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Background: This paper describes the experience of conducting a co‐researched project with people with learning disabilities in Madrid, Spain, during the COVID pandemic and lockdown. I discuss the advantages and limitations of working online and challenges encountered while coordinating and facilitating the research. Methods: Our research project was on the impact of COVID on the lives of people with learning disabilities, which the eight co‐researchers chose. As part of my PhD, I offered my services as researcher to work together with persons with learning disabilities. Eight people took up my offer. We worked together from January 2021 to March 2022 virtually and I recorded this experience. I have written the paper, but as part of my co‐researcher agreement, I have shared my reflections and work with my co‐researchers, and we have co‐written a section to share our findings. Findings: In this paper, I discuss the advantages and limitations of working online, challenges I encountered while coordinating and facilitating the research and the work together. Remote work enabled the group to work on a biweekly basis and with members from different parts of Madrid. It saved people time and effort getting around town, yet we had to introduce express times and spaces to socialise and create a working relationship that is less natural than during in‐person interactions and breaks. During our fieldwork, we found that the pandemic had spurred the access to digital devices and programmes, but people may still be reliant on their environment, carers or supporters to facilitate it. I included a section written with my co‐researchers, in which we reflect together on the experience of working online and how we reached out to their peers during our fieldwork. We identified limitations due to our online research methodology such as lack of owning a digital device, the difficulties having access to a private space from which to connect online and the joy of meeting other people to exchange experiences. Conclusion: Human rights based participatory research can be done online. There are different ways of overcoming barriers to participation. However, there are people with no access to the internet or without digital skills that are being excluded and we must ensure that we reach out to them as well. Accessible summary: I did an online participatory research project with 8 people with learning disabilities from Spain using Zoom. Participatory research means taking part and being involved in the decisions on how the research is done.I discuss online way to make decisions, share power and control over the research, have some social connection in the group, and give information.I show that people with learning disabilities can work remotely but need more opportunities to learn digital skills. Digital skills are the skills to use technological devices, e.g., a smartphone, a tablet or a computer.Digital skills were very important during the pandemic and the lockdown, for example knowing how to find and use information and stay safe online and how to communicate with others over the internet.Participatory research projects need to support co‐researchers to learn new skills and apply them. The researchers need to be creative to make the online work engaging. [ABSTRACT FROM AUTHOR]

Background: Down syndrome (DS) is a neurodevelopmental disorder of genetic origin with a cognitive‐behavioural profile that distinguishes it from other syndromes. Within this profile, language difficulties are particularly marked, having been more studied in childhood than in adulthood. More generally, there is a paucity of research on the prosodic skills of individuals with DS, despite the relevance of this linguistic component for effective communication. Aims: This study aimed to analyse, for the first time, the prosodic profile of Spanish‐speaking teenagers and young adults with DS. We hypothesized that participants with DS would show significantly lower skills for the perception and production of prosodic functions and forms when compared to peers with intellectual disability (ID) of unknown origin. We also hypothesized that teenagers and young adults with DS would have better prosody perception than prosody production. Methods & Procedures: The final sample included in the study comprised 28 Spanish‐speaking teenagers and young adults with DS and 29 teenagers and young adults with other ID matched on chronological age and nonverbal cognition. Their prosodic skills were tested by means of the Profiling Elements of Prosody for Speech and Communication battery. This battery allows for the separate evaluation of the comprehension and expression of the communicative functions of prosody and the discrimination and production of the forms that carry out such functions. Outcomes & Results: In the prosody function tasks, which are the most adaptive tasks for the communicative process, we found, as expected, significantly lower scores on the turn‐end, chunking, and focus tasks in the group with DS. However, no significant between‐group differences were found for the affect tasks. Participants with DS also had significantly lower scores on the prosodic form tasks than participants with other ID. The results of the comparison between prosodic perception and production skills showed that a generalization about a better profile in comprehension versus production is not possible and that there is a dependence on the demands of the prosodic task undertaken. Conclusions & Implications: The findings contribute to the ongoing development of the language profile of teenagers and young adults with DS and imply the need to design prosodic intervention programs based on their specific profile. WHAT THIS PAPER ADDS: What is already known on the subject: Prosody is a fundamental element of language, and its mastery affects the effectiveness of communication. However, research on prosody in Down syndrome (DS) that offers a holistic view from a psycholinguistic approach is still scarce. To date, studies focused on providing a detailed profile of prosodic skills in individuals with DS have been mainly conducted with a few English‐speaking children. These studies have shown that the comprehension and production of prosody is severely impaired, especially when considering affect and focus production, as well as the perception and production of prosodic forms. During childhood, greater efficacy is found in prosody comprehension than in prosody expression. What this study adds: This is the first study analysing the prosodic profile of a large group of Spanish‐speaking teenagers and young adults with DS. Poorer performance in the perception and production of both prosodic functions and forms was observed in participants with DS compared to participants with intellectual disability of unknown origin matched on chronological age and nonverbal cognition. Unlike what has been previously found in children, teenagers and young adults with DS performed at the same level as the control group on the understanding and expression of affect through prosodic cues. Results also showed that a generalization about a better prosody profile in comprehension versus production is not possible. What are the clinical implications of this work?: This study provides new data on the prosodic skills of Spanish‐speaking teenagers and young adults with DS. Given the impact of prosody on effective communication and the pattern of difficulties found in this study, speech and language therapists working with individuals with DS should consider including prosodic skills in interventions not only in childhood but also in adolescence and adulthood. Therefore, the prosodic profile of strengths and weaknesses in individuals with DS found in this research has direct implications for clinical practice. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Obesity is a chronic disorder associated with high mortality rates and high morbidity. The risk of obesity is associated with certain personality traits (PTs). Some studies have found correlations among some PTs and gender. Additionally, obesity implies higher costs in daily living. The aim of this paper is to overcome this problem in the literature and estimate the association between PTs and obesity by taking into account the economic situation of the individual. This study employs data from the English Longitudinal Study of Ageing (ELSA). We focus on waves 5 and 6 of the ELSA with a sample of 6562 individuals. The results suggests that the traits of agreeableness (β=0.071,se=0.016,p<0.001) and openness (β=0.028,se:0.014,p<0.001) are positively and significantly associated with obesity. On the other hand, consciousness has a negative and statistically significant effect on obesity β=0.072,se:0.017,p<0.001. Results are robust to the inclusion/exclusion of different regressors. [ABSTRACT FROM AUTHOR]

Background: The growth of teaching practices conducted to promote cognitive activation and active participation in the classroom in recent years has become the epicentre of an active debate regarding their effectiveness. Objectives: This study is aimed to shed some light on this topic by empirically analysing the causes and consequences of more modern strategies in Spanish secondary schools. Methods: The database used in the study was PISA 2018. In order to analyse the causes behind the teaching style followed by teachers, a logit model was used. Likewise, to analyze the consequences that a modern teaching style has on students at the age of 15, we used propensity score analysis techniques. Results and Conclusions: Regarding the results obtained through a logit model, it is shown that the likelihood of a modern teaching style decreases if teachers work for a state school or if they usually apply traditional strategies. Similarly, this series of practices are shown to be more common in schools where teachers and students make greater use of digital devices. The second section of results, focused on analysing the effect this type of teaching strategies has on cognitive, non‐cognitive and wellbeing among students, show that, on the one hand, modern teaching style negatively affects students' performance in mathematics, science or language. On the other hand, modern teaching style has been shown to contribute to improving the students' well‐being, motivation and cooperation, only being significant the latter. Moreover, this teaching style contributes to reducing bullying among students. Lay Description: What is already known about this topic: Modern teaching style is gaining increased popularity.Teaching style is determined by students characteristics, performance and characteristics of the teacher and the class in general.There is not an agreed‐upon hypothesis on the impact of a modern teaching style on the academic results obtained by students. What this paper adds: This study analyses empirically the factors that explain modern teaching practices at secondary schools.Modern teaching practices are negative associated with more traditional practices, being more common this style between teachers that work at private school or use more digital services, among others.Reports the first analysis, taking into account teacher and students responses about teacher style, on the effects of modern teaching practice on cognitive, non‐cognitive and wellbeing among students. Implications for practice and/or policy: Knowing the factors behind the teaching style followed by teachers can be useful in trying to adapt teaching strategies to the needs of students.Modern teaching style can be good ally to promote collaborative practices among students.Modern teaching style should be complemented with traditional practices, like summaries previous class or advice students to achieve goals, which the literature has demonstrated to be effective to improve mathematics or reading competences.Teaching style adopted by the teachers can be decisive in improving the educational system as a whole. [ABSTRACT FROM AUTHOR]

Background: The present study analyses the design of programming literacy in the sixth grade of Primary Education, starting from the use of simple activities with visual block‐based programming, through Scratch, and progressively linking difficulty to the use of the Unity engine, and the C# language, with simple activities identical to those created in Scratch. Objectives: This research aims to evaluate future teachers' abilities and attitudes regarding programming and its educational possibilities. We intend to evaluate the viability of a teaching proposal that combines a visual block‐based programming environment and a more advanced one, based on C#. Method: In the settings of two public Spanish universities, we analyse the possibilities in the training of future teachers who are studying for a degree in Primary Education Teaching and a degree in Pedagogy. Based on a test and three scales, descriptive data and statistical inference are detailed through a quasi‐experimental design with a Student's t‐test in the first dimension, and a Wilcoxon test in the second dimension. Results: The participants improved their performance and attitudes towards programming with the intervention of the study in the use of coding. Conclusions: It can be concluded that coding is essential in teacher training, and that a greater presence of programming training in higher education is essential. The benefits are visible in the pedagogical approach of coding related to creativity, innovation, motivation, an active approach and interest, highlighting the fact that the implementation of visual block‐based programming by blocks and engines is feasible in Elementary Education. The training proposal—provided by appropriate progression, selection, and sequencing of content—fosters basic and practical teacher training, and this can be defined as an apt training solution. Lay Description: What is already known about this topic: Visual Programming Language (Scratch) provides benefits in educational contextsEducational Technology in classroom provides motivation and encouragement.Active methods and interactions are interesting and beneficial to elementary school students What this paper adds: Visual programming and game engine are feasible in Elementary Education, detailing significant improvements regarding academic outcomesWe found benefits in this pedagogical approach related to creativity, innovation, motivation, active approach and interest. Implications for practice and/or policy: Due to the benefits and positive results obtained in this research it is recommended to implement Visual Programming LanguageWe recommend the introduction to engine in educational settings in 6th grade in primary education though a cross‐curricular implementation.We recommend to apply an active approach, innovation, and learning computational concepts. [ABSTRACT FROM AUTHOR]

We introduce a novel methodology for mapping academic institutions based on their journal publication profiles. We believe that journals in which researchers from academic institutions publish their works can be considered as useful identifiers for representing the relationships between these institutions and establishing comparisons. However, when academic journals are used for research output representation, distinctions must be introduced between them, based on their value as institution descriptors. This leads us to the use of journal weights attached to the institution identifiers. Since a journal in which researchers from a large proportion of institutions published their papers may be a bad indicator of similarity between two academic institutions, it seems reasonable to weight it in accordance with how frequently researchers from different institutions published their papers in this journal. Cluster analysis can then be applied to group the academic institutions, and dendrograms can be provided to illustrate groups of institutions following agglomerative hierarchical clustering. In order to test this methodology, we use a sample of Spanish universities as a case study. We first map the study sample according to an institution's overall research output, then we use it for two scientific fields ( Information and Communication Technologies, as well as Medicine and Pharmacology) as a means to demonstrate how our methodology can be applied, not only for analyzing institutions as a whole, but also in different disciplinary contexts. [ABSTRACT FROM AUTHOR]

Elaborative feedback (EF) containing explanations on students' responses benefits learning. Computer‐based environments provide learners with EF in different ways, for example, on an immediate question‐by‐question basis or after answering a set of questions. Recent findings also suggest that delaying EF enhances learning. However, it is unclear to what extent different types of delayed‐EF favour students' performance. This study examines whether and how two types of delayed‐EF (question‐based vs. summative) influence students' question‐answering performance and final learning over immediate‐EF. One hundred thirty‐three secondary‐school students read a scientific text and answered 12 multiple‐choice questions in a computer‐based environment. A day later, students completed a final learning test with 20 open‐ended questions. Results showed that neither question‐based delayed EF nor summative delayed EF outperformed immediate EF. However, EF moderated the relationship between students' prior knowledge and their performance outcomes, suggesting that students with higher levels of prior knowledge receiving summative delayed EF benefited more. Lay Description: What is already known about this topic: Elaborative Feedback (EF) containing explanations about the students' responses benefits learning.Computer‐based learning environments can provide students with different types of delayed and immediate EF messages.Results in regard to what type of delayed EF is best for learning are inconclusive.EF effects can vary as a function of individual differences in Prior Knowledge. What this paper adds: The role of delaying EF over immediate EF on both question‐answering and learning outcomes.The effects of summing up EF (summative)in comparison to delivering question‐based EF.The interplay between students' prior knowledge and EF on question‐answering and learning outcomes. Implications for practice and/or policy: Neither question‐based nor summative delayed EF outperformed immediate EF.Students with higher levels of prior knowledge receiving summative delayed EF benefited more.Designers of computer‐based learning environments may provide learners with delayed EF messages.The design of content‐efficient EF cannot be fully understood without considering learners' prior knowledge. [ABSTRACT FROM AUTHOR]

Difficulties in implementing effective instruction for at‐risk students arise from two challenges: the transfer of evidence‐based knowledge and the lack of economic resources. Computer‐assisted programmes offer a suitable solution, providing quality instruction using low‐cost resources. Thirty‐two first‐grade students with early learning difficulties were identified and paired based on at least three of the pre‐intervention reading measures (reading efficiency of monosyllabic and disyllabic items, words, pseudowords and text reading speed). Each pair was assigned to one of two different intervention programmes: a computer‐assisted intervention programme (CAIP) focused on syllables or the programme provided by the Spanish State School Assistance Services (SSAS). Every week, the CAIP participants received in pairs four 15‐min training sessions on syllable decoding plus one 30‐min group comprehension session. The CAIP was delivered by trainee students. The SSAS programme typically consisted of a 1‐hr individual or in small groups sessions per week delivered by trained practitioners. Both programmes were administered for 11 weeks. The CAIP intervention showed better results than the SSAS intervention for both decoding and comprehension, with moderate to large effect sizes. Lay Description: What is already known about this topic: Implementing effective instruction for at‐risk students presents two challenges: evidence‐based knowledge transfer and lack of economic resources.The use of computer‐assisted programmes to provide quality instruction for at‐risk students is not a common practise in the Spanish context. What this paper adds: A comparison between a computer‐assisted instructional programme (CAIP) and a programme provided by the Spanish State School Assistance Services (SSAS).A programme designed to be applied by professionals or non‐professionals with minor guidance.The CAIP intervention showed better results after 11 weeks of application, replicating the positive effects of computer programmes in other languages. Implications for practise and/or policy: Findings showed that computer programmes represent an effective tool for the transfer of scientific knowledge to educational practise with little economic cost, minor teaching training and short time. [ABSTRACT FROM AUTHOR]

The present study evaluated the effects of web‐based training on Spanish pre‐service and in‐service teacher knowledge and implicit beliefs on learning to write. A sample of pre‐service teachers and in‐service teachers from Mexico, Guatemala, Ecuador, Colombia, and Spain participated in the online course. Findings suggest that teachers may improve their knowledge of transcription skills (i.e., handwriting/typing, spelling), text production, and strategies for composing as necessary components of quality writing instruction. Effects were also found on the teachers' implicit beliefs. Finally, both pre‐service and in‐service teachers positively rated the online course received. Lay Description: What is currently known about the subject: Teaching children how to write demands a high degree of specialization.The benefits of web‐based training to professional development have been well‐documented in the literature.Preparing of pre‐service and in‐service teachers through an online context is limited in the field of writing.Teachers' knowledge, satisfaction, and beliefs have been commonly used as outcome measures to define high‐quality e‐learning instruction. What this paper adds: A Spanish web‐based training was developed to improve professional development in writing instruction.The Trazo web‐based training changed teacher's beliefs about learning to write.Teachers learned more about the essential component of the writing process.Teachers' rating of the training and support website was highly positive. Implications for practitioners: Web‐based training allows teachers to learn at their own pace.Teachers can improve their knowledge from virtually at any geographic location with an Internet connection.The Trazo web‐based training offers research‐based knowledge to Spanish‐speaking teachers. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. Design: A multi‐country, phenomenological, qualitative study. Methods: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Results: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. Conclusions: A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. Implications for the profession: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Impact: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Public Contribution: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement. [ABSTRACT FROM AUTHOR]

This paper studies how the integration of group awareness tools in the knowledge management system called KnowCat (Knowledge Catalyser), which promotes collaborative knowledge construction, may both foster the students' perception about the meaningfulness of visualization of group awareness information and promote better collaborative processes as well as enhance better task performance. Forty-seven university students participated in a research study, where one group of 23 students used KnowCat without the awareness console (non-awareness group); the other 24 students used KnowCat with the awareness console (awareness group). Both groups used KnowCat during one semester. Data analysis revealed that the awareness group means were higher than those of the non-awareness group in terms of participation, cognitive and metacognitive learning activities, and task performance. Moreover, students revealed that knowing what, where and how much their classmates were contributing acted as positive feedback by encouraging participation and orienting their own behaviour and their contribution to the collaborative work. In this paper, we claim that the visualization group awareness information in KnowCat, a utility allowing students to visualize and track what, where, how much and how often other participants contributed to the KnowCat knowledge area, had a positive impact on the students' collaborative behaviour. [ABSTRACT FROM AUTHOR]

Abstract: Rationale, aims and objectives: Self‐monitoring of blood glucose (SMBG) is recommended to monitor glycaemic levels. The recent development of real‐time continuous glucose monitoring (RT‐CGM) enables continuous display of glucose concentration alerting patients in the event of relevant glucose fluctuations, potentially avoiding hypoglycaemic events and reducing long‐term complications related to glycosylated haemoglobin (HbA1c) levels. This paper aims to evaluate the cost‐effectiveness of RT‐CGM compared to SMBG in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) which should support decision‐making on public funding of RT‐CGM in Spain. Methods: We performed a systematic review and meta‐analyses on the effectiveness of RT‐CGM in the reduction of HbA1c levels and severe hypoglycaemic events. A cost‐effectiveness analysis was conducted using a Markov model which simulates the costs and health outcomes of individuals treated under these alternatives for a lifetime horizon from the perspective of the Spanish Health Service. The effectiveness measure was quality‐adjusted life years (QALYs). We ran extensive sensitivity analyses, including a probabilistic sensitivity analysis. Results: Real‐time continuous glucose monitoring provides a significant reduction of HbA1c for T1DM (13 studies; weighted mean difference (WMD) = −0.23%, 95% CI: −0.35, −0.11) and T2DM (5 studies; WMD = −0.48%, 95% CI: −0.79, −0.17). There were no statistically significant differences in the rate of severe hypoglycaemic events in T1DM (9 studies; OR = 1.16, 95% CI: 0.78, 1.72) or T2DM (no severe hypoglycaemic events were reported in any study). In the base case analysis, RT‐CGM led to higher QALYs and health care costs with an estimated incremental cost‐effectiveness ratio of €2 554 723 and €180 553 per QALY for T1DM and T2DM patients respectively. Sensitivity analyses revealed that the study results were robust. Conclusions: Real‐time continuous glucose monitoring is not a cost‐effective technology when compared to SMBG in Spain. [ABSTRACT FROM AUTHOR]

This paper explores the usefulness of OpenAIRE, BASE, Recolecta, and Google Scholar (GS) for evaluating open access (OA) policies that demand a deposit in a repository. A case study was designed focusing on 762 financed articles with a project of FIS‐2012 of the Instituto de Salud Carlos III, the Spanish national health service's main management body for health research. Its finance is therefore subject to the Spanish Government OA mandate. A search was carried out for full‐text OA copies of the 762 articles using the four tools being evaluated and with identification of the repository housing these items. Of the 762 articles concerned, 510 OA copies were found of 353 unique articles (46.3%) in 68 repositories. OA copies were found of 81.9% of the articles in PubMed Central and copies of 49.5% of the articles in an institutional repository (IR). BASE and GS identified 93.5% of the articles and OpenAIRE 86.7%. Recolecta identified just 62.2% of the articles deposited in a Spanish IR. BASE achieved the greatest success, by locating copies deposited in IR, while GS found those deposited in disciplinary repositories. None of the tools identified copies of all the articles, so they need to be used in a complementary way when evaluating OA policies. [ABSTRACT FROM AUTHOR]

The Wound‐QoL assesses the impact of chronic wounds on patients' health‐related quality of life (HRQoL). A 17‐item and a shortened 14‐item version are available. The Wound‐QoL‐17 has been validated for multiple languages. For the Wound‐QoL‐14, psychometric properties beyond internal consistency were lacking. We aimed to validate both Wound‐QoL versions for international samples representing a broad range of European countries, including countries for which validation data had yet been pending. Patients with chronic wounds of any aetiology or location were recruited in Austria, Lithuania, the Netherlands, Poland, Slovakia, Spain, Switzerland and Ukraine. Psychometric properties were determined for both Wound‐QoL versions for the overall sample and, if feasible, country‐wise. We included 305 patients (age 68.5 years; 52.8% males). Internal consistency was high in both Wound‐QoL‐17 (Cronbach's α: 0.820–0.933) and Wound‐QoL‐14 (0.779–0.925). Test–retest reliability was moderate to good (intraclass correlation coefficient: 0.618–0.808). For Wound‐QoL‐17 and Wound‐QoL‐14, convergent validity analyses showed highest correlations with global HRQoL rating (r = 0.765; r = 0.751) and DLQI total score (r = 0.684; r = 0.681). Regarding clinical data, correlations were largest with odour (r = −0.371; r = −0.388) and wound size (r = 0.381; r = 0.383). Country‐wise results were similar. Both Wound‐QoL versions are valid to assess HRQoL of patients with chronic wounds. Due to its psychometric properties and brevity, the Wound‐QoL‐14 might be preferrable in clinical practice where time is rare. The availability of various language versions allows for the use of this questionnaire in international studies and in clinical practice when foreign language patients are being treated. [ABSTRACT FROM AUTHOR]

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

This paper analyzes the reasons for the scarce development of the private long-term care insurance market in Spain, and its relationship with health insurance. We are also interested in the effects the crisis has had both on the evolution of the demand for long-term care insurance and on the existence of regional disparities. We estimate bivariate probit models with endogenous variables using Spanish data from the Survey on Health and Retirement in Europe. Our results confirm that individuals wishing to purchase long-term care insurance are, in a sense, forced to subscribe a health insurance policy. In spite of this restriction in the supply of long-term care insurance contracts, we find its demand has grown in recent years, which we attribute to the budget cuts affecting the implementation of Spain's System of Autonomy and Attention to Dependent People. Regional differences in its implementation, as well as the varying effects the crisis has had across Spanish regions, lead to the existence of a crowding-in effect in the demand for long-term care insurance in those regions where co-payment is based on income and wealth, those that have a lower percentage of public long-term care beneficiaries, or those with a smaller share of cash benefits over total public benefits. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper analyses how social support enhances family resilience in kinship foster families by involving the families in an educational group programme. Sixty‐two kinship foster families from Spain participated in the research. The data were collected before the programme (interviews) and after the programme (interviews and focus groups), and these were analysed by content analysis with the programme Atlas.ti. The results show that the factors that contribute most to the development of family resilience are as follows: (i) feeling able to look for solutions when facing problems; (ii) an increase of their network of formal support; (iii) being able to offer support to other foster families; and (iv) feeling that the support they give to parents' foster children is socially recognized. [ABSTRACT FROM AUTHOR]

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

Aim: To analyse the perception of patient safety culture among nursing students and to compare patient safety outcomes between the different year nursing groups. Design: A cross‐sectional descriptive study was conducted with nursing students (n = 266) between first and fourth years from one university in Spain. Methods: The project was conducted during the 2020/21 academic year. The data were collected using a translated and adapted version of the "Hospital Survey on Patient Safety" developed by the Agency of Healthcare Quality (AHQR). Results: Significant differences were found between the year of study of the nursing degree and whether or not specific training in patient safety culture had been received. The nursing students who had received specific training gave scores lower than anyone else in all questionnaire items, but only the indicators of "good practice" (p = 0.00) and "frequency of reported events" (p = 0.0012) showed significant differences. In some cases, fourth‐year students had lower significant mean scores in their "perception of patient safety within unit/sector," "indicators of good practice" and "total score." Public Contribution: Adverse events related to clinical practice continue to be a global problem. Improvements in patient safety require an increase in the patient safety culture of professionals and the promotion of development facilitators. Clinical practice and specific theoretical training foster greater awareness and demand related to patient safety, which is of interest when it comes to the development of new programmes that combine both methodologies and improve their effectiveness. Patient safety will continue to be a focus for all healthcare systems. The patient safety culture of future healthcare professionals should be developed at the university level in order to avoid unnecessary adverse events. [ABSTRACT FROM AUTHOR]

Background: Most health systems are insufficiently prepared to promote the participation of chronically ill patients in their care. Strong primary health care (PHC) strengthens patients' resources and thus promotes their participation. The tasks of providing continuous care to people with chronic diseases and promoting self‐management are the responsibility of PHC nurses. Recent research assessing enablers of or barriers to nurses' efforts to support patients' participation has mostly not considered the special situation of patients with chronic diseases or focused on the PHC setting. Objective: To investigate enablers of and barriers to PHC nurses' efforts to promote the participation of chronically ill patients in their care. Methods: We interviewed 34 practicing PHC nurses and 23 key informants with advanced knowledge of PHC nursing practice in Brazil, Germany and Spain. The data was analyzed using thematic coding. Results: We identified four categories of barriers and enablers. (1) Establishing bonds with patients: Interviewees emphasized that understanding patients' views and behaviours is important for PHC nurses. (2) Cooperation with relatives and families: Good relationships with families are fundamental, however conflicts within families could challenge PHC nurses efforts to strengthen participation. (3) Communication and cooperation within PHC teams: PHC nurses see Cooperative team structures as a potential enabler, while the dominance of a 'biomedical' approach to patient care is seen as a barrier. (4) Work environment: Interviewees agreed that increased workload is a barrier to patient participation. Discussion and Conclusions: Supporting patient participation should be acknowledged as an important responsibility for nurses by general practitioners and PHC planners. PHC nurses should be trained in communicative competence when discussing participation with chronically ill patients. Interprofessional education could strengthen other professionals' understanding of patient participation as a nursing task. Patient or Public Contribution: This study is part of a research project associated with the research network 'forges: User‐oriented care: Promotion of health in the context of chronic diseases and care dependency'. The study's focus and provisional results were discussed continuously with partners in health and social care practice and presented to and discussed with the public at two conferences in which patient representatives, professionals and researchers participated. [ABSTRACT FROM AUTHOR]

This paper presents a further step in the use and validation of a systematic, functional-analytic method of describing psychologists' verbal behaviour during therapy. We observed recordings from 92 clinical sessions of 19 adults (14women and 5men of Caucasian origin, with ages ranging from 19 to 51 years) treated by nine cognitive-behavioural therapists (eight women and one man, Caucasian as well, with ages ranging from 25 to 48 years). The therapists' verbal behaviourwas codified and then classified according to its possible functionality. A cluster analysis of the data, followed by a discriminant analysis, showed that the therapists' verbal behaviour tended to aggregate around four types of session differentiated by their clinical objective (assessment, explanation, treatment and consolidation). These results confirm the validity of our method and enable us to further describe clinical phenomena by distinguishing psychologists' classes of clinically relevant activities. Specific learningmechanismsmay be responsible for clinical change within each class. These issues should be analysed more closely when explaining therapeutic phenomena and when developing more effective forms of clinical intervention. [ABSTRACT FROM AUTHOR]

Objective This clinical technique article is focused on the use of prefabricated veneers to enhance the esthetic appearance of the anterior dentition in patients who needed an alternative esthetic solution more affordable than traditional porcelain veneers. Clinical considerations Because prefabricated composite veneer systems have been recently introduced, they are not widely used. The Componeer system ( Coltene, Altstätten, Switzerland) contains thin pre-polymerized hybrid composite shells, several shades of a direct hybrid composite resin, an etch-and-rinse adhesive system, and restorative accessories including finishing points and disks. The prefabricated restorations can be customized in the mouth for color and shape. The technique described in this article can be used to restore function and esthetics in one office visit. Conclusions The prefabricated composite veneer technique has some of the advantages of direct composite restorations, as only one session is required without the need to take impressions to send to the dental laboratory. This new treatment option may open new opportunities for dental professionals and their patients. However, it is paramount to carry out controlled clinical studies with this restorative technique prior to recommending it without restrictions in general practice. Clinical Significance The clinical technique described in this paper has the potential for being used routinely to lengthen anterior teeth, to correct malpositioned teeth, to mask discolorations, and to close diastemas. The technique can also be used to restore extensive caries lesions and tooth fractures, and to refurbish large old anterior restorations, especially when other treatment options are out of reach for the patient for financial reasons. [ABSTRACT FROM AUTHOR]

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

ABSTRACT This paper analyses the evaluation of residential care from the perspective of the adolescents in care. Twelve discussion groups were carried out in 12 different centres in Catalonia (Spain). A total of 66 adolescents aged between 16 and 18 years of age participated. The data contributed by the discussion groups were analysed and categorized using descriptive analysis matrices. Most notable from the results is that the majority of those interviewed call for increased emotional involvement from the social workers, more contact with their families and re-educational intervention within their families, which renders the return to these possible within a shorter period of time. Data provided by the adolescents lead us to reconsider the concept of optimum professional distance and to suggest replacing it with optimum professional proximity; this would be based on emotional involvement and not on emotional distance, although not on emotional dependence either. [ABSTRACT FROM AUTHOR]

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

Objectives This paper examines the awareness and use of nonoccupational HIV post-exposure prophylaxis ( nPEP) in Spain, and the factors that influence this awareness. Methods Between June 2009 and July 2010, a mobile unit offered free, rapid HIV tests in a number of Spanish cities. A total of 2545 people were passively recruited and tested, and answered a self-administered questionnaire containing sociodemographic, behavioural and nPEP-related questions. Bivariate and multivariate analyses were performed, stratifying by gender/sexual behaviour. Results Some 34% of the responders were men who have sex with men ( MSM), 30% were men who have sex exclusively with women ( MSW), and 35% were women. Approximately 26% were foreigners, 46% had a university degree, and 51% had previously taken an HIV test. Overall, 22% were aware of nPEP. Only 2% had ever used it; 70% of these after high-risk sexual intercourse. Awareness was higher among MSM (34%) than women (16%) and MSW (15%). Multivariate analysis showed a lack of nPEP awareness to be associated with being born in Latin America, while awareness increased with the number of previous HIV tests among women and MSW. In MSM, awareness was also associated with having a university degree, the degree of interaction with gay culture, number of partners, and use of the internet as the main way of meeting partners. Conclusions nPEP awareness in the studied population was unacceptably low. The promotion of its availability should be made a major objective of prevention programmes, as a complementary measure to condom use. [ABSTRACT FROM AUTHOR]

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

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

O'BRIEN T and ACKROYD S. Nursing Inquiry 2012; 19: 39-50 Understanding the recruitment and retention of overseas nurses: realist case study research in National Health Service Hospitals in the UK This paper illustrates one of the possible applications of critical realist ideas to the analysis of health services, in the use of comparative case study research design, to elucidate the causal social processes underlying events. In the research reported here, a comparative research design was used as a basis for improving our understanding of the processes involved in the assimilation of overseas nurses (OSN) into the salient long-term workforce of the National Health Service (NHS) hospitals in the UK. The work brought to light the salient experiences of overseas nurses during their initial work in the NHS hospitals, and these were used as a basis for developing an account of the general mechanisms typically underlying the recruitment and assimilation at work. The authors conclude that successful assimilation is often hindered by the presence of occupational closure mechanisms, by which home nurses effectively excluded recruits from participation and promotion; these mechanisms, which articulate with everyday racism, threaten successful assimilation for obvious reasons. If the treatment recruits receive does not lead to withdrawal, it is because they typically have very strong economic motives to continue despite unfavourable and sometimes inhumane treatment. Thus, the research offered substantial reasons why recruitment policies should be reviewed by policy-makers. [ABSTRACT FROM AUTHOR]

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

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

Background: Studies revealed unidirectional associations between frailty and medication‐related problems (MRPs) among older adults. Less is known about the association between frailty and the risk of MRPs. We aimed to assess the bi‐directional association between frailty and the risk of MRPs in community‐dwelling older adults in five European countries. Methods: Participants were 1785 older adults in the population‐based Urban Health Centres Europe project. Repeated assessments were collected at baseline and one‐year follow‐up, including frailty, the risk of MRPs, and covariates. Linear regression analyses were conducted to examine the unidirectional associations. A cross‐lagged panel modeling was used to assess bi‐directional associations. Results: The unidirectional association between frailty at baseline and the risk of MRPs at follow‐up remained statistically significant after adjusting for covariates (β = 0.10, 95%CI:0.08, 0.13). The association between the risk of MRPs at baseline and frailty at follow‐up shows similar trends. The bi‐directional association was comparable with reported unidirectional associations, with a stronger effect from frailty at baseline to the risk of MRPs at follow‐up than reversed path (Wald test for comparing lagged effects: p < 0.05). Conclusion: This longitudinal study suggests that a cycle may exist where older adults with higher frailty levels are more likely to have a higher risk of MRPs, which in turn contributes to developing a higher level of frailty. Further research is needed to validate our findings and explore underlying pathways. [ABSTRACT FROM AUTHOR]

This article describes the design of the "First Comprehensive Strategic Plan for Volunteering and Citizen Participation in Andalusia," which establishes the priorities and strategies for promoting citizen engagement in the Autonomous Community of southern Spain. The drawing up of the strategic plan was developed in two phases. First, a theoretical analysis of the effective practices for promoting citizen participation was conducted. Second, the opinion of a total of 35 representatives of Third Sector organizations was obtained. The review of evidence‐based practices made it possible to identify 13 basic strategies for community awareness, education for participation, volunteer management, and the development of inter‐organizational networks. Next, 19 interviews were conducted with representatives of the most prominent social entities in the region and two participatory workshops with 16 leaders of the volunteer movement in Andalusia were held. The results showed the existence of a consolidated social fabric, with a "community of practice" constituted over two decades in which awareness‐raising and training strategies have been effectively combined to promote volunteering. Representatives of the Third Sector consider educational strategies for participation as a priority, such as service‐learning, early participation experiences during adolescence and the training of volunteers and members of associations. On the other hand, although social organizations are aware of the need to adapt to new forms of participation (more individualized, one‐off, or episodic), they generally defend strategies that contribute to a higher level of organizational commitment. The resulting plan integrates measures to promote participation and volunteering through cross‐cutting actions. [ABSTRACT FROM AUTHOR]

Introduction: Patients' and companions' participation in healthcare could help prevent adverse events, which are a significant cause of disease and disability. Before designing interventions to increase participation, it is first necessary to identify attitudes to patient safety. This study aimed to explore patients' and companions' perceptions, attitudes and experiences of patient safety, taking into account contextual factors, such as cultural background, which are not usually captured in the literature. Methods: We conducted a qualitative study with a theoretical sampling of 13 inpatients and 3 companions in a university hospital in Barcelona, Spain. Information was obtained from individual and triangular interviews. A descriptive thematic content analysis was conducted by four analysts and a consensus was reached within the research team on the key categories that were identified. We also conducted a card‐sorting exercise. Results: All informants emphasized the role of good communication with health professionals, a calm environment and the need for patient education. Discursive positions differed by cultural background. Informants from a Pakistani–Bangladeshi background emphasized language barriers, while those from European and Latin‐American backgrounds stressed health professionals' lack of time and the need for more interdisciplinary teamwork. The card‐sorting exercise identified several opportunities to enhance participation: checking patient identification and medication dispensation, and maintaining personal and environmental hygiene. Conclusion: This exploration of informants' discourse on patient safety identified a wide variety of categories not usually considered from institutional perspectives. The findings of this study could enrich interventions in areas with diverse cultural backgrounds, as well as current frameworks based exclusively on institutional perspectives. Patient or Public Contribution: The results of the study were communicated to patients and accompanying persons via telephone or email. Similarly, a focus group was held with a patient forum to comment on the results. In the design of subsequent interventions to improve patient safety at the hospital, the proposals of patients and companions for their participation will be included together with healthcare professionals' opinions. [ABSTRACT FROM AUTHOR]

Scholarly interest in the experience of dehumanization, the perception that one is being dehumanized, has increased significantly in recent years, yet the construct lacks a validated measurement. The purpose of this research is therefore to develop and validate a theoretically grounded experience of dehumanization measurement (EDHM) using item response theory. Evidence from five studies using data collected from participants in the United Kingdom (N = 2082) and Spain (N = 1427), shows that (a) a unidimensional structure replicates and fits well; (b) the measurement demonstrates high precision and reliability across a broad range of the latent trait; (c) the measurement demonstrates evidence for nomological and discriminant validity with constructs in the experience of dehumanization nomological network; (d) the measurement is invariant across gender and cultures; (e) the measurement demonstrates incremental validity in the prediction of important outcomes over and above conceptually overlapping constructs and prior measurements. Overall, our findings suggest the EDHM is a psychometrically sound measurement that can advance research relating to the experience of dehumanization. [ABSTRACT FROM AUTHOR]

Aim: To characterize the subgingival microbiome in subjects with different periodontal health statuses. Materials and Methods: In this cross‐sectional observational study, subgingival samples were harvested from Spanish subjects with different periodontal health statuses, based on the 2018 Classification of Periodontal and Peri‐Implant Diseases and Conditions. Samples were processed using high‐throughput sequencing technologies (Illumina MiSeq). Taxa differentially abundant were identified using Analysis of Compositions of Microbiomes with Bias Correction (ANCOM‐BC). α‐ and β‐diversity metrics were calculated using q2‐diversity in QIIME2. The analyses were adjusted for age, gender and smoking status. Results: The identified subgingival microbiome showed statistically significant differences among subjects, categorized into periodontal health, gingivitis and stages I‐II and III‐IV periodontitis (p <.05). In patients with severe (stages III‐IV) periodontitis, the genera Filifactor and Fretibacterium were detected 24 times more frequently than in periodontally healthy subjects. Similarly, the genera Porphyromonas, Prevotella and Tannerella were detected four times more frequently (p <.05). The genera Granulicatella, Streptococcus, Paracoccus, Pseudomonas, Haemophilus, Actinobacteria, Bergeyella and Capnocytophaga were significantly associated with healthier periodontal status (p <.05). Conclusions: Significant differences were detected in the subgingival microbiome among periodontal health, gingivitis and stages I‐II or III‐IV periodontitis, suggesting overlapping, yet distinguishable microbial profiles. [ABSTRACT FROM AUTHOR]

BACKGROUND: Interpersonal relationships undoubtedly have a bidirectional connection with the health of individuals and communities. Relational models based on equity contribute to well‐being, while asymmetrical relationships based on hierarchies and differences of power negatively impact mental, physical, and social health. METHODS: A conceptual framework for understanding the determinants of interpersonal relational models was developed. RESULTS: Structural determinants were identified as the combined action of systems of oppression, the socio‐historical context that normalizes violence, and social stratification and segregation, consequences which included inequitable access to power, resources, and opportunities. Intermediate determinants include individual, psychosocial, behavioral, and community aspects. Structural and intermediate determinants impact health and health inequalities through multiple relational patterns that are simultaneously established and sustained by individuals and communities. The health impact of inequitable relational patterns includes: Reduced self‐esteem; anxiety, stress, and depression; acceptance of violence; physical and sexual harm; suicide; and murder. CONCLUSIONS: This conceptual framework allows for the modification of relational models by influencing structural and intermediate determinants. Six areas of intervention have been identified: educative policies, school governance, physical and symbolic space, school curriculum, school‐community relations, and socio‐educative interventions to promote healthy and equitable relationships. Healthy and equitable relationships are associated with improved subjective well‐being, health status and protection from violence. Socio‐educational interventions that consider the elements of this conceptual framework may be effective in promoting healthy and equitable relational models. [ABSTRACT FROM AUTHOR]

Objectives: To describe prevalence and factors associated with unplanned pregnancies, and social and partner support during pregnancy among women from the Cohort of the Spanish HIV/AIDS Research Network (CoRIS). Methods: We included all women recruited in CoRIS from 2004 to 2019, aged 18–50 years at recruitment who were pregnant during 2020. We designed a questionnaire, organized into the following domains: sociodemographic characteristics, tobacco and alcohol consumption, pregnancy and reproductive health, and social and partner support. The information was gathered via telephone interviews conducted from June to December 2021. We calculated prevalence of unplanned pregnancies as well as odds ratios (ORs) of association and 95% confidence intervals (CIs) according to sociodemographic, clinical and reproductive characteristics. Results: Among 53 women who were pregnant during 2020, 38 (71.7%) answered the questionnaire. Median age at pregnancy was 36 years [interquartile range (IQR) 31–39], 27 (71.1%) women were born outside of Spain, mainly in sub‐Saharan Africa (39.5%) and 17 (44.7%) were employed. Thirty‐four (89.5%) women had been through previous pregnancies and 32 (84.2%) had experienced previous abortions/miscarriages. Seventeen (44.7%) women had shared with their clinician their desire to get pregnant. Thirty‐four (89.5%) pregnancies were natural and four used assisted reproductive techniques (in vitro fertilizations; one additionally used oocyte donation). Of 34 women with natural pregnancies, pregnancy was unplanned in 21 (61.8%) and 25 (73.5%) had information on how to become pregnant avoiding HIV transmission to the baby and partner. Women who did not seek advice from their physician about becoming pregnant had a significantly increased risk of unplanned pregnancy (OR = 71.25, 95% CI: 8.96–566.67). Overall, 14 (36.8%) women reported having low social support during pregnancy and 27 (71.0%) had good/very good support by their partner. Conclusions: Most pregnancies were natural and unplanned and very few women had talked with their clinician about their desire to become pregnant. A high proportion of women reported low social support during pregnancy. [ABSTRACT FROM AUTHOR]

Siblings' interactions and shared experiences influence their perceptions of quality of life. Recently, research about siblings of children with intellectual and developmental disabilities has been significantly expanded but data from Southern European countries is still missing. This research was carried out in Catalonia (northeast Spain) a region in the Mediterranean area with its own shared culture, language and traditions that equally embraces an important diversity of ethnicities and cultures. The main aim was to collect siblings' perceptions on quality of life from siblings' own voices. Semi‐structured interviews were conducted with 14 siblings aged 5–11 years old and thematically analyzed using the following domains: joint activities; mutual understanding; private time; acceptance; forbearance; trust in well‐being; exchanging experiences; social support; and dealing with the outside world. Siblings reported a variety of experiences in relation to having a brother or a sister with intellectual and developmental disabilities (I/DD), including unique characteristics of their quality of life perceptions. There were also some common factors amongst the siblings' experiences, such as the importance of being able to communicate properly with their brothers or sisters with I/DD. It emerged that having their own time with their parents was an important factor in their own development. This research echoes some siblings' beliefs that society needs to provide a conscious revision of values and ideas regarding disability. Implications for research and practice are described. [ABSTRACT FROM AUTHOR]

A team's ability to respond positively to adversities, problems, and obstacles during their season is an essential part of success in collective sports. Grounded in team resilience theory and using a multilevel analytical approach, this study examined the relationship of the characteristics of resilience and vulnerability under pressure with perceived individual and team performance. Participants were 676 soccer players (530 males and 146 females) aged 15–42 years (M = 21.40, SD = 5.38), who played on 64 senior and under‐18 soccer teams of several national leagues in Spain. In the final month of the season, factors related to team resilience and individual and team performance were analyzed. We estimated multilevel models by including perceived individual and team performance as dependent variables. Characteristics of resilience and vulnerability under pressure were considered as fixed and random effects (i.e., individual‐ and team‐level intercepts and slopes). At the individual level, results showed that characteristics of resilience were positively associated with subjective individual and team performance, whereas vulnerability under pressure was negatively related to perceived team (but not individual) performance. At the team level, only characteristics of resilience positively predicted team performance. These findings suggest that more resilient teams report more successful performance from an individual and team perspective, whereas teams that are more vulnerable under pressure report poorer team performance. Taken together, the study underscores the importance of practitioners to develop strategies that improve their teams' resilience, given that team resilience helps to achieve positive subjective individual and team outcomes. [ABSTRACT FROM AUTHOR]

This article employs concepts from family sociology to explore how 'family' is conceptualised in 14 life narratives of young people in foster care in Spain. The article draws on a multi‐method approach with young people who are in long‐term non‐kinship foster care. Seven girls and seven boys aged 10 to 22 took part in the study. The empirical material reveals an interplay between biological preference and foster family affective practices in young people's narratives, illuminating a struggle to make sense of the concept of family in foster care. Most of the participants understand family as shared affective practices sustained through love, commitment, consistent care and reciprocity rather than blood ties. Some show a preference for biological connectivity, while others describe family as determined by rituals and family displays. The key practice implications highlight the importance helping young people positioning themselves in birth family relationships, and supporting their sense of family belonging. [ABSTRACT FROM AUTHOR]

The arrival of unaccompanied minors from Africa in Spanish territory has been a constant since the last decade of the twentieth century. This migratory phenomenon has forced the child welfare system to attend to thousands of migrant children. The transition to adult life is a decisive stage in overcoming the situation of social exclusion. This research aims to analyse which socio‐educational intervention strategies are effective during the process of transition to independent living with unaccompanied minors of African origin. We designed a qualitative research according to the grounded theory, which we divided into two phases. Twenty‐nine young people (26 men and 3 women) participated. In phase 1, we performed two focus groups (N = 11), and in phase 2, we conducted longitudinal follow‐ups (N = 18) for 24 months through 180 interviews. The results indicate the effectiveness of designing socio‐educational accompaniment, prioritizing spaces of trust from which to attain the goals of emancipation. Young people consider effective those strategies that favour their knowledge of the social, labour and legal reality of the host society, designed considering each minor's individualized situation. We concluded that professional involvement acts as a buffer, reducing the bureaucratic obstacles implemented by the Spanish government. [ABSTRACT FROM AUTHOR]

Purpose: Smoking cessation interventions should be promoted in cancer centers to improve clinical outcomes among cancer patients and the quality of life of cancer‐free patients and survivors. The aim of the present study was to examine long‐term abstinence (1, 3, and 5 years) among smokers who received an intensive nurse‐led smoking cessation intervention. Design: A prospective follow‐up study was conducted in a smoking cessation clinic in Barcelona. Methods: The study included 479 smokers who received a nurse‐led smoking cessation intervention that included motivational interviewing, psychological support, behavioral change counseling, promotion of smoke‐free policies, and relapse‐prevention strategies, as well as pharmacotherapy if necessary, for 12 months. We calculated overall and sex‐specific 1‐, 3‐, and 5‐year abstinence probabilities (Kaplan–Meier curves) and adjusted hazard ratios (aHRs) of relapse with 95% confidence intervals (CIs) using Cox regression. Findings: The overall probability of abstinence at 1 and 5 years was 0.561 (95% CI: 0.516–0.606) and 0.364 (95% CI: 0.311–0.417), respectively. Females had a higher, but not significant, hazard ratio for relapse compared to males (aHR = 1.180; 95% CI: 0.905–1.538). Attending <5 visits was the most remarkable determinant of relapsing compared to attending 5–9 visits or ≥10 visits, both overall and by sex (p for trend: overall, p < 0.001; males, p = 0.007; and females, p < 0.001). Conclusions: Abstinence probability decreased over the 5‐year follow‐up but was relatively high. Males had higher abstinence rates than females in all follow‐up periods. Completeness of the intensive intervention was the main predictor of cessation. Clinical Relevance: Smoking cessation interventions should consider sex and incorporate strategies to increase adherence to obtain higher long‐term abstinence rates. [ABSTRACT FROM AUTHOR]

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

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]

Background: Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long‐term conditions such as Parkinson's disease. Objective: This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. Methods: A mixed‐methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta‐ethnography approach was used to analyse and synthesize cross‐national findings. Results: A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. Conclusions: Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. Patient or Public Contribution: Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of a multicomponent, eHealth‐based self‐efficacy intervention to promote subjective well‐being and self‐efficacy in patients with cardiovascular disease, exploring sex differences. Design: A pilot study of a two‐arm non‐randomized controlled trial. Methods: Forty‐two cardiovascular patients (31% women) participated in the study. The experimental group received a personalized psychoeducational session and a 14‐days eHealth intervention. Subjective well‐being (positive and negative affect) and self‐efficacy (chronic and cardiac) were assessed at baseline, post‐psychoeducational session, post‐eHealth intervention and at two follow‐ups. Results: The levels of the experimental group in positive affect, at post‐eHealth and follow‐up 1, and self‐efficacy, at post‐eHealth, and both follow‐ups, were statistically significantly higher compared to the control group (all ps <.05). When considering sex, the intervention was effective only for men. The results highlight the potential of eHealth interventions for cardiac patients and underline the importance of considering a gender perspective in their treatment. [ABSTRACT FROM AUTHOR]

The development of tool use in early childhood is a topic of continuing interest in developmental psychology. However, the lack of studies in ecological settings results in many unknowns about how children come to use artifacts according to their cultural function. We report a longitudinal study with 17 sociodemographically diverse children (8 female) attending a nursery school in Madrid (Spain) and their two adult female teachers. Using mixed‐effects models and Granger causality analysis, we measured changes in the frequency and duration of children's object uses between 7 and 17 months of age and in the directional influences among pairs of behaviors performed by teachers and children. Results show a clear shift in how children use artifacts. As early as 12 months of age, the frequency of conventional uses outweighs that of all other types of object use. In addition, object uses become shorter in duration with age, irrespective of their type. Moreover, certain teachers' nonlinguistic communicative strategies (e.g., demonstrations of canonical use and placing gestures) significantly influence and promote children's conventional tool use. Findings shed light on how children become increasingly proficient in conventional tool use through interactions with artifacts and others in nursery school. [ABSTRACT FROM AUTHOR]