice settings to better understand nurses' attitudes towards evidence-based practice. [ABSTRACT FROM AUTHOR]

Aims: To analyse the histological structure and histomorphometric characteristics of human hard palatal mucosa in order to determine the donor site of choice for connective tissue grafts from a histological point of view. Materials and Methods: Palatal mucosa samples from six cadaver heads were harvested at four sites: incisal, premolar, molar and tuberosity. Histological and immunohistochemical techniques were performed, as was histomorphometric analysis. Results: In the current study, we found that the density and size of cells were higher in the superficial papillary layer, whereas the thickness of the collagen bundles increased in the reticular layer. Excluding the epithelium, the mean percentage of lamina propria (LP) and submucosa (SM) was 37% and 63%, respectively (p <.001). LP thickness showed similar values in the incisal, premolar and molar regions, and a significantly greater thickness in tuberosity (p <.001). The thickness of SM increased from incisal to premolar and molar, disappearing in the tuberosity (p <.001). Conclusions: As dense connective tissue of LP is the tissue of choice for connective tissue grafts, the best donor site from a histological point of view is tuberosity because it is composed only of a thick LP without the presence of a loose submucosal layer. [ABSTRACT FROM AUTHOR]

Background: Cannabis use is increasing among Andalusian adolescents, causing health, social and financial problems. School nurses visit schools and provide health promotion to adolescents in Andalusia. In order to better tailor health promotion programs, it is important to understand the sociodemographic and motivational factors related to cannabis use in Andalusian adolescents. Design/Methods: In this cross‐sectional study, 369 students (aged 15–18 years) from secondary schools in Andalusia were involved. An anonymous questionnaire based on the I‐Change Model was self‐administered during school hours. Cannabis users were compared with non‐cannabis users regarding sociodemographic and motivational factors. Contingency tables, mean comparison tests, and logistic regression analyses were conducted. Results: The prevalence of cannabis use in the last year was 21.6%. Non‐cannabis users had a few positive beliefs toward cannabis use (e.g. the ability to relax or medical benefits), as well as users. Users recognized some disadvantages of cannabis use but played down their importance and mentioned more advantages. Moreover, social influence, especially from peers, plays a critical role in cannabis use. Specific social situations and moods seemed to be special risk factors for cannabis use, such as being at a celebration or feeling good. Results of regression analysis showed that cannabis use is mainly associated with age, low family function, low family affluence, high pocket money, perceiving few disadvantages of cannabis use, much social modeling of cannabis use, social norm and pressure favoring cannabis, low self‐efficacy to resist using cannabis and positive intentions to use cannabis. Conclusions: Based on our results, prevention programmes lead by nurses can be tailored to the factors important to prevent cannabis use, focusing on outlining the disadvantages of cannabis use, alternatives for using cannabis when feeling good, increasing salience of healthy social influences and reinforcing self‐efficacy to resist temptations to use cannabis are recommended. Clinical Relevance: Nurses need to know the sociodemographic factors and motivations associated with the use of cannabis in adolescents in order to establish effective preventive interventions at school. [ABSTRACT FROM AUTHOR]

If children in child protection cannot be cared for by their natural parents, should they be adopted or live in foster home? Results from a study of representative samples of populations (n = 12 330), in eight European countries—Austria, England, Estonia, Finland, Germany, Ireland, Norway and Spain—and California, USA, reveal that people would recommend adoption over foster care, if a child in public care cannot grow up with their natural parent(s). There are cross‐country differences between populations, and examining if institutional context such as type of child protection system explains differences, we find that child maltreatment‐oriented systems are more supportive of adoption than other types of systems. Citizens having little confidence in the child protection system were only weakly correlated with preference for adoption. In conclusion, people prefer adoption as placement options for children in care are more than foster homes, and possible this finding reflects a sort of refamalialization of children into the private sphere. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to describe nursing teams' theoretical knowledge of delirium and their perceptions of the way in which it is handled in acute inpatient units. Design: This is a descriptive cross‐sectional study using a questionnaire comprising ten questions on knowledge and seven on perception. Methods: The sample consisted of 216 professionals working at a hospital complex in Madrid, Spain. Descriptive and non‐parametric bivariate analyses were performed for a p <.05. Results: Fifty‐three point two per cent of staff possessed sufficient theoretical knowledge, and this figure rose significantly among professionals with more years of experience. Areas for improvement in theoretical knowledge included the use of therapeutic immobilization, screening scale, subtypes of delirium and precipitating factors. Sixty‐eight point five per cent of staff perceived their knowledge as fair, 50% agreed that delirium was underdiagnosed and 48.1% agreed that preventive measures were only occasionally taken. Perceived barriers included lack of training, work overload, ineffective coordination and lack of standardized protocols. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic had a notable impact on the psychological well‐being of a large part of the population, putting them at risk of developing depressive symptoms, different levels of anxiety disorders, and posttraumatic stress disorder (PTSD). One group considered to be at high risk are Nursing students; they were affected as learning strategies changed and clinical practices were cancelled. This study attempts to assess the psychological impact COVID‐19 pandemic had on Nursing students and to explore the sociodemographic differences that can be risk factors for mental health disturbance. The psychological impact was evaluated using the Impact of Event Scale‐Revised (IES‐R) and Hospital Anxiety and Depression Scale (HADS). The study took place 4 months after the state of alarm was declared over in Spain. From a total sample of 304 Nursing students, 26.7%, 39.8%, and 15.5% showed PTSD, anxiety, and depression symptoms, respectively. Severe levels of psychological impact have been associated with being a female, a smoker, and feeling fear and stress. Having a relative test positive has been linked to lower anxiety levels while being afraid or stressed to higher anxiety levels. Being a female, co‐habit with friends and feeling stress have been associated with higher depression levels. [ABSTRACT FROM AUTHOR]

Transition to adulthood is an accelerated and early process for care leavers that requires intensive preparation, training and support from child welfare services. This study aimed to explore the perceived readiness for independent living of a group of care‐experienced young people preparing for leaving care in Spain and to compare it with the perceptions of their peers from the general population. A sample of 508 youth (50% women) aged 14–21 (M = 16.67; SD = 1.72) took part, of whom 279 were care experienced and 229 belonged to the general population in Spain. Participants' independent living skills, personal autonomy, self‐efficacy and sociodemographic characteristics were assessed through an online survey using standardized instruments. Care‐experienced young people displayed higher levels of life skills and autonomy in self‐care, daily living at home and employment domains, but not related to making daily arrangements in their community. However, their educational level and self‐efficacy levels were lower than in the comparison group. Work experience stood out as a significant predictor of care‐experienced young people's life skills level. These findings support the importance of assessing life skills as an outcome of leaving care preparation services and providing care‐experienced young people with real‐life experiences to develop their life skills. [ABSTRACT FROM AUTHOR]

Aim: To explore the impact of the COVID‐19 pandemic on the mental health of nurses working in primary, secondary, and tertiary healthcare centers in Navarre (Spain). Background: Healthcare workers, especially nurses, are at high risk for developing mental health problems during the COVID‐19 pandemic. Introduction: Spain ranks among the European countries with the highest incidence of and mortality from COVID‐19 and has a 31% deficit in the number of nurses compared with the average for the European Union. Methods: This was a cross‐sectional study involving 800 Registered Nurses in Navarre, Spain. Four standardized instruments, along with a self‐administered online questionnaire, were used to measure the impact in terms of depression, anxiety, insomnia, and posttraumatic stress disorder. The STROBE checklist for cross‐sectional studies was used to report this study. Results: Of the 800 nurses, 68% had some level of depression, anxiety, insomnia, and distress, and of these, 38% had moderate or severe symptoms. Those who worked in hospital COVID units and in nursing homes showed a higher impact on their mental health. Discussion: The sustained pressure that nurses have experienced in their work during the COVID‐19 pandemic has negatively affected their mental health. Conclusion: This study found that nurses who worked in hospital COVID units and in nursing homes during the pandemic had worse mental health outcomes. Implications for nursing/policy: Recommendations for nursing policy include the need to implement coaching and emotional programs to support nurses on the frontlines of the pandemic. There is also an urgent need for the implementation of national training programs to strengthen health emergency preparedness, improve response capacity, and increase the resilience of nurses to disasters. [ABSTRACT FROM AUTHOR]

Background: A culture of shared leadership is widespread among palliative care teams based on a commitment to valuing and including all people equally. As compassion is a core value for end‐of‐life care work, compassionate leadership may be the best way to lead in palliative care. Aims: The aims of this study were twofold: (1) to adapt and validate the Compassionate Leadership Self‐reported Scale in a sample of palliative care professionals; and (2) to study the relation between compassionate leadership and associated concepts of self‐compassion, awareness and self‐care. Methods: A cross‐sectional survey of 296 Spanish end‐of‐life care professionals was conducted. Analyses included descriptive statistics, a confirmatory factor analysis (CFA) with four‐correlated factors, reliability estimates and a structural model. Results: Results suggested there were medium to high levels of compassionate leadership in the sample. The CFA showed an adequate overall fit: χ2(98) = 277.595 (p < 0.001); CFI = 0.986; SRMR = 0.047; RMSEA = 0.088 [0.076, 0.100]. Reliability estimates for four subscales of compassionate leadership (attending, understanding, empathising and helping) were also adequate, ranging from 0.72 to 0.96. Finally, the structural model predicting compassionate leadership suggested that the dimensions of attending and understanding were most highly related to positive self‐compassion and awareness; empathising, to self‐care and awareness; and helping, to positive self‐compassion and self‐care. Conclusion: The Compassionate Leadership Scale has adequate psychometric properties when used to assess compassionate leadership in the context of end‐of‐life care. Our results indicate that self‐compassion, awareness and self‐care are important correlates of such compassionate leadership. [ABSTRACT FROM AUTHOR]

Background: Patients treated in intensive care units (ICUs) experience life‐threatening medical conditions but some external factors in ICUs do not help or even adversely affect and complicate their evolution. Among others, such factors include noise pollution due to alarms and medical clinical equipment, as well as the activities of the health care personnel themselves. Aim: This study aimed to evaluate the influence of elevated sound levels on physiological variables and the consciousness state of patients treated in a cardiovascular area in an ICU. Design: A longitudinal study with several observations was carried out during 1 month in the cardiovascular area of an ICU of a third‐level hospital in southern Spain. Methods: Sound levels were monitored in different work shifts and patients' physiological data and consciousness status were recorded. Generalized additive mixed models (GAMMs) were developed to detect the variability of the sound levels together with the vital parameters of the patients in the ICU. Results: Thirty‐eight patients were included. The mean sound level was 54.09 dBA. The GAMM sound levels analysis showed a significant increase in sound levels from 4:30 p.m. to 8:00 p.m. (1.83 dBA; P <.001) and 8:00 p.m. to 11:30 p.m. (3.06 dBA; P <.001). An increase in heart rate (3.66 bpm; P <.001), respiratory rate (2.62 rpm; P <.001) and the Glasgow Coma Scale (0.50 units; P =.002) was detected during the 4:30 p.m.–8:30 p.m. period. Conclusions: Elevated sound levels in cardiovascular ICUs seem to influence positively the physiological and consciousness status of patients. Given the importance of the findings for patient safety, future intervention studies are recommended. Relevance to Clinical Practice: The finding of this study could translate into structural changes in ICU facilities, as well as the development of clinical practice guidelines that influence the behaviour of health care professionals. [ABSTRACT FROM AUTHOR]

In this study, we examine the cross-cultural differences in human resource (HR) managers' beliefs in effective HR practices by surveying HR practitioners in Finland (N = 86), South Korea (N = 147), and Spain (N = 196). Similar to previous studies from the United States, the Netherlands, and Australia, there are large discrepancies between HR practitioner beliefs and research findings, particularly in the area of staffing. In addition, we find that interpersonal-oriented aspects of HR practices tend to be more culturally bound than technical-oriented aspects of HR practices. We interpret the differences using Hofstede's cultural dimensions (Power Distance, Individualism versus Collectivism, Masculinity versus Femininity, Long-Term Orientation versus Short-Term Orientation, and Uncertainty Avoidance). We discuss the overall nature of the science-practice gap in HR management, and the implications for evidence-based management. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Postnatal sense of security is a relevant construct related to several variables of motherhood. However, it has not yet been studied in the Spanish context. The aims were: (a) To analyze the psychometric properties of a Spanish version of the Mothers' Postnatal Sense of Security Scale (PPSS‐S); (b) analyze the factors related to mothers' sense of security during the first 2 weeks following childbirth (sociodemographic variables and factors related to maternity); and (c) examine the predictive utility that mothers' sense of security has on symptoms of postpartum depression 6–11 months after childbirth. This was a prospective longitudinal study performed in the first 6–11 months post‐partum in four regions of Spain. A total of 928 mothers whose mean age was 33.67 years (standard deviation = 4.54) participated. The confirmatory factor analysis showed adequate adjustment to the original structure (χ2 = 17,272.79, df = 153, p <.001; Tucker–Lewis index = 0.98; comparative fit index = 0.98; root mean square error of approximation = 0.058 [0.053‐0.063])and the overall internal consistency was 0.89. Direct relationships were shown between women' sense of security and already having had a child, the absence of postpartum health complications (either in the mother or the newborn) and receiving consistent information from healthcare professionals. Our results showed adequate evidence for the reliability and validity of the Spanish version of the PPSS‐S. Understanding mothers' sense of security during the early months of motherhood, as well as related factors in the postpartum period, will allow health professionals to implement preventive measures to promote mental health and could help reduce symptoms of postpartum depression. [ABSTRACT FROM AUTHOR]

Current competitive environments have created a growing interest in employee flexibility in firms. Recently researchers have differentiated between two facets of employee flexibility: behavior flexibility and skill flexibility. This study proposes a model of relationships between these two facets of employee flexibility and the extent to which HR practices influence them. This model is tested by estimating structural equation models on a sample of 226 commercial departments in Spanish companies. The results of the study show that the two facets of employee flexibility are interrelated, in that skill flexibility influences behavior flexibility. Furthermore, findings confirm the influence of job enrichment on employee flexibility and the significant effect of the internal fit among HR practices on employee flexibility. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Both researchers and managers are increasingly interested in how firms can pursue ambidextrous learning-that is, simultaneously exploring new knowledge domains while exploiting current ones. In this study, we attempt to bring human resource management into this forum by introducing and testing how high-involvement human resource practices shape the social climate that affects the firm's ambidextrous learning and subsequent performance. A field study of 198 companies from Spain showed that high-involvement human resource practices were positively related to the social climate that, in turn, facilitates ambidextrous learning and improved performance. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background/aim: Cocaine consumption may result in irreversible structural changes in the brain. The long‐term effects of cocaine are related to a wide range of deteriorated cognitive functions. This study aimed to examine the fine motor control and hand‐function in cocaine users compared to healthy controls. Methods: An observational study was conducted. Sociodemographic variables, substance consumption, the Purdue Pegboard and the Jebsen–Taylor Hand‐function Test were evaluated bilaterally in 35 participants who were cocaine users and in 35 healthy participants. Differences between sides (dominant and non‐dominant hands) and groups were analysed with analysis of variance (ANOVA). Results: The ANOVA revealed significant differences between groups (P < 0.001) and between sides (dominant and non‐dominant hands) (P = 0.005) for the one‐hand pin placement subtest of the Purdue Pegboard Test. Also, ANOVA tests showed significant differences between sides, but not groups, for the simulated feeding (P < 0.001) and stacking checkers (P < 0.001) Jebsen–Taylor subtests. Cocaine user participants exhibited significantly lower scores in bilateral pin placement and required more time for the Jebsen–Taylor subtests compared to healthy participants. Conclusions: Cocaine user participants display deficits of fine motor control and some aspects of manual dexterity when compared to healthy controls. These findings show the convenience of incorporating functional rehabilitation by occupational therapists as a key component within the treatment of cocaine users. This study therefore opens a new field of practice for occupational therapy based on the assessment and treatment of motor deficits in the hand and the upper limb of people who consume cocaine. [ABSTRACT FROM AUTHOR]

This study investigated the effect of a 3-km walking test (3kWT) carrying different military equipment on shooting performance, rating of perceived exertion (RPE), heart rate (HR), and test time. The relative combat wear and backpack weight (as percentage of soldier's body weight [%BW]) was reported and, along with HR, its relationship to marksmanship variables was tested. Thirty-nine Spanish Army males walked as fast as possible to complete the 3kWT in the following conditions in a randomized order: unloaded walking; wearing the combat uniform; and carrying the combat uniform plus combat backpack. A shooting test was completed before and after the 3kWT. The HR and RPE were evaluated. The marksmanship variables and HR were analysed using a two-way repeated measures ANOVA, and a repeated ANOVA was also used for 3kWT completion time and HR reserve analysis. Correlation analyses were performed between the equipment's weight, HR, and marksmanship variables. The results showed that shooting score decreased after the 3kWT in both load conditions (p < 0.001). The 3kWT time, RPE, and HR increased from control to load conditions, and also between load conditions. The HR reserve showed no significant effects between conditions. The %BW of the backpack condition negatively influenced aiming accuracy (r = −0.35; p = 0.04) and cleanness triggering (r = 0.37; p = 0.03). Correlations between HR and shooting variables were non-significant. In conclusion, wearing the Spanish Army combat wear and backpack resulted in shooting performance degradation. Furthermore, fatigue and RPE increased and this could decrease physical marksmanship and performance capacity in combat situations. [ABSTRACT FROM AUTHOR]

This study examined the types of youth‐led activities performed during the community‐based program "Building My Future" and their impact on personal, problem‐solving, and community competences. At‐risk and non‐at‐risk adolescents (N = 410) participated in 49 groups in the local social services. Different types of pre‐intervention and intervention activities and the meetings held with external resources were associated with pre‐post changes in self‐concept, productive task orientation, connectedness, coping skills, participation, and integration with the community, using cluster analyses. Results showed that adolescents who performed the pre‐intervention activity carried out more modules and performed more intervention activities. Performing group dynamics as a pre‐intervention activity, carrying out creative activities, volunteering, excursions, and games, but no sports, and meeting up with associations were related to the most positive changes in at‐risk groups. Non‐at‐risk groups that mainly participated in amusing activities experienced a decrease in their competence scores. This shows the relevance of the types of self‐selected activities carried out when promoting positive development and can serve as guidance for future community work. [ABSTRACT FROM AUTHOR]

Aim: Depression among older adults has serious implications, especially because suicide rates are higher in this group than in younger adults. Research has identified biological and social risk factors. However, studies addressing cultural and psychosocial factors associated with specific ethnic groups, such as Spanish Romani, are lacking. The objective of the present study was to establish the differential prevalence of depression among Romany and non‐Romany people older than 55 years of age. It also aimed to explore how cultural, sociodemographic, and psychosocial factors predispose individuals to depression. Methods: A total of 181 people were interviewed. The sample consisted of 95 self‐adscribed Romany individuals and 86 non‐Romany individuals over the age of 55; the latter group served as the control group. We performed bifactorial univariate anova, epidemiological analysis using Epi Info software, and analysis of correlations between Geriatric Depression Scale scores and the different factors analyzed. Results: Significant differences in Geriatric Depression Scale score related to ethnicity and sex were found. Probable depression or depression in Romany men was four times higher than in non‐Romany men. In Romany women, the risk was more than twice as high as in non‐Romany women. Among the factors analyzed, income level, activity at home, and perception of being valued by family members showed significant differences between the groups. Conclusions: In short, we can state that Romany people develop symptoms of depression to a greater extent than non‐Romany people, and although Romany women have a higher risk of depression, the differential effect of ethnicity is greater among Romany men. Income level, activity at home, and perception of being valued by family members are unambiguously related to ethnicity. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine the prevalence of Ineffective Self‐Health Management (ISHM) (00078) and its related factors in polymedicated patients over the age of 65 years. METHODS: A cross‐sectional, descriptive design was used. A home interview was conducted with each participant (N = 375) for data collection. FINDINGS: The prevalence of ISHM was 37.3%. The risk factors associated were social risk, depression, noncompliance, medication errors, and confusion with medications. CONCLUSIONS: Among polymedicated elderly patients, the prevalence of ISHM is high. The diagnosis is closely connected to the compliance and complexity of the treatment regimen, in addition to those relating strictly to social and emotional factors. IMPLICATIONS: Nursing methodology encompasses instruments that allow nurses in clinical practice to evaluate the issue of compliance. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aims of this study were to (1) examine the reactions of teachers and student teachers to children experiencing pain, (2) identify the most common challenges and potential resources that are associated to dealing with them, and (3) examine whether their responses differed as a function of their experience or sex. METHODS Forty teachers and 318 student teachers completed a survey which included descriptive information, a questionnaire that assesses different responses of participants to children who experience pain, and provides a list of problems and resources that participants might encounter and implement, respectively, when dealing with these children. RESULTS The study participants most often endorsed use of coping and health-promoting responses. Experienced teachers endorsed solicitous responses significantly more often than student teachers. Women reported responding more with solicitous responses than men. Absenteeism and the negative effect of pain on the ability of students to engage in school activities were the most common pain-related challenges mentioned by the study participants overall. CONCLUSIONS The findings emphasize (1) the need for developing guidelines to help teachers to help students experiencing chronic pain, and (2) the importance of including information about pediatric chronic pain in teachers training. [ABSTRACT FROM AUTHOR]

Objective To compare the effect of two newly formulated chlorhexidine ( CHX) and cetylpyridinium chloride ( CPC) mouthrinses after scaling and root planing ( SRP) in terms of clinical, microbiological, patient-based variables and adverse events, with a positive control with the same active components, already marketed and tested. Methods A pilot, randomized clinical trial, double-blind, parallel design with 1-month follow-up was conducted. Chronic periodontitis patients requiring non-surgical periodontal therapy were enrolled and randomly assigned to: (i) SRP and test-1 (new reformulation: 0.12% CHX and 0.05% CPC); (ii) SRP and test-2 (new formulation: 0.03% CHX and 0.05% CPC); or (iii) SRP and positive control (commercial product: 0.12% CHX and 0.05% CPC). All variables were evaluated at baseline and 1 month after SRP. Quantitative variables were compared by means of anova or Kruskal-Wallis test and qualitative variables by chi-square or McNemar tests. Results Thirty patients (10 per group) were included. After 1 month, there were significant differences among groups in plaque levels ( P = 0.016) as test-1 showed less sites with plaque than test-2 (31.15% [standard error- SE 2.21%] versus 49.39% [ SE 4.60%), respectively). No significant differences were found for global patient perception of the product or in adverse effects. Test groups showed better results in levels and proportions ( P = 0.022) of Capnocytophaga spp. Conclusions Within the limitations of this pilot study, it can be concluded that the newly formulated 0.12% CHX and 0.05% CPC mouthrinse showed larger plaque level reductions, without showing more adverse effects, when compared to the other two mouthrinses, after SRP. [ABSTRACT FROM AUTHOR]

When students solve problems on the Internet, they have to find a balance between quickly scanning large sections of information in web pages and deeply processing those that are relevant for the task. We studied how high school students articulate scanning and deeper processing of information while answering questions using a Wikipedia document, and how their reading comprehension skills and the question type interact with these processes. By analyzing retrospective think-aloud protocols and eye-tracking measures, we found that scanning of information led to poor hypertext comprehension, while deep processing of information produced better performance, especially in location questions. This relationship between scanning, deep processing, and performance was qualified by reading comprehension skills in an unexpected way: Scanning led to lower performance especially for good comprehenders, while the positive effect of deep processing was independent of reading comprehension skills. We discussed the results in light of our current knowledge of Internet problem solving. [ABSTRACT FROM AUTHOR]

SUMMARY Background Initiating dialysis can produce psychological benefits. These positive changes, most frequently referred to as posttraumatic growth (PTG), have not previously been explored in these patients. Objective To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress. Design A prospective, longitudinal, observational study. Setting and Methods The sample included 98 patients, aged from 18 to 70 years, who commenced dialysis in the nine nephrology units of the Basque Country, Spain. Three assessments were carried out at 1, 6 and 12 months, using a PTG questionnaire and the Perceived Stress Scale. ANOVAs with post-hoc analysis were performed to identify significant differences between the groups. Results Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG. Maintaining high PTG and decreasing PTG levels was associated with moderate levels of perceived stress. Conclusion Four different patterns of PTG have been identified, contributing to our understanding of the dynamics of the process of growth and enabling us to identify patients who may be more vulnerable. [ABSTRACT FROM AUTHOR]

Objectives Interpersonal emotion regulation ( ER) plays a significant role in how individuals meet others' emotional needs and shape social interactions, as it is key to initiating and maintaining high-quality social relationships. Given that individuals with borderline personality disorder ( BPD) or Asperger's syndrome ( AS) exhibit problems in social interactions, the aim of this study was to examine their use of different interpersonal ER strategies compared to normative control participants. Methods Thirty individuals with AS, 30 with BPD, and 60 age-, gender-, and education-matched control participants completed a battery of measures to assess interpersonal ER, which assessed to what extent participants tended to engage in interpersonal affect improvement and worsening and to what extent they used different strategies. Before completing those measures, all groups were screened for disorders of Axis I and Axis II with the Structured Clinical Interview for DSM- IV Axis I and Axis II Disorders. Results Compared to controls, individuals with AS and with BPD engaged less in affect improvement. No differences were found for affect worsening. Individuals with AS reported to use less adaptive (attention deployment, cognitive change) and more maladaptive (expressive suppression) interpersonal ER strategies, compared to individuals with BPD and control participants who did not differ from each other. Conclusions The obtained results suggest the need to develop tailored ER interventions for each of the clinical groups studied. Furthermore, they highlight the need to study further potential differences in intrapersonal and interpersonal ER in clinical populations. Practitioner points Individuals with Asperger's syndrome ( AS) and borderline personality disorder ( BPD) engaged significantly less than healthy controls in interpersonal affect improvement., Individuals with BPD did not differ from healthy controls in the use of interpersonal strategies., Individuals with AS reported to use more maladaptive and less adaptive strategies than BPD individuals and healthy controls., Understanding differences in interpersonal emotion regulation in individuals with AS and with BPD and normative controls might help practitioners develop better interventions. [ABSTRACT FROM AUTHOR]

How do individuals deal with group disadvantage when their fellow in-group members conceive it as legitimate? Integrating research on the normative conflict model (Packer, 2008, Pers. Soc. Psychol. Rev., 12, 50) and collective action, we expect high identifiers to reject the in-group norm of legitimacy that justifies the inequality, and to assert that the group is actually able and willing to contest the disadvantage by collective means. In Study 1 and Study 2, we tested this hypothesis in different intergroup contexts. The results confirmed our predictions and also showed one boundary condition for high identifiers, namely that the content of the social identity supports resistance. In Study 3, we found support for our hypothesis using artificial groups and manipulating identification experimentally. These results show that even when a disadvantaged group appears to accept its situation, high identified in-group members will still contest this and, moreover, expect other in-group members to support them in this endeavour. [ABSTRACT FROM AUTHOR]

In this study, we estimated the risk of acute coronary syndrome and stroke associated with several emerging cardiovascular risk factors. This was a case-control study, where an age - and sex-matched acute coronary syndrome group and stroke group were compared with controls. Demographic and clinical data were collected through patient interviews, and blood samples were taken for analysis. In the bivariate analysis, all cardiovascular risk factors analyzed showed as predictors of acute coronary syndrome and stroke, except total cholesterol and smoking. In the multivariate logistic regression model for acute coronary syndrome, hypertension and body mass index, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent predictors. For stroke, the predictors were hypertension, diabetes mellitus, body mass index, and N-terminal section brain natriuretic peptide. Controlling for age, sex, and classical cardiovascular risk factors, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent emerging cardiovascular risk factors for acute coronary syndrome, but pregnancy-associated plasma protein-A was not for stroke. High levels of cardiovascular risk factors in individuals with no episodes of cardiovascular disease requires the implementation of prevention programs, given that at least half of them are modifiable. [ABSTRACT FROM AUTHOR]

Social question & answer forums offer great learning opportunities, but students need to evaluate the credibility of answers to avoid being misled by untrustworthy sources. This critical evaluation may be beyond the capabilities of students from primary and secondary school. We conducted 2 studies to assess how students from primary, secondary, and undergraduate education perceive and use 2 relevant credibility cues in forums: author's identity and evidence used to support his answer. Students didn't use these cues when they evaluated forums with a single answer (Experiment 1), but they recommended more often answers from self-reported experts than from users with a pseudonym when multiple sources were discussed in the forum (Experiment 2). This pattern of results suggested that multiple viewpoints increase students' attention to source features in forum messages. Experiment 2 also revealed that primary school students preferred personal experience as evidence in the messages, whereas undergraduate students preferred the inclusion of documentary sources. Thus, while children mimic the adult preference for expert sources in web forums, they treat source information in a rather superficial manner. To conclude, we outline possible mechanisms to understand how credibility assessment evolves across educational levels, and discuss potential implications for the educational curriculum in information literacy. [ABSTRACT FROM AUTHOR]

Objectives To compare the use of sonic powered or manual toothbrush in patients with intellectual disability ( ID) in terms of plaque (PlI) and gingival ( GI) indices and adverse effects. Material and Methods Subjects with ID were recruited for this cluster-randomized, single blinded (examiner), 6-month clinical trial, comparing powered versus manual toothbrushing. Outcome variables included PlI and GI, evaluated at baseline and 3 months after supervised toothbrushing and after 3 additional months of unsupervised used. Clinical outcome variables were analysed by repeated measures ANCOVA considering time and group as factors and respective baseline values as covariates (generalized linear model). Results Sixty-four patients (34 male, mean age 34.5) in six clusters were included in the study. No statistically significant effect of toothbrushing group was observed for PlI or GI. A significant effect of time was identified ( p < 0.001) with mean reductions ranging 0.44-0.45 for PlI and 0.30-0.36 for GI from baseline to 3-6 months. No relevant adverse effect or technical problems were observed. Conclusion The tested sonic powered toothbrush was as effective and safe as the manual toothbrush. The use of powered or manual toothbrushes, together with fluoride toothpaste, may improve plaque and gingivitis levels, in patients with mild to limit ID. [ABSTRACT FROM AUTHOR]

Background There is a lack of large epidemiological studies researching the major factors of the oral well-being in schoolchildren. Aims To quantify the impact of the different clinical conditions related to caries and periodontal and dento-facial anomalies on the quality of life captured by the Child- OIDP. Design A standardized epidemiological study was conducted on 2041 Spanish schoolchildren, aged 6-12 years, to assess caries and periodontal and dento-facial disease. Data on oral health-related quality of life were collected using the Child- OIDP. Bivariate and multivariate analyses were performed to evaluate the modulating factors in the perceived oral well-being. Results The prevalence of impact in this sample was 45.7%, mostly for eating (24.3%) but also for smiling (16.2%); however, 72.5% of the subjects had at least one type of normative needs, mainly for periodontal treatment (52.3%), followed by caries (32.3%) and orthodontic treatments (20.6%). The main predictors of the impact on quality of life were perceived dental treatment needs, caries, and periodontal diseases. Also, some demographic (age and gender) and behavioural factors (consumption of sweets) modulated the impact on several domains. Moreover, subjects who rated their general health as good or very good reported a significantly better oral well-being than their counterparts. Conclusions Pain and aesthetic-related domains (i.e., problems when eating or smiling) are the major components of the oral health-related quality of life perceived by Spanish schoolchildren. Perceived treatment needs as well as dental and periodontal status were the strongest predictors of oral well-being. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to assess the accuracy of periapical radiography in measuring peri-implant bone levels. Materials and Methods Twenty-five subjects with 46 implants in need of surgical treatment for peri-implantitis were included in this cross-sectional study. Prior to surgery, periapical radiographs were taken, a prediction of type of defect was made and radiographic peri-implant bone levels ( Rx BL) were determined at the mesial and distal aspects. Intra-operatively, the peri-implant bone level ( Surg BL) was assessed mesially, distally, buccally and orally and the type of defect was recorded. A paired t-test was applied to detect differences between inter-proximal Rx BL and Surg BL. ANOVA was used to compare Surg BL at different circumferential positions. Results The mean inter-proximal Rx BL was 4.0 ± 2.2 mm and the mean inter-proximal Surg BL was 5.3 ± 2.3 mm. The difference between Rx BL and Surg BL was statistically significant ( p = 0.014). There were no significant differences in Surg BL at the mesial, distal, buccal and oral aspects ( p > 0.05). Conclusions The intra-operatively measured peri-implant bone levels were more apical than the radiographic bone levels. The intra-operatively assessed peri-implant bone levels ( Surg BL) were similar at all the circumferential positions around the implant. [ABSTRACT FROM AUTHOR]

Rationale aims and objectives The increasing amount of the clinical research conducted in the primary health care has enabled extending research beyond traditional settings, but this transfer has implied some trade-offs. Health care professionals who conduct research with trusted patients require assuming the ethical standards of research and communication skills to enable patients' autonomy and freedom of choice. This study aims to measure the opinions of health professionals and patients on issues of communication in clinical research. Method A cross-sectional study with health care professionals and patients from primary health care centres in Barcelona ( Spain). Each group completed a similar self-administered questionnaire. A Rasch model was fitted to data. After examination of goodness-of-fit, differences between groups were compared using analysis of variance, and patients' measures were calibrated to professionals' measures to compare overall mean measures. Results Professionals and patients found the ethical attitudes most difficult to endorse related to trust in clinical researchers and conflicts of interest. Patients' perceptions of professional ethical behaviour were significantly lower than professionals'. Different item functioning between nurses and family doctors was found in the item on seeking ethical collaboration when collaborating in clinical research. Effective knowledge of ethical norms was associated with greater perceived ethical values in clinical research and confidence in health care professionals among patients. Conclusions Differences in the views of the communication process between patients and professionals could alert research boards, health care institutions and researchers to the need for greater transparency, trust and ethical instruction when patients are involved in clinical research. [ABSTRACT FROM AUTHOR]

This research focuses on female underrepresentation in managerial positions. Specifically, two studies examine gender-typing for managerial roles in Spain using ratings for real and ideal managers. In addition, we analyse the existence of same-gender bias on evaluations of the behavior of actual leaders. In the first study, 195 Spanish workers evaluate the extent to which gender-stereotypical traits are important for becoming a successful middle manager in three conditions (female managers, male managers, and managers in general). In the second study, we explore the degree to which the behavior of real Spanish managers is gender-typed and the existence of same-gender bias on leadership styles - transformational, transactional and avoidant/passive - and on leadership outcomes - effectiveness, extra effort and satisfaction - from the perspective of subordinates ( N = 605). Overall, the results demonstrate that masculine characteristics were rated as more important than feminine characteristics for managerial positions, and they were more often assigned to male managers than to female managers. Unexpectedly, this manager-male association is stronger among female participants than among male participants. Our findings also demonstrate that women subordinates evaluate their same-sex supervisors more favorably in transformational leadership, effectiveness, and extra effort. The negative consequences derived from gender-typing managerial positions are highlighted according to the role congruity theory of prejudice toward female leaders. The positive effects of in-group female bias on behavior ratings are also noted. The mixed implications of these results for women's advancement to leadership positions are discussed. [ABSTRACT FROM AUTHOR]

Background The problem of mobbing has attracted a great deal of attention over the past few years. This concern has increased the study of the phenomena, which has resulted in many scientific publications. Mobbing has been characterised as an emerging risk at work. The aim of this longitudinal study was to analyse the influence of mobbing on depressive symptoms in a sample of employees working with people with intellectual disabilities (ID). Method The sample consisted of 372 Spanish employees working with people with ID at 61 job centres in the Valencian Community ( Spain). Seventy-nine (21.2%) participants were men, and 293 were (78.8%) women. Mobbing was evaluated by the Mobbing- UNIPSICO scale, and depressive symptoms were measured using the Zung Self Rating Depression Scale. Using analyses of variance ( anova), we tested the differences in depressive symptoms according to the mobbing criteria indicated by Leymann, that is, frequency and duration at Time 1 and Time 2. Results Employees who met the mobbing criteria: frequency (at least once a week) and duration (at least 6 months) at the two study times presented significantly higher levels of depressive symptoms than employees who met mobbing criteria at Time 1, but did not meet any criteria for mobbing at Time 2, and employees who did not meet any criteria for mobbing at Time 1 or Time 2. Conclusions We conclude that permanence of mobbing from Time 1 to Time 2 increases depressive symptoms. [ABSTRACT FROM AUTHOR]

Background There are doubts on whether patients feel that they have sufficient information for actively participating in clinical decisions. Objective To describe the type of information that patients receive. To determine whether patients consider this information sufficient, and whether it contributes or not to improve clinical safety. To identify the barriers for patient participation in clinical decision making. Study Design Cross-sectional study with 764 patients and 327 physicians. Study Setting and participants Fourteen health centres belonging to three primary care districts and three hospitals in Spain. Principal Findings Just 35.1% (268) (95% CI 32.2, 39.1%) of patients preferred to have the last word in clinical decisions. Age (39 vs. 62%, P < 0.001) and severity of illness (38 vs. 46%, P = 0.002) increased the tendency to take a passive role. In 85.1% (650) (95% CI 83.3, 88.3%) of the cases, patients reported having received sufficient information. Lack of consultation time (29.6%, 95% CI 25.8, 32.5%) and patients' use of Internet or other sources (19.2%, 95% CI 16.4, 22.2%) were identified as new obstacles to doctor-patient communication by the patients. Only 19.6% (64) (95% CI 15.4, 24.2%) of doctors considered that they could intervene to involve patients in the decisions. Discussions and Conclusions The majority of patients prefer the decisions to be made by their doctor, especially those with more severe illnesses, and older patients. Patients are not normally informed about medication interactions, precautions and foreseeable complications. The information provided by general practitioners does not seem to contribute enough to the patient involvement in clinical safety. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether different phases of training affect oxidative stress and antioxidant defences in professional cyclists. Ten professional cyclists, aged 21.8 ± 2.5 years, were enrolled in the study. They were classified into two groups of five athletes each one with similar nutritional intake excepting for the overload of vitamin C (1000 mg day−1) and E (400 mg day−1) supplementation in one of them. The cyclists of both groups performed the same exercise design, consisting of hard, tapering and recovery training periods. Total antioxidant capacity (TAC) of the diet, plasma oxygen radical absorption capacity (ORAC), lipid peroxidation (LPO), DNA damage (8-OHdG) and erythrocyte glutathione disulfide/glutathione ratio (GSSG:GSH−1) were measured. During the intense exercise trainings, the cyclists without vitamin supplements had the TAC of diet significantly lower than the supplemented group. Plasma ORAC, LPO and 8-OHdG were similar in both groups of athletes. Athletes with supplements had a basal LPO:ORAC−1 ratio lower than that without supplements, but this ratio converged to the same level at the end of the training in both groups of cyclists. Both groups of cyclists showed similar changes in GSSG:GSH−1 ratio and in GSSG and GSH levels along the study. The data suggest that well-trained athletes with suitable ultra-endurance training volume and intensity do not require antioxidant vitamin supplements to adapt their endogenous antioxidant defenses to exercise-induced ROS. [ABSTRACT FROM AUTHOR]

Dental appearance may play a key role on the way we develop a first impression of another person. To test whether relatively minor changes in the lightness of tooth colour would influence the perceived social appeal (social, intellectual, psychological and relational abilities) of an unknown male and unknown female, this cross-sectional study was performed on 555 Spanish adults. The two major independent variables related to the photograph were tooth lightness (computer-derived), divided into three levels that included lightened teeth, natural teeth and darkened teeth, and the gender of the observed face. Moreover, six independent variables related to the observer were assessed (age, gender, educational level, place of residence, frequency of brushing and self-reported health status). The dependent variables were scored on five-point Likert scales designed to quantify four domains (social, intellectual, psychological and relationship competences) of the Social Appeal Scale ( SAS). Tooth lightness influences the perception of social appeal in all dimensions, as darkened smiles received significantly poorer scores than natural-colour smiles, but these were also worse than lightened smiles. A logistic regression analysis revealed that the major predictor of social appeal was tooth lightness, and for each increment in lightness (from darkened to lightened smiles), the odds ratio ( OR) of positive values being perceived increased significantly in all items (from 2·3 in Popularity to 6·9 in Happiness). A perceptible change in dental lightness is the strongest factor associated with the dental attractiveness stereotype, affecting significantly the 12 traits assessed, but mainly the Happiness, Social Relations and Academic Performance. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Low-intensity exercise applied in anorexia nervosa patients has been shown to have a harmless effect on body composition and to effect short-term improvements in muscular strength and agility. The aim of this study was to determine the effects of a high-intensity resistance training program designed for adolescents to improve strength and agility in anorexia nervosa restricting-type patients (AN-R). Methods From a total of 36 female patients with AN-R, one group (intervention, n = 18) underwent a supervised high-intensity resistance training program lasting 8 weeks, and the other group with no exercise (control, n = 18). Body weight, body mass index, whole-body muscular strength, and agility were assessed before, after, and 4 weeks after training (detraining). Results Leg-press, bench-press, and lateral row tests improved significantly ( p < 0.001) after 8 weeks of training compared with controls. Improvements were maintained after the detraining period. The training program also showed beneficial effects on agility. Discussion A high-intensity resistance training program adapted to the recommendations for adolescents in AN-R patients was effective and safe, improving muscular strength in the whole body and the ability to perform daily tasks. However, long-term maintenance of gains seems to be linked to the continuance of training or the use of a maintenance program. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:601-609) [ABSTRACT FROM AUTHOR]

Aim To find the prevalence of molar-incisor hypomineralization ( MIH) in a random sample of Spanish children, and to investigate the gender influence, distribution of defects, the treatment need associated and the relation between this disorder and dental caries. Design A cross-sectional study was carried out to determine MIH and caries prevalence in a randomly selected sample of 840 children from the 8-year-old population of the Valencia region of Spain. The examinations were carried out in the children's schools by one examiner who had previously been calibrated with the MIH diagnostic criteria of the European Academy of Paediatric Dentistry ( EAPD). Results The percentage of children with MIH was 21.8% (95% CI 19.1-24.7), with a mean 3.5 teeth affected (2.4 molars and 1.1 incisors) been the maxillary molars the most affected. No gender differences were found. Of those with MIH, 56.8% presented lesions in both molars and incisors Children with MIH needed significantly more urgent and non-urgent treatment than those without MIH (chi-squared test P-value < 0.005). Both caries indices were significantly higher (Student's t-test P-value < 0.05) in the children with MIH than in the healthy children: the DMFT scores were 0.513 and 0.237 and the DMFS scores 1.20 and 0.79, respectively. Conclusions Molar-incisor hypomineralization prevalence is high in the child population of this region and equally affects boys and girls. The condition increases significantly the need of treatment of affected children. A significant association with dental caries was observed. [ABSTRACT FROM AUTHOR]

Aim To assess the efficacy of a 0.07% cetylpyridinium chloride ( CPC) mouth rinse in the control of plaque and gingival inflammation during a 6-month period. Material and Methods Adult subjects with moderate gingivitis were selected [≥40% bleeding on marginal probing ( BOMP)]. After retrieving microbiological samples and evaluating the clinical parameters (plaque, BOMP and stain indexes), a professional prophylaxis was performed and subjects were randomly assigned to the test ( CPC mouth rinse) or to the placebo group. Subjects were re-assessed after 3 and 6 months. Results A total of 67 patients (35 test, 32 placebo) were included in the analysis. At 6 months, intra-group significant plaque reductions were observed in the test group (0.691, p < 0.001), but not in the placebo (0.181, p = 0.653). At 6 months, the mean BOMP values were lower in the test group ( p = 0.052). Changes between baseline and 6 months were significantly higher in the test group both for plaque ( p = 0.002) and BOMP ( p = 0.037) when compared with the placebo. A microbiological impact was observed in the test group, especially for Prevotella intermedia. Conclusion The evaluated 0.07% CPC-based mouth rinse, used three times per day adjunctively to mechanical tooth cleaning, prevents plaque accumulation and gingival inflammation, as compared to the placebo, for at least 6 months. [ABSTRACT FROM AUTHOR]

Background The present study aimed to assess the association of obesity and malnutrition with the mortality of hospitalised patients with acute exacerbation of chronic obstructive pulmonary disease ( COPD) and the risk of readmission in <30 days. Methods A retrospective chart review of consecutive patients admitted with COPD as the primary reason for discharge in Spain between 1 January 2006 and 31 December 2007 was performed. Patients with a diagnosis of obesity or malnutrition in the hospital discharge clinical report were identified. The in-hospital mortality and re-admittance 30 days after discharge indices of obese and malnourished patients were compared against the subpopulation without these diagnoses. Results Of the 313 233 COPD admittances analysed, there were 22 582 (7.2%) diagnoses of obesity and 6354 (2.0%) diagnoses of malnutrition. In-hospital global mortality and the re-admittance risk were 12.0% and 16.7%, respectively. Obese patients showed a lower in-hospital mortality risk [odds ratio ( OR) = 0.52; 95% confidence interval (CI) = 0.49-0.55] and early re-admittance risk ( OR = 0.87; 95% CI = 0.85-0.92) compared to non-obese patients. Malnourished patients had a much higher risk of death when in hospital ( OR = 1.73; 95% CI = 1.62-1.85) or of being re-admitted within 30 days after discharge ( OR = 1.29; 95% CI = 1.22-1.38), even after adjusting for possible confounding factors. Conclusions Obesity in patients hospitalised for COPD substantially reduces in-hospital mortality risk and the possibility of early re-admittance. Malnutrition is associated with an important increase in in-hospital mortality and risk of re-admittance in the 30 days following discharge. [ABSTRACT FROM AUTHOR]

The large majority of studies on job insecurity have focused upon the individual level. Recent research has also paid some attention to job insecurity at the level of the organisation, referred to as job insecurity climate. This research has shown negative relationships between job insecurity climate and employees' individual job attitudes. Nevertheless, in these studies no attention has been paid to organisational climate strength, in spite of the recommendations formulated in the literature on this topic. In response, this study aims to account for climate strength in the relationship between job insecurity and job attitudes. We hypothesise that climate strength is related to job satisfaction, organisational commitment, work involvement, and organisational trust. Moreover, we hypothesise that the relationship between job insecurity climate and these outcomes may be stronger when there is a strong agreement among employees concerning their job insecurity perceptions compared to when there is a weak agreement (strong versus weak climate strength). Results based on a Spanish sample of 428 employees from 20 organisations largely supported our hypotheses except in the case of work involvement: climate strength was negatively related to job attitudes, and the relationship between job insecurity climate and individual job attitudes was moderated by climate strength. [ABSTRACT FROM AUTHOR]