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Newer higher valency pneumococcal conjugate vaccines (PCVs) have the potential to reduce the adult community-acquired pneumonia (CAP) burden. We describe the evolution and distribution of adult community-acquired pneumonia (CAP) serotypes in Spain, focusing on serotypes contained in the 20-valent PCV (PCV20). This was a prospective, observational study of chest X-ray (CXR)-confirmed CAP in immunocompetent adults hospitalized in one of four Spanish hospitals between November 2016 and November 2020. Pneumococci were isolated from cultures and detected in urine using BinaxNow® and Pfizer serotype-specific urinary antigen tests UAD1 and UAD2. We included 1948 adults hospitalized with CXR-CAP. The median age was 69.0 years (IQR: 24 years). At least one comorbidity was present in 84.8% (n = 1653) of patients. At admission, 76.1% of patients had complicated pneumonia. Pneumococcus was identified in 34.9% (n = 680) of study participants. The PCV20 vaccine-type CAP occurred in 23.9% (n = 465) of all patients, 68.4% (n = 465) of patients with pneumococcal CAP, and 82.2% (83/101) of patients who had pneumococcus identified by culture. Serotypes 8 (n = 153; 7.9% of all CAP) and 3 (n = 152; 7.8% of all CAP) were the most frequently identified. Pneumococcus is a common cause of hospitalized CAP among Spanish adults and serotypes contained in PCV20 caused the majority of pneumococcal CAP. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyze the influence of teachers' views of corporate reputation on behavioral outcomes in educational cooperatives. Educational cooperatives are social companies that must adequately manage their intangible assets to improve their competitiveness in the education sector. However, research on how teachers perceive corporate reputation is limited. Data was obtained through a survey of 101 teachers to test the research model proposed using path analysis. The findings highlight that teachers' views of corporate reputation in educational cooperatives have significant and positive effects on employee satisfaction, retention and perceived service quality. Likewise, employee satisfaction has significant effects on teacher retention and perceived service quality. Therefore, given that employee satisfaction is a relevant variable in an educational organization's operation, employees' views of corporate reputation can be used as a strategic tool to manage and improve organizational outcomes. [ABSTRACT FROM AUTHOR]

Background Spain introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in the childhood National Immunization Program in 2015–2016 with coverage of 3 doses of 94.8% in 2018. We assessed the evolution of all pneumococcal, PCV13 vaccine type (VT), and experimental PCV20-VT (PCV13 + serotypes 8, 10A, 11A, 12F, 15B, 22F, 33F) hospitalized community-acquired pneumonia (CAP) in adults in Spain from 2011–2018. Methods A prospective observational study of immunocompetent adults (≥18 years) admitted to 4 Spanish hospitals with chest X-ray–confirmed CAP between November 2011 and November 2018. Microbiological confirmation was obtained using the Pfizer serotype-specific urinary antigen detection tests (UAD1/UAD2), BinaxNow test for urine, and conventional cultures of blood, pleural fluid, and high-quality sputum. Results Of 3107 adults hospitalized with CAP, 1943 were ≥65 years. Underlying conditions were present in 87% (n = 2704) of the participants. Among all patients, 895 (28.8%) had pneumococcal CAP and 439 (14.1%) had PCV13-VT CAP, decreasing from 17.9% (n = 77) to 13.2% (n = 68) from 2011–2012 to 2017–2018 (P  = .049). PCV20-VT CAP occurred in 243 (23.8%) of those included in 2016–2018. The most identified serotypes were 3 and 8. Serotype 3 accounted for 6.9% (n = 215) of CAP cases, remaining stable during the study period, and was associated with disease severity. Conclusions PCV13-VT caused a substantial proportion of CAP in Spanish immunocompetent adults 8 years after introduction of childhood PCV13 immunization. Improving direct PCV13 coverage of targeted adult populations could further reduce PCV13-VT burden, a benefit that could be increased further if PCV20 is licensed and implemented. [ABSTRACT FROM AUTHOR]

This paper addresses enchantment among teachers, differentiating similar concepts and exploring the organisational conditions and critical aspects of teacher enchantment in an attempt to help schools manage them. The results, derived from a Delphi method, show that training, school facilities, school organisation and the changes and challenges stemming from COVID-19 are important factors in re-enchanting teachers in Spanish secondary and vocational training schools. Management teams, educational authorities and teacher educators can improve teacher enchantment by leveraging these factors. Some recommendations are proposed to re-enchant teachers, such as promoting training (mainly in leadership), investment, professional collaboration and cultural values. • Employee enchantment implies active participation and meaningful experience that reinforce employees' work and leisure links. • Training, schools facilities, school organization and COVID-19 challenges are factors that influence teachers' enchantment. • Leadership, information and communication management and school culture of change are also important enchantment factors. • Items to measure each re-enchantment factor are provided following a Delphi method. • Teacher re-enchantment can be achieved through training, investment and fostering expert collaboration and cultural values. [ABSTRACT FROM AUTHOR]

Abstract Background Community-acquired pneumonia (CAP) has large impact on direct healthcare costs, especially those derived from hospitalization. This study determines impact, clinical characteristics, outcome and economic consequences of CAP in the adult (≥18 years) population attended in 6 primary-care centers and 2 hospitals in Badalona (Spain) over a two-year period. Methods Medical records were identified by codes from the International Classification of Diseases in databases (January 1st 2008-December 31st 2009). Results A total of 581 patients with CAP (55.6% males, mean age 57.5 years) were identified. Prevalence: 0.64% (95% CI: 0.5%-0.7%); annual incidence: 3.0 cases/1,000 inhabitants (95% CI: 0.2-0.5). Up to 241 (41.5%) required hospitalization. Hospital admission was associated (pS pneumoniae was identified in 57.5% cases. Time to recovery was 29.9±17.2 days. Up to 7.5% inpatients presented complications, 0.8% required ICU admission and 19.1% readmission. Inhospital mortality rate was 2.5%. Adjusted mean total cost was €2,332.4/inpatient and €698.6/outpatient (p Conclusions Strategies preventing CAP, thus reducing hospital admissions could likely produce substantial costs savings in addition to the reduction of CAP burden.

The aim of this paper is to show how managing human capital companies are able to enhance their corporate reputation and financial performance. In particular, this preliminary study analyses the impact of human capital on reputation perceived by employees and financial performance (by means of the return on capital employed -ROCE-). Using a database of Spanish audit sector and applying an exploratory and confirmatory factor analyses, three factors of human capital are obtained (Staff Quality, Staff Management and Staff Results) which have been related to the dimensions of employees' views of reputation and ROCE through a path analysis. The results reveal that staff quality (firms with creative employees, who perform their best and think actions through, and where there is no trouble if individuals left) has a significant and positive influence on all the dimensions of reputation. Staff management (firms with clear recruitment and succession training programs, upgrade employees' skills and employees who give their all) has a significant and positive impact on resource management, ethics and media reputation. Staff results (employees are satisfied and they do not have to bring down to others' level) have a positive and significant effect on business leadership, resource management, ethics and media reputation. No significant effects are found in when human capital factors and financial performance are linked as a consequence of the financial crisis. We also obtained unexpected results in the impact of reputation perceived by employees on financial performance. In any case, a practical implication for these results is that service companies which manage adequately their human capital can increase the employee views of corporate reputation, having the factor Staff Quality a double significant and positive influence on reputation than other two factors. [ABSTRACT FROM AUTHOR]

The growing global need for social cohesion and sustainable development gives visibility to cooperatives because their principles help to achieve these objectives and the adoption of Sustainable Development Goals (SDGs). Among them, gender equality policies are in the forefront. This paper explains how cooperatives contribute to women's professional opportunities and to balancing the presence of women in management positions. It analyzes the predominant leadership styles and gender differences in cooperatives with a sample of 114 cooperative firms. The results show that: (a) Both transformational and transactional leadership styles are widely used; (b) no significant differences in leadership styles between men and women exist; and (c) the composition of management teams results in significant leadership style differences. The transformational style is less often used in mixed teams with a male majority and a woman president, and most often used in homogeneous teams (made up of only men or only women). Transactional leadership is more frequently implemented in teams made up only of women than in mixed masculine teams with a female president. These findings identify women's leadership styles in cooperatives, pointing out their difficulties and introducing innovative proposals for contributing to their success and the achievement of SDGs in cooperatives. [ABSTRACT FROM AUTHOR]

Abstract Serotypes/genotypes causing invasive pneumococcal disease (IPD) in adults are determined by vaccination strategies. The aim of this study was to assess the epidemiology of IPD in adults (≥18 years) after PCV13 introduction for children: serotypes, clonal complexes, antibiotic non-susceptibility and clinical presentations. We performed a prospective, clinical surveillance of hospitalized culture-confirmed IPDs in adults in nine Spanish hospitals (August 2010–June 2015). A total of 1087 culture-confirmed IPD episodes were included, of which 772 (71.0%) had bacteremic pneumonia (401 complicated/371 uncomplicated pneumonia), 122 (11.2%) meningitis, 102 (9.4%) non-focal bacteremia, 34 (3.1%) peritonitis and 57 (5.3%) others. The most common serotypes were: 3 (12.7%), 19A (8.5%), 8 (7.7%), 7F (6.3%), 1 (4.2%), 6C (4.2%), 11A (4.2%), 22F (4.2%) and 14 (4.0%). Vaccine types (PCV13 + 6C) caused 49.8% of IPD episodes, with a significant decrease over the 5-year period, and significant decreases in serotypes 6C and 7F. The most common genotypes were: CC180 (8.4%), CC191 (6.0%), and CC53 (5.0%). Vaccine types caused 53.9% (414/768) pneumonia episodes and 58.9% (235/399) complicated pneumonia, 53.4% IPD in adults <50 years (143/268), and 54.7% IPD in immunocompetent patients (337/616). Overall non-susceptibility was 25.9% to penicillin (1.1% for parenteral criteria), 24.9% to erythromycin and 2.7% to levofloxacin. Conclusions Although the percentage of vaccine-types causing IPDs in adults significantly decreased, it remained high. Associations of vaccine types with pneumonia (with complicated pneumonia for specific serotypes), and immunocompetent patients point to the burden of IPD caused by PCV13 serotypes. [ABSTRACT FROM AUTHOR]

Background Streptococcus pneumoniae serotypes distribution in community-acquired pneumonia (CAP) requiring hospitalization in adults after introduction of PCV13 in children is not well known. Our aim was to evaluate the distribution of serotypes in pneumococcal pneumonia according to risk factors and comorbidity conditions after the introduction of PCV13 in children in 2010. Methods A prospective study from 2011 to 2014 was performed in immunocompetent adults hospitalized with CAP in 3 Spanish hospitals. Microbiological confirmation was obtained using a serotype specific urinary antigen detection test (UAD test), Binax Now and conventional cultures. Results 1258 adults were enrolled and pneumococcal pneumonia (invasive disease in 17.7%) was confirmed in 368 (29.3%) and 17.6% of the any-cause CAP were caused by PVC13 serotypes (3.5% PCV7 serotypes). Around 60% of pneumococcal CAP were caused by PCV13 serotypes (74.6% in invasive episodes vs 57.4% in non-invasive ones). The most prevalent serotypes in invasive disease were 1, 3, 7F, 19A and 14. No significant differences were observed in the distribution of PCV13 serotypes across the study periods. Regarding comorbidity, the rate of PCV13 serotypes was similar among them, and it was slightly higher in those with no underlying conditions. Conclusions Serotypes included in PCV13 caused a significant proportion of CAP in adults with underlying conditions and in healthy adults, with no significant changes in cases due to PCV7 or PCV13 from 2011 to 2014, suggesting an insufficient indirect protection from childhood vaccination. Strategies for implementing pneumococcal vaccination of adults are encouraged to reduce the incidence of pneumococcal episodes. [ABSTRACT FROM AUTHOR]

The real burden of community-acquired pneumonia (CAP) in non-hospitalized patients is largely unknown. This is a 3-year prospective, observational study of ambulatory CAP in adults, conducted in 24 Spanish primary care centers between 2016-2019. Sociodemographic and clinical variables of patients with radiographically confirmed CAP were collected. Pneumococcal etiology was assessed using the Binax Now ® test. Patients were followed up for 10 ± 3 days. A total of 456 CAP patients were included in the study. Mean age was 56.6 (±17.5) years, 53.5% were female, and 53.9% had ≥1 comorbidity. Average incidence of CAP was 1.2-3.5 cases per 1000 persons per year. Eighteen patients (3.9%) were classified as pneumococcal CAP. Cough was present in 88.1% of patients at diagnosis and fever in 70.8%. Increased pulmonary density (63.3%) and alveolar infiltrates with air bronchogram (16.6%) were the most common radiographic findings. After 14.6 ± 6.0 days (95% CI = 13.9-15.3), 65.4% of patients had recovered. Hospitalization rate was 2.8%. The most frequently prescribed antibiotics were quinolones (58.7%) and β-lactams (31.1%). In conclusion, one-third of CAP patients did not fully recover after two weeks of empiric antibiotic therapy and 2.8% required hospitalization, highlighting the significant burden associated with non-hospitalized CAP in Spain.