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This study focused on the specific challenges of university students in the face of the COVID-19 pandemic and examined similarities and differences in COVID-related concerns and difficulties in functioning in samples of undergraduate students in five countries. A sample of 4306 undergraduate university students (43.8% males, 56.2% females) from Israel, Kosovo, Ukraine, Cyprus and Germany participated in an anonymous online survey during the first wave of the pandemic, between March and June 2020. Study variables included the assessment of the exposure to COVID-19, perceived health status, specific COVID-related concerns and functional difficulties, social support, and the perceived level of coping. Similar concerns about the uncertainty regarding the termination of the health crisis and worry for the health of family members were identified as the most common concerns in the five countries. Challenges in online learning and financial difficulties were rated as the most central difficulties. Both COVID-related concerns and COVID-related difficulties predicted lower levels of perceived coping. Greater social support was associated with better perceived coping. Policymakers should be informed by the accumulating research showing the substantive relationships between academic difficulties and perceived COVID-related distress and coping.

Previous studies have reported dysbiosis in the gut microbiota (GM) of children with autism spectrum disorders (ASD), which may be a determining factor on child development through the microbiota-gut-brain axis. However, it is not clear if there is a specific group of dysbiotic bacteria in ASD. The aim of this study was to carry out a meta-analysis on the studies that analyze GM in children with ASD. 18 studies fulfilled our selection criteria. Our results showed a lower relative abundance of Streptococcus (SMD(+) = - 0.999; 95% CI - 1.549, - 0.449) and Bifidobacterium genera (SMD(+) = - 0.513; 95% CI - 0.953, - 0.073) in children with ASD. Overall, the Bifidobacterium genera is involved. However, differences found between studies are attributed to factors such as reporting bias.

Purpose: To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries. Methods: Cross-sectional design. We recruited 1,555 participants ages 13–16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence—dating violence, bullying, cyberbullying, abuse in childhood—and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex. Results: Acceptance of violence was higher for those who had lower perceived social support from parents (βgirls = −154, p < .001; βboys = −.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (βgirls = .067, p = .035; βboys = .225, p < .001; (βgirls = .118, p < .001; βboys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys. Conclusions: Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence. The project “Lights, Camera and Action against Dating Violence” (Ligts4Violence) was funded by the European Commission Directorate-General Justice and Consumers Rights, Equality and Citizen Violence Against Women Program 2016 for the period 2017–2019 to promote healthy dating relationship assets among secondary school students from different European countries, under grant agreement No. 776905. It was also cosupported by the CIBER of Epidemiology and Public Health of Spain for its aid to the Gender-based Violence and Youth Research Program. info:eu-repo/semantics/publishedVersion

There is a need to improve psychological interventions in women experiencing intimate partner violence (IPV) and reduce its long-term sequelae. The objective of this qualitative study was to explore the needs of female IPV survivors, the support they receive, and their strategies for coping with this experience over the long term. During 2017, 53 female IPV survivors participated in the study, of whom 38 (71.7%) were recruited from women’s associations against gender violence from three Andalusia provinces (Southern Spain). In a semi-structured interview, the women responded to four open-ended questions about the effects of IPV on their life and how they coped with this situation. Four main themes were identified: (1) changes after the experience, (2) support during recovery, (3) perceived needs and obstacles, and (4) current situation. The survivors considered formal and informal social support to be critical to their recovery and emotional well-being. They also highlighted the need for continuity in support programs and for specialist interventions to address long-term psychological sequelae. These findings reinforce the need for psychological programs more tailored to the needs of these women.

Background Sexism results in a number of attitudes and behaviors that contribute to gender inequalities in social structure and interpersonal relationships. The objective of this study was to evaluate the effectiveness of Lights4Violence, an intervention program based on promoting health assets to reduce sexist attitudes in young European people. Methods We carried out a quasi-experimental study in a non-probabilistic population of 1146 students, aged 12–17 years. The dependent variables were the difference in the wave 1 and wave 2 values in the subscales of the Ambivalent Sexism Inventory: benevolent sexism (BS) and hostile sexism (HS). The effect of the intervention was evaluated through linear regression analyses stratified by sex. The models were adjusted by baseline subscales scores, socio-demographic and psychological variables. Results In girls, we observed a decrease in BS in the intervention group compared to the control group (β = − 0.101; p = 0.006). In the wave2,, BS decreased more in the intervention group compared to the control group in girls with mothers with a low level of education (β = − 0.338; p = 0.001), with a high level of social support (β = − 0.251; p p p Conclusions The implementation of the Lights4Violence was associated with a significant reduction in BS in girls, which highlights the potential of interventions aimed at supporting the personal competencies and social support. It is necessary to reinforce the inclusion of educational contents that promote reflection among boys about the role of gender and the meaning of the attributes of masculinity. Trial registration Clinicaltrials.gov : NCT03411564. Unique Protocol ID: 776905. Date registered: 26-01-2018.

The prevalence of mild cognitive impairment (MCI) has significantly increased in recent years. No specific instruments are available in Spanish for assessing health‐related quality of life (HRQoL) in people with MCI. The aim of this study was to adapt transculturally and validate the mild cognitive impairment questionnaire (MCQ) in Spanish people with MCI. A standardized transcultural adaptation process was carried out, and the structural equivalence of the Spanish version of the scale was examined. In addition, we studied the reliability and construct validity of the instrument. The sample comprised 100 people with MCI, with a mean age of 79.5 years. In a confirmatory factor analysis, we found the instrument had a one‐factor structure and adequate internal consistency. Related to the construct validity, we found meaningful relationships with measures of HRQoL and depression. Our results indicate that the Spanish version of the MCQ is a reliable and valid tool for measuring HRQoL in Spanish patients with MCI. The availability of specific tools, such as the MCQ allows nurses to evaluate new intervention strategies to improve the HRQoL of these patients. Furthermore, this scale can be used by researchers and clinicians to improve the standards of care provided to this population.

After the paper Cognition or genetics. Predicting progression to Alzheimer's disease with practice effects, APOE genotype and brain metabolism [Neurobiol Aging, 2018; 71:234-240] was published, we identified a coding error of one of the variables analyzed. To correct, update and expand the previous work, this study compared simple and complex regression-based Reliable Change Index (RCIRB) to identify individuals at risk of progression to AD (AD-risk) after six years using either delayed recall or recognition scores. Auditory Verbal Learning Test (AVLT) scores at six months for 394 individuals with normal cognition (NC) from the Alzheimer's Disease Neuroimaging Initiative database were regressed on baseline AVLT scores only (simple RCIRB), or with age, sex and education (complex RCIRB). Standardized residuals were used to classify 816 individuals with amnestic mild cognitive impairment (aMCI) as showing low practice effects (PE-) when the discrepancy between observed and predicted scores was found in fewer than 5% of NC. RCIRB for delayed recall scores were not significant to predict AD-risk. For recognition scores, the AD-risk was associated with age (P=.012), brain metabolism (P

The COVID-19 pandemic has caused several changes in society, especially in the educational context, where several learning methodologies and social interactions have been modified significantly. This fact could have had a negative impact on academic stress levels of students and the classroom climate, especially in the university context. The main aim of the present study was to identify changes in academic stress and the perceived classroom climate caused by COVID-19 in a sample of Spanish university students. Academic stress was evaluated trough the Stressor Academic Scale (SAS) and perceived classroom climate employing the Perceived Classroom Responsibility Climate (PCRC) questionnaire. A longitudinal study was conducted. 135 students (97 females and 38 males) from the Gastronomy (n = 31) and Criminology (n = 104) degrees were evaluated before and after the COVID-19 lockdown in Spain. Academic stress levels and perceived classroom climate were analyzed before (Time 1) and after (Time 2) the lockdown declaration. An increase in academic stress was found, especially in the categories regarding Teachers’ Methodological Deficiencies, Academic Over-Burden and Beliefs About Performances. Females and final year students suffered higher levels of academic stress. No differences were found between Time 1 and 2 in perceived classroom climate. The obtained results point out a significant increase of academic stress in university students due to the COVID-19 pandemic in Spain. The implemented educational changes and the uncertainty that resulted from the pandemic could have a significant negative impact on mental health in this population, resulting in higher levels of academic stress, especially in females and final year students. Future studies should analyze the strategies that students are employing to cope with these educational challenges and intervention strategies to promote them in the context of higher education. This research was supported by the Program of Networks-I3CE of Investigation in University Teaching (Program Networks) from the Vice-Rectorate of Quality and Educational Innovation and Education Sciences Institute of the University of Alicante (2019–2020). Ref.: (4913).

Background: Machismo and acceptance of violence (AV) against women are part of the social construction of hegemonic masculinity and are related to the risk of dating violence. This study aims to analyze the effectiveness of the Lights4Violence program in reducing machismo and AV in secondary school students from different European cities. Methods: Quasi-experimental longitudinal study using a convenience sample of 1,146 high school students from different European cities (12–17 years old) including 575 intervention group students (59.1% girls) and 571 control group students (62.7% girls). We performed linear regression models to identify the effect of the intervention, modelling the difference in means in machismo and AV (dependent variables) between wave-2 and wave-1. Results: An interaction was identified between the group variable and the empathy variable. In wave-2, girls with high empathy at baseline in the intervention group obtained lower mean AV scores (β: -0.131; p = 0.004). However, the boys in the intervention group (reference: control group) with low empathy at baseline registered a significant increase in the mean values of machismo (β: 0.247; p

Health care personnel constitutes the most vulnerable group of professionals, as they are employed in a work context with higher exposure to SARS-CoV-2 infection. This study aims to estimate the prevalence of SARS-CoV-2 infection in health personnel (n = 2858) of two health departments in the Valencian community between March 2020 and April 2021, as well as the sociodemographic and work variables predicting higher infection prevalence in this group. A cross-sectional descriptive study was performed on health workers from the health departments of Torrevieja and Elche-Crevillente of the Valencian Community (Spain). After obtaining the samples, the cases were identified through an active infection diagnostic test (AIDT). The analyzed variables were: sex, age (18–34/35–49/>50 years), professional category, health care, risk service, and AIDT. A total of 2858 staff members were studied. Of them, 55.4% (1582) underwent an AIDT, with 9.7% (277) of positive cases. Infection predominated in the age group of 18 to 34 years, 12.6% (OR = 1.98, 95% CI [1.26, 3.11]); nurses, 12.1% (OR = 1.5, 95% CI [1.00, 2.23]); and at-risk services, 11.4% (OR = 1.3, 95% CI [1.06, 1.81]). A very low positivity rate was identified in the health personnel linked to the health departments analyzed during the 14 months of the study period. Based on our results, prevention strategies could focus more intensively on the most at-risk groups, specifically young nurses who work in at-risk services, mainly in emergency and internal medicine.

Background: Standardised patient simulations seem to be useful for improving the communication skills of health sciences students. However, it is important to define the effectiveness of these types of interventions in complex scenarios linked to disease chronicity and end-of-life contexts. Methods: A quasi-experimental study with pre- and post-intervention measures was carried out in a single group. A total of 161 nursing students completed different assessment instruments to measure their attitudes towards communication (Attitude Toward Communication Scale), self-efficacy (Self-Efficacy of Communication Skills, SE-12), and communication skills (Health Professionals Communication Skills Scale, EHC-PS) before and after simulation training with standardised patients. The objective of the program was to train students in non-technical skills for complex situations involving chronicity and end-of-life care. It comprised eight sessions lasting 2.5 h each. Results: The results showed notable baseline gender differences in attitudes towards communication and in the informative communication dimension, with women obtaining higher scores. The participants’ self-efficacy and communication skills significantly improved after completing the intervention, with no significant differences being found for the attitudes towards communication variable. Conclusion: The standardised patient simulation programme for complex scenarios related to chronicity and end-of-life contexts improved communication self-efficacy and communication skills in these nursing students. In future work it will be important to analyse the influence of gender and attitudes towards communication as variables in the learning of communication skills in nursing students., Program Redes-I 3CE for Research in University Teaching of the Institute of Education Science (Vice-Chancellorship of Quality and Educational Innovation) of the University of Alicante, edition 2018-19 (No. XARXES-I3CE-20184344).

Meta-analysis is a powerful and important tool to synthesize the literature about a research topic. Like other kinds of research, meta-analyses must be reproducible to be compliant with the principles of the scientific method. Furthermore, reproducible meta-analyses can be easily updated with new data and reanalysed applying new and more refined analysis techniques. We attempted to empirically assess the prevalence of transparency and reproducibility-related reporting practices in published meta-analyses from clinical psychology by examining a random sample of 100 meta-analyses. Our purpose was to identify the key points that could be improved, with the aim of providing some recommendations for carrying out reproducible meta-analyses. We conducted a meta-review of meta-analyses of psychological interventions published between 2000 and 2020. We searched PubMed, PsycInfo and Web of Science databases. A structured coding form to assess transparency indicators was created based on previous studies and existing meta-analysis guidelines. We found major issues concerning: completely reproducible search procedures report, specification of the exact method to compute effect sizes, choice of weighting factors and estimators, lack of availability of the raw statistics used to compute the effect size and of interoperability of available data, and practically total absence of analysis script code sharing. Based on our findings, we conclude with recommendations intended to improve the transparency, openness, and reproducibility-related reporting practices of meta-analyses in clinical psychology and related areas. This research has been funded with a grant from the Ministerio de Ciencia e Innovación and by FEDER funds (Project n° PID2019-104080GB-I00).

Evidence accumulated to date suggests that excess weight in the adult population is associated with a wide range of impairments in executive function. However, most studies have only examined the influence of body mass index (BMI) on the cognitive function of individuals with overweight and obesity. This study examined the potential associations of markers of adiposity (BMI, body fat, and visceral fat) with five domains of executive function including cognitive flexibility, inhibition, monitoring, planning, and working memory in a sample of 87 adult with overweight (n = 34) and obesity (n = 53). The results show that obese people had poorer working memory than those with overweight. After controlling for educational levels and physical activity, the results suggest that neither the waist-hip index not visceral fat were associated with cognitive function. In overweight, body fat was negatively associated with executive components of inhibition (p = 0.05) and monitoring (p = 0.02). In the obesity subgroup, body fat was negatively associated with inhibition (0.02) and working memory (0.04). The results provide evidence of the importance of adiposity for cognitive function. The implications for understanding the influence of markers of adiposity in adults with overweight and obesity are discussed.

Health Promoting Universities (HPUs) are more likely to perform actions intended to change habits and increase personal empowerment, than they are to develop community actions. The objective of this research is to create an asset map to visualize collective actions in a Chilean HPU. A qualitative study, based on the ABCD model was conducted. There were 149 people, distributed into 48 semistructured interviews and 14 focus groups, who participated in this study (students, employees, ex-students and retirees). An asset map was elaborated, identifying the contributions of residents, associations and organizations, local institutions, physical resources, economic assets and local culture and with a new category, ‘connecting assets’. These categories show the range of resources in a university. According to the participants, the questions on asset identification were a tool for reflection, and by giving their opinions and discovering or drawing attention to new resources, they gained a better understanding of the assets in the university. Several participants stated that these talks could generate a positive emotional environment, which boosted their wellbeing. There were gender- and group-based differences in how the assets were valued. Students stressed assets related to services and benefits from the institution, green areas, and collective spaces. Employees, retirees and ex-students emphasized assets related to belonging, identity and traditions. Men appreciated openness and privacy in physical spaces. Women highlighted assets related to the institution. The resulting map, displays a range of resources that can help the university develop new possibilities for comprehensive and collective actions that would revitalize the HPU strategy. This study is part of the project VRID 217.089.007-1.0IN, funded by the Vice-rectorate for Research and Development of the University of Concepción, Chile.

Background and aimsResearch shows inconsistent findings about the link between muscle dysmorphia (MD) and eating disorder (ED) symptomatology. The aim of this study is to synthesize the scientific evidence available on this topic, the researchers conducted a systematic review and meta-analysis.MethodsThe literature search enabled us to identify 39 published articles, which provided 36 independent estimations of the correlation between the two variables.ResultsOur analysis found a positive association between MD and ED symptoms (r+ = .36; 95% CI = 0.30, 0.41). Moderator analyses showed that the type of sample and the tools for assessing MD and ED were statistically associated with the MD–ED effect sizes. The methodological quality of the studies exhibited a positive, statistically significant association with the MD–ED effect sizes.ConclusionsHigher levels of MD were related to greater ED symptomatology, but several study characteristics may moderate the association between the two variables. In this study, we discuss limitations and implications for clinical practice and future research.

Background Changes in the demographic epidemiology of multiple sclerosis (MS) may challenge the view of a latitudinal gradient in the distribution of MS. The objective of this study was to assess the incidence and prevalence of MS in addition to information on MS phenotypes and the use of disease modifying therapies (DMTs) in San Vicente del Raspeig in south eastern Spain. Methods This was a prospective epidemiological study of MS in San Vicente del Raspeig (population of 57,175 inhabitants based on the 2017 census) from 2005 to 2018. Multiple sources were used to identify MS cases. We considered as prevalent and incident cases all patients who satisfied either the criteria of Poser for clinically or laboratory-supported definite MS, or McDonald criteria. MS phenotypes were defined according to the 2013 revisions. Results For the prevalence data, 64 patients were identified. The non-adjusted prevalence was 111.9 (95% CI: 87.7–142.9) cases per 100,000 inhabitants; the prevalence was 159.3 cases per 100,000 inhabitants for women and 63.6 cases per 100,000 inhabitants for men. The female-to-male ratio was 2.6:1. The age-adjusted prevalence for the European standard population was 107 cases per 100,000 inhabitants. During the study period, the incidence was 5 cases per 100,000 inhabitants per year. Most patients were being treated with DMTs (81.3%). MS was active in at least 12.5% of patients. Conclusions The results are consistent with the increased risk of MS in Spain observed over the last three decades, with growing prevalence rates that place the country in the high-risk prevalence zone.

BACKGROUND: Preventing intimate partner violence or dating violence (DV) among adolescents is a public health priority due to its magnitude and damaging short and long-term consequences for adolescent and adult health. In our study protocol, we complement prior experiences in DV prevention by promoting protective factors (or assets) against gender violence such as communication skills, empathy and problem-solving capability through "Cinema Voice", a participatory educational intervention based on adolescents' strengths to tackle DV. METHODS/DESIGN: A longitudinal quasi-experimental educational intervention addressed to boys and girls ages 13-17 years, enrolled in secondary education schools in Alicante (Spain), Rome (Italy), Cardiff (UK), Iasi (Romania), Poznan (Poland) and Matosinhos (Portugal). Both process and results evaluations will be carried out with 100-120 intervention and 120-150 control group students per city at three time periods: before, after and 6 months after the implementation of the following interventions: 1) Training seminar with teachers to promote knowledge and skills on the core issues of intervention; 2) Workshops with intervention groups, where participants produce their own digital content presenting their perspective on DV; and 3) Short film exhibitions with participants, their families, authorities and other stakeholders with the objective of share the results and engage the community. Outcome measures are self-perceived social support, machismo, sexism, tolerance towards gender violence, social problem-solving and assertiveness as well as involvement in bullying/cyberbullying. Other socio-demographic, attitudes and violence-related co-variables were also included. DISCUSSION: This study may provide relevant information about the effectiveness of educational interventions that combine a positive youth development framework with educational awareness about the importance of achieving gender equality and preventing and combating gender violence. To our knowledge, this is the first study that involves six European countries in an educational intervention to promote violence protective assets among enrolled adolescents in secondary schools. This study may provide the needed tools to replicate the experience in other contexts and other countries. TRIAL REGISTRATION: Clinicaltrials.gov: NCT03411564 . Unique Protocol ID: 776905. Date registered: 18-01-2018. This paper was funded by the European Union’s Rights, Equality and Citizenship Programme (2014–2020), under grant agreement No. 776905. Sí

The socioeconomic status (SES) of parents has a crucial influence on the cognitive development of children, but it is not clear whether this effect varies as a function of the children’s age. The objective of this study was to investigate the development of children aged 7, 9, and 11 years of parents with extremely low SES in a developing country (Ecuador). Participating children were divided between a medium-SES group and a low-SES group. Statistically significant differences were observed as a function of SES group and age in verbal memory, language, and executive function, observing wider between-group differences among the 11-year-olds. This work was supported by the Spanish Agency for International Development Cooperation (AECID) [A3/042954/11] (PI: Francisco Cruz-Quintana) and Conselleria d'Educació, Investigació, Cultura i Esport de la Generalitat Valenciana (Proyectos I+D+i desarrollados por grupos de investigación emergentes) [GV/2017/166] (PI: Manuel Fernández-Alcántara).

Background The diagnosis of intellectual disability in children can produce complex grief-related feelings in their parents. Previous studies have focused on the moment of the diagnosis or the early life of the children, and little research has been conducted on their feelings of grief in adulthood. The objective was to analyse the process of grief/loss in parents of adult offspring with intellectual disability. Method The intentional sampling included sixteen parents who responded to semi-structured interviews. A qualitative study was conducted based on grounded theory. Results Five categories were identified: "Reception of the diagnosis", "Emotional bonds with the child", "Experience of loss and feelings in response to intellectual disability diagnosis", "Recurrent grief" and "Coping strategies". Conclusions Recurring feelings of loss experienced by parents in relation to their child's diagnosis persist over time. Specialized emotional interventions are needed to help parents to reduce the intensity of their feelings of grief.

Given the seriousness of the existing situation regarding the mental health of children and adolescents relating to the confinement period imposed due to COVID-19, we conducted this study to describe the effects of the confinement on state anxiety and executive functioning dimensions in a period of online educational modality. A sample of 953 children and adolescents was assessed. A sociodemographic questionnaire, the State Anxiety Inventory for Children (STAIC), and the Behavioral Evaluation of Executive Function (BRIEF-2) scale were applied. The analysis of the results indicates that 68.8% of children and adolescents presented medium–high levels of anxiety. Regarding sex, females showed higher levels of anxiety and worse levels of executive functioning. Although the group aged 11 to 18 years showed methodologically higher state anxiety (p = 0.041) than the group aged 6 to 10 years, the difference was not clinically relevant (δ = −0.113). The state anxiety variable was also correlated positively and significantly to the three executive functioning dimensions explored. In conclusion, it seems evident that COVID-19 lockdowns could have psychological and emotional effects on children and adolescents.

Background: Dating Violence (DV) is a public health problem that is on the rise. In this paper, we aim to analyse different factors associated with DV victimization among female and male adolescents in Spain, considering socioeconomic circumstances, sexual orientation and the presence of different attitudes and experiences related to violence. Methods: Cross-sectional data from a convenience sample of 640 ever-partnered adolescents aged 13 to 17 at schools in the cities of Alicante (n = 359, 50.1% girls) and Terrassa (n = 281, 51.9%) in the context of an educational intervention to promote healthy relationships. We calculated the prevalence of different forms of DV (physical, sexual and control and fear) and carried out multivariate regression models by sex. Results: 5.5% of girls and 8.7% of boys declared having suffered lifetime physical and/or sexual violence, while 22% of girls and 20.5% of boys reported control and/or fear victimization. The likelihood of DV was higher among migrants and those with foreign-born parents (aPR girls = 2.1 CI95%: 1.1-3.9; aPR boys = 1.9: CI95%: 1.0-3.6); prior experiences of abuse (aPR girls = 1.6; CI95%: 1.0-2.6; aPR boys = 1.7; CI95%: 1.1-2.6); and those who showed higher levels of machismo (aPR girls = 1.0; CI95%: 1.0-1.1; aPR boys = 1.0; CI95%: 1.0-1.1). In girls, DV increased among those who reported lesbian/bisexual orientation and poor relationship with teachers. Conclusions: DV is socially patterned and increases among LGB adolescents (especially in the case of girls), migrants, and those with foreign-born parents, and adolescents who reported prior experiences of violence in childhood. Future DV prevention programs should consider social inequalities in the likelihood of DV and by reinforcing adolescents' abilities to recognize social support sources and reject machismo and violence. The project was funded by the Spanish Ministry of Economy, Industry and Competitiveness and the Carlos III Institute (Ref. PI18/00590 and PI18/00544) in 2019 and 2021. This study has also been conducted within the grant received from Instituto de Salud Carlos III & FEDER of which VP is recipient of Predoctora Contract for Training in Health Research (PFIS) grant from European Social Found (FSE) (FI19/00201). Sí

Anthropometrics are a set of direct quantitative measurements of the human body’s external dimensions, which can be used as indirect measures of body composition. Due to a number of limitations of conventional manual techniques for the collection of body measurements, advanced systems using three-dimensional (3D) scanners are currently being employed, despite being a relatively new technique. A systematic review was carried out using Pubmed, Medline and the Cochrane Library to assess whether 3D scanners offer reproducible, reliable and accurate data with respect to anthropometrics. Although significant differences were found, 3D measurements correlated strongly with measurements made by conventional anthropometry, dual-energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP), among others. In most studies (61.1%), 3D scanners were more accurate than these other techniques; in fact, these scanners presented excellent accuracy or reliability. 3D scanners allow automated, quick and easy measurements of different body tissues. Moreover, they seem to provide reproducible, reliable and accurate data that correlate well with the other techniques used. TIN2017-89069-R funded by the Ministry of Economy, Industry and Competitiveness and the European Regional Development Fund (FEDER).

Dating violence (DV) among adolescents is a public health issue because of its negative health consequences. In this study, we aimed to analyse the prevalence and the psychosocial and socioeconomic risk and protective factors associated DV among male and female adolescents in Europe. It was performed a cross-sectional study based on a non-probabilistic sample of 1555 students aged 13–16 years (2018–2019). The global prevalence of DV victimization was significantly greater among girls than boys (girls: 34.1%, boys: 26.7%, p = 0.012). The prevalence of DV in both girls and boys was greater for those over age 15 (girls: 48.5% p &lt, 0.001, boys: 35.9%, p = 0.019). There was an increased likelihood of DV victimization among girls whose fathers did not have paid employment (p = 0.024), who suffered abuse in childhood, and reported higher Benevolent Sexism [PR (CI 95%): 1.01 (1.00–1.03)] and machismo [1.02 (1.00–1.05)]. In the case of boys, the likelihood of DV increased with abuse in childhood (p = 0.018), lower parental support [0.97 (0.96–0.99)], high hostile sexism scores (p = 0.019), lower acceptance of violence (p = 0.009) and high machismo (p &lt, 0.001). Abuse in childhood was shown to be the main factor associated with being a victim of DV in both population groups, as well as sexism and machismo attitudes. These results may contribute to future DV prevention school programs for both, teenagers and children of elementary school ages.

Background Dying at home is the most frequent preference of patients with advanced chronic conditions, their caregivers, and the general population. However, most deaths continue to occur in hospitals. The objective of this study was to analyse the socioeconomic inequalities in the place of death in urban areas of Mediterranean cities during the period 2010–2015, and to assess if such inequalities are related to palliative or non-palliative conditions. Methods This is a cross-sectional study of the population aged 15 years or over. The response variable was the place of death (home, hospital, residential care). The explanatory variables were: sex, age, marital status, country of birth, basic cause of death coded according to the International Classification of Diseases, 10th revision, and the deprivation level for each census tract based on a deprivation index calculated using 5 socioeconomic indicators. Multinomial logistic regression models were adjusted in order to analyse the association between the place of death and the explanatory variables. Results We analysed a total of 60,748 deaths, 58.5% occurred in hospitals, 32.4% at home, and 9.1% in residential care. Death in hospital was 80% more frequent than at home while death in a nursing home was more than 70% lower than at home. All the variables considered were significantly associated with the place of death, except country of birth, which was not significantly associated with death in residential care. In hospital, the deprivation level of the census tract presented a significant association (p Conclusions The probability of dying in hospital, as compared to dying at home, increases as the socioeconomic deprivation of the urban area of residence rises, both for palliative and non-palliative causes. Further qualitative research is required to explore the needs and preferences of low-income families who have a terminally-ill family member and, in particular, their attitudes towards home-based and hospital-based death.

Early View: Online Version of Record before inclusion in an issue., [Background and Aims]: Several recent studies have investigated the relationship between telomere length and substance use disorders with inconsistent results. We aimed to assess this association and to identify moderators of the relationship., [Methods]: Systematic review and meta‐analysis. Selection criteria were observational studies reporting telomere length in people with a substance use disorder compared with a control group. Studies focused solely on nicotine addiction, employing other study designs, and non‐human studies were excluded. Study selection and data extraction were independently conducted by two researchers following a standardized protocol and included studies until December 2019. Standardized mean differences were used as the effect size index [d; 95% confidence interval (CI)] and random‐effects models were used for the meta‐analysis. Cochran's Q‐statistic, I2 index, visual inspection of the forest plot and a 95% prediction interval were applied to verify study heterogeneity. Subgroup analyses and meta‐regressions were conducted to explore heterogeneity. Small study effects were examined using the ‘funnel plot’, the Egger test, Duval & Tweedie's trim‐and‐fill method and the precision‐effect test–precision‐effect estimate with standard error (PET‐PEESE) method. The risk of bias and the quality of evidence were assessed., [Results]: Ten studies (12 analysis units with 2671 cases and 4532 controls) met the selection criteria. An overall effect size of moderate magnitude was found (d+ = −0.63; 95% CI = −1.00 and −0.26; P = 0.0008). A potential small study effect was detected, as well as large heterogeneity between studies (Q‐statistic P < 0.001, I2 = 97.3%). Selection of controls, reporting laboratory quality control procedures and total sample size significantly affected the effect size. The quality of the evidence was very low, based on risk of bias analysis and the grading of recommendations assessment, development and evaluation (GRADE) system., [Conclusions]: People with substance use disorders appear to have shorter telomere length than controls; however, this finding should be interpreted with caution due to the poor quality of the evidence., The publication of this study is supported by the ‘Observatorio sobre Drogas de la Región de Murcia’ and IMIB‐Arrixaca as part of the PEGASUS‐Murcia (Psychiatric Enquiry to General Population in Southeast Spain‐Murcia) project.

Background: Previous studies have confirmed that parenting a child diagnosed with an intellectual disability (ID) can negatively a ect the parents’ quality of life in several dimensions. However, fewer have assessed its impact years after the initial diagnosis. The objective of this work was to carry out an in-depth analysis of the current quality of life and concerns of both mothers and fathers of adults diagnosed with ID, having as a reference the moment of the diagnosis. Methods: 16 parents of adult children with ID were evaluated using a semi-structured interview format. A thematic qualitative analysis was carried out by employing ATLAS.ti software. Results: The results suggested that both the emotional and physical well-being of parents, as well as their interpersonal relationships, had declined. In addition, the multiple life changes that had occurred over the time considered in this study, as well as day-to-day worries, had prevented improvements in their quality of life. Conclusions: Several dimensions of the parents’ quality of life were a ected years after a child is diagnosed with ID. These included poor physical and psychological health, economic di culties, lack of social and family support, and lack of time for self-care., FPU predoctoral research grant from the University of Alicante, Spain UAFPU2018-026, Program Redes-I 3CE for Research in University Teaching of the Institute of Education Science (Vice-chancellorship of Quality and Educational Innovation) of the University of Alicante 4884

Environmental sensitivity is the ability to perceive, register and process information about the environment, which differs among children and adolescents. The Highly Sensitive Child (HSC) scale has been used to assess environmental sensitivity in youngsters. The HSC scale is a short and 12-item adapted version of the Highly Sensitive Person (HSP) scale. The aim of this pilot study is to transculturally adapt the Highly Sensitive Child (HSC) scale, and to analyze its factorial structure, reliability and validity. First, a transcultural adaptation was conducted by bilingual experts. Second, once the questionnaire was translated, the psychometric properties were analyzed. The Spanish version of the HSC scale was administered to parents answering about information of 141 children between 6 and 10 years old. The Spanish version of the Emotionality, Activity and Sociability Survey (EAS) was also applied. The results of the confirmatory factor analysis confirmed the three-factor structure of sensitivity in our Spanish sample. This structure included the following dimensions: (1) Ease of Excitation (EOE), (2) Low Sensory Threshold (LST), and (3) Aesthetic Sensitivity (AES). Moreover, both Cronbach’s α and McDonald’s ω values indicated that the Spanish version of the HSC scale was a reliable measure of environmental sensitivity, as a general factor of sensitivity (α = 0.84), and even in its three dimensions: EOE (α = 0.86), LST (α = 0.77) and AES (α = 0.73). Finally, the correlations for convergent validity showed positive associations, especially among the three dimensions of SPS and Emotionality (EOE r = 0.351; LST r = 0.274; AES r = 0.259), which was one of the domains of the EAS survey. The pilot study provided interesting results, which showed a reliable and valid replication of the original structure of sensitivity in the Spanish samples. This research was funded by the European Union, Grant number: 2018-1-PL01-KA201-501033.

Communication is one of the determining factors of healthcare quality, however, a health model that prioritizes clinical over non-technical skills remains prevalent. The aims of this article were: (a) to validate a communication skills scale in a sample of fourth-year nursing degree students from two Spanish universities and (b) determine their perception of communication skills. The study included 289 fourth-year nursing undergraduate students with a mean age of 22.7 (SD = 4.87) years, 81.7% were female. The Health Professionals Communication Skills Scale (HP-CSS) questionnaire was adapted for use among nursing students. We analysed the psychometric properties and relationships with the variable attitudes toward communication skills. The HP-CSS showed a high internal consistency (0.88) and good fit of data to the model (TLI = 0.98, CFI = 0.97, RMSEA = 0.05 [95% CI = 0.04&ndash, 0.06]). The total score and subscale scores correlated with the variable attitude towards communication skills. High scores were obtained for the students&rsquo, perception of communication skills. The HP-CSS is a valid and reliable tool to assess the communication skills in nursing students. This scale provides university teachers with a rapid and easily applied instrument to assess the level of communication skills and relationship with patients.

Background: Human bisphenol-A (BPA) exposure has been linked to adverse health effects even at low doses, which may be of potential public health concern. Objective: To summarize BPA concentrations in general human population and their variability according to sex, geographic area, and analytical method. Methods: Systematic review and meta-analysis of studies reporting BPA concentrations in adult human populations. Separate meta-analyses of median values were carried out for BPA in serum, creatinine-adjusted urinary BPA, and unadjusted urinary BPA concentrations using a random-effects model. Cochran's Q-statistic, I2 index, 95% prediction intervals (PIs), between-studies standard deviation (τ), and forest plots were applied to verify study heterogeneity. Sensitivity and subgroup analyses and weighted ANOVAs and meta-regressions were conducted. Funnel plots and Egger's tests were used to examine publication bias. Results: Fifteen studies were included in the meta-analysis, totaling 28,353 participants. BPA was detected in over 90% of participants. The pooled creatinine-adjusted urinary BPA concentration was 1.76 μg/g (95% PI: 0.79–2.73), with individual estimates ranging between 1.20 and 2.41. The pooled estimate for unadjusted urinary BPA was 1.91 μg/l (95% PI: 0–3.97), ranging between 0.81 and 3.50, while the pooled estimate for serum BPA was 1.75 μg/l (95% PI: 0–10.58), ranging between 0.34 and 3.76. No differences were found by sex, geographic area or analytical technique. Larger sample sizes were associated with lower BPA concentrations. There was large heterogeneity across studies, whereas data for urinary BPA levels suggested a publication bias affecting research in low exposed populations. Conclusion: This first meta-analysis of human BPA concentrations highlights a widespread population exposure to BPA. Although there was high heterogeneity across studies, the expected range of estimated human BPA concentrations suggests that potential health risks are unlikely. Further studies are warranted to better characterize the epidemiology of human BPA exposure, accounting for ethnic, geographic, individual and environmental variability. This work was supported by the AECC-Junta Provincial de Murcia (FFIS-2006), and received partial funding from the Murcia Biomedical Research Institute (IMIB)-FFIS and the Spanish Biomedical Research Network Center (CIBER) (BOE-A-2020-6018).

Background and objectives The objective of mindfulness-based stress reduction (MBSR) programmes is to promote awareness of the present moment without judging, evaluating or reacting to the different thoughts or emotions that may arise. Development of these abilities appears especially important for healthcare professionals. The objective of this study was to evaluate the effectiveness and medium- and long-term effects of a MBSR programme for primary care (PC) health professionals on their health-related quality of life and quality of work life. Design Randomised clinical trial using an intervention and control group with follow-up of the experimental group. Setting Primary Care centres in the Alicante Public Health Service (Spain). Participants Participants were PC health professionals (N = 58) divided between an intervention group receiving the 8-week MBSR programme and a control group receiving a theoretical training session alone. Method Both groups were evaluated at baseline and at 8 weeks, and the intervention group was additionally evaluated at 3-, 6-, 9- and 12-month postprogramme. Results In comparison to the control group, the intervention group obtained higher scores postintervention for mindfulness, health-related quality of life, mood and compassion satisfaction and a lower score for burnout. Improvements in mindfulness, mood and burnout syndrome persisted at 12 months after the programme. Conclusions In conclusion, MBSR is an effective intervention to enhance the health-related quality of life and quality of work life of Primary Care Health professionals.

The circumstances of coronavirus disease (COVID-19)-related deaths embed multiple traumatic characteristics, alongside several external factors that can disenfranchise individual grief. In this context, severe forms of traumatic distress, guilt, somatization, regret, anger, and unspecific symptoms not yet included in prolonged grief disorder (PGD) criteria could emerge. This article (a) analyzes factors related to bereavement in the context of the COVID-19 pandemic; (b) proposes avenues for meaning-making practices to facilitate individual and collective mourning process; and (c) invites clinicians to pay attention to the traumatic characteristics of COVID-19-related deaths adopting a holistic approach of PGD clinical manifestations, as well as in evaluation and treatment of cases. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effectiveness of deprescription interventions in primary care, and to describe the barriers and enablers of the process from the point of view of patients and healthcare professionals. Methods We designed an umbrella review which includes nine systematic reviews. More than 50% of included studies were performed with adults in primary care. Two reviewers independently performed data extraction and analysis. Results In considering studies of the effectiveness of interventions, it can be observed that the educational component of deprescription procedures is a key factor, whilst procedures tailored towards the patient’s situation offer better results. With regards to studies involving healthcare professionals, the main explored areas were the balance between risks and benefits, and the need to improve communication with patients as well as other colleagues involved in patient care. Amongst the identified barriers we found lack of time, inability to access all information, being stuck in a routine, resistance to change and a lack of willingness to question the prescription decisions made by healthcare colleagues. With regards to patients, it is clear that they have worries and doubts. In order to overcome these issues, a good relationship with healthcare professionals and receipt of their support is required during the process. Conclusions Optimizing medication through targeted deprescribing is an important part of managing chronic conditions, avoiding adverse effects and improving outcomes. The majority of deprescription interventions in primary care are effective. Good communication between healthcare professionals is a key element for success in the deprescription process.

This study is part of a larger project to generate norms for letter verbal fluency test (VFT) in 3,284 children from nine Latin American countries. The letter VFT (letters M, R, and P) was administered and multiple linear regressions, including age, age2, MPE (mean parental education), MPE2, sex, and interactions were used as predictors. Results showed significant differences across countries for all scores. Age affected scores linearly except for Ecuador (P-letter), in which a quadratic effect was found. Scores increased linearly as a function of MPE, with the exception of Mexico (R-letter), in which a quadratic effect was found. Age by MPE (M- and P-letters), and age by MPE2 (R-letter) interactions were found in Mexico. Sex had an impact on letter R in Cuba, and letter P in Ecuador and Paraguay. Age2 by sex interaction was found in Ecuador (P-letter). These norms will be useful for clinical neuropsychologists in these countries to evaluate their patients’ verbal fluency.

The Medical Outcome Study‐HIV Health Survey (MOS‐HIV) is one of the most used questionnaires for the evaluation of the health‐related quality of life (HRQoL) in people living with HIV (PLWHIV) in both medical settings and research studies. This study aimed to estimate the average reliability of the MOS‐HIV scores and to evaluate the characteristics of the studies that could explain the variability between reliability estimates. Furthermore, the study aimed to estimate the induction rate of the reliability of the MOS‐HIV. A systematic review of the previous literature, including studies that reported α and/or test–retest coefficients with the data at hand for the total score of the MOS‐HIV and the subscales, was conducted. Fifty studies (52 samples; N = 14,132) were included in the reliability generalization meta‐analysis. The average α coefficient for the total score of MOS‐HIV was .91 and above .80 for all of the subscales, except for role functioning, which had an average coefficient of .76. Different study dimensions were related to the heterogeneity of reliability between studies. Reliability induction was found to be 76.1%. The results obtained in the present study indicate that the MOS‐HIV is a reliable instrument for HRQoL evaluation in PLWHIV, for clinical and research purposes. In the clinical practice of health services, nurses could employ this gold standard for reliable evaluations of HRQoL in PLWHIV. This study was funded by the Office of the Vice President of Research and Knowledge Transfer of the University of Alicante (GRE‐18‐17B).

Background: Older people have different nutritional requirements from those of the general population, in particular, they need a lower energy intake, higher protein content to preserve muscle mass, and a greater supply of vitamins and minerals to maintain good bone health. The objective of this study is to evaluate the degree of compliance with nutritional recommendations, and its relationship with sociodemographic characteristics, clinical conditions, and lifestyles in older people residing in the Spanish Mediterranean. Methods: Cross-sectional study with 341 people over 60 years old. Participants were selected using a snowball strategy. A validated food intake frequency questionnaire for older populations was used to determine the daily food intake. This evaluation was carried out at two time points from which the average nutrient intake was obtained. Sociodemographic, clinical, and lifestyle variables were obtained from an ad hoc elaborated questionnaire. Results: Compliance with dietary intakes was low, by deficiency, such as in vitamin D, where none of the participating subjects met the requirements, and iodine, where the compliance rate did not exceed 20%, or by excess, such as with monounsaturated fatty acids, fiber, iron, B vitamins, vitamin E, and vitamin C. People with better blood pressure, cholesterol, and glucose levels observed a higher degree of compliance with the recommended intakes. Living in rural areas, being divorced, or being illiterate negatively influence meeting the recommended intakes of certain nutrients. Increased physical activity was associated with an increased compliance with Kcal recommendations, cholesterol, and vitamin B2 intake. Conclusion: this study highlights the importance of accurately knowing the dietary intakes in the older population, and what factors, such as lifestyles or sociodemographic characteristics, may predispose to better or worse compliance with the recommendations.

To determine the prevalence of low scores on two neuropsychological tests commonly used to evaluate learning and memory in children. 6,030 healthy children from 10 countries in Latin America and Spain were administered Rey–Osterrieth Complex Figure (ROCF) and the Test de Aprendizaje y Memoria Verbal–Infantil (TAMV-I). Results showed that low scores are common when multiple neuropsychological outcomes (tests and/or scores) are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores in a given individual when evaluating learning and memory using various sets of scores to reduce false-positive diagnoses of cognitive deficits in pediatric populations.

Objective: To explore the views of the Internet in childhood, identifying both health assets and risks. Method: A qualitative study was performed using 14 focus groups, eight of which comprised boys and girls, four of which comprised parents and two of which were mixed (children and parents) in primary schools in urban and rural settings in Andalusia (Spain). Teachers in these schools were also asked to complete an online questionnaire using LimeSurvey. This study involved 114 individuals: 64 pupils (33 girls and 31 boys), 28 parents (18 mothers and 10 fathers), and 22 teachers (14 women and 8 men). Analysis of manifest content and underlying meanings was carried out. QSR NVivo 9 software was used to facilitate analysis and make it systematic. Results: Our findings show how the differences in the way parents and children understand health and wellbeing affect the way they discuss the Internet and health. The discussion of results looks at the implications of computer literacy for public health and wellbeing, particularly with regard to health assets. Conclusions: Parents and children understand the contribution of the Internet to health and wellbeing differently. Whilst parents emphasize the risks (unsafe environment, relationships and quality of information, social networks, physical problems and addiction), the children emphasize the assets offered by the Internet. Objetivo: Explorar la visión de Internet en la infancia, identificando riesgos y activos para la salud. Método: Estudio cualitativo con 14 grupos focales: ocho con niños y niñas, cuatro con familias y dos mixtos con niños/as y familias en centros de educación primaria de los ámbitos rural y urbano en Andalucía (España). También se aplicó un cuestionario on-line al profesorado de los centros educativos. En total participaron 114 personas (33 chicas y 31 chicos; 18 madres y 10 padres; 14 maestras y 8 maestros). Se llevó a cabo un análisis de contenido manifiesto y contenido latente, utilizando el software QSR NVivo 9 para facilitar dicho análisis y hacerlo más sistemático. Resultados: Los resultados ponen de manifiesto cómo la forma diferencial de entender la salud y el bienestar entre padres/madres e hijos/as influye en la orientación de los discursos sobre Internet y salud. Los resultados son discutidos ampliando el debate existente en torno a las implicaciones en salud pública de la alfabetización digital y su conexión con el enfoque de activos para la salud. Conclusión: Las familias y la infancia entienden la contribución de Internet a la salud y al bienestar de manera muy diferente. Mientras los padres y las madres enfatizan los riesgos (ambiente inseguro, relaciones y calidad de la información, redes sociales, problemas físicos y adicciones), los/las niños/as se centran en enfatizar las potencialidades de Internet, descritas como activos. The study was financial support by the Andalusian Government’s Health Department.

Introduction Children's experience of grief is influenced by many factors, such as the response of the school environment. The objective of this paper was to explore the grieving children's responses, as well as the factors that facilitate and hinder the grieving process from the teachers' perspective. Methods A qualitative-descriptive study design was used, which included a semi-structured interview conducted with 63 teachers. A thematic analysis was conducted using Atlas.ti7.0. Results Great variability was found between different children's reactions to death (decreased academic performance, isolation, etc.). The factors influencing the children's reactions were both child-specific and environmental. The teachers pointed to communication, emotional support, and spirituality as facilitating elements, but pointed to discomfort when talking about death as a factor which hinders the grieving process. Conclusions In conclusion, although children can naturally adapt to a loss, both providing emotional support and training in providing such support are necessary. Nurses can help in the design and planning of specific programmes to help students cope with death and loss.

This study examined the psychometric properties and factor structure of the Spanish version of the Homophobic Content Agent Target (HCAT) scale in a sample of 1848 high school students. Participants completed an online survey including measures of homophobic bullying, depression, and anxiety. The factor structure showed adequate fit indices in Spanish adolescents similar to the original scale. An exploratory factor analysis showed a simple factor solution of two related factors strongly correlated describing the extent to which students use homophobic language (agent) and the extent to which students are called homophobic epithets (target) due to sexual orientation. The Spanish HCAT scale showed high Cronbach’s alpha coefficient at the subscale score levels, as well as good convergent validity. This study contributes a Spanish-language validated measure of homophobic victimization to be used among adolescents. Implications for understanding homophobic bullying in adolescents are discussed. This study was funded by the Vicerrectorado de Investigación y Transferencia de Conocimiento para el fomento de la I+D+I Universidad de Alicante. Grant number: GRE-16-32.

Introduction: Obesity is one of the most important health problems worldwide. The prevalence of obesity has increased dramatically in the last decades and is now recognized as a global epidemic. Given the dramatic consequences of obesity, new intervention approaches based on the potential of technologies have been developed. Methods: We conducted a systematic review of studies using PubMed, ScienceDirect, Cochrane Library, and MedLine databases to assess how different types of technologies may play an important role on weight loss in obese patients. Results: Forty-seven studies using different types of technologies including smartphones, app, websites, virtual reality and personal digital assistant were included in the review. About half of interventions (47%) found a significant effect of the technology-based interventions for weight lost in obese patients. The provision of feedback could also be effective as a complement to interventions carried out using technology to promote weight loss. Conclusions: The use of technologies can be effective to increase weight loss in patients with obesity improving treatment adherence through self-monitoring. TIN2017-89069-R funded by the Ministry of Economy, Industry and Competitiveness and the European Regional Development Fund (FEDER).

Background and objectives Healthcare professionals play an important role in supporting and attending to families that experience a perinatal loss. Previous research has identified the existence of obstacles that professionals may encounter during their practices. The main objective of the current research was to identify and examine the subjective experiences and practices of experienced professionals attending to perinatal loss in the hospital context in Spain. Design Qualitative descriptive design. Setting Three different hospitals in Spain. Participants Sixteen professionals were interviewed, including doctors, nurses, midwives, nursing assistants, a psychologist and a funeral home manager. Methods Individual semi-structured interviews focusing on three areas were carried out: practices with the baby-foetus, practices with parents and interaction with the team. A thematic analysis was performed using the three main focuses of the semi-structured interview (deductive approach) and the codes that emerged from the data (inductive approach). Results Regarding guideline-based care for the baby/foetus, participants made a distinction between the initial process of care for the baby and the decision-making process with parents. Where support for families was concerned, participants identified considerable variability in the practices used and lack of organisational and care guidelines, psychological support and follow-up. Finally, interactions with other team members were perceived as a source of support, although participants identified a significant lack of coordination. Conclusion Participants reported variability of practices in care for the baby and parents, lack of continuity-of-care guidelines and the importance of support from a coordinated healthcare team.

Pediatric neuropsychologists and researchers commonly interpret a low score as a cognitive weakness. The purpose of the study was to determine the prevalence of low scores for three neuropsychological tests used to evaluate executive function in 4,595 healthy children from Latin-America and Spain. Results showed that low scores are common when multiple neuropsychological outcomes are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores in a given individual when evaluating executive functions using various sets of scores to reduce false-positive diagnoses of cognitive deficits in a child.

The complexity of palliative care means that the emotional distress and burden that primary family caregivers su er under can be particularly high. The objective of this study was to determine the level of burden endured by these primary family caregivers and to identify the variables that predict it in the caregiving relatives of people who require home-based palliative care. A descriptive-correlational cross-sectional study was conducted. Socio-demographic and clinical data were collected from caregivers through a self-administered questionnaire that included questions from the 12-Item Short Form Health Survey (SF-12), Zarit Caregiver Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS), Brief Resilient Coping Scale (BRCS), Post Traumatic Growth Inventory (PTGI), and Fatigue Assessment Scale (FAS). A total of 77 caregivers participated; 66.2% were women, and the mean age was 61.5 years. Most (62.3%) were providing care to cancer patients. From among these data, the presence of anxiety as a clinical problem (48.1%), a high average fatigue score (FAS) of 23.0 (SD = 8.5), and the prevalence of intense overload (41.6%) stood out. We found statistically significant correlations between the variables of burden, fatigue, post-traumatic growth, anxiety, and depression, with the latter two being the main predictive variables of burden. In addition, caregiver burden was associated with a worsening of health. Identifying the factors that influence the appearance of overburden will allow the specific needs of careers to be assessed in order to o er them emotional support within the healthcare environment., This work was supported by grants UGP-18-255 from ISABIAL, PI17/00328 from the Carlos III Health Research Institute (ISCIII) belonging to the Spanish Ministry of Health, and by FEDER (“A way of making Europe”) project funds.

Twin studies have consistently found that genetic factors explain a substantial proportion of the variance for insomnia. However, studies vary widely in their heritability estimates. Therefore, this meta-analysis aimed to: 1) Estimate the mean heritability of insomnia; 2) Assess heterogeneity among twin studies of insomnia; and 3) Search and analyse characteristics of the studies (moderator variables) that may explain heterogeneity among estimates. For this purpose, separate meta-analyses were carried out for MZ and DZ correlations and for heritability estimates by assuming random-effects models. Thirteen independent samples were included in this meta-analysis. The heterogeneity index for heritability estimates was significant in both best fitting models (I2 = 98.77, P < .0001) and full models (I2 = 97.80, P < .0001). MZ correlations were higher (0.37; 95%CI: 0.31,.43) than DZ correlations (0.15; 95%CI: 0.12,.18). A mean heritability of 0.39 (95%CI: 0.32,.44) was found for insomnia. These results highlight the role of genetic factors in explaining differences among the population on insomnia and Emphasize heterogeneity among studies. Further research is needed to identify variables that could explain this heterogeneity.

Neuropsychological studies on refugee children are scarce, but there are even less in the case of Palestinian children. This work aims to study the neuropsychological performance of Palestinian refugee children in Palestine compared to other Palestinian children living outside refugee camps. A comprehensive Neuropsychological battery was administrated to 584 Palestinian school children (464 refugees and 120 non-refugees) aged 6, 7, and 8 years old. Results showed that non-refugee children outperformed refugee children in sustained attention, verbal comprehension, verbal memory, and visual memory. This study is the first to have performed a comprehensive neuropsychological assessment, based on a standardized and validated battery with the Palestinian refugee children. It supports professionals in their evaluation of neurodevelopment and neuropsychological alterations in refugee and non-refugee children in Palestine., Center for Development Cooperation Initiatives (Centro de Iniciativas de Cooperación al Desarrollo—CICODE), Granada University, Spain (Reference No. C14P11_9359)

Recent trends in grief research have been exploring how symptoms of prolonged grief disorder (PGD) and depression co-occur in bereaved individuals using Latent Class Analysis (LCA). However, the PGD criteria have kept undergoing changes and the newest DSM-5 PGD criteria have not been captured in these studies. Also, previous LCA-grief studies have been conducted in Western cultures, focusing more on bereaved adult populations. In this study, we applied LCA on a non-Western sample of bereaved young and middle-aged adults to examine whether the consistently observed 3 latent classes will emerge. We explored if the socio-demographic, loss-related factors, religiousness, spirituality, and continuing bond to the deceased, differentiated the latent classes. We confirmed the 3 latent classes comprising the Resilient class (20.6%), the predominantly PGD class (44.7%), and the combined PGD and Depression class (34.7%). Age, time elapsed since the loss, continuing bond and relationship with the deceased as well as spiritual beliefs were the differential predictors of class membership. This study increases our conceptual and clinical understanding of the predictability of PGD symptomology outcome, according to the newest DSM-5 criteria following bereavement in a non-Western sample. In addition to the continuing bond which was the strongest correlate, attention should be paid to important sociocultural frameworks in grief management.

Objective To generate normative data for the Rey-Osterrieth Complex Figure (ROCF) in Spanish-speaking pediatric populations. Method The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the ROCF as part of a larger neuropsychological battery. The ROCF copy and immediate recall (3 minutes) scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. Results The final multiple linear regression models showed main effect for age on copy and immediate recall scores, such that scores increased linearly as a function of age. Age2 affected ROCF copy score for all countries, except Puerto Rico; and ROCF immediate recall scores for all countries, except Chile, Guatemala, Honduras, Paraguay, and Puerto Rico. Models indicated that children whose parent(s) had a MLPE >12 years obtained higher scores compared to children whose parent(s) had a MLPE≤12 years for Chile, Puerto Rico, and Spain in the ROCF copy, and Paraguay and Spain for the ROCF immediate recall. Sex affected ROCF copy and immediate recall score for Chile and Puerto Rico with girls scoring higher than boys. Conclusions This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the ROCF Test in pediatric populations.

OBJECTIVE: To generate normative data for the Concentration Endurance Test (d2) in Spanish-speaking pediatric populations. METHOD: The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the d2 test as part of a larger neuropsychological battery. The Total number of items processed (TN), Total number of correct responses (CR), Total performance (TP), and Concentration performance (CP) scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models showed main effects for age on all scores, such that scores increased linearly as a function of age. TN scores were affected by age2 for Guatemala and Puerto Rico; CR scores were affected by age2 for Mexico; TP scores were affected by age2 for Chile, Mexico, Puerto Rico, and Spain; and CP scores for Mexico and Spain. Models indicated that children whose parents had a MLPE >12 years obtained higher scores compared to children whose parents had a MLPE≤12 years for Mexico and Spain in all scores, and Puerto Rico for TN, CR, and TP, and Guatemala and Paraguay for CP scores. Sex affect the scores for Ecuador and Honduras (CP scores). CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the d2 test in pediatric populations.

OBJECTIVE: To generate normative data for the Trail Making Test (TMT) in Spanish-speaking pediatric populations. METHOD: The sample consisted of 3,337 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the TMT as part of a larger neuropsychological battery. The TMT-A and TMT-B scores were normed using multiple linear regressions and standard deviations of residual values. Age, age 2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models showed main effects for age on both scores, such that as children needed less time to complete the test while they become older. TMT-A scores were affected by age 2 for all countries except, Cuba, Guatemala, and Puerto. TMT-B scores were affected by age 2 for all countries except, Guatemala and Puerto Rico. Models indicated that children whose parent(s) had a MLPE >12 years of education needed less time to complete the test compared to children whose parent(s) had a MLPE ≤12 years for Mexico and Paraguay in TMT-A scores; and Ecuador, Mexico, Paraguay, and Spain for TMT-B scores. Sex affected TMT-A scores for Chile, Cuba, Mexico, and Peru, in that boys needed less time to complete the test than girls. Sex did not affect TMT-B scores. CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the TMT in pediatric populations. © 2017 - IOS Press and the authors. All rights reserved.

Objective To generate normative data for the phonological and semantic verbal fluency tests (VFT) in Spanish-speaking pediatric populations. Method The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the VFT as part of a larger neuropsychological battery. Scores for letters F, A, S, and animals and fruit categories were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. Results The final multiple linear regression models showed main effects for age on all scores, such that scores increased linearly as a function of age. Age2 had a significant effect in Chile (animals), Cuba (A letter, fruits), Ecuador (animals, fruits), Honduras (F letter), Mexico (animals, fruits), Peru (fruits), and Spain (S letters, animals, fruits). Models showed an effect for MLPE in Chile (A letters, animals, fruits), Ecuador (S letter, animals, fruits), Guatelama (F, S letter, animals), Honduras (animals), Mexico (F, A, S letters, animals, fruits), Puerto Rico (A, letters, animals), and Spain (all scores). Sex scores were found significant in Chile (animals), Ecuador (A letter, fruits), Mexico (F letter, fruits), Paraguay (F, A, S letters, fruits), Puerto Rico (F letter, animals, fruits), and Spain (F letter, fruits). Conclusions This is the largest multi-national Spanish speaking-pediatric normative study in the world, and as such it will allow neuropsychologists from these countries to have a more accurate way to interpret the phonological and semantic VFT in pediatric populations.