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Knowledge of the value generated within higher education institutions is of great interest for various agents, particularly managers, as well as governments and society. University mission statements and their scope complicate any comparable measurement of the effects each university may have within a particular region. Perhaps the most adequate term for it and one that includes simple economic impact is value. This study is centered on the estimation of the short-term economic impact of the University of Granada (UGR). Using a method based on the input-output framework and multipliers, the total (direct, indirect, and induced) effects of UGR on production, income, and employment are quantified, differentiating between economic sectors. The total economic impact of UGR is 3.2 times the expenditure of the agents linked to the activities of the university, which implies that each Euro that the government invested was converted into 7.1 Euros. Its effect on total production surpassed two-thousand million Euros, with an income of one-thousand million Euros and over 25,000 equivalent jobs. Quantification of the impact is a measure of the importance of UGR within the province of Granada and the performance of public-sector investment in higher education.

In recent years, MOOCs have become firmly established as valid e-learning environments and, as such, have been developed by many universities using different types of platform. Given the voluntary nature of MOOC enrollment, motivation is crucial to our understanding of why students register for and complete these courses. The present study explores the motivations that characterize MOOC participants and how they relate to technology acceptance variables (data collected via questionnaires) and participation variables (observational data collected via the platform). Our results indicate that students show exceptionally high levels of intrinsic motivation. However, extrinsic motivation also plays a relevant role, suggesting that the two are not mutually exclusive. Although only intrinsic motivation appears to be systematically associated with differences in technology acceptance, both are associated with differences in participation, but in contrasting ways. Our results provide insights that will enable us to improve MOOC design in order to enhance participant satisfaction, particularly when different sources of motivation are involved. Future research based on the modeling of technology acceptance and participation will also benefit from this study.

Our study analyzes an educational experience based on the integrated use of social media within a higher education course under a personal learning environment approach and investigates the factors that determine students' loyalty to social media learning. We examined the moderating role of need for cognition (NFC) in students' formation of attitudes, satisfaction, and loyalty toward this learning experience. The results indicate that NFC has an influence on these variables, significantly moderating how loyalty toward social media learning is formed. For high-NFC students, satisfaction with the learning experience is the most important variable to explain loyalty; whereas for low-NFC students, attitudes have a stronger effect. Different strategies are suggested, according to the learners' NFC levels, for increasing the use of social media in personal learning environments. Practical implications for improving the integration of such informal resources into formal education are discussed.

As long as students use Web 2.0 tools extensively for social purposes, there is an opportunity to improve students' engagement in Higher Education by using these tools for academic purposes under a Personal Learning Environment approach (PLE 2.0). The success of these attempts depends upon the reactions and acceptance of users towards e-learning using Web 2.0. This paper aims to analyse the factors (e-learning satisfaction and students' perceptions, among others) that determine the intention of use of a PLE 2.0 initiative. The study in addition analyses the moderating role of the Need for Cognition (NFC) in the model. The results indicate that the model proposed has a high explanatory power of the intention to use a PLE 2.0 and gives support to the moderating role of NFC. The study discusses how this analysis can help to improve course designs by teachers.

Background: Primary Health Care nurses express deficits in their training in Palliative Care. The purpose of this study is to design a Palliative Care training plan and a bereavement care protocol for Primary Health Care nurses of the Dr. Peset Health Department according to their needs. Methods: Assessment of theoretical and practical training needs and literature review for the design of the training plan. Results: A training plan was elaborated that included a protocol of care for the bereaved. The plan was adjusted to the needs detected in Primary Health Care nurses of the Dr. Peset Health Department. Important training deficits were detected in clinical practice; Conclusions: Improving the care of people with palliative needs in Primary Health Care requires adequate training of the nurses who care for them so their knowledge is the basis of their interventions. This study was not registered. [ABSTRACT FROM AUTHOR]

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

Background : Burns are one of the most common causes of mortality and morbidity among children. This study aims to assess the epidemiology of pediatric major burns in a third level hospital in Spain to evaluate demographics, etiology, and outcomes. Methods: A retrospective study was held by the Plastic, Reconstructive and Burn Surgery department of the hospital. We included 147 patients under 18 admitted to hospital between January 2008 and December 2020 who meet the inclusion criteria: partial thickness burns > 10% total body surface area (TBSA) in patients < 18 years old. Clinical data extracted included age, gender, date of admission, %TBSA, burn types, severity and sites of burn, length of stay, length of ventilator support, intensive care admission, blood transfusion, surgical interventions, and complications. Results: Three groups of age were analyzed. The average %TBSA was 18.7 (SE 0.9). Scalds were the main mechanism of injury (70.1%) and upper extremity was the most frequent location affected (68%). The 28.6% of patients suffered some complication, but the mortality rate was low (0.7%). In our series, the group aged 13–18 showed significantly higher %TBSA, more number of surgeries and blood transfusions. Conclusions: Scald burns are the most frequent mechanism of injury in pediatric burns. However, teenagers suffer more severe burns and complications, usually caused by flame. Despite the low mortality rates, more measures of prevention should be taken to increase children security. Level of evidence: Level IV, Risk/Prognostic. [ABSTRACT FROM AUTHOR]

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

Featured Application: Model for designing and implementing self-protection plans for public buildings. Adaptability of self-protection plans for elderly residences. COVID-19 is reflecting the importance of self-protection plans in nursing homes, especially when it concerns persons of older age. Self-protection plans intend to prevent and control the risks of residential buildings. The goal of this research is to develop a design process for self-protection plans of public buildings, and specifically a nursing home. In this regard, it is key for the viability of the nursing home operations to be capable of adapting to any potential future event. Starting from some initial hypotheses that establish the need for adaptability, a self-protection plan model is developed for public buildings based on a new approach consisting of four elements and three steps. It was applied to an elderly residence which is currently under construction. The methodology followed has consisted of a process by stages, to design and implement a novel self-protection plan for public buildings. Subsequently, it has been applied to the specific case study, using the most common tools and applications available for later analysis of the result obtained with the starting hypotheses. The results show how the research allows an increase in the adaptability of self-protection plans for any publicly owned building, although there is an extensive and precise subsequent work of adaptation to specific cases considering the different legal frameworks which makes the work challenging. Finally, the research on adaptability and its application for elderly residences enabled the derivation of recommendations regarding self-protection plans in general and specifically in homes for the elderly. [ABSTRACT FROM AUTHOR]

This article explores the process carried out by Spain's state radio station -Radio Nacional de España- to devise the figure of Francisco Franco, first as a war hero, supreme chief of the rebel side of Spanish Civil War and, after the conflict ended, as a statesman and rebuilder of the Spanish nation, in his roles as head of state and Caudillo de España (leader of Spain). Through the examination of materials from newspapers, magazines, sound archives, censored scripts and administrative documentation, this research focuses on the capacity of state radio to adapt its discourse to convey the figure of a 'charismatic' ruler that satisfies the needs of the Francoist regime to survive and legitimize itself. The article shows how state radio constructs a discourse around Franco arranged to the different speeds of the national and international political context that shook Spain, Europe and the occidental world from 1937 to 1961. [ABSTRACT FROM AUTHOR]

The late incorporation of Spain into the international circuit for the publication of results of scientific research in Communication has not proved to be an obstacle to reaching a level similar to international research in this discipline recently. However, this development is still subject to some obstacles. In this study, we carried out co-word and cocitation analyses of the intellectual and thematic structure of articles published by researchers affiliated with Spanish centers in journals indexed in the Communication category in Scopus and published between 1980 and 2020 (n = 7,422). This enables an analysis of the intellectual and thematic structure of Communication studies between 1980 and 2020 and its evolution. The aim is to contextualize this process, in a broad sense, thus establishing the similarities to and differences from European (n = 33,615) and Latin American (n = 5,160) Communication research during the same period. The results reveal a homogenization of the research interests between Spanish academics and their European counterparts during the last decade, with an emphasis on digital technologies and social networks. The first prominent studies in Spanish research have also appeared, albeit not yet becoming established as such on the international stage during the last decade. It is concluded that Spanish Communication research has developed around Journalism while the other classic disciplines (Audiovisual Communication, and Advertising and Public Relations) have not managed to consolidate a coherent and cohesive thematic and intellectual community to date, mainly due to their greater heterogeneity. [ABSTRACT FROM AUTHOR]

Framing processes are one of the preferred objects of study in the area of Communication, despite the frequent criticism regarding their theoretical and methodological strength. This study follows the proposal of Matthes and Kohring (2008) of the detection of frames through statistical analysis of clusters that operationalize the components as defined by Entman (2003) using framing elements. This is applied to the study of the electoral campaign on Facebook of the main Spanish political parties in the election of 28 April 2019. All messages published on this social network during the 15 days of the electoral campaign were captured automatically. The use of four large frames by the parties was detected, corresponding to events and political questions, request for vote, the rival party, and media treatment. The parties used these frames to different degrees: from the institutional and positive campaign of the PSOE, to the campaign aimed at criticizing the ruling party of the main opposition party, the PP, through the inclination towards media treatment of Unidas Podemos, or a focus on their own events and proposals by Ciudadanos and Vox. A negative correlation was detected between the frames most used by the political formations as a whole and the level of user engagement on Facebook, although the use of frames by PSOE and Unidas Podemos showed a greater parallelism with the levels of interaction in this social network. [ABSTRACT FROM AUTHOR]

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

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

• A strategy of integrated marketing communication requires a holistic approach. • Hospitality businesses benefit from the effective implementation of IMC. • Integrated marketing communication positively relates to sales-related performance. • Integrated marketing communication impacts positively on brand advantage. • Integrated marketing communication enhances customer satisfaction and loyalty. Over the last decade, scholars have recently emphasized the need for tourism marketers to orchestrate the wide range communication activities and forms via the adoption of Integrated Marketing Communication (IMC). However, prior research has almost neglected the role of IMC in hospitality management. This paper adopts a broad organizational approach conceiving IMC as a concept that involves the whole organizational entity and aims to analyze the effects of IMC on market performance, in terms of superior sales and financial results, greater brand advantage and customer-related outcomes for those businesses providing lodging services. To pursue this research purpose, a survey has been conducted among corporate-level senior managers of lodging businesses operating in Spain. The findings provided further and more compelling empirical proof of the positive influence of IMC on market performance, responding to the call for more rigorous empirical research to demonstrate the beneficial effects of firm-wide IMC on market performance. [ABSTRACT FROM AUTHOR]

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

The Blue Division, Spain’s most notable military contribution to the Second World War, has been examined from many different perspectives, though the role of communication has not featured among them. This study aims to analyse the role played by Spanish state radio in the creation and maintenance of Spain’s war effort in that period. In order to achieve this, we used documentary sources, and more specifically, reconstructed the radio programming schedules, mainly using the press, due to the lack of audio recordings from the era. Finally, this work explores the role of radio from the Blue Division’s inception through to its official disbandment; or, put another way, the transition from commitment to the Axis powers to gradual estrangement from them. A dual transition process occurred on Radio Nacional de España: firstly, from zealous glorification to the silencing of the divisionaries by official order. The second transition was from a radio station that, since the Civil War, had lost its persuasive power, to a new perception of propaganda based on the familiar and the emotional. [ABSTRACT FROM PUBLISHER]

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

This research is focused on two fiction representations of the coup d'état in 1981, February 23rd in Spain. Specifically two series broadcasted in February 2009, namely: February 23rd: King's hardest day and February 23rd: the history of a betrayal. In this way, we assume not only the proposal that fiction is a useful instrument to rebuild historical memory, but also the concern that it is able to renew the perception of some social institutions. [ABSTRACT FROM AUTHOR]

This article offers an analysis of the sound construction of the figure of Francisco Franco through the discourse broadcast by Radio Nacional de España (the National Radio of Spain) during the Civil War and the first twenty years of the Franco regime in Spain. The purpose of the study is to determine the characteristics and evolution of the propaganda used to build the mythical figure of Franco adjusted to the political interests of the regime's propaganda apparatus. [ABSTRACT FROM AUTHOR]

This research presents a review of the theoricdevelopment that have received newsgames as informative practice and particularize, briefly, which were aimed at spanish context. We analyzed these products from their objectives and usability after establishing the characteristics of the medium from the point of view of communication. As advances in the conclusions, this is a genre that an unqualified international contexts, begins to acquire a significant presence in the Spanish area but is still in an embryonic state. [ABSTRACT FROM AUTHOR]

An analysis of travelers’ satisfaction with a holiday trip to Spain’s Andalusia region found a distinct difference in the information sources used by first-time visitors and repeat visitors. In addition to determining the travelers’ satisfaction with the trip itself, this study also assessed the travelers’ satisfaction with the travel-related information they received before taking their trip. The framework for the study was a rural tourist trip, a little studied area. Repeat visitors relied primarily on their own experience in terms of expectations for their trips, and any external information sources they consulted had no effect on their satisfaction with the trip. Of the several external sources consulted by the first-time visitors, only mass-media advertising was associated with favorable satisfaction results for the first-timers. Other sources, including word of mouth, the internet, and noncommercial media placements (such as news stories), were associated with negative effects on satisfaction, perhaps because these sources created unrealistic expectations. Destination promotions attracted both new and returning visitors, but again the two groups had different views on which types of promotion were most effective. First-time travelers responded primarily to price discounts in some form, whereas repeat travelers were more inclined toward such nonprice promotions as gifts and prize drawings. For hospitality and tourism officials, the findings focus on the need to ensure that information sources are accurate and create appropriate expectations for first-time travelers. This may require more activity in social media, since internet sources apparently created incorrect expectations or simply offered the first-time travelers so much information that they felt overloaded. [ABSTRACT FROM AUTHOR]

Copyright of Educación XX1 is the property of Editorial UNED and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article offers -from different types of sources- the guidelines Radio Nacional de España followed in its emissions to a children and youth audience during the Spanish Civil War and the First Francoism. This research provides goals of their leaders, the problems they had to state to carry out the broadcasts, and -will be pointed- the possible influence of these emissions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research analyzes the feminine identity through love and engagement representations in Spanish cinema during the first years of francoism (1939-1959). The fieldwork was two hundred films released in these years. The election agreed two criterion: first, how much time they were showed in cinema and, second, relevance with this research. We have completed with the analysis of censorship reports about that films. This research strand reflects the master lines of the regime about the representation of the official model of woman. This research consulted the most relevant women magazines to check similarities and differences with cinema. In conclusion, love -in Spanish films in these years- wasn't the romantic feeling, other artistically forms represents. The female audience understood this sensation -love- with engagement (conducted to marriage) and family. That's all the spanish women have to done in the francoism Spain. [ABSTRACT FROM AUTHOR]

This article analyses the formation of women's identity in relation to love and courtship in the Spanish cinema during the first Franco regime (1939-1959). To this end, two hundred films produced in Spain during this time were analysed. These films were chosen based on two criteria: Their permanence in the box office and their relevance to the subject under study. This research was complemented with the analysis of the censorship reports about these films, which facilitated the understanding of the guidelines and influence of the government towards the representation of an official model of the Spanish women. Moreover, in order to know whether other media also contributed to the creation of the feminine identity, we consulted the most important women's magazines and compared their messages whit those offered to women on the big screen. [ABSTRACT FROM AUTHOR]

Esta investigación aborda la reacción de diferentes públicos ante la exhibición del documental Spanish Earth (Joris Ivens, 1937). El trabajo analiza los propósitos iniciales del director y los medios a su alcance, las expectativas de las distribuidoras y las críticas de los periódicos en Inglaterra, Estados Unidos y España. Por último, se analizan las claves ideológicas y temáticas de la película y la representación audiovisual que se hace de la guerra y, a partir de este análisis, se explica el porqué de su escaso éxito de taquilla y difusión tanto en Estados Unidos como, sobre todo, en el Madrid de la Guerra Civil. This article analyses the reactions of various audiences when the documentary Spanish Earth (Joris Ivens, 1937) was screened in theatres. The research studies the aim of the film-maker, the resources accessible to him during filming, the expectations from the distributors and the newspaper critics from three different countries: Spain, England and the United States. Moreover, we show the key ideas included in Spanish Earth and focus on the audio-visual representation that the film makes about the Spanish Civil War. Finally, we explain why Spanish Earth had a limited audience in the United States and, above all, why it did not succeed in the box office in Madrid during the Spanish Civil War. [ABSTRACT FROM AUTHOR]

In both strategic city planning and city marketing, a fundamental starting point is to evaluate the image of the city itself. Knowing a city’s image is a key element in the diagnosis, which should serve as the basis of city planning. The concept of city image is multidimensional; it is not limited solely to one urbanistic aspect but, rather, includes other dimensions. This study identifies those dimensions that may have implications for the forming of city image. After validating the measurement scales, a causal model applied to the city of Granada is obtained that helps to understand the forming of its image. The interpretation and conclusions drawn from the model complement the diagnosis and suggest actions to be carried out to improve a city’s image. [Copyright &y& Elsevier]

In order to analyse consumer response to differing levels of comparative advertising, we have designed a causal model that includes various measurements of advertising effectiveness (cognitive, affective and connative), along with some of the main moderating factors considered in prior academic research. Thus, we carried out an experimental study in Spain using a total sample of 720 consumers spread out over four large geographical areas of the country. The results drawn from estimating the proposed model indicate that the greater the comparative advertising intensity, the lower the consumer's perception of believability. Likewise, the number of counter-arguments presented by the consumer increases, which negatively affects both attitudes and purchase intentions. However, the less well-known brands on the market are those that benefit most from this advertising strategy, increasing the audience's attention and improving purchase intentions. [ABSTRACT FROM AUTHOR]

Celiac disease is strongly associated with HLA DQ, specifically with haplotypes. DRB1*03-DQA1*05:01/DQB1*02:01 (DQ2.5),DRB1*07-DQA1*02:01/DQB1*02:02 (DQ2.2), DRB1*11-DQA1*05:05/DQB1*03:01 (DQ7.5), and DRB1*04-DQA1*03:01/DQB1*03:02 (DQ8). The distribution of these risk haplotypes in patients with celiac disease is different in the geographical areas investigated. A high frequency of DRB1*07- DQA1*02:01/DQB1*02:02 (DQ2.2) and DRB1*11-DQA1*05:05/DQB1*03:01 (DQ7.5), has been described in Southern Europe. We analyzed 2102 confirmed CD cases with information on both DQB1* alelles and their distribution by geographical area in Spain. According to the presence of this haplotype in one or two chromosomes, the genotype is classified in: DQ2 homozygous, DQ2 heterozygous (cis or trans), DQ8 homozygous, DQ8/DQ2.5, DQ 2.2 homozygous and genotype known as "half DQ2". Two different patterns of risks related to CD were identified. In the Basque Country and Navarre, the Mediterranean Area (Aragon, Catalonia, Valencia, Balearic Islands, and Murcia), the South of Spain (Andalucía and Extremadura), and the Canary Islands, higher frequency of DQ2.5 trans, and more than 80% of DQ2.5/DQ2.2 homozygosis were described. The Cantabrian Coast (Cantabria, Asturias, and Galicia) and Central Areas (Castilla-León and Castilla-La Mancha) showed a higher percentage of DQ2.5/DQ2.5 homozygosis and a lower DQ2.5 in trans frequency, as in Northern Europe. Madrid has an intermediate model between the two described above. 17 cases (0.8%) did not carry any CD risk haplotypes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.)

Aim: Asses training, perception of readiness and training needs in palliative care (PC) theoretical and practical of primary care nurses in Spain, through descriptive cross-sectional study., Design: Descriptive cross-sectional study., Setting: Primary care nurses in Spain with online access., Participants: Primary care nurses in Spain, January and February 2021. 344 responses, 339 met the inclusion criteria., Main Neasurements: Sociodemographic variables, PC training, training needs were analyzed. Through Google Forms online questionnaire and INCUE Instrument. Descriptive analyses were performed and the results were compared using the exact symmetry test and the Mann-Whitney test., Results: 82,6% women, with an average age of 45.5years. 86.1% of the nurses had training in PC, been basic in the 45.4%. Only 40.5% feel quite or very prepared to take care for palliative patients. Nurses demanded more training in psycho-emotional and grief and coping with losses. 83.76% passed the theoretical block compared to 43.36% of the practical, detecting higher training needs in the last (P<.001). The passed rates varied depending on the educational level., Conclusions: Nursing training in PC in primary care continues to be deficient, especially in practical application. Targeted training is necessary to have an impact on the care of people with palliative needs and their families., (Copyright © 2022 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)

Aim: This study aims to assess the influence of training on nurses' attitudes toward end-of-life care during the COVID-19 pandemic alarm state in Spain., Design: Cross-sectional descriptive study. Data collection was carried out by means of an ad hoc questionnaire using Google Forms in April and May 2020. The score of attitudes toward end-of-life care was used, to which sociodemographic variables and training in palliative care were added., Methods: Data were collected from 238 nursing professionals who had cared for COVID-19 and non-COVID-19 adult patients at the end-of-life stage in a hospital or nursing home., Results: Results showed that 51% of the nurses in the sample had training in palliative care. However, the percentage decreased to 38.5% among those who cared for COVID-19 patients and to 44.5% in those who cared for non-COVID-19 patients. In relation to attitudes about end-of-life care, more positive attitudes and a higher mean score were found in the trained group., Conclusions: Palliative care training is a key element in end-of-life care and is even more important in times of COVID-19., Impact: Although end-of-life accompaniment has been studied, few studies have included the influence of training on this during the pandemic. This study identifies key elements of accompaniment and training in a comparison of COVID-19 and non-COVID-19 patients during the pandemic. In relation to attitudes toward end-of-life care, the results showed a more positive attitude and a higher mean score in the trained group (3.43 ± 0.37 versus 3.21 ± 0.32), the difference being statistically significant ( p < 0.001).

Introduction: Diabetes mellitus (DM) is one of the most prevalent chronicdiseases and has a significant health and social impact. Strict control of blood glucose levels and other risk factors for vascular disease (VD) reduces complications and mortality and is related to the quality of care received. Although care should be interdisciplinary, based on the coordination of primary care (PC) and hospital care (HC), little information is available on the effectiveness of the different existing intervention models., Objective: To assess, in a population with DM from a healthcare area, the impact on health, quality of care, and effectiveness in the use of resources of a specific model of shared management of patients with DM (Instrument for Evaluation of Models of Chronic Care in Diabetes Mellitus; IEMAC-DM)., Patients and Methods: A quasi-experimental before-after intervention study in patients with DM in the Cádiz-San Fernando Healthcare Area (Andalusia, Spain) that allows for identifying the capacity of the program to improve the quality indicators both in the whole population with DM and in that referred to HC. For this, a working group consisting of healthcare professionals of different profiles and care levels was set up. An initial self-assessment was done using the IEMAC-DM tool and, after analysis of the preliminary results, improvement strategies were established and implemented. Finally, the clinical and resource management results were assessed before and two years after the implementation of the model., Results: During the study period, no significant changes were seen in process indicators related to laboratory practices or examinations in the health area. The proportion of patients with acceptable metabolic control [glycosylated hemoglobin (HbA1c) level < 8%] was 49% in 2015 and 45% in 2017. The number of admissions related to acute myocardial infarction (AMI) and stroke remained constant, but there was an increase in the standardized ratio of major lower limb amputations (1.5 vs. 1.9). Of the 295 patients referred from PC to HC, the proportion of adequate referrals increased from 40% in 2015 to 76% in 2017 (P = .001). In the referred patients, a significant improvement was seen in the mean difference in glycosylated hemoglobin levels (HbA1c; 1.14 ± 1.73%; 95% CI: 0.73-1.55; P = .0001) and cholesterol (11.28 ± 40 mg/dL; 95% CI: 2.07-20.48; P = .012)., Conclusions: This study shows that an intervention based on a chronicity care model adapted to patients with DM improves certain aspects related to the quality of care and the degree of metabolic control. Improving health outcomes will require long-term evaluation and, probably, other additional interventions., (Copyright © 2020 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: The aim of this study was to assess the incidence and clinical pattern of celiac disease (CD) presently diagnosed in Spanish children., Methods: A prospective, multicenter, nationwide registry of new cases of CD in children <15 years was conducted from June 1, 2006 to May 31, 2007. The parameters studied were age at diagnosis, sex, clinical symptoms, associated diseases, nutritional status, CD serology, histological lesions, and HLA-DQ2/-DQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births and as new cases per 100,000 person-years <15 years of age., Results: A total of 974 new cases of CD were included. The median age at diagnosis was 2.3 years; 39.5% of CD diagnoses occurred in the first 2 years, 42% between 2 and 6, and 18.4% from 6 to 15. Total number of cases in each age group was 385, 409, and 180, respectively. Regarding clinical presentation 70.9% showed classical symptoms, 21.9% were nonclassical, and 7% were asymptomatic. A total of 95.7% of 931, 94.7% of 611, and 86.7% of 651 children tested positive, respectively, for immunoglobulin A (IgA) anti-transglutaminase type 2 antibodies, IgA endomysial antibodies, and IgA anti-gliadin antibodies. Villous atrophy was observed in 92.4% and increased intraepithelial lymphocytes with crypt hyperplasia in 3.3%. Of the children, 55% had normal growth, and 3.4% were overweight. The HLA phenotype was DQ2: 88.3%, DQ2/DQ8: 8.4%, and DQ8: 2.3%. The incidence rate was 7.9 cases of CD per 1000 live births and 54 cases per 100,000 person-years., Conclusions: In Spain, the most frequent clinical presentation of CD is the classical form, mainly diagnosed during the first 2 years of life. The observed incidence of CD in Spanish children is much higher than the present CD incidence rates observed in other European countries.

Background and Objective: Different epidemiological studies have shown that maternal excess of weight during pregnancy is associated with adverse outcomes of pregnancy, childbirth and morbidity of the neonate. Prevalence of obesity in a pregnant population of Canary Islands is reported here., Subjects and Methods: The group studied was an integrated cohort of all the pregnant women being followed-up at the Materno-Infant University Hospital of the Canarias [Hospital Universitario Materno-Infantil de Canarias; HUMIC] and who concluded their gestation during the year 2008 (n=6693). BMI was measured at the beginning of the pregnancy., Results: 25.0% of the sample of pregnant women were overweight and 17.1% were obese, increasing both with age and not influenced with the educational level., Conclusions: The prevalence of obesity and overweight among pregnant women from the Canary Islands is high. Among the values available from other European countries, only the UK reported values greater than our study sample., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Purpose: The purpose of this paper is to test a theoretically driven model of the relationship between job demands, employees' motivation and resources, and supervisory support on employees' quality of work lives and their general health. DEISGN/METHODOLOGY/APPROACH: The study uses large survey data that were collected in the years 1995, 2002, and 2003 respectively, drawn from the public health care employees sector in Catalonia (Spain). Albeit cross-sectional methodology, the study embraces an additional retrospective and longitudinal design., Findings: The 2002 cross-sectional study (n = 2,926) supports the assertion made by stress researchers regarding the extent to which both job demands and lack of supervisory support predict low QWL and negative health outcomes: perceived motivation, resources and capabilities also appear as determinants but to a lesser extent. The stability of the results obtained was tested retrospectively by cross-legging the model for the 1995 survey (n = 2,901). In addition, a follow-up study (i.e. longitudinal) was conducted in 2003 (n = 10,003) to see whether the model still holds. By and large, the three-level design shows the stability of the prediction in the same direction., Practical Implications: The paper discusses some possible prevention strategies to reduce the low QWL and negative health outcomes within the Public Health Sector., Originality/value: The paper covers all categories of personnel in the health care personnel and thus external validity is very strong. Findings permit the taking of concrete actions to reduce stress, reduce negative health outcomes and by and large enhance the quality of work lives of the people in this sector.

Aims: To find the prevalence of auricular fibrillation in over-65s., Design: Descriptive cross-sectional study through face-to-face interview and electrocardiogram., Setting: La Solana Health District, Talavera de la Reina (Toledo)., Participants: The entire population aged 65 or over (1206 people). Main measurements. Structured interview, study of patients clinical history, taking of blood pressure, and electrocardiogram with standardised measurement., Results: 5.6% prevalence of auricular fibrillation. Distribution according to gender: 4.5% in men and 6.4% in women (p = 0.060; adjusted OR, 1.5). Prevalence of auricular fibrillation by age groups: from 65 to 74, 3.9%; from 75 to 84, 7.8%; over 85, 18.2% (p = 0.0001; adjusted OR, 2.14)., Conclusions: There is greater prevalence of auricular fibrillation in the over 65s than in the general population. Prevalence increases with age. Gender has no statistical significance in the 65 to 74 age group, though it has in the over-85 group, in whom auricular fibrillation is more prevalent in women.