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The apps for drawing are present in our children's life. Nevertheless, little is known about the impact of mobile technology on the freehand drawing educational activity. There are few works which are contextualised within short periods of time, with teachers who are not theirs and, in some cases, outside the children's classroom. In this paper, we are focussed on the use of technology on freehand drawing activity. Thus, we have compared the graphics produced by 4- and 5-year-old children with paper&crayon in comparison with those with tablet-finger. Children made the drawings during a planned free-drawing activity, in their ordinary classrooms, with their teachers and during five sessions. Assessment of drawings has evidenced tablet feasibility for making graphics. Nevertheless, with the passing of time, quality of graphics (tablet-finger vs paper&crayons), are nearly matched, demonstrating the low impact level technology has on this activity. In addition, if drawings are analysed specifically according to ages, results have shown that both groups have to develop adaptation strategies of visual perceptual skills and fine motor skills for the touch screen in order to obtain the same quality in the drawings made on both support types. [ABSTRACT FROM AUTHOR]

The adoption of Information and Communication Technologies in early childhood education is crucial for adapting traditional classrooms to the digital era. Over time, young children are increasingly using touch screen technologies such as tablets at home and in early childhood settings. However, the literature shows that there is a significant gap in knowledge of using this technology in early childhood education. Most researchers have focused on the pedagogical theory behind using touch screen devices, but there have not been many empirical studies about how these technologies affect students' learning processes. This paper presents three learning experiences where early childhood students perform educational activities using tablet computers, interactive whiteboards, and paper cards. The results show that students who used the technology were more motivated and achieved better results that those who used paper cards. Lay Description: What is already known about this topic: The use of ICT in childhood education offers new possibilities for teachers to provide new and more visual digital learning content to their students.Touch technologies seem suitable for young students. Because their motor skills are not fully developed yet, interacting with computers through a mouse and a keyboard is more difficult than doing it through natural gestures.There are many studies in higher education levels that demonstrate that proper use of ICT in education can lead to an increase of the students' motivation and learning. What this paper adds: Three empirical studies in three different childhood education classrooms to shed some light about how ICT can impact positively students learning.A comparison of interactive whiteboards and tablet computers benefits regarding more traditional methodologies in childhood education.Insights about how hardware and software can be combined to provide students a suitable learning environment in childhood education classrooms. Implications for practice and/or policy: Teachers should consider how they will create the workgroups. It is highly advisable to create heterogeneous groups taking into account the students' skills. This way, members of the same group can help each other, creating a richer learning scenario.Several teachers who participated in our studies said that they were not able to use ICT in their classrooms because they did not have enough digital competences. Our studies and the results obtained led them consider integrating technology in their classrooms. The good results obtained by the students who worked with technology changed the teachers' perspective about the use of technology in the classroom.Students showed a great interest in the use of tablet computers and interactive whiteboards, which translated into higher motivation compared with the students who solved the activities on paper. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence and clustering of NANDA‐International nursing diagnoses in patients assisted by pre‐hospital emergency teams. Design: Retrospective descriptive study of electronic record review. Methods: Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two‐step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020. Results: Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six‐cluster solution (n = 26.788) was found. Five clusters had a single high‐prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co‐occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051). Conclusion: Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre‐hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases. Implications for the profession and/or patient care: Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre‐hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre‐hospital clinical setting. Impact: What problem did the study address? There are different models of pre‐hospital emergency care services.The use of standardized nursing languages in the pre‐hospital setting is not homogeneous.Studies on NANDA‐I nursing diagnoses in the pre‐hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA‐I nursing diagnoses in the pre‐hospital care setting.Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance.Patients attended by pre‐hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre‐hospital setting, increasing the evidence of individualized and standardized care plans for pre‐hospital care. Reporting method: STROBE checklist has been used as a reporting method. No Patient or Public Contribution: Only patients' records were reviewed without further involvement. [ABSTRACT FROM AUTHOR]

Background: Many caregivers are insufficiently prepared, and little is known about measures that can be employed to enhance their preparedness. Aim: The aim of this study was to explore the factors associated with caregiver preparedness and establish a predictive model including the relationship between preparedness, burden, resilience and anxiety. Design: A cross‐sectional design was used. Methods: The sample included 172 family caregivers who were selected from one private hospital and daytime nursing centres. Caregivers were recruited from 2018 to 2019; they completed assessments for caregiver preparedness, anxiety, resilience and burden. A multiple linear regression analysis was performed to identify the factors associated with preparedness. Results: Preparedness was significantly associated with high levels of resilience and a low level of burden, while it was not associated with anxiety. Caregivers' gender, experience and cohabitation status were the main predictors. Resilience is an explanatory factor for caregiver preparedness in the predictive model. Conclusion: The demographic variables related to preparedness can be used to guide efforts to meet the needs of vulnerable caregivers. A caregiver's preparedness depends on their level of burden and resilience. Nursing interventions focused on these aspects could make the caregiver's role easier and improve the quality of care provided. Summary statement: What is already known about this topic? Many caregivers are inadequately prepared for this role, and ensuring adequate preparedness is important for family caregivers.Preparedness and factors predictive of this in Spanish family caregivers have not been well‐documented.Resilience, burden and anxiety affect caregivers, but the degree to which they influence caregivers' preparation levels is unknown. What is the contribution of this paper? Specific factors influence the preparedness of family caregivers. Men and caregivers who do not cohabit in the same household with the care‐dependent person may present greater deficits in preparedness. Moreover, poor health and lack of experience in caring can result in inadequate caregiving performance.Readiness, resilience and burden are significantly related, and the best predictor of family caregivers' preparedness is resilience.Resilience leads to greater preparedness in caregivers, and better‐prepared caregivers experience a lighter burden. What are the implications of this paper? Knowing the factors associated with preparedness in advance will allow health‐care professionals to prevent deficits in vulnerable family caregivers.Resilience is a decisive factor which prevents negative consequences such as low preparedness. A resilient coping style can diminish the burden and promote successful adaptation in caregivers. [ABSTRACT FROM AUTHOR]

In this paper, the first virtual reality (VR) photography application that incorporates elements on panoramic images to assess short-term spatial memory is presented. It also allows the interaction with these elements. A study was conducted (N = 50) to compare participants' performance outcomes and subjective experience when using a VR application with and without panoramic photography. The results show that both applications are effective in assessing short-term spatial memory. The results with panoramic photography include: 1) It was effective for short-term recall since, after using the application, the participants were able to verbally recall the objects and place them without significant differences with respect to the objects correctly placed; 2) The performance outcomes were independent of age and gender; 3) The perceived level of presence was directly related to experiencing less cybersickness when using the application; 4) The level of satisfaction was directly related to perceived enjoyment, concentration, usability, competence, calmness, and expertise; 5) The more the familiarity with VR applications, the less the perceived cybersickness. Finally, the application offers two main advantages: 1) The evaluators can customize the environment by adding as many elements as desired to the panoramic photograph; 2) It could be especially suitable for groups with reduced mobility. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The role of informal caregiver can have both negative and positive consequences for a person's well‐being. The main theoretical framework for explaining these consequences is the stress process model, which considers contextual variables, stressors and mediating/moderating factors. The latter are psychosocial factors such as coping strategies, personal mastery, social support or beliefs and values which may influence caregiver well‐being. The perception of gains in caregiving has also been proposed as a mediating variable since it may act as a coping strategy. However, few studies have examined values and perceived gains as mediating variables with life satisfaction as the outcome. What the paper adds to existing knowledge?: This study explores the role of character strengths and caregiver gains as mediators between stressors and life satisfaction in informal caregivers of persons with dementia. The results identify hope as a key character strength, its lack being one pathway through which stress may lead to low life satisfaction and low perceived gains from caregiving. What are the implications for practice?: Caregivers who experience a lack of hope may be less able to generate goals and be less motivated to achieve them. Our findings are relevant to gerontological nursing based on the Senses Framework as they confirm the importance of the senses of purpose and achievement. Nursing and care staff can play an active role in helping informal caregivers to meet their goals by promoting these two senses, thereby fostering a more positive caregiving experience. Introduction: Being an informal caregiver can have both negative and positive consequences for well‐being. Within the framework of the stress process model, few studies have examined values and perceived gains of caregiving as mediating variables of life satisfaction. Aim: To explore the role of character strengths and perceived gains as mediators in the association between life satisfaction and primary and secondary stressors in informal caregivers of persons with dementia. Method: Participants were 112 informal caregivers. Hierarchical regression, correlation and mediation analyses were performed. Results: Lower life satisfaction was associated with being female, unmarried, caring for someone with greater cognitive impairment, a higher level of stress, having restricted leisure time and perceiving financial difficulties. Hope mediated the associations between perceived stress and both life satisfaction and perceived gains of caregiving. Discussion: Hope is a key strength and its lack is one pathway through which stress may cause low satisfaction and low perceived gains from caregiving. Implications for practice: Without hope, it is difficult for caregivers to generate goals and be motivated to achieve them. Nursing and care staff should aim to promote a sense of purpose and achievement among informal caregivers so as to foster a more positive caring experience. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to understand the profile of use of gerontechnology in Spanish older adults considering their age group (60–70; 71–80 and over 80 years) and to discern whether groups of subjects with similar characteristics can be established to ascertain which factors are behind the profile of frequent gerontechnology use. Design/methodology/approach: A quantitative study is presented to understand the profile of use of gerontechnology in Spanish older adults. The sample comprised 497 participants (aged between 60 and 94 years). Findings: The results show that, even though most participants consider technology to be useful in their daily lives, there is still a lack of knowledge on how to use it, especially among older subjects. This highlights the importance of promoting technological cocreation initiatives such as senior living labs. Research limitations/implications: Other researchers are encouraged to include the voices of older adults using gerontechnology in further studies. Practical implications: If we want to increase the acceptance of technology by older adults, we must first let them take part in the design of the technologies they will use. Social implications: This research provides promising data that should merit attention to contribute to the well-being and quality of life of older adults in a society where currently technology is a key part in every sphere of our daily life. Originality/value: The value of this research lies in the implications of "aging in place" studies today. [ABSTRACT FROM AUTHOR]

Serious games have proven to be a powerful tool in education to engage, motivate, and help students learn. However, the change in student knowledge after playing games is usually measured with traditional (paper) prequestionnaires–postquestionnaires. We propose a combination of game learning analytics and data mining techniques to predict knowledge change based on in‐game student interactions. We have tested this approach in a case study for which we have conducted preexperiments–postexperiments with 227 students playing a previously validated serious game on first aid techniques. We collected student interaction data while students played, using a game learning analytics infrastructure and the standard data format Experience API for Serious Games. After data collection, we developed and tested prediction models to determine whether knowledge, given as posttest results, can be accurately predicted. Additionally, we compared models both with and without pretest information to determine the importance of previous knowledge when predicting postgame knowledge. The high accuracy of the obtained prediction models suggests that serious games can be used not only to teach but also to measure knowledge acquisition after playing. This will simplify serious games application for educational settings and especially in the classroom easing teachers' evaluation tasks. Lay Description: What is currently known about the subject matter Serious games are a powerful tool to engage, motivate, and help students learn.Pre‐post experiments are commonly used to measure knowledge acquisition.Game learning analytics can be applied to interaction data from games. What this paper adds We present a two‐step approach combining game learning analytics and data mining to predict players' performance in serious games based on their interactions.The approach is tested in a case study with pre‐post experiments collecting interaction data with 227 students playing a serious game to determine if performance can be accurately predicted.The comparison of prediction models has helped to determine if pretest information is essential.The highly accurate prediction models obtained suggest that games can be used to teach and measure knowledge acquisition after playing. Implications of study findings for practitioners The approach aims to simplify the measurement of players' learning with serious games.It may be generalized at least to similar scenarios (e.g., games for procedural learning or game‐likesimulations) where similar interaction data are feasible.Game mechanics and educational design should define the interaction data to capture.Using an accepted standard tracking profile is a clear recommendation. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to first assess the long-term effects of the adaptation of the American Strengthening Families Programme in Spain (known as the Programa de Competencia Familiar, translated into English as the Family Competence Programme (FCP)). The second aim is to identify family typologies and family changes regarding family competence over time. The paper’s initial hypothesis is that families have different behaviours and take advantage of the FCP in different ways. Design/methodology/approach – Monitored applications of the FCP were conducted using a quasi-experimental design consisting of a control group and pre-test, post-test and two-year follow-up assessments. The sample was made up of 136 families who took part in the programme and another 18 who participated in the control groups. Validated instruments were applied to assess the methodological processes and the family assessments. A cluster analysis was undertaken to identify different family typologies and their evolution in relation to the FCP goals. Findings – The FCP shows effective and consistent results over time for families in a variety of difficult situations, with important result maintenance. The longitudinal analysis (i.e. the two-year follow-up) demonstrates that the majority of changes identified (using the factors under consideration) maintained their relevance for most of the families, producing positive change. Originality/value – There is little long-term evaluation or longitudinal analysis of family prevention programmes that are evidence-based and include cognitive-emotional content. This paper analyses the long-term evaluation of family prevention programmes and identifies the ways in which families change over time. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people.There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties.There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. What does the paper add to existing knowledge?: The positive evolution of attitudes towards mental illness does not last over time.Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. What are the implications for practice?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices.The design of any anti‐stigma intervention must include the factor of "time". Introduction: The stigma of health professionals is a contributing factor to morbi‐mortality among people with mental health difficulties. There is a lack of research on long‐term outcomes in nursing students. Objective: To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method: A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self‐education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results: Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion: Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications: Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti‐stigma activities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Newborns in neonatal intensive care units (NICUs) are in contact with a variety of medical products whose production might include synthetic chemicals with hormonal activity. OBJECTIVES: Our aim was to assess the content of bisphenol A (BPA) and parabens (PBs) and the hormone-like activities of a subset of medical products commonly used in NICUs in prolonged intimate contact with NICU newborns. METHODS: Fifty-two NICU items were analyzed, determining the concentrations of BPA and PBs [methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butylparaben (BuP)] and using the E-Screen and PALM-luciferase assays to measure the in vitro (anti-)estrogenic and (anti-)androgenic activity, respectively, of the extracts. Items found to have elevated BPA/PB content or hormone-like activities were further extracted using leaching methodologies. RESULTS: BPA was found in three-fifths and PBs in four-fifths of tested NICU items, and ~25% and ~10% of extracts evidenced estrogenic and anti-androgenic activity, respectively. The highest BPA content was found in the three-way stopcock (>7.000 ng/g), followed by patterned transparent film dressing, gastro-duodenal feeding tubes, sterile gloves, single-lumen umbilical catheters, and intravenous (IV) infusion extension sets (concentrations ranged from 100 to 700 ng/g BPA). A total PB concentration (?PPBs) >100 ng/g was observed in several items, including light therapy protection glasses, patterned transparent film dressing, winged IV catheters, IV infusion extension sets, and textile tape. The highest estrogenic activity [>450 pM estradiol equivalent (E2eq)] was found in small dummy nipples, three-way stopcocks, and patterned transparent film dressing and the highest anti-androgenic activity [>5 mM procymidone equivalent units per gram (Proceq/g)] in small dummy nipples and three-way stopcocks. DISCUSSION: According to these findings, neonates might be exposed to multiple sources of BPA and PBs in NICUs via inhalation, dermal, oral, and IV/parenteral routes. There is a need to address the future health implications for these extremely vulnerable patients and to adopt precautionary preventive measures as a matter of urgency. [ABSTRACT FROM AUTHOR]

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalised, and coordinated intervention under the value-based care approach to address frailty's multidimensional nature in older people in the primary care setting. It employed a pre–post randomised controlled design involving 242 frail individuals aged over 65 years living in the community in Valencia (Spain) between 2021 and 2023. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalised care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty, and social frailty. The study found significant improvements in physical frailty, quality of life, reduced health resource use and hospitalisations and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalised, comprehensive programs for older individuals with frailty. [ABSTRACT FROM AUTHOR]

The current paper describes Spanish acquisition of rhotic onset clusters. Data are also provided on related singleton taps/trills and /l/ as a singleton and in clusters. Participants included 9 typically developing (TD) toddlers and 30 TD preschoolers in Chile, and 30 TD preschoolers and 29 with protracted phonological development (PPD) in Granada, Spain. Results showed age and developmental group effects. Preservation of cluster timing units preceded segmental accuracy, especially in stressed syllables. Tap clusters versus singleton trills were variable in order of mastery, some children mastering clusters first, and others, the trill. Rhotics were acquired later than /l/. In early development, mismatches (errors) involved primarily deletion of taps; where substitutions occurred, [j] frequently replaced tap. In later development, [l] more frequently replaced tap; where taps did occur, vowel epenthesis sometimes occurred. The data serve as a criterion reference database for onset cluster acquisition in Chilean and Granada Spanish. [ABSTRACT FROM AUTHOR]

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

Empirical evidence supports the simultaneous relationship between parental warmth and child-to-parent violence (CPV). However, no studies analyze the lagged effects of perceived parental warmth and the potential impact of cognitive mechanisms legitimizing immoral behavior on this relationship. This study aimed to examine the mediating role of moral disengagement strategies (reconstruction of immoral behavior, obscuring personal responsibility, misrepresenting injurious consequences, and blaming the victim) in the relationship between the perceived paternal and maternal warmth dimensions (warmth-communication and criticism-rejection) during childhood and CPV towards the father and mother. The sample included 2122 Spanish adolescents (57.7% female) aged 13 to 18 years. The Child-to-Parent Violence Questionnaire (CPV-Q), the Mechanisms of Moral Disengagement Scale (MMDS-S), and the Warmth Scale were used as assessment instruments. The results indicate that paternal and maternal warmth-communication is negatively associated with CPV, whereas paternal and maternal criticism-rejection and moral disengagement strategies are positively related to CPV. The mediation models show that the reconstruction of immoral behavior plays a crucial mediation role in the relationship between paternal and maternal warmth-communication and CPV as well as in the relationship between maternal criticism-rejection and CPV. The results emphasize the necessity of early prevention programs for parents promoting positive parenting practices, including parental warmth, to foster children's adaptive socio-cognitive development. In addition, addressing moral disengagement in adolescents could help prevent or stop a pattern of violent behavior toward parents. [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]

CrossFit is characterized by being a standardized training program that improves physical performance through the provision of several stimuli regardless of the participant's strength level. This study aimed to compare the acute response in total repetitions as a measurement of performance, jump ability, physiological demand (heart rate and blood lactate), and perceived effort considering the participants' strength level with individualized intensity in CrossFit. Thirty-five participants were assessed and asked to participate on two separate days in a standardized and relative 'As Many Repetitions As Possible' (AMRAP) CrossFit circuit. Both AMRAPs comprised strength, gymnastic and aerobic exercises, although only strength was individualized according to the participant's level. Before the statistical analysis, participants were allocated to higher- or lower-strength groups following the one-repetition maximum-bodyweight ratio in the push press exercise. Results support the existence of a strong relationship between strength level and total repetitions in both AMRAPs. In addition, differences in total repetitions and rate of perceived exertion between strength groups are discarded when AMRAP intensity is individualized while physiological demand and jump ability are maintained. Thus, the higher-strength participants may benefit from similar responses with a lower number of repetitions. Therefore, CrossFit trainers should be encouraged to prescribe strength tasks based on the percentage of 1RM for every training. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to report results of the impact of the information and communication technology (ICT) platform and telecare services developed by the MonAMI consortium on the quality of life (QOL) of older people in three European communities. Design/methodology/approach – In a three-month trial, the MonAMI technology was installed in the homes of older people with various needs, in the cities of Stockholm, Sweden; Zaragoza, Spain; and Kosice, Slovakia. Evaluation criteria and instrumentation were developed to assess the effects of the services on users' perceived QOL in the domains of independence, physical health, psychological wellbeing, social networking, and physical environment. Findings – A total of 62 users, with a mean age of 79 years, participated in the trial. Results demonstrate that the MonAMI services had some positive, significant effects on users' QOL. For instance, users with a higher number of disabilities at baseline reported greater confidence in keeping intruders from entering their home compared to users with fewer disabilities (OR=2.51, 0.01 p<0.05). However, overall findings show that healthier, more independent users perceived more benefits from the services compared to users who report more health problems and are less independent. Research limitations/implications – The complexities of conducting the MonAMI trial led to a small, heterogeneous sample of users over a short time span. This in turn created difficulties in observing the potential effects of the services and achieving significance on some indicators of QOL. Originality/value – This paper provides quantitative analyses around the impact of telecare services; suggests important directions for further research; and highlights the methodological challenges of evaluating ICT-based care services in a community setting. [ABSTRACT FROM AUTHOR]

What is already known about this subject There is an association between adiposity levels and physical activity guidelines for adolescents., Achieving physical activity recommendations helps adolescents to prevent obesity status., What this study adds This paper presents an association between physical activity levels and obesity status., This paper supports physical activity recommendations to avoid children's obesity levels., This paper emphasizes vigorous physical activity for this matter., Background There is no information about physical activity (PA) recommendations to avoid children's obesity levels and how much of vigorous PA (VPA) is included into the '60 minutes of MVPA 5 days a week' recommendation for children. Objective The aim of this study was to examine the association between PA and adiposity in children and to examine whether the current PA guidelines are associated with a low risk of having excess of body fat in children, with special focus on sex differences, and PA intensity. Methods A sample of 439 Spanish children aged 8-10 years from the European Youth Heart Study participated in the study. The variables measured were anthropometric characteristics (height, weight, body mass index [ BMI], skin-folds and waist circumference) and PA was measured during 6 consecutive days using the GT1M accelerometer. Results Receiver operating characteristic analysis showed significant cut-off points associated with non-overweight: 45 min d−1 of VPA and 67 min d−1 of moderate-to-vigorous physical activity ( MVPA) (using BMI categories); and non-fat: 41 min d−1 of VPA and 67 min d−1 of MVPA (using percentage of body fat) and 38 min d−1 of VPA and 47 min d−1 of MVPA (using waist circumference categories) for boys. For girls, the optimal cut-offs of moderate-to-vigorous activity and MVPA associated with non-overweight were 24 and 57 min d−1, respectively ( BMI). Boys who did not meet 67 min in MVPA had an increased risk of being overweight + obese and overfat + obese (odds ratio [ OR] = 2.48, 95% confidence interval [ CI] = 1.36, 4.53, and OR = 2.56, 95% CI = 1.12, 5.82). Conclusions The findings support current PA recommendations (60 min d−1 of MVPA) to avoid excess of body fat in Spanish children. However, VPA appears to be an important component for the prevention of obesity, and our findings suggest that PA recommendations should specify the dose of VPA required for optimal health. Therefore, public health PA recommendations should incorporate specifically a greater dose of VPA into the total amount of MVPA in 8- to 10-year-old boys. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? In general, the current studies of positive mental health use questionnaires or parts thereof. However, while these questionnaires evaluate aspects of positive mental health, they fail to measure the construct itself., What does this paper add to existing knowledge? The widespread use and the lack of specific questionnaires for evaluating the positive mental health construct justify the need to measure the robustness of the Positive Mental Health Questionnaire. Also six factors are proposed to measure positive mental health., What are the implications for practice? The availability of a good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals., Abstract Introduction Nursing has a relevant role in managing mental health. It is important to identify and thereafter to enhance positive aspects of mental health among university nursing students. Aim The aim of the present study was to analyse the psychometric properties of the Positive Mental Health Questionnaire ( PMHQ) in terms of reliability and validity using confirmatory factor analysis in a sample of university students. Method A cross-sectional study was carried out in a sample of 1091 students at 4 nursing schools in Catalonia, Spain. The reliability of the PMHQ was measured by means of Cronbach's alpha coefficient, and the test-retest stability was measured with the intraclass correlation coefficient ( ICC). Confirmatory factor analysis was used to determine the validity of the factorial structure. Results Cronbach's alpha coefficient was satisfactory (>0.70) for four of the six subscales or dimensions and ranged from 0.54 to 0.79. ICC analysis was satisfactory for the six subscales or dimensions. The hypothesis was confirmed in the analysis of the correlations between subclasses and the overall scale, with the strongest correlations being found between the majority of the subscales and the overall scale. Confirmatory factor analysis showed that the model proposed for the factors fit the data satisfactorily. Discussion This scale is a valid and reliable instrument for evaluating positive mental health in university students. Implications for Practice A good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals. [ABSTRACT FROM AUTHOR]

Purpose: Oxysterols are cholesterol-oxygenated derivatives generated in the organism and also present in foods because of cholesterol oxidation during processing and storage. They are the natural ligands of liver X receptors (LXRs) and are generally recognized as hypocholesterolemic and anti-inflammatory molecules although this latter property is still controversial. Most oxysterol studies have been performed in macrophages, whereas the effects of oxysterols in neutrophils are poorly known. In this study, human neutrophils were exposed to two different oxysterols, 7-keto-cholesterol (7-k-chol) and 25-hydroxy-cholesterol (25-OH-chol), and their possible participation in inflammatory process was evaluated. Methods: Human neutrophils were incubated with 7-k-chol and 25-OH-chol, and ROS production, translocation of the NADPH oxidase cytosolic components, hemoxygenase-1 (HO-1) expression and lysozyme secretion were analyzed. Results: An increase in ROS production was observed within a short period of time (minutes) with both molecules. These oxysterols also stimulated the cellular membrane translocation of the NADPH oxidase cytosolic components, p47phox and p67phox. On the other hand, HO-1 expression, a cytoprotector enzyme, is inhibited in human neutrophils upon oxysterols treatment. Moreover, both oxysterols were associated with high lysozyme enzyme secretion at 5 and 18 h of incubation. Conclusions: The present paper describes for the first time that two oxysterols (7-k-chol and 25-OH-chol) enhance the ROS production within a short period of time in human neutrophils, stimulate the translocation of the cytosolic components of NADPH oxidase to the cellular membrane and increase lysozyme secretion. These data suggest that both oxysterols are able to activate pro-inflammatory effects in human neutrophils which contrasts with the role assigned to the oxysterols when they act through LXR at long time of incubation. [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]

(1) Background: Healthy aging is the process of developing and maintaining functional capacity and optimizing involvement in order to improve one's quality of life as people age. This study aimed to encourage healthy aging in people with cognitive impairment, as well as a control group, via the use of the Nintendo Switch combined with occupational therapy sessions, aiming to improve gross and fine motor skills, functionality, quality of life, and cognitive status. (2) Methods: A randomized clinical trial was undertaken. The sample was randomized using the OxMar software program Attribution 4.0 International, facilitating the division into a control group (CG), who received conventional occupational therapy sessions, and an experimental group (EG), who received therapy incorporating the Nintendo Switch, in addition to conventional occupational therapy sessions. The intervention period with the Nintendo Switch lasted for 8 weeks. (3) Results: Thirty-two participants were included in the study. Significant differences were found in the vast majority of the variables analyzed, which shows an improvement following the intervention; these improvements were mainly observed in measures of skill and the perception of quality of life. (4) Conclusions: An eight-week intervention with the Nintendo Switch alongside conventional occupational therapy helps to maintain cognitive status and functional independence. Following 8 weeks of intervention with the Nintendo Switch, improvements in gross motor dexterity, fine motor dexterity, and quality of life were observed in older people with cognitive impairment. [ABSTRACT FROM AUTHOR]

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

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

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]

Some previous studies have shown that the availability of orthographic information leads to positive effects for second language (L2) phonology, while others document negative effects. In this paper, we examine the role of orthography on novel spoken-word learning by comparing word pairs that differed in most or all of their segments (nonminimal pairs) and those that only differed in one phoneme (minimal pairs) that was considered easy or difficult to discriminate. We tested the performance of learners whose native languages have transparent orthographies as well as learners with opaque orthographies. Our findings show that regardless of linguistic background and native orthographic system, availability of orthographic information during word learning did not have an effect on nonminimal pairs or perceptually easy minimal pairs. However, it had a positive effect on two minimal pairs that had the highest accuracy among the seven perceptually difficult ones, indicating that orthography only helped contrasts that were relatively easy to discriminate. The implications of these findings for L2 teaching and for future directions within L2 phonology are discussed. [ABSTRACT FROM AUTHOR]

This study aimed to explore the family profile of adolescent-to-parent abuse cases. Concretely, this paper examines whether or not there is a different family profile of parent-abuse offenders compared with other types of offenders and with non-offender adolescents. The sample included 90 adolescents who were clustered into three groups (parent-abuse offenders, other type of offenders, and non-offender adolescents). Participants completed measures of quality of communication with parents and parents' educational styles. They were also evaluated using a brief interview with questions about family structure. Results indicate offenders who assault their parents have a different family structure and dynamics. Differences were found concerning the type of household, family size, and family incomes. In addition, parent-abuse offenders reported a lower quality of communication with both parents perceiving them as less warm, more rejecting, and less inductive than did the other groups. [ABSTRACT FROM AUTHOR]

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Vitamin D is an essential nutrient to be consumed in the habitual dietary intake, whose deficiency is associated with various disturbances. This study represents a validation of vitamin D status estimation using a semi-quantitative FFQ, together with data from additional physical activity and lifestyle questionnaires. This information was combined to forecast the serum vitamin D status. Different statistical methods were applied to estimate the vitamin D status using predictors based on diet and lifestyle. Serum vitamin D was predicted using linear regression (with leave-one-out cross-validation) and random forest models. Intraclass correlation coefficients, Lin's agreement coefficients, Bland–Altman plots and other methods were used to assess the accuracy of the predicted v. observed serum values. Data were collected in Spain. A total of 220 healthy volunteers aged between 18 and 78 years were included in this study. They completed validated questionnaires and agreed to provide blood samples to measure serum 25-hydroxyvitamin D (25(OH)D) levels. The common final predictors in both models were age, sex, sunlight exposure, vitamin D dietary intake (as assessed by the FFQ), BMI, time spent walking, physical activity and skin reaction after sun exposure. The intraclass correlation coefficient for the prediction was 0·60 (95 % CI: 0·52, 0·67; P < 0·001) using the random forest model. The magnitude of the correlation was moderate, which means that our estimation could be useful in future epidemiological studies to establish a link between the predicted 25(OH)D values and the occurrence of several clinical outcomes in larger cohorts. [ABSTRACT FROM AUTHOR]

The built environment (BE) impacts on people's disability and health, in terms of overweight, depression, alcohol abuse, poor self-rated health and presence of psychological symptoms; it is reasonable to assume that BE also impacts on participation levels. This paper presents the validation of the COURAGE Built Environment Self-Reported Questionnaire (CBE-SR), an instrument designed to evaluate BE in the context of health and disability. Subjects participating to COURAGE, a cross-sectional study conducted on 10 800 citizens of Poland, Finland and Spain, completed a protocol inclusive of the CBE-SR. Psychometric properties and factor structure were analysed, and factor scores created. Gender differences, differences between persons from different age groups and persons reporting the environment as facilitating, hindering or neutral were calculated. Eight items were deleted so that the final version of CBE-SR comprises 19 items. Cronbach's alpha ranged from 0.743 to 0.906, and test-retest stability was demonstrated for the majority of items. Four subscales were identified: Usability of the neighbourhood environment; Hindrance of walkable environment; Easiness of use of public buildings, places and facilities; and Risk of accidents and usability of the living place. Younger respondents reported their neighbourhood as more usable but perceived walkways as more hindering and public buildings as less easy to use; gender differences were almost inexistent. The CBE-SR is a four-scale instrument with good psychometric properties that measures the person-environment interaction. It is sensitive across age groups and is consistent with the subject's overall judgement of the degree to which the environment is facilitating or hindering. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Poor built environments have a negative impact on the level of a person's participation. However, instruments measuring the person-environment interaction are lacking., The CBE-SR is a valid and reliable instrument that researchers can use to assess the relationships between the intrinsic health state and the objective features of the environment., Understanding this relationship would provide further insight into the need of addressing the individual's functioning either by means of interventions directed to the individual or by making changes to the individual's environment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Muscle fatigue of the trunk extensor musculature plays a considerable role in chronic low back pain (LBP). The underlying physiology of fatigue is complex and not fully understood. The Kinesio® Taping (KT) supports damaged structures while allowing mobility and at the same time may influence some of the mechanisms associated with muscle fatigue such as blood flow and proprioception. OBJECTIVE: The aim of this study is to determine the influence of KT on the resistance to fatigue of the lumbar extensor musculature in a sample of young healthy subjects. METHODS: A randomized, controlled, doubled-blinded clinical trial was conducted. Ninety nine healthy subjects were randomized in to the three arms of the study Kinesio® Tape (KT), placebo (P) and control (C). Directly after application of KT we measured lumbar extensor musculature endurance with the Biering-Sorensen test. Subjects and researchers were blinded to the intervention. Time achieved (seconds) was compared between groups with one-way ANOVA with confidence intervals of 95%. RESULTS: There were significant differences between the time achieved in the KT group versus the control group (p < 0.05). The placebo group performed better than the control group but worse than the KT group, these were not significant in either case. CONCLUSIONS: KT appears to improve the time to failure of the extensor muscle of the trunk obtained using the Biering-Sorensen test. These findings suggest that KT influences processes that lead to muscle fatigue and that KT could be effective in the management of LBP. [ABSTRACT FROM AUTHOR]

The objectives of this paper were to evaluate the association of subjective memory complaints (SMC) with perceived state of health, mood and episodic memory (associative and everyday memory). We studied these areas using two different complaint assessment methods (three general questions and a validated scale). The study included 269 older adults (aged 65-87) with age-related memory changes, but without cognitive impairment. They were evaluated with Mini-cognitive Exam, Rivermead Behavioural Memory Test (a test of everyday memory), Paired Associates Learning Test, Memory Failures of Everyday Questionnaire, three memory complaints questions, Nottingham Health Profile and Geriatric Depression Scale. The results indicated that memory for everyday performance, mood and perceived health were independent predictors of SMC, with mood and perceived health being stronger predictors than actual memory performance. Age was not associated with subjective memory and, with regard to level of education, only the illiterate level was associated with SMC. A specific questionnaire on subjective memory was found to be preferable to an aggregate of complaints questions on self-reported memory; only health profile was found to predict the outcomes on memory complaints questions. Our conclusion is that a group of underlying factors other than everyday memory were playing a role in SMC; these SMC of subjects with age-related memory changes were mainly associated with subjective evaluations of their health. [ABSTRACT FROM AUTHOR]

This paper presents the results of a study carried out in Spain with 214 families with children aged between 3 and 10, comparing the quality of family context and the internal and external adjustment of children living in six different types of family structure: traditional, single-parent, stepfamilies, adoptive, same-sex parent and multiple-birth. Members of the research team interviewed the families in their homes and administered the assessment instruments (Development History, HOME inventory, Parenting Stress Index and Behavior Assessment System for Children). The results indicate that although some significant differences were observed between families (children living in same-sex parent families scored higher for internal and external adjustment, and those from stepfamilies scored lowest in these same measures), these differences disappeared when the effects of sociodemographic and contextual variables were statistically controlled in a covariance analysis. It can therefore be concluded that it was not family structure itself that was related to children's adjustment, but rather the sociodemographic and contextual variables associated with it. Thus, all the family structures analysed in the study are capable of promoting positive child development and adjustment, providing they meet the necessary conditions, such as good-quality care and a stimulating environment free from conflict and stress. [ABSTRACT FROM AUTHOR]

Objectives Lipoatrophy is a long-term adverse effect of some antiretrovirals that affects quality of life, compromises adherence and may limit the clinical impact of HIV treatments. This paper explores the effect of tenofovir/emtricitabine ( TDF/ FTC) on the amount of limb fat in patients with virological suppression. Methods A randomized, prospective clinical trial was performed to compare continuation on a zidovudine/lamivudine ( ZDV/3TC)-based regimen with switching to a TDF/ FTC-based regimen in terms of the effect on limb fat mass as assessed by DEXA over a 72-week period. Results Eighty patients were included (39 in the TDF/ FTC arm and 41 in the ZDV/3 TC arm) and 73 completed the study (37 and 36, respectively). In the switch arm, limb fat increased by a median of 540 g from baseline ( P = 0.022), while in the ZDV/3TC arm it decreased by a median of 379 g ( P = 0.112; p between groups = 0.007). Subjects with baseline limb fat ≤ 7200 g, previous time on ZDV > 5 years or a body mass index > 25 kg/m2 experienced higher limb fat gains than other subjects, and these differences were statistically significant. Haemoglobin increased by a median of 1.0 g/d L in the TDF/ FTC arm ( P < 0.001) and remained unchanged in the ZDV/3TC arm (p between groups = 0.0002). There were no significant differences between groups in other secondary endpoints (body weight, total body and trunk fat content, total body bone mineral density, laboratory parameters, CD4 cell count and viral load). Conclusions Switching from a ZDV/3TC-based to a TDF/ FTC-based regimen led to a statistically significant improvement in limb fat, in contrast to the progressive loss of limb fat in subjects continuing ZDV/3TC. [ABSTRACT FROM AUTHOR]

Possessing sufficient nutritional knowledge is a necessary component in the prevention and treatment of obesity. A solid understanding of nutrition can help people make appropriate food selections and can also help correct irrational ideas or myths people may believe about food. It is a challenge to provide this information to children in ways that are exciting. Thus, we propose an online video game platform to deliver the information. The objective of this study was to study the efficacy and acceptability of an online game called ‘ETIOBE Mates’ that was designed to improve children’s nutritional knowledge; furthermore, we compare it with the traditional paper–pencil mode of information delivery. A sample of 228 children participated in the study. Participants were divided into two groups: an experimental group (who used ETIOBE Mates) and a control group (who were given a pamphlet). Both groups increased their scores for nutritional knowledge. The interaction between group × time was also statistically significant; it indicated that acquisition of nutritional knowledge was superior in the experimental group. The children considered the serious games platform to be a useful medium for improving their nutritional knowledge. Online games can be an effective method of delivery for preventive and treatment tasks that are otherwise tedious for children. [ABSTRACT FROM PUBLISHER]

This paper aims to identify the inter-relationships between the social factors that influence epidemiological patterns in the city neighbourhood of Casablanca, Zaragoza (Spain). Data for a cross-sectional survey were collected between January 2008 and April 2008 from a representative random sample of 1032 residents aged more than 15 years. The study interview contained information scales on healthcare behaviours, treatment evaluation, the number of medical consultations in the weeks pervious to the interview and the perceived health status of the respondents, using The Health Perception Questionnaire. The global index (continuous variable) allowed inferences to be made on the individual's perception of his/her own health. The assessment of social vulnerability was based on the occupational, educational and economic conditions of the interviewees. An individual was considered to belong to a vulnerable subeconomic group if he/she had a personal income of 6000 euros or less; or had no formal education or had been educated up to primary school level only; or was not in paid employment at the time of the interview. A descriptive and comparative analysis of the vulnerable and non-vulnerable population groups for perceived and diagnosed health variables was undertaken using parametric and non-parametric tests. A total of 550 interviewees (53.3%) were considered vulnerable people. Low level of instruction (primary or no education) was the main characteristic of this group (356 subjects, 64.7% of those identified as vulnerable). Binary logistic regression was used to analyse the association between belonging to the vulnerable group and a number of health variables adjusted for gender, age and area of residence. The vulnerable group had worse levels of perceived health even when controlled for gender and area of residence. In Casablanca, the place of residence is an important social stratification indicator reflected in the characteristics of the vulnerable population group and its perceived health. [ABSTRACT FROM AUTHOR]

Purpose -- This paper's aim is to examine the relationship between intimate partner violence, childhood abuse and psychiatric disorders among 118 female drug users in treatment in Barcelona, Spain. Design/methodology/approach -- Secondary analysis of a cross-sectional study of the psychiatric, behavioural and social risk factors for HIV. DSM-IV disorders were assessed using the Spanish Psychiatric Research Interview for Substance and Mental Disorders; the Composite Abuse Scale assessed intimate partner violence and the Child Maltreatment History Self-Report assessed childhood physical and sexual abuse. Findings -- The odds of experiencing intimate partner violence were 2.42 times greater among those with any depressive disorder (95 per cent CI 1.13, 5.20), over three times greater for those who reported ever attempting suicide (OR 3.20; 95 per cent CI 1.29, 7.94), met criteria for borderline personality disorder (OR 3.05; 95 per cent CI 1.31, 7.11), had been abused in childhood (OR 3.38; 95 per cent CI 1.45, 7.85) or currently lived with a substance user (OR 3.74; 95 per cent CI 1.29, 10.84). In multiple logistic regression, only living with a substance user (OR 3.42; 95 per cent CI 1.08, 10.86) and a history of childhood abuse (OR 2.87; 95 per cent CI 1.05, 7.86) remained significant in the model examining intimate partner violence victimisation. Research limitations/implications -- The small sample size, together with the fact that the study was not originally powered to examine differences in intimate partner violence may have increased the possibility of type II errors. Originality/value -- Histories of psychiatric disorders, intimate partner violence and childhood abuse are common in female substance users in treatment. Research suggests that such histories result in poorer treatment outcomes. Histories of intimate partner violence and childhood abuse should be identified and addressed in substance abuse treatment to enhance treatment outcomes. [ABSTRACT FROM AUTHOR]

Among the many fields of application of Ergonomics, this research deals with the services offered to Justice from the expertise recognized by the Law on prevention of occupational risks within the framework of the Law of Civil Procedure: Ergonomics forensic also called Legal Ergonomics. In Spain there are experiences since 1995 and an important development and this paper is to investigate the actions required for a more widespread use in trials. Consensus methods such as the Delphi survey technique are being employed to help enhance effective decision-making in the future development of Ergonomics Forensics. The Delphi survey is a group facilitation technique, which is an iterative multistage process, designed to transform opinion into group consensus. It is a flexible approach, that is used commonly within the health and social sciences, however, there is little use and practice of ergonomics as a technique to facilitate the participation of all experts involved: judges, lawyers and expert ergonomists [ABSTRACT FROM AUTHOR]

INTRODUCTION The availability of lower-cost cigarettes in neighboring countries provides price-sensitive smokers with incentives to purchase cheaper out-of-country cigarettes. This study estimates the prevalence of and factors associated with cross-border purchasing of cheaper cigarettes among smokers from Germany, Greece, Hungary, Poland, Romania, and Spain. The prevalence of cross-border purchasing was estimated by residential location, defined as living in regions bordering a lower-price country (where prices were at least €1/pack lower), regions bordering a similar- or higher-price country, and internal non-border regions. METHODS Data were from a survey of nationally representative samples of adult smokers (n=6011) from Germany, Greece, Hungary, Poland, Romania, and Spain. The primary outcome was purchasing cheaper out-of-country cigarettes in the previous six months. Residential location was defined using The Nomenclature of Territorial Units for Statistics (NUTS2 in Germany and NUTS3 in the other countries). Multivariable logistic regression tested differences in purchasing cheaper out-of-country cigarettes by country and residential location. RESULTS Residential location was associated with purchasing cheaper out-of-country cigarettes in Germany and Poland (p<0.05): 31% of German and 11% of Polish smokers living in regions bordering lower-price countries reported purchasing cheaper out-of-country cigarettes in the previous six months. Smokers living in regions bordering lower-price countries had 4.21 times greater odds of purchasing cheaper out-of-country cigarettes compared to smokers living in non-border regions. CONCLUSIONS Overall, only a minority of smokers in the six countries purchased cheaper cigarettes outside their country. However, smokers living in regions bordering countries where cigarettes were at least €1/pack lower than their home country had significantly higher odds of purchasing cheaper out-of-country cigarettes. This effect was especially prominent among German smokers. Tax harmonization policies designed to minimize crossborder price differentials can eliminate lower-priced alternatives for price-sensitive smokers. [ABSTRACT FROM AUTHOR]

Institutionalized individuals with intellectual disabilities have few opportunities to participate in instrumental activities of daily living (IADLs), which probably affects higher cognitive functions, or vice versa. The objectives of this study were to evaluate the possible difference in the ability to perform IADLs and executive functioning between individuals with and without intellectual disabilities and to determine if executive functions are associated with the performance of IADLs in people with intellectual disabilities. This was a multi-center cross-sectional study, conducted between July 2019 and May 2020. Participants with intellectual disabilities were recruited from four centers for people with intellectual disabilities. Adults without these disabilities were gathered from several community centers. The sample consisted of 90 individuals with moderate intellectual disabilities and 79 individuals with no intellectual disability. Executive functions were evaluated using the Wechsler Adult Intelligence Scale—WAIS-IV, the INECO Frontal Screening test, the Semantic Verbal Fluency Test, and the Behavioural Assessment of the Dysexecutive Syndrome—BADS—Scale. The performance of the IADLs was assessed by the Lawton and Brody Scale. The results showed that the higher the function in instrumental activities, the lower the impairment of executive functions. Executive functions accounted for 81% of the total variance in the ability to perform the IADLs. In conclusion, individuals with moderate intellectual disabilities demonstrated limitations in executing the IADLs, which were partially associated with low performance in executive functions. This information could help in the development of evidence-based intervention programs and facilitate the formulation of appropriate support strategies to enhance participation in these activities. [ABSTRACT FROM AUTHOR]

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

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

Aims: 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]

Purpose: Diabetes remission is a phenomenon described in the context of drastic weight loss due to bariatric surgery or low-calorie diets. Evidence suggests that increasing the intake of plant protein could reduce the risk of type 2 diabetes. We sought for association between changes in plant protein intake in the context of 2 healthy diets without weight loss nor glucose-lowering medication, and diabetes remission in coronary heart disease patients from the CORDIOPREV study. Methods: Newly diagnosed type 2 diabetes participants without glucose-lowering treatment were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was assessed with a median follow-up of 60 months according to the ADA recommendation. Information on patient's dietary intake was collected using food-frequency questionnaires. At first year of intervention, 177 patients were classified according to changes in plant protein consumption into those who increased or decreased its intake, in order to perform an observational analysis on the association between protein intake and diabetes remission. Results: Cox regression showed that patients increasing plant protein intake were more likely to remit from diabetes than those who decreased its intake (HR = 1.71(1.05–2.77)). The remission occurred mainly at first and second year of follow-up with diminished number of patients achieving remission in the third year onwards. The increase in plant protein was associated with lower intake of animal protein, cholesterol, saturated fatty acids, and fat, and with higher intake of whole grains, fibre, carbohydrates, legumes, and tree nuts. Conclusion: These results support the need to increase protein intake of vegetal origin as dietary therapy to reverse type 2 diabetes in the context of healthy diets without weight loss. [ABSTRACT FROM AUTHOR]

This study examines the influence of exposure to family violence during childhood on child-to-parent violence (CPV) through moral disengagement. The sample included 1868 Spanish adolescents aged between 13 and 18 years (57.9% female, Mage = 14.94, SD = 1.37). Participants completed the Child-to-Parent Violence Questionnaire, the Mechanisms of Moral Disengagement Scale, and the Exposure to Violence Scale during childhood. Results showed that exposure to family violence during childhood (vicarious and direct violence) contribute independently and positively to CPV. Moreover, the relationship between vicarious and direct exposure to family violence and CPV is mediated by moral disengagement. The structural model was replicated for both CPV towards the father and CPV towards the mother. The results highlight the importance of early exposure to family violence and moral disengagement in violent behavior towards parents. It is necessary to stage an early intervention with children who have been exposed to family violence in order to prevent an intergenerational transmission of violent behaviors. [ABSTRACT FROM AUTHOR]

Nurses' attitudes toward families play an important role in improving relationships with patients' families. It is essential to have valid and reliable instruments to assess nurses' attitudes toward involving families. The aim of this study was to analyze the psychometric properties of the refined Spanish version of the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) according to classical test theory and the Rasch model (N = 263). Cronbach's alpha values were.73 to.87 and intraclass correlation coefficients ranged from.72 to.86. Rasch analysis results suggested that it was a multidimensional scale with four dimensions and a simpler response scheme than the original scale. Except for one item, the scale was free from bias regarding age and experience time. The FINC-NA is a reliable and valid measure showing a good fit to the Rasch model and is ready to map nurses' attitudes and measure the effectiveness of family nursing educational interventions. [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]