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Background: Specific data is needed to safely expand bariatric surgery and to preserve good surgical outcomes in response to the non-stop increase in obesity prevalence worldwide. Objective: The aims of this study are to provide an overview of the baseline characteristics, type of surgery, and 30-day postoperative morbidity and mortality in patients undergoing bariatric surgery in Spanish public hospitals, and evaluate changes throughout the 2000-2014 period. Material and Methods: This is a descriptive study using data from the RICIBA, a computerized multicenter and multidisciplinary registry created by the Obesity Group of the Endocrinology and Nutrition Spanish Society. Three periods according to the date of surgery were created: January 2000 to December 2004 (G1), January 2005 to December 2009 (G2), and January 2010 to December 2014 (G3). Results: Data from 3843 patients were available (44.8 ± 10.5 years, a 3:1 female-to-male ratio, 46.9 ± 8.2 kg/m). Throughout the 15-year period assessed, candidate patients for bariatric surgery were progressively older and less obese, with an increase in associated comorbidities and in the prevalence of men. The global trend also showed a progressive decrease in Roux-en-Y gastric bypass, the most performed bariatric procedure (75.1 % in G1, 69.3 % in G2, and 42.6 % in G3; p < 0.001), associated with a parallel increase in sleeve gastrectomy (0.8 % in G1, 18.1 % in G2, and 39.6 % in G3; p < 0.001). An overall mortality rate of 0.3 % was reported. Conclusions: Data from Spain is similar to data observed worldwide. Information recorded in the National Registries like RICIBA is necessary in order to safely expand bariatric surgery in response to increasing demand. [ABSTRACT FROM AUTHOR]

Since the university education of psychologists began in Spain in 1954, the history of psychology course has been included in the curriculum. In the first few years, only half of the curricula offered the course. From 1973 to 2007, the universities' organization and regulation underwent successive reforms that involved changes in the curricula, decreeing specific national guidelines for each degree and establishing a minimum set of common required courses, called core courses, including the history of psychology. In 2007, the European Higher Education Area was set up, transforming the 5-year bachelor's degrees into 4-year degrees and eliminating the required guidelines, with each university being able to define the content of their curricula. The Dean's Conference for Psychology agreed on some recommendations related to core courses, which continued to include the history of psychology and were adopted by the majority of the universities. In 2015, the government established a new national regulation that makes it possible for each university to voluntarily reduce the length of the bachelor's degree to 3 years. Some psychology historians believe that this hypothetical reduction in the length of the degree, along with the already existing general tendency to prioritize applied or practical courses over basic or fundamental ones, could produce an appropriate scenario for the disappearance of the history of psychology course in some universities. [ABSTRACT FROM AUTHOR]

This article reviews in a systematic way the research of the evolution of Inequality of Educational Opportunities (IEO) in Spain undertaken to date. To accomplish this objective, Spanish studies are compared to international ones, both in methodological and substantive terms. Three characteristics have been observed in the existing research of the Spanish case: 1) methodological heterogeneity; 2) lack of agreement about the evolution of IEO, even with the same data; 3) deficit of theoretical and analytical explanations of tendencies. Finally, this article calls for more research of IEO in Spain that, on the one hand, is linked with international debates and, on the other hand, aims not only at describing tendencies but also at explaining them. [ABSTRACT FROM AUTHOR]

This article reviews in a systematic way the research of the evolution of Inequality of Educational Opportunities (IEO) in Spain undertaken to date. To accomplish this objective, Spanish studies are compared to international ones, both in methodological and substantive terms. Three characteristics have been observed in the existing research of the Spanish case: 1) methodological heterogeneity; 2) lack of agreement about the evolution of IEO, even with the same data; 3) deicit of theoretical and analytical explanations of tendencies. Finally, this article calls for more research of IEO in Spain that, on the one hand, is linked with international debates and, on the other hand, aims not only at describing tendencies but also at explaining them. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) 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 current work responds to the lack of studies analysing the antecedents and consequences of organisational commitment in the context of senior executives in MNC subsidiaries. A simultaneous equations analysis using a sample of 101 senior executives of subsidiaries of multinationals with foreign direct investment in Spain confirms that these managers' intent to leave the subsidiary and the multinational is determined by affective commitment and by continuance commitment in its two dimensions (high sacrifice and low alternatives), and that these commitments are in turn determined by the managers' cultural values and their participation in the governance of the firm. The current research offers contributions in three areas. Theoretically, it sheds light on the culture-commitment and governance-commitment relations, and on the explanatory value of affective and continuance commitments. The work offers methodological contributions that should help guide future research. Finally, the work also offers practical recommendations for company managers. [ABSTRACT FROM AUTHOR]

This study represents the first integrated approach to the lithic raw materials exploited by the Neanderthals that occupied the Abric Romaní site (NE Iberia). Focusing on chert as the most abundant raw material (>80% of the assemblages), we determine the potential procurement areas and the mobility patterns. Geo-archaeological surveys within a radius of 30 km from the site documented 32 primary locations with silicifications. The chert abundance ratio, a quantitative approach to the raw material availability, together with macroscopic and petrographic analyses, confirm the underexploitation of the local raw materials (<10 km). The main procurement areas are located between 16 km (Sant Martí de Tous chert) and 24 km (Panadella chert), indicating different procurement strategies and mobility patterns. Stone tool assemblages from levels M and Oa fall within a foraging radius, whereas level P, in part, suggests a logistical radius, demonstrating a complex scenario of extensive knowledge and intensive exploitation of the landscape among Neanderthals. • Landscape exploitation and mobility among Neanderthals at Abric Romaní (NE Spain). • Petrologic analyses and statistics models determine the stone tools provenance. • Results suggest a regional range for procurement, denying the distance-decay model. • Different mobility strategies are detected independently of technological constraints. • Behavioral complexity based on group size, occupation duration and/or site function. [ABSTRACT FROM AUTHOR]

Abstract: Recent research in Paleolithic archeology has stressed the importance of temporal issues in assemblage interpretation. Archeological assemblages are temporal constructs, formed by the addition of an unknown number of depositional events. This temporal dimension is also evident at the artifactual level, since single artifacts may undergo different events of modification and/or uses over time. The recycling of previously discarded blanks for tool production is one of the best examples of the temporal nature of artifacts. The aim of this paper is to evaluate the importance of recycling in a Late Upper Paleolithic site, examining a type of artifact – burned tools – that has up to now been little used to approach this issue. Our results suggest that recycling was probably a significant component of Upper Paleolithic provisioning behavior, with important implications in site formation processes and the typological variability of assemblages. The expedient or curated character of recycling is also discussed. [Copyright &y& Elsevier]

Introduction: Introduction: malnutrition is a very frequent problem in oncology patients and may have serious repercussions. Adequate nutritional management is cost-effective in terms of health and survival in this population, but it requires multidisciplinary coordination, specific training, and continuous follow-up. Objective: to validate the applicability and efficacy of a multidisciplinary nutritional support protocol in oncology patients. Methods: a multidisciplinary nutritional protocol was developed for oncology patients, with guidelines for screening and assessment of malnutrition, treatment, re-evaluation, and management of side effects, as well as guidance on supplementation and eating patterns. The protocol would be implemented in various clinical centers, collecting data through a structured questionnaire, registering variables before and after implementation. Results: the protocol and its impact were implemented and evaluated in 39 centers. An improvement in nutritional care was observed, evidenced by an earlier initiation of nutritional assessment and an increase in the number of patients receiving adequate care following the protocol implementation. Problems related to inadequate malnutrition coding in the centers, limited resources, and the need for greater interdepartmental collaboration were identified. Conclusions: the conduct of this study provides insights into how the implementation of a multidisciplinary nutritional support protocol can improve the nutritional care received by patients and informs about the main obstacles to adequate implementation.

Objective: In Spain, a total of 95,149 voluntary terminations of pregnancy (VTP) took place only in the year 2019, 90% of them requested by the woman, 53% of whom had at least one child. This situation highlights the relevance of postpartum family planning (PFP) and the work of the professionals in charge of its promotion. The aim of this study was to establish whether midwives and the rest of the nursing professionals regard PFP as an activity to perform within their professional role and how they implement it, as well as to identify their knowledge on it., Methods: Study performed through an ad-hoc questionnaire between March 2017 and June 2019 in three groups of Nursing professionals dedicated to woman care (n=153) made up of: 1) Nurses specialized in Obstetrics and Gynecology Nursing (Midwifery) of the Delivery suite Department; 2) midwives in Primary Care; 3) Nurses in Postpartum Unit from 3 different hospitals and 37 associated health centers. Analysis by labor group and the comparison of the different professional activities were performed through Pearson chi-squared test or a likelihood ratio, depending on sample size in qualitative variables, and in quantitative variables, by Kruskal-Wallis' test., Results: Not all professionals regard PFP as an activity within their professional role, and there is no consensus regarding its implementation (P<0.001). Concerning their level of knowledge, there are differences among professionals regarding the timeframe when the woman should receive the information on PFP (P=0.002), only 13% of them know that PFP should be started from day 21 of postpartum, and although 95% of them know about the incompatibility of breastfeeding with some contraceptive methods, this knowledge is higher among midwives than among general nurses (P=0.012)., Conclusions: Although midwives are the most aware and knowledgeable professionals on PFP, the responsibility of informing women on postpartum contraception does not always fall on them, and this situation could have an effect on the woman's health and reduce the incidence of unwanted pregnancies., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Patients with autoimmune disorders are at an increased risk of venous thromboembolism (VTE), but this association has not been consistently evaluated. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) database to compare the rates of VTE recurrences, major bleeding, and death during the course of anticoagulation, according to the presence or absence of autoimmune disorders. Of 71 625 patients with VTE recruited in February 2018, 1800 (2.5%) had autoimmune disorders. Median duration of anticoagulant therapy was slightly longer in patients with autoimmune disorders (median, 190 vs 182 days; P = .001). On multivariable analysis, patients with autoimmune disorders had a similar risk of VTE recurrences (hazard ratio [HR]: 0.93; 95% confidence interval [CI]: 0.68-1.27) or major bleeding (HR: 1.07; 95% CI: 0.82-1.40) and a lower risk to die (HR: 0.66; 95% CI: 0.54-0.81) than those without autoimmune disorders. Patients with giant cell arteritis had the highest rates of major bleeding (8.6 events per 100 patient-years) and the lowest rate of recurrences (zero). In other subgroups, the rates of both events were more balanced. During anticoagulation, patients with or without autoimmune disorders had similar rates of VTE recurrences or major bleeding. However, there were some differences between subgroups of patients with autoimmune disorders.

Object: Few studies have addressed the prognostic implications of D-dimer in patients with pulmonary embolism. The aim of this study was to investigate the correlation between D-dimer levels and mortality in patients with pulmonary embolism., Design: Observational study., Setting: Hospitals participating in the Registro Informatizado de la Enfermedad Tromboembólica (RIETE)., Patients: A total of 588 consecutive patients with symptomatic pulmonary embolism who were included in the RIETE between March 2001 and December 2004., Interventions: Quantitative D-dimer measurement was performed on admission using an automated latex agglutination test (IL Test D-dimer). All patients underwent clinical follow-up for 3 months., Measurements and Main Results: Overall mortality rate was 10.5%. The cause of death was pulmonary embolism in 18 patients (3.0%), fatal bleeding in one patient (0.2%), and other causes in 43 patients (7.3%). There were 28 (4.8%) nonfatal venous thromboembolism recurrences and 35 (6.0%) nonfatal bleeding episodes. The incidence of D-dimer 500-2499 ng/mL, D-dimer 2500-4999 ng/mL, and D-dimer >or=5000 ng/mL was 47.8%, 26.0%, and 20.4%, respectively. Compared with patients with D-dimer 500-2499 ng/mL, the relative risk (odds ratio) of overall mortality was 1.91 (95% confidence interval 0.91-4.09) and 2.94 (95% confidence interval 1.42-6.25) in patients with D-dimer 2500-4999 ng/mL and D-dimer >or= 5000 ng/mL, respectively (p = .032). Patients with D-dimer >or=5000 ng/mL showed higher risk of death from fatal pulmonary embolism (odds ratio 4.4, 95% confidence interval 0.5-33.0) than death from other causes (odds ratio 2.1, 95% confidence interval 0.7-6.0). Elevated D-dimer levels were associated with more severe disease, as assessed by clinical features., Conclusions: In patients who present with pulmonary embolism, D-dimer concentration is an independent predictive factor associated with all-cause and pulmonary embolism-related death. D-dimer >or=5000 ng/mL occurs in about one in five patients and is associated with a 2.9-fold increased risk of overall mortality. These results suggest that D-dimer quantification could be a useful biomarker and help determine initial therapies.

Objective: To know the social profile of Andalusian urban adolescents and analyse the similarities and differences they have with those at risk of presenting with eating disorders., Design: Cross-sectional community study. Stratified cluster sampling., Setting: Public and private education institutions in Andalusian cities with more than 100 000 inhabitants (Sevilla, Malaga, Granada, Cordoba, Cadiz, Huelva, Almeria, Jaen, Algeciras, and Jerez)., Participants: Pupils from 12 to 16 years, attending an academic course in the year 2002-2003 (N=1667)., Main Measurements: To compare the results of the sample with adolescents who are at risk of presenting with eating disorders (those who scored more than 20 in the 26-item Eating Attitudes Test [EAT-26]) we used the chi2 test for the nominal variables and the Spearman rho for the interval variables, with a significance level of P=.05., Results: There were no differences between either group as regards family structure, friend relationships, academic performance, and sporting activities. The differences centred on disciplinary practices, the number of friends diagnosed with an eating behavioural disorder, the objectives for practicing sports, and the type of diet that they followed. The subjects who scored highest on the EAT-26 were those who had a higher body mass index and a lower social status., Conclusions: It appears that diet changes are a response to certain social conditions. It would be speculative to include subjects who obtain high EAT-26 scores in the population at risk of anorexia.

Mutations in mtDNA have been implicated in the development of hypertrophic cardiomyopathy (HCM), including cases from families with a maternal transmission. Alleles at several polymorphic sites in mtDNA define different haplogroups and some of these haplogroups have been involved in the risk of developing several diseases in which mitochondria should be involved. We analysed the association between the nine common European haplogroups and HCM. A total of 130 Spanish patients and 300 healthy controls were genotyped for eight mitochondrial single nucleotide polymorphisms (SNPs) through polymerase chain reaction followed by digestion with a restriction enzyme (PCR-RFLP). We compared the frequencies of these polymorphisms and mitochondrial haplogroups between patients and controls. Haplogroup T, specifically defined by 13368A, was significantly involved in the risk of developing HCM in our population (p=0.007; OR=2.42; 95% CI=1.25-4.67). Our data suggest that the genetic variation at the mitochondrial genome could significantly contribute to the risk for HCM.

The production of extended-spectrum beta-lactamases (ESBLs) among 357 clinical isolates of Escherichia coli and 175 of Klebsiella spp. was studied using both the National Committee for Clinical Laboratory Standards disk diffusion method and the semiautomated Wider system. We highlight the predominance of E. coli (50, 92.6%) among positive samples and the largely outpatient origin of these (40, 80%), including 39 samples of urine (97.5%) and one of urethral exudate. There were only four ESBL-producing isolates of Klebsiella spp. (7.4%), and three were in outpatient urine samples (75%, 2 K. oxytoca and 1 K. pneumoniae). The positive and negative predictive values for the Wider system were 81% and 98.5%, respectively. We stress the high incidence of ESBL in our setting, the predominance of cases in the outpatient setting, and the acceptable detection of ESBL by means of the Wider system in E. coli and Klebsiella spp.