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With the purpose of promoting academic inclusion, it is essential for educators to understand the nature underlying poor reading comprehension in children with Autism Spectrum Disorder (ASD). In this study, we examined the time course of anaphor resolution during text comprehension in children and adolescents with ASD and a group of children with Typical Development (TD) matched in chronological age (age range: 9-16) and non-verbal IQ. Their eye movements were monitored as they read short paragraphs in which two factors were manipulated: (1) the semantic typicality of an antecedent (e.g. shark vs. salmon) with regards to a category noun that serves as anaphor (e.g. fish) and (2) the distance between the antecedent and anaphor (e.g. near vs. far). Both, children with ASD and TD showed more and longer first fixations in the near anaphors than in the far anaphors but not in the post-anaphor region which suggests that the effect of distance on anaphor resolution was immediate. The reverse effect of distance indicated that the far condition was too demanding for students of these ages to occur online. Typical antecedents received fewer and shorter revisits than atypical antecedents but only for participants with TD. In contrast, ASD participants did not show such typicality facilitation. Finally, children with ASD made more but shorter fixations and revisits in general than their typical peers. Theoretical and applied implications of our results for the literacy training on ASD participants are discussed.

Spain was close to meeting the 90–90–90-treatment target set by UNAIDS. However, data on health care quality regarding people with HIV and their health-related quality of life (HRQoL) after the COVID-19 pandemic onset is scarce. By considering the perspective of people with HIV and HIV specialists, we aimed to determine some aspects of the quality of care in Spain, such as access to health resources or satisfaction with primary and speciality care, and assess people with HIV health-related quality of life. Ex post facto cross-sectional surveys were administered to 502 people with HIV and 101 HIV clinicians. Unmet needs related to healthcare system and healthcare resources access and to antiretroviral treatment administered by hospital pharmacies were detected. There was also room for improvement in the primary care service delivery and in various aspects concerning people's with HIV HRQoL. About one-fourth of them experienced stigmatisation in the healthcare setting, which was significantly related to HRQoL. Women, heterosexual participants and those with problems accessing the healthcare system scored poorer in the HRQoL scales. Moreover, according to our data, HIV specialists did not seem to be fully aware of patients' with HIV needs and overestimated their HRQoL. [ABSTRACT FROM AUTHOR]

A wide array of digital supports (such as apps) have been developed for the autism community, many of which have little or no evidence to support their effectiveness. A Delphi study methodology was used to develop a consensus on what constitutes good evidence for digital supports among the broader autism community, including autistic people and their families, as well as autism-related professionals and researchers. A four-phase Delphi study consultation with 27 panel members resulted in agreement on three categories for which evidence is required: reliability, engagement and effectiveness of the technology. Consensus was also reached on four key sources of evidence for these three categories: hands-on experience, academic sources, expert views and online reviews. These were differentially weighted as sources of evidence within these three categories.

Objectives Methods Results Conclusions The objective is to assess the interconnectedness of a network of health‐related quality of life (HRQoL) variables among people with HIV (PHIV) to identify key areas for which clinical interventions could improve HRQoL for this population.Between 2021 and 2023, we carried out a cross‐sectional study within the Spanish CoRIS cohort. We conducted a weighted and undirected network analysis, which examines complex patterns of relationships and interconnections between variables, to assess a network of eight HRQoL dimensions from the validated Clinic Screening Tool for HIV (CST‐HIV): anticipated stigma, psychological distress, sexuality, social support, material deprivation, sleep and fatigue, cognitive problems and physical symptoms.A total of 347 participants, predominantly male (93.1%), currently working (79.0%), self‐reported homosexual (72.6%) and college‐educated (53.9%), were included in the study. Psychological distress showed the highest centrality in the network, indicating its strong connections with sleep and fatigue, cognitive problems and social support within the HRQoL network.Psychological distress, sleep and fatigue, cognitive issues and social support were identified as key factors in an HRQoL network, indicating that interventions focused on these areas could significantly enhance overall well‐being. [ABSTRACT FROM AUTHOR]

Background: Effective screening for alcohol‐associated liver disease is relevant in the context of chronic, excessive alcohol consumption. Patients with alcohol‐associated liver disease are often not diagnosed until their liver disease is decompensated. We analyzed the prevalence and associations of Fibrosis‐4 index (FIB‐4) values suggestive of advanced liver fibrosis in patients referred for their first treatment of alcohol use disorder (AUD). Methods: We conducted a cross‐sectional, multicenter study of noncirrhotic individuals referred for their first AUD treatment between March 2013 and April 2021. We obtained sociodemographic data, substance use characteristics, and blood samples at admission. We considered a FIB‐4 value ≥2.67 suggestive of advanced liver fibrosis and used logistic regression analyses to identify features associated with this value. Results: We included 604 patients (67% male), with a median age at admission of 48 years [IQR: 41–56 years]. The median duration of regular alcohol consumption was 21 years [IQR: 18–30 years] and the median alcohol consumption was 105 standard drink units (SDU)/week [IQR: 63–160 SDU/week]. A FIB‐4 value ≥ 2.67 was present in 19.3% of cases. These patients reported more frequent binge drinking (75.4% vs. 66%, p = 0.05) than those with FIB‐4 values below 2.67. In multivariate analysis, a history of binge drinking (OR 1.9, 95% CI, 1.05–3.47), anemia (OR 2.95, 95% CI, 1.42–6.11), leukopenia (OR 7.46, 95% CI, 2.07–26.8), and total serum bilirubin >1 mg/dL (OR 6.46, 95% CI, 3.57–11.7) were independently associated with FIB‐4 values ≥2.67. Conclusions: One in five patients admitted to treatment for AUD without evidence of decompensated liver disease have FIB‐4 values suggestive of advanced liver fibrosis. The presence of a binge drinking history, anemia, leukopenia, and elevated bilirubin levels is associated with high FIB‐4 values. [ABSTRACT FROM AUTHOR]

Copyright of Spanish Journal of Comparative Education / Revista Española de Educación Comparada is the property of Editorial UNED and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Language & Law / Revista de Llengua i Dret is the property of Revista de Llengua i Dret and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Corpora have been used in English as a foreign language materials for decades, and native corpora have been present in the classroom by means of direct approaches such as Data-Driven Learning (Johns, T., and P. King 1991. "'Should you be Persuaded'- Two Samples of Data-Driven Learning Materials." In "Classroom Concordancing," 1-16. Birmingham University. English Language Research Journal 4.). However, the suitability of using learners' output in classroom tasks remains controversial. This paper describes a pilot study in the application of a non-standard direct approach where Spanish university students are invited to reflect on their production. In the experiment, carried out in several sessions during the course, the students were exposed to a selection of erroneous sentences from their compositions. Prior to the classroom activity, the teacher contrasted the learners' sentences with correct versions produced by native English speakers. A relevant part of the methodology consisted in getting learners collectively involved in finding the errors and suggesting improvements. After that, solutions were discussed through the analysis of the alternative sentences provided by the native students. The results show that students are willing to accept this methodology as a supplement to textbooks' proposals. We claim that authentic and highly specific learner data obtained from a reliable ad hoc learner corpus and direct exposure to these data through controlled activities may cover certain learners' needs not found in textbooks.

Objectives: We aimed to assess HIV symptoms from the perspective of both patients and HIV specialists and the impact of discontinuing antiretroviral treatment (ART) on symptomology. We gathered opinions from HIV specialists and people living with HIV about ideal ART parameters and treatment satisfaction. Methods: Ex post‐facto cross‐sectional surveys were administered to 502 people living with HIV and 101 HIV clinicians in Spain (18 sites). Results: The median age of participants with HIV was 43.2 years, 74.5% were male, and 91.6% had an undetectable viral load. The mean time since initiation of ART was 10.2 years. Between 54% and 67% of people living with HIV reported experiencing nervousness or anxiety, sadness, fatigue, sleep problems, or muscle/joint pain during the preceding 4 weeks. However, only 22%–27% of specialists acknowledged the presence of these symptoms. The most bothersome symptoms were related to mental health or the central nervous system. There were significant differences between the burden of symptoms reported by people living with HIV and those acknowledged by specialists. The symptoms that more frequently caused ART discontinuation were depression, dizziness, and sleep problems. Both people living with HIV and specialists prioritized ART efficacy and low toxicity, but their importance ratings differed for 5 of the 11 ART characteristics assessed. People living with HIV rated their satisfaction with ART at a mean (± standard deviation) of 8.9 ± 1.5 out of 10, whereas HIV specialists rated it lower, at 8.3 ± 0.7 (p < 0.001). Conclusions: Despite advances in HIV care and treatment, a large proportion of patients still experience symptoms. HIV specialists may not be fully aware of these. People living with HIV and HIV specialists are, overall, satisfied with ART. However, the importance they place on different ART characteristics may vary. [ABSTRACT FROM AUTHOR]

Background: The reasons for mental health consultations are becoming increasingly relevant in primary care. The Catalan health care system is undergoing a process of digital transformation, where eHealth is becoming increasingly relevant in routine clinical practice. Objective: This study aimed to analyze the approach to depressive episodes and the role of eHealth in the Catalan health care system from 2017 to 2022. Methods: A retrospective observational study was conducted on diagnostic codes related to depressive episodes and mood disorders between 2017 and 2022 using data from the Catalan Institute of Health. The sociodemographic evolution and prevalence of depression and mood disorders in Catalonia were analyzed between 2017 and 2022. Sociodemographic variables were analyzed using absolute frequency and percentage. The prevalence of depressive episodes was calculated, highlighting the year-to-year changes. The use of eHealth for related consultations was assessed by comparing the percentages of eHealth and face-to-face consultations. A comparison of sociodemographic variables based on attendance type was conducted. Additionally, a logistic regression model was used to explore factors influencing face-to-face attendance. The analysis used R software (version 4.2.1), with all differences examined using 95% CIs. Results: From 2017 to 2022, there was an 86.6% increase in the prevalence of depression and mood disorders, with women consistently more affected (20,950/31,197, 67.2% in 2017 and 22,078/33,169, 66.6% in 2022). In 2022, a significant rise in depression diagnoses was observed in rural areas (difference 0.71%, 95% CI 0.04%-1.43%), contrasting with a significant decrease in urban settings (difference --0.7%, 95% CI --1.35% to --0.05%). There was a significant increase in antidepressant use in 2022 compared to 2017 (difference 2.4%, 95% CI 1.87%-3.06%) and the proportion of eHealth visits rose from 4.34% (1240/28,561) in 2017 to 26.3% (8501/32,267) in 2022. Logistic regression analysis indicated that men (odds ratio [OR] 1.06, 95% CI 1.04-1.09) and younger individuals had a higher likelihood of eHealth consultations in 2022. Furthermore, individuals using eHealth consultations were more likely to use antidepressants (OR 1.54, 95% CI 1.50-1.57) and anxiolytics (OR 1.06, 95% CI 1.03-1.09). Conclusions: The prevalence of depression in Catalonia has significantly increased in the last 6 years, likely influenced by the COVID-19 pandemic. Despite ongoing digital transformation since 2011, eHealth usage remained limited as of 2017. During the lockdown period, eHealth accounted for nearly half of all health care consultations, representing a quarter of consultations by 2022. In the immediate aftermath of the COVID-19 pandemic, emerging evidence suggests a significant role of eHealth in managing depression-related consultations, along with an apparent likelihood of patients being prescribed antidepressants and anxiolytics. Further research is needed to understand the long-term impact of eHealth on diagnostic practices and medication use. [ABSTRACT FROM AUTHOR]

Nurse educators' competence requirements are constantly evolving. Continuous professional development opportunities vary and there are very few programmes that utilize international collaboration. An Erasmus+ funded New Nurse Educator project developed and implemented a 30 ECTS study programme for nurse educator education and continuous professional development. The aim of the current study is to report the evaluation of the utility of the Empowering Nurse Educators in the Changing World (ENEC) study programme. International descriptive multi method study with a pre-test post-test design was conducted. Evaluation of the impact of the programme on the participants utilized five different instruments and participants' learning diaries. Programme participants were nurse educators and nurse educator candidates from six European countries (n = 42). Analyses indicate that the participants' competence increased in all areas measured after the programme, and that their competence is good. Participants highly valued the international collaboration and exchange of experiences and expertise. The evaluation indicates that international nurse educator education programmes are beneficial for both seasoned and aspiring nurse educators. This study provides novel information on the development and enhancement of nurse educator competence. For further development of continuing professional development, it is crucial to support the development of nurse educator education study programmes in Europe. [ABSTRACT FROM AUTHOR]

Simple Summary: This study seeks to assess the efficacy of bevacizumab (BVZ) in the context of glioblastoma treatment, with a particular focus on the identification of a predictive biomarker, rCBVmax. The findings indicate that BVZ demonstrates marked benefits for patients with moderately vascularized tumors, resulting in a substantially extended median survival after tumor progression compared to those who do not receive second-line treatment. The proposed utilization of rCBVmax as a biomarker has the potential to enable personalized treatment decisions, enhancing patient outcomes by guiding the selection of optimal therapy. Additionally, the establishment of a threshold at 7.5 for categorizing patients based on tumor vascularity presents a more refined approach to the selection of second-line treatments. This research holds promise for improving the management of glioblastoma and optimizing treatment strategies for individual patients. Background: Aberrant vascular architecture and angiogenesis are hallmarks of glioblastoma IDH-wildtype, suggesting that these tumors are suitable for antiangiogenic therapy. Bevacizumab was FDA-approved in 2009 following promising results in two clinical trials. However, its use for recurrent glioblastomas remains a subject of debate, as it does not universally improve patient survival. Purposes: In this study, we aimed to analyze the influence of tumor vascularity on the benefit provided by BVZ and propose preoperative rCBVmax at the high angiogenic tumor habitat as a predictive biomarker to select patients who can benefit the most. Methods: Clinical and MRI data from 106 patients with glioblastoma IDH-wildtype have been analyzed. Thirty-nine of them received BVZ, and the remaining sixty-seven did not receive a second-line treatment. The ONCOhabitats method was used to automatically calculate rCBV. Results: We found a median survival from progression of 305 days longer for patients with moderate vascular tumors who received BVZ than those who did not receive any second-line treatment. This contrasts with patients with high-vascular tumors who only presented a median survival of 173 days longer when receiving BVZ. Furthermore, better responses to BVZ were found for the moderate-vascular group with a higher proportion of patients alive at 6, 12, 18, and 24 months after progression. Conclusions: We propose rCBVmax as a potential biomarker to select patients who can benefit more from BVZ after tumor progression. In addition, we propose a threshold of 7.5 to stratify patients into moderate- and high-vascular groups to select the optimal second-line treatment. [ABSTRACT FROM AUTHOR]

This study provides with evidence of the presence of sea surface microplastics in a UNESCO marine biosphere reserve: the island of Menorca in the north-western Mediterranean Sea. From a total of 90 samples, in 100% of the samples, microplastics were observed with a mean value of 0.18 ± 0.01 items/m2. According to data, no significant differences were observed for sampling period with very similar values between 2021 (0.17 ± 0.02 items/m2) and 2022 (0.18 ± 0.02 items/m2). However, significant differences were observed regarding sampling area (both site and locality) suggesting that sea surface plastics in the study area might be more dependent of the spatial scale rather than on the temporal scale. Fibre type microplastics predominated over fragments, films, pellets, and foams, but in the commercial Port de Maó, almost 50% of the identified items were foams which could be related to the transportation of packed goods to this port. Results from the model applied to study the relation between waste management indicators and microplastic abundance indicate that when considering all marine litter categories, the explanatory variables are plastic waste generated by residents population (tonnes/year/km2) and waste collection rate (%), whereas if only plastics are considered, the indicator regarding waste per capita (kg/hab/year) is also included. Data in this study is obtained through a harmonized protocol which can be used to define baseline and threshold values to evaluate good environmental status regarding descriptor 10 of the Marine Strategy Framework Directive. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Language & Law / Revista de Llengua i Dret is the property of Revista de Llengua i Dret and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: Early diagnosis of potentially malignant oral disorders (OPMD) is crucial in reducing oral cancer mortality. It is necessary to investigate and identify predictive biomarkers capable of estimating the risk of malignant transformation in potentially malignant oral lesions. In this study, we analyzed a panel of salivary markers, including adenosine deaminase (ADA), ferritin (FRR) and total protein (TP). We found no significant differences in salivary ADA between the OPMD group and controls. However, we did observe statistically significant differences in ferritin and total proteins when compared to the control group. Therefore, ferritin and total proteins may serve as potential salivary biomarkers for diagnosis. Furthermore, saliva tests are a reliable and non-invasive diagnostic tool, offering an intriguing alternative for screening large populations. Nevertheless, validation through extensive clinical studies is required. Introduction: Oral potentially malignant disorders (OPMD) are lesions associated with an increased risk of transformation (MT) into cancer. Objective: A study was made of the salivary levels of adenosine deaminase (ADA), ferritin (FRR) and total proteins (TP) in healthy individuals and in patients with oral potentially malignant disorders (OPMD), assessing the potential role of saliva as a diagnostic tool. Methods: A total of 91 subjects participated in the study, divided into two groups—59 patients with OPMD (oral leukoplakia or oral lichen planus) and 32 healthy controls—with measurements being made of salivary ADA, ferritin (FRR) and total proteins (TP). Results: There were no significant differences in salivary mean ADA between the OPMD group 0.85 ± 2.18 UI/I and the controls 0.71 ± 1.72 UI/I (p = 0.934), though the levels of both FRR mean OPMD, 12.66 ± 10.50 (µg/L), versus control, 7.19 ± 4.44 (p = 0.001), and TP, 23.41 ± 17, versus control, 14.15 ± 15.19, were significantly higher in the OPMD group (p = 0.001). Patients with oral lichen planus showed significant differences in terms of FRR (p = 0.009) and TP (p = 0.003). The ferritin in LPO with a cut-off point of 8.5C showed a sensitivity and specificity of 54.3% and 82.3, respectively. The area under the curve (AUC) was 0.69 (95% confidence interval (95% CI): 0.58–0.82; p = 0.003). Conclusions: Ferritin and total proteins may constitute potential salivary biomarkers for oral lichen planus, though further studies are still needed in this field. In addition, saliva testing is a reliable and noninvasive diagnostic tool and appears to be a reliable strategy offering an interesting alternative for the screening of large populations. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to confirm the efficacy of the ERBITAX scheme (paclitaxel 80 mg/m2 weekly and cetuximab 400 mg/m² loading dose, and then 250 mg/m² weekly) as first-line treatment for patients with recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN) who are medically unfit for cisplatin-based (PT) chemotherapy. Materials and methods: This retrospective, non-interventional study involved 16 centers in Spain. Inclusion criteria were to have started receiving ERBITAX regimen from January 2012 to December 2018; histologically confirmed SCCHN including oral cavity, oropharynx, hypopharynx, and larynx; age ≥18 years; and platinum (PT) chemotherapy ineligibility due to performance status, comorbidities, high accumulated dose of PT, or PT refractoriness. Results: A total of 531 patients from 16 hospitals in Spain were enrolled. The median age was 66 years, 82.7% were male, and 83.5% were current/former smokers. Patients were ineligible to receive PT due to ECOG 2 (50.3%), comorbidities (32%), PT cumulative dose ≥ 225 mg/m² (10.5%), or PT refractoriness (7.2%). Response rate was 37.7%. Median duration of response was 5.6 months (95% CI: 4.4-6.6). With a median follow-up of 8.7 months (95% CI: 7.7-10.2), median PFS and OS were 4.5 months (95% CI: 3.9-5.0) and 8.9 months (95% CI: 7.8-10.3), respectively. Patients treated with immunotherapy after ERBITAX had better OS with a median of 29.8 months compared to 13.8 months for those who received other treatments. The most common grade ≥ 3 toxicities were acne-like rash in 36 patients (6.8%) and oral mucositis in 8 patients (1.5%). Five (0.9%) patients experienced grade ≥ 3 febrile neutropenia. Conclusion: This study confirms the real-world efficacy and tolerability of ERBITAX as first-line treatment in recurrent/metastatic SCCHN when PT is not feasible. Immunotherapy after treatment with ERBITAX showed remarkable promising survival, despite potential selection bias. [ABSTRACT FROM AUTHOR]

Background: Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. Methods: A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. Results: Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. Conclusions: Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients. [ABSTRACT FROM AUTHOR]

Political and academic discourses generally argue that it is possible for all land to be viewed as landscape. Research into social discourse about the landscape, however, reveals that only certain parts of the land possess the characteristics required for its inhabitants to consider it as landscape, as this study shows by analysing several interviews and focus group discussions conducted in two provinces in the south of Spain (Granada and Almería) to understand how people perceive and experience landscapes. This perspective can be very detrimental regarding conservation actions: if the landscape value is not recognised, there is no reason to conserve it. The repercussions for landscape management and protection policies in this regard can be far-reaching. It is not sufficient to merely assert that all land is landscape; rather, society must recognise it as such if the landscape is to be both valued and cared for. [ABSTRACT FROM AUTHOR]

Background Completely extradural spinal schwannomas have a unique morphology (dumbbell tumors) with an intra- and extraspinal component. When they compromise two contiguous vertebral bodies or have an extraspinal extension >2.5 cm, they are classified as giant spinal schwannomas. The aim of this study is to present our experience in the surgical management of completely extradural giant spinal schwannomas with a minimally invasive approach. Methods This study is a case series of patients treated at the Neurosurgery Department of the University Clinical and Provincial Hospital of Barcelona, Spain, between January 2016 and December 2019. Results Fifteen patients met the inclusion criteria, with thoracic and lumbar spines being the most frequent locations. All patients underwent surgical treatment, with a mini-open interlaminar and far-lateral technique. Total gross resection was accomplished in all patients and spine instrumentation was not necessary. Conclusions Microsurgery is the treatment of choice for spinal schwannomas, and gross total resection with low morbidity must be the surgical goal. Mini-open interlaminar and far-lateral access is a valid surgical option, with low morbidity in experienced hands, and there is no need for spinal instrumentation. [ABSTRACT FROM AUTHOR]

Solar photovoltaic self-consumption is an attractive approach to increase autarky and reduce emissions in the building sector. However, a successful deployment in urban rooftops requires both accurate and low-computational-cost methods to estimate the self-consumption potential and economic feasibility, which is especially scarce in the literature on net billing schemes. In the first part of this study, a bottom-up GIS-based techno-economic model has helped compare the self-consumption potential with net metering and net billing in a Mediterranean municipality of Spain, with 3734 buildings in total. The capacity was optimized according to load profiles obtained from aggregated real measurements. Multiple load profile scenarios were assessed, revealing that the potential self-sufficiency of the municipality ranges between 21.9% and 42.5%. In the second part of the study, simplified regression-based models were developed to estimate the self-sufficiency, self-consumption, economic payback and internal rate of return at a building scale, providing nRMSE values of 3.9%, 3.1%, 10.0% and 1.5%, respectively. One of the predictors with a high correlation in the regressions is a novel coefficient that measures the alignment between the load and the hours with higher irradiance. The developed correlations can be employed for any other economic or demand scenario. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to test the psychometric properties of the Facilitative Student–Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries. Design: A multi‐country, cross‐sectional survey design was applied. Methods: A convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha. Results: Both validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two‐factor construct explaining 47.7% of the total variance, identifying two sub‐scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two‐factor structure. The Cronbach alpha coefficients (0.8–0.9) indicated acceptable reliability of the scale. [ABSTRACT FROM AUTHOR]

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

The 2021-updated guidelines of the Spanish Society of Neonatology Guidelines have moved the zone of parental discretion to 23 + 0–23 + 6 weeks. The objective of this study was to describe the changes in perinatal management at this gestational age along the last decade and to determine if a more active perinatal management has contributed to improved outcomes. Retrospective analysis of prospectively collected data from the 23-week infants included in the Spanish SEN 1500 neonatal network during the period 2010–2019. The main study outcomes were survival at discharge and survival without major morbidity of actively managed infants. Two periods were compared: 2010–2014 (Period 1) and 2015–2019 (Period 2). NICUs were classified into low activity NICUs (less than 50 admissions of very low birth weight infants per year) and high activity NICUs (50 or more admissions) A total of 381 infants were included, 182 in Period 1 and 199 in Period 2. In Period 2 an increase in the use of intrapartum magnesium sulfate (21.5% vs 39.9%, p.002), antenatal steroids (56.6% vs 69.3%, p.011) and active neonatal approach in delivery room (76.9% vs 86.9%, p.011) were observed. The clinical outcomes of the actively managed 313 infants were similar in both periods, except for less arterial hypotension in Period 2. Survival was 27.1% in Period 1 and 25% in Period 2 (p.068) and survival without major morbidity was 2.1% and 2.3% respectively (p.914). No difference was found between low and high activity NICUs. A change to a more active intention to treat infants born at 23 weeks is taking place in Spain. But the survival rate of the actively-managed infants has remained stable around 25–30% during the study period. A multidisciplinary effort is needed to improve outcomes in this population. [ABSTRACT FROM AUTHOR]

I assess the macroeconomic and redistributive effects of tax reforms aimed at increasing tax revenue in Spain. To this end, I develop a theory of entrepreneurship that mimics key facts on the wealth and income distribution in Spain. I find two reforms that raise fiscal pressure in Spain to the average value among countries in the Euro area. The first reform involves doubling the average effective tax rate on labor and business income for all individuals whose income is above a threshold level. I find that this reform reduces the inequality in after-tax income, wealth, and consumption. However, it implies a substantial GDP reduction. The second reform increases the flat tax rate on consumption by fifteen percentage points. While this reform does not reduce long-run output, it does not decrease household inequality. All in all, the desirability of the two reforms depends on the government's preferences for reducing inequality at the expense of aggregate output losses. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Language & Law / Revista de Llengua i Dret is the property of Revista de Llengua i Dret and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students' clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher's cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries. Methods: A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher's pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018–2019. The data were analyzed using a Chi-Square test, Pearson's correlation coefficients, and linear models. Results: A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher's pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher's pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country. Conclusions: This study reveals that nurse teachers play an essential role in supporting and guiding nursing students' final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers' pedagogical cooperation role within the clinical learning environment. [ABSTRACT FROM AUTHOR]

Background: In settings with high antiretroviral therapy coverage, numerous health-related issues continue to undermine the health and health-related quality of life (HRQoL) of people living with HIV (PLHIV). As part of a larger study to develop and validate a new patient-reported outcome measure for use in HIV clinical care in Spain, we sought to identify the most burdensome health-related issues experienced by PLHIV in order to determine which issues should be addressed in the new instrument.Methods: We conducted a literature review and a qualitative study based on four focus group discussions (FGDs) with key informants in Spain. Participants were selected via purposive sampling. Two FGDs convened 16 expert HIV service providers, and two convened 15 PLHIV with diverse epidemiological profiles. FGDs followed semi-structured interview scripts and incorporated an exercise to prioritise the most critical health-related issues among those named in the discussions. Content analysis was conducted using MAXQDA 12.Results: The analysis of FGD data identified several broad categories of issues that were perceived to negatively affect PLHIV. The most frequently named issues fell within the categories of social problems; physical symptoms; psychological problems; and sexuality-related problems. Regarding social problems, stigma/discrimination was by far the issue raised the most frequently. In the prioritisation exercise, stigma/discrimination was also ranked as the most burdensome issue by both service providers and PLHIV. Within the physical symptoms category, the issues named most frequently were sleep-related problems, fatigue, physical pain and body fat changes. Regarding psychological problems, FGD participants most commonly spoke of emotional distress in general terms, and also called attention to depression and anxiety. In the prioritisation exercise, both service providers and PLHIV ranked psychological well-being as the second-most important issue following stigma. Sexuality-related problems that were reported included sexually transmitted infections, hormonal problems, lack of libido, and general sexual dissatisfaction.Conclusions: PLHIV are negatively affected by a wide range of health-related issues. HIV-related stigma and psychological well-being remain major challenges. Identifying and addressing these and other issues in routine clinical care supports healthy aging and may ultimately contribute to better health and HRQoL outcomes in this population. [ABSTRACT FROM AUTHOR]

Vulnerability is an emerging topic in many different fields, but data protection and privacy discussions of vulnerability have rarely engaged with gender studies. This paper investigates the notion of the ‘vulnerable data subject’ from a gender perspective, to question whether gender should be regarded as factor of vulnerability at all, and, if yes, how. It also asks what do these reflections tell us about the (gendered or un-gendered) notion of ‘standard data subject’. Even though the term ‘vulnerable data subject’ is only incidentally mentioned in EU data protection law, and in the GDPR only referring explicitly to children, several Data Protection Authorities (e.g. in Spain and Poland) have considered “being female” as a potential source of data subject’s vulnerability (e.g. in case of consumers victims of sex-related crimes). The US privacy tort – as originally conceived – was built off gendered notions of female modesty, suggesting women were vulnerable, and connecting women’s privacy claims to the ‘wrong kind of privacy’. Looking at the history and foundations of privacy and data protection law, surface questions such as whether the ‘average data subject’ in privacy and data protection legislation is, by default, a man, and whether women might have to be regarded as vulnerable data subjects just because they are women. This article then looks into law and economics analysis of consumers’ behaviour, but also political philosophy and, in particular, gender studies, to observe an intellectual polarisation: on the one hand the universalist approach, according to which every human must be regarded as vulnerable, as otherwise vulnerability would be a stigmatising label; on the other hand the particularistic approach, according to which some subjects are more vulnerable than others (in particular, women are more vulnerable – i.e. subject to adverse effects – than men in many contexts: workplace, education, etc.). A third way might be the ‘layered’ theory of Luna, based on a contextual and relational (even situational) nature of vulnerability. This solution is compatible with the layered riskbased approach in the GDPR, but also with intersectional approaches in gender studies. This ‘third way’ might be also a cautious solution to the ambiguous and inconsistent treatment of vulnerability both in the European Union policies surrounding data protection law and in the EU data protection practice itself (considering, e.g. the ineffective protection of children). [ABSTRACT FROM AUTHOR]

Our purpose was to identify the reasons why members of the population, aged 18–60 years, are vaccinated against COVID-19 at the mass vaccination point in Bages, Spain. This is 1 of 42 provisional spaces outside of health centres which have been set up in Catalonia in the context of the COVID-19 pandemic, and where people from all over Catalonia could go to be vaccinated by appointment. Methodology: We performed a cross-sectional study of users attending mass vaccination points in Bages during the months of July, August, and September 2021. Results: A total of 1361 questionnaires were statistically analysed. The most common reasons for vaccination were fear of infecting family (49.52%) and fear of self-infection (39.45%), followed by socialising (31.00%) and travel (30.56%). However, by applying a logistic regression model to each reason for vaccination, it was possible to estimate the associations regarding age, sex, marital status, educational level, production sector, mass vaccination point, previous COVID-19 infection, and COVID-19 infection of a family member. Relevance: The data generated will inform decisions and formulations of appropriate campaigns that will promote vaccination in specific population groups. [ABSTRACT FROM AUTHOR]

NutriCOVer is a global research program sponsored by Nutricia to support initiatives in clinical investigation in 16 countries worldwide. The program's objective is to adapt nutritional care to the needs of patients with COVID-19 who have been discharged from the intensive care unit. In Spain -- a reference country for the NutriCOVer program -- three research projects are being carried out. These studies analyze the clinical course of COVID-19 patients from a nutritional point of view, evaluating relevant aspects such as the prevalence and evolution of malnutrition and sarcopenia (the NUTRICOVID study), the prevalence and impact of dysphagia (the COVID-19-DN-OD study), or changes in corporal composition measured through nutritional ultrasound and bioimpedance analysis (the NUTRIECOMUSCLE study). In this article, the principal investigators of the three projects discuss the steps taken to develop these studies in the context of a worldwide pandemic: from initial concept, study design, and patient recruitment to problems in the execution of the project in day-to-day practice and publication policies. Also, they offer some insights on the initial results and the implications which these studies may have for current clinical practice. [ABSTRACT FROM AUTHOR]

Aims: To identify the risk factors for lymphoedema following axillary lymph node dissection (ALND) in a European sample and to propose a lymphoedema prediction model for this population. Design: Predictive retrospective cohort study comparing women who developed lymphoedema in 2 years of undergoing ALND with those who did not developed lymphoedema. Methods: We reviewed the clinical records of 504 women who, between January 2008 and May 2018, underwent surgery for breast cancer that involved ALND. Logistic regression was used to identify significant risk factors for lymphoedema. The prediction accuracy of the model was assessed by calculating the area under the receiver operating characteristic curve. Results: Of the 504 women whose records were analysed, 156 developed lymphoedema. Significant predictors identified in the regression model were level of lymph node dissection, lymph node status, post-operative complications, body mass index (BMI) and number of lymph nodes extracted. The prediction model showed good sensitivity (80%) in the study population. Conclusions: The factor contributing most to the risk of lymphoedema was the level of lymph node dissection, and the only patient-related factor in the prediction model was BMI. The model offers good predictive capacity in this population and it is a simple tool that breast care units could use to assess the risk of lymphoedema following ALND. Nurses with specialist knowledge of lymphoedema have a key role to play in ensuring that women receive holistic and individualized care. Impact: What problem did the study address? Secondary lymphoedema is one of the main complications in the treatment of breast cancer. What were the main findings? The prediction model included five factors associated with the risk of lymphoedema following ALND. The strongest predictor was the level of lymph node dissection, and the only patient-related factor was BMI. Where and on whom will the research have an impact? The prediction model offers breast care units a tool for assessing the risk of lymphoedema in women undergoing surgery involving ALND. The results highlight the importance of weight reduction as a preventive measure and support a more conservative surgical approach. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to examine the association between the characteristics of a nursing student's final clinical practicum and the success of transition of newly graduated nurses (NGNs) in six European countries. Design: A longitudinal design with two data collections points (pre‐ and post‐graduate). Methods: The data were collected with an online survey between May 2018 and April 2020 from graduating nursing students (n = 1796) in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Altogether, 642 NGNs responded to the second questionnaire 1 year after graduation. Logistic and linear regression analyses were used to examine the associations between five clinical practicum characteristics and three indicators for the success of transition (ease of transition, turnover intentions and occupational commitment). Models were adjusted for demographic and background/workplace factors and professional competence. Results: Several associations were observed between the different clinical practicum characteristics and the indicators for a successful transition. Good pedagogical atmosphere and good supervisory relationship were associated with higher likelihood of an easy transition. Good leadership style of the ward manager, good premises of nursing care on the ward and a good supervisory relationship were associated with higher occupational commitment. No consistent association with turnover intention was found. Conclusion: Having a good final clinical practicum before graduation can contribute to an easier transition experience for newly NGNs and strengthen their commitment to the nursing profession. Impact: This study adds to the limited existing knowledge about the importance of final clinical practicums in shaping the transition process and occupational commitment of NGNs. Investing in creating a good final practicum experience could help healthcare organizations engage new nursing professionals and thus alleviate the existing shortage of nurses. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Language & Law / Revista de Llengua i Dret is the property of Revista de Llengua i Dret and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Drug use implies important challenges related to HIV management, particularly due to an increased risk of potential interactions between antiretroviral therapy (ART) and illicit drugs (pDDIs). This study analyses the prevalence and severity of pDDIs among people living with HIV (PLHIV). It also explores their awareness of pDDIs and their beliefs about the toxicity that they may cause, as well as the impact of pDDIs on selected health variables. We conducted an on-line cross-sectional survey across 33 Spanish hospitals and NGOs to collect demographics and clinical data. pDDIs were checked against the Interaction Checker developed by Liverpool University. The sample of the present study was composed of 694 PLHIV who used illicit drugs. They represented 49.5% of the 1,401 PLHIV that participated in the survey. After excluding 38 participants due to lack of information on their ART or illicit drug use, 335 (51.1%) participants consuming drugs presented with some potentially significant pDDIs between their ART and illicit drugs, with a mean of 2.1±1.7 (1–10) pDDIs per patient. The drugs most frequently involved in pDDIs were cocaine, cannabis, MDMA and nitrates ("poppers"). The prevalence of pDDIs across ART regimens was: protease inhibitors (41.7%); integrase inhibitor-boosted regimens (32.1%), and non-nucleoside reverse transcriptase inhibitors (26.3%). An awareness of pDDIs and beliefs about their potential toxicity correlated positively with intentional non-adherence (p<0.0001). Participants with pDDIs exhibited a higher prevalence of intentional non-adherence (2.19±1.04 vs. 1.93±0.94; p = 0.001). The presence of pDDIs was not associated with poorer results in the clinical variables analysed. A significant proportion of PLHIV who use drugs experience pDDIs, thereby requiring close monitoring. pDDIs should be considered in the clinical management of HIV patients. Adequate information about pDDIs and indicators about how to manage ART when PLHIV use drugs could improve ART non-adherence. [ABSTRACT FROM AUTHOR]

Copyright of Crónica Tributaria is the property of Instituto de Estudios Fiscales, Ministerio de Hacienda y Funcion Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The aim of this study was to determine the presence of periodontal disease among patients with rheumatoid arthritis (RA) in comparison with a control group. Method and Materials: The study included 44 patients diagnosed with RA according to American Rheumatism Association (ARA) criteria, who were attending the Morales Meseguer Hospital Rheumatology Service (Murcia, Spain), and 41 control subjects. Patients younger than 18 years or patients suffering systemic diseases that could affect the immune system were excluded. Age, sex, smoking habits, alcohol consumption, and body mass index were registered. Each patient underwent a full periodontal examination. Results: Bleeding on probing was significantly greater in the RA group (0.9±0.36) than the control (P < .001). The Plaque Index was significantly higher in the RA group (0.76±0.34) versus the control group (0.55±0.2) (P<.001). RA patients showed a 0.13 increased risk of periodontal disease (95% confidence interval, 0.05-0.37). Conclusion: Patients with RA suffered a higher risk of periodontal disease and for this reason these patients must be instructed to intensify their oral hygiene regimes. [ABSTRACT FROM AUTHOR]

Background: Numerous health-related issues continue to undermine the health and health-related quality of life (HRQoL) of people living with HIV (PLHIV). We developed a clinic screening tool (CST-HIV) for the purpose of identifying these issues in routine specialist clinical care in Spain. Methods: We used the following established instrument development procedures: (1) a literature review; (2) four focus group discussions (FGDs), two that convened 16 expert HIV care providers, and two that convened 15 PLHIV; (3) prioritisation, selection and definition of constructs (health-related issues) to include in the CST-HIV and drafting of initial item pool; and (4) a pilot study to analyse psychometric properties and validity of items and to determine which to retain in the final CST-HIV. The FGD interview scripts incorporated an exercise to prioritise the health-related issues perceived to have the greatest negative effect on HRQoL. The online questionnaire used for the pilot study included the pool of CST-HIV items and validated measures of each construct. Results: We identified 68 articles that reported on factors associated with the HRQoL of PLHIV. The most burdensome health-related issues identified in the FGDs related to stigma, socioeconomic vulnerability, sleep/fatigue, pain, body changes, emotional distress, and sexuality. Based on the literature review and FGD findings, we selected and defined the following constructs to include in the initial CST-HIV: anticipated stigma, emotional distress, sexuality, social support, material deprivation, sleep/fatigue, cognitive problems, and physical symptoms. Two researchers wrote six to eight items for each construct. Next, 18 experts rated 47 items based on their clarity, relevance, and representativeness. Pilot testing was carried out with 226 PLHIV in Spain. We retained 24 items based on empirical criteria that showed adequate psychometric properties. Confirmatory factor analysis confirmed the eight-factor structure with a good fit to the data (RMSEA = 0.035, AGFI = 0.97, CFI = 0.99). We found strong positive correlations between the instrument's eight dimensions and validated measures of the same constructs. Likewise, we found negative associations between the dimensions of the CST-HIV and HRQoL. Conclusion: The CST-HIV is a promising tool for use in routine clinical care to efficiently identify and address health-related issues undermining the HRQoL of PLHIV. [ABSTRACT FROM AUTHOR]

Featured Application: HADES, a software tool for the optimal operation of liquid bulk terminal management, is based on an optimization model for the allocation of liquid bulk berths to reduce congestion and vessel waiting time. By means of a user-friendly interface, all the agents involved in the process share the data relevant to optimal quay management, supervised by port authorities. Ports are key factors in international trade, and new port terminals are quite costly and time consuming to build. Therefore, it is necessary to optimize existing infrastructure to achieve sustainability in logistics. This problem is more complex in multi-client port terminals, where quay infrastructure is shared among terminal operators who often have conflicting interests. Moreover, the berth allocation problem in liquid bulk terminals implies demanding restrictions due to the reduced flexibility in berth allocation for these types of goods. In this context, this paper presents HADES, a multi-agent platform, and the experience of its pilot use in the Port of Cartagena. HADES is a software platform where agents involved in vessel arrivals share meaningful but limited information. This is done to alleviate potential congestion in multi-client liquid bulk terminals, promoting a consensus where overall congestion anchoring is reduced. A study is presented using a mixed integer linear program (MILP) optimization model to analyze the maximum theoretical reduction in congestion anchoring, depending on the flexibility of vessel arrival time changes. Results show that 6 h of flexibility is enough to reduce congestion anchoring by half, and 24 h reduces it to negligible values. This confirms the utility of HADES, which is also briefly described. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of sickle cell disease (SCD) in Spain is markedly inferior compared with other European and Mediterranean countries. However, the diagnosis of new patients with SCD is expected to increase. In this multicenter retrospective study, we analyze the hematopoietic stem cell transplantation (HSCT) results obtained in Spain. Methods: Forty‐five patients who underwent a matched sibling donor (MSD) HSCT between 1999 and 2018 were included. Primary endpoint was event‐free survival (EFS), and secondary endpoints included acute and chronic graft‐versus‐host disease (GvHD) and overall survival (OS). Results: Bone marrow was the most frequent stem cell source (93.3%). Most patients received a conditioning regimen based on busulfan and cyclophosphamide (69%). Cumulative incidence of grade III‐IV acute GvHD and chronic GvHD was 6.8% (95% CI: 2.3%‐20.1%) and 5.4% (95% CI: 1.38%‐19.9%), respectively. EFS and overall survival (OS) at 3 years post‐HSCT were 89.4% (95% CI: 73.9%‐95.9%) and 92.1% (95% CI: 77.2%‐97.4%), respectively. All patients aged ≤ 5 presented 100% EFS and OS. Conclusions: An early referral to HSCT centers should be proposed early in life, before severe complications occur. MSD HSCT should be considered a curative option for all patients aged ≤ 5 years and for older pediatric patients who present complications derived from the disease. [ABSTRACT FROM AUTHOR]

Purpose: To investigate relationships between intentional and non-intentional non-adherence behaviors and patient experience with healthcare and beliefs in medications. Patients and Methods: This is a post hoc analysis of a cross-sectional anonymous survey distributed between May and September 2017 to patients with rheumatic disease, inflammatory bowel disease, HIV infection or diabetes mellitus from outpatient and primary care clinics in Spain. Patients answered five questions about non-adherence behaviors and completed questionnaires on their experience with healthcare (IEXPAC: Instrument to Evaluate the EXperience of PAtients with Chronic diseases) and beliefs about medicines (BMQ: Beliefs About Medicines Questionnaire). Results: Among 1530 respondents, 53% showed ≥ 1 non-adherence behavior; 35% had ≥ 1 non-intentional non-adherence behavior, and 33% had ≥ 1 intentional non-adherence behavior. Patients with HIV infection had the lowest frequency of intentional non-adherence behaviors. Non-intentional non-adherence was associated with patient beliefs (inversely with BMQ overall score) and patient experiences (inversely with IEXPAC Factor 3 sub-score, self-management). Intentional non-adherence was strongly associated with beliefs scores (directly with BMQ concerns and inversely with BMQ necessity sub-score) and inversely associated with HIV infection. Conclusion: The different associations of intentional and non-intentional non-adherence behaviors found in this study help to understand how patient experiences and beliefs influence medical non-adherence, and in the development of strategies for reducing non-adherence. [ABSTRACT FROM AUTHOR]

• This study analyses the phenomenon of the reshoring of services in crisis period. • It consists in a strategy that reverses previous offshoring strategies. • The reshoring of services in Spain was important with levels of over 23%. • The reshoring impact on employment is not significant in services. • The reshoring impact on employment is not significant in manufacturing. Reshoring of services emerged in advanced economies barely a decade ago. It has hardly been analysed and there are no academic studies on its possible effects. This study addresses two objectives: The measurement of the reshoring of services in Spain for 2008 to 2010; and its impact on employment. The results reveal that there is a percentage reduction of imported services inputs per unit of product of over 29% in manufacturing sectors and of over 23% in service sectors. Its impact on employment for manufacturing and services is not significant. [ABSTRACT FROM AUTHOR]

Background: To explore the use of illicit drugs by people living with HIV (PLHIV) taking antiretroviral therapy (ART) and their relationship with variables relevant to the management of HIV infection, such as knowledge and beliefs about drug–drug interactions (DDIs), ART adherence, quality of life (QoL), and use of health-care resources. Methods: 21 PLHIV in Spain who concomitantly took illicit drugs and ART participated in this qualitative study. Eight experts collaborated in the design of the semi-structured interview guide which explored the following topics: illicit drug use, knowledge and beliefs about DDIs and their impact on ART adherence, the effects of using illicit drugs on health, QoL, and use of health-care resources. Four of those experts, who were PLHIV and members of the executive boards of non-government organizations (NGOs) from four Spanish regions, recruited the participants through their NGOs and carried out the face-to-face interviews. Content analysis of the qualitative data was conducted with the support of the MAXQDA 12 program. Results: Participants were mainly men (85.7%) and only 14.3% of them were heterosexual. Content analysis showed that the most frequently consumed illicit drugs were poppers, cocaine, and cannabis. Participants were polydrug users and this was, in many cases, prior to HIV diagnosis. Most participants presented theoretical potential moderate DDIs that would require monitoring. More than three quarters of them were not aware of these DDIs. Participants reported interactive toxicity beliefs that lead to intentional nonadherence behaviors. In most cases (n = 17), the participant's doctor knew about their drug use, however only six of them had had an open dialogue with their physician about it. Illicit drug use led to some health-related problems, mainly sexually transmitted infections. A positive QoL's self-perception was found among several participants that used recreational illicit drugs. Conclusions: Adequate information about DDIs and clues about how to manage ART when PLHIV are using illicit drugs could reduce the negative effects of such interactions and improve ART adherence and QoL. [ABSTRACT FROM AUTHOR]

Mandibles from separate populations of free-living mouflons (Ovis aries musimon) from Southern Spain, submitted to different ecological conditions, were studied. Searching for ontogenetic shape variations we used geometric morphometrics tools and we explored the use of several mathematical models for describing growth rate variations between populations and sexes. A strong allometry was detected with variations in shape mainly matching with molar and premolar eruption. Mandible shape did not vary significantly with sex nor was sexual size dimorphism detected in adults, whatever the population. By modeling growth we detected differences between populations in all parameters such as the maturity rate describing precocity, and the time it took to reach asymptotic size (varying from 9 up to 18 months). A longer period of growth did not result in a larger asymptotic size, but it led to smaller mandibles. Mouflons with relatively late teeth replacement, lower maturation rate and smaller adult size were those of the population submitted to extreme environmental conditions, like epizootic disease, droughts and ungulate overpopulations. We discuss how a delay in reaching mature size has probably an important subsequent impact on reproductive and life-history traits in this species. Being able to record the effects of density-dependent and densityindependent factors, mandibles become a target of interest for ecological and management studies also on mouflons. [ABSTRACT FROM AUTHOR]

Background: Monocyte activation and inflammation are prominent features of alcohol‐related liver disease; however, they have not been thoroughly assessed in patients with alcohol use disorder (AUD) without overt liver disease. This study aimed to analyze associations among clinical and laboratory variables and markers of monocyte activation (CD163 and sCD14), and inflammation (interleukin [IL]‐6) among AUD patients. Methods: We analyzed the aforementioned associations in the highest quartile in 289 patients (77.5% male; median age, 50 years) consecutively admitted for alcohol detoxification in 2 tertiary hospitals in the Barcelona metropolitan area, Spain. Results: Median alcohol intake was 142 g/d; median glucose, albumin, creatinine, and bilirubin levels (mg/dl), 92, 40, 0.78, and 0.69, respectively; median AST, 41 U/l; median hemoglobin, median corpuscular volume, and platelet count, 14.1 g/dl, 94.8 fL, and 189 × 109/l, respectively; median cholesterol, triglyceride, fibrinogen, and ferritin levels, 187 mg/dl, 109.3 mg/dl, 341 mg/dl, and 177 ng/ml, respectively. In addition, 36.7% patients had an erythrocyte sedimentation rate >20 mm, 32.5% had a C‐reactive protein (CRP) level of >5 mg/l, and 10.9% were hepatitis C virus (HCV)‐positive. Median CD163, sCD14, and IL‐6 levels were 759, 1.68 × 106, and 4.37 pg/ml, respectively. On logistic regression analyses, glucose, AST, bilirubin, hemoglobin levels, and HCV infection (adjusted odds ratio [aORs]: 1.01, 1.02, 3.04, and 9.73, respectively) were associated with CD163. Glucose, AST, triglyceride, and CRP >5 mg/l (aORs: 1.02, 1.01, 1.00, and 3.49, respectively) were associated with sCD14. Alcohol consumption upon admission, MCV, total cholesterol levels, and CRP >5 mg/l (aORs: 0.99, 1.05, 0.99, and 2.56, respectively) were associated with IL‐6. Conclusions: Monocyte activation and systemic inflammation are associated with higher glucose, liver enzyme, and lipid levels, HCV infections, and CRP of >5 mg/l, thus potentially identifying patients with AUD at high risk of midterm poor outcomes. [ABSTRACT FROM AUTHOR]

• This study analyzes for the first time for Spain the impact of the service offshoring on the employment of the service sector • The data drawn from the Input-Output Tables of Spain's National Accounts • The empirical analysis is carried out by estimating a labour demand function with constant elasticity of substitution (CES), with panel data methods • The results show that the impact on employment of offshoring services by service industries is not significant and the values obtained are very small in all cases. [ABSTRACT FROM AUTHOR]

Studies exploring gender differences in health-related quality of life (HRQOL) of people living with HIV/AIDS (PLWHA) are scarce and contradictory. This study evaluated gender differences in HRQOL of 744 PLWHA with median (IQR) age 44 (37–48) years and HIV infection diagnosed 12 (5–20) years earlier. Results showed important differences between genders (p <.05). Better male physical health was related to being employed, not having economic worries, not receiving psychological support, not having injected drugs in past, low negative mood HIV-related, low HIV illness representation and internalized stigma, and high body image satisfaction and health behavior. For women, variables were fewer years since HIV diagnosis and low enacted stigma-personal experience of rejection. Mentally, variables in men were being employed, not having injected drugs, having a stable partner, high health behavior, use of problem-solving coping, personal autonomy and personal meaning. In women, better mental health was related to high CD4 cells, self-esteem and body image satisfaction, and negative mood HIV-related. Men and women coincided in absence of past opportunistic infections being related to better physical and mental health, and absence of side effects for physical health and low HIV-related stress and HIV illness representation for mental health. Our results highlight the need for detailed study of gender differences that identify the bio-psycho-socio inequalities that affect HRQOL. [ABSTRACT FROM AUTHOR]

Objectives. To describe and compare clinical findings in different subtypes of biopsy-proven intraocular lymphomas (IOLs). Design. Retrospective, observational case series. Methods. The clinical and pathologic features in IOLs at the Hospital Clinic of Barcelona from 1995 to 2018 were retrospectively studied. Results. Twenty-one patients, 12 men (57%), median age 60 (interquartile range, IQR: 18 years), and a median follow-up of 30 (IQR 60) months were included. Eleven patients had primary vitreo-retinal lymphoma (PVRL, 52%), 4 had primary uveal lymphoma (PUL, 19%), and 6 had systemic metastatic retinal lymphomas (SMRLs, 28%). Diffuse large B-cell lymphoma was the main IOL subset in PVRL (91%) and in SMRL (83%), whereas extranodal marginal zone lymphoma was the only type in PUL (100%). Survival rate was 44% in PVRL and 20% in SMRL at 5 years (p=0.047). One patient had flow cytometry of two different vitreous humour samples. With them, flow cytometry was performed in a total of 11 samples, yielding 7 positive samples. Conclusions and Relevance. Even though PVRL is the most frequent IOL subtype, our findings suggest that PUL and SMRL should be considered as potential IOL causes. Overall survival was poor in PVRL and even shorter in SMRL patients. [ABSTRACT FROM AUTHOR]