Study on the Attitudes and Knowledge of Teachers and Future Teachers about Immediate Health Care Measures at School.

The level and need for immediate health care measures training for teachers are of growing concern for two main reasons: on the one hand, these contents are part of the school curriculum and, on the other hand, teachers are the first adults to intervene in case of school injury. However, in Spain, first aid (FA) does not appear as obligatory content in the university training of teachers. The aim of the present study was to design and validate a questionnaire on the attitude of pre-school and primary school teachers towards first aid knowledge adapted to the school context and to analyze its psychometric properties. First of all, the psychometric values of the questionnaire were tested: through its validation and reliability. Subsequently, a correlation study was carried out as well as a logistic regression in order to know the knowledge and attitudes of teachers and future teachers about the importance of the Immediate Attention Measures at school. The sample consisted of 392 participants: active teachers (71%) and future teachers (29%, the latter being final year students) of the infant and primary stages from the northern, central and southern areas of Spain. The results show adequate psychometric values, establishing three factors: attitude towards general knowledge in FA and learning methodology; attitude towards wounds and CPR algorithm (most frequent and/or serious events); self-perception of knowledge or skill in FA. Pearson's correlation test identified significant values (p < 0.01) and positive association between Factors 1 and 2 (r = 0.422) and between 1 and 3 (0.244). The conclusions of the results of the validation process of the questionnaire on the attitude of teachers and future teachers to knowledge for immediate health care measures training are valid and reliable to an acceptable degree. Regression study demonstrates the importance of including first aid training in teachers' degrees.

Quality in Higher Education and Satisfaction among Professors and Students.

The aim of this study was to analyze the significant differences in satisfaction with educational quality in higher education in Italy (Naples) among students and professors. The sample consisted of 501 higher education students and 121 professors, resulting in a total sample size of 622 subjects. Once the quality parameters of the instrument were determined, reliability was confirmed, and data collection was initiated. In order to analyze the results, a test of independent means (Student's t-test) was performed, interrelating the variables of educational quality, concerning both management and satisfaction with higher education. Based on the results, we concluded that there are significant differences between the group of students and the group of professors, highlighting a higher level of satisfaction with quality reported by students regarding the coordination of teachers and staff in the educational process; therefore, the inclusion of students in the direct management of the center should be more active and an indicator to be taken into account in self-evaluation. Despite the limitations in the sample at the regional level, it offers many possibilities for future research.

Promoting Emotional and Social Well-Being and a Sense of Belonging in Adolescents through Participation in Volunteering.

The aim of this study was to analyze the differences within education-related degrees with respect to participation in volunteering. Volunteering motivation promotes and encourages emotional and social well-being and a sense of belonging in university students. This study was based on a total sample of 985 students undertaking Degrees in Early Childhood Education, Primary Education, and Social Education who attended higher education institutions in Northern Africa (Spain) and Eastern Spain. Once the quality parameters of the instrument were determined, the reliability was confirmed, and data collection was initiated. In order to analyze the results, a multilevel study (ANOVA) was conducted by interacting the variables for degrees with three levels (PE = Primary Education; EC = Early Childhood Education; SE = Social Education) and the variable "volunteering is my motivation to feel better", with five levels (strongly disagree, disagree, unsure, agree, and strongly agree). From the data obtained, it was concluded that there were significant differences between the different degree paths, the assessment covering sociodemographic variables and areas of interest showing that volunteering benefits university students both socially and in their decision-making processes.

Gender and Socioeconomic Status as Factors of Individual Differences in Pre-University Students' Decision-Making for Careers, with a Focus on Family Influence and Psychosocial Factors.

The present study analyses the influence of family, specifically parents, on the career decisions of their children, and how gender and socioeconomic status influence this choice. Research was carried out using data obtained from a questionnaire administered to a representative sample of students who took the university entrance examination (PEvAU, its Spanish acronym) in Spanish North Africa. A quantitative research design was adopted in which multivariate analysis (MANOVA) was applied anda decision tree, which was also used for graphical and analytical analysis. The main results indicated a significant influence of parents on their children's choices, this being the best predictor regarding the decision to take the said examination. It was also verified that their choice of Spanish Baccalaureate programme was significantly associated with their selected career path, and gender and socioeconomic status had a significant impact on that decision. These results lead to the need for further research on guidance from secondary education onwards. It would be interesting to analyse factors neglected thus far, such as those related to the cultural environment of students.

Words-Deeds Gap for the Purchase of Fairtrade Products: A Systematic Literature Review.

Rationale: Nowadays ethical consumerism is part of the agenda of consumers, businesses, and governments for its promise of a brighter future through the consumption of goods with added social or environmental value. Consumption of fair trade goods has been enjoying huge growth in the last few years as people are becoming more conscious of their consumption practices. Objective: In this piece of research we identify existing literature on the words-deeds gap for the purchase of fairly traded products. Moreover, we present and analyze the moderators to the ethical purchasing gap. Method: A collection of research articles was compiled using a key-word search in 3 databases: Scopus, Springerlink, and Sciencedirect. The research was carried out using various groups of keywords and completed using the following three criteria: articles published in English, between 2010 and 2018, in refereed journals. Further to the systematic literature review, all pertinent articles were imported into Atlas.ti for further thematic analysis. Results: Two thousand and seventy eight articles were identified from which 32 met the inclusion criteria. The content analysis resulted in the following themes: Values, Theory of Planned Behavior and Theory of Reasoned Action, Willingness-to-pay, Labels and Certification, Religion, Guilt, Dual Attitudes, Demographics. Conclusion: Despite "moral" products tasting better and self-claims to this direction, there is still a gap between claimed and actual consumption. Research has mostly concentrated on different perspectives, such as willingness to pay, items from the theory of planned behavior or theory of reasoned action. Given the recent developments in the theory of dual attitudes and further to our research this area is currently underrepresented in FT research and could provide useful insights that may increase consumption of FT products.

Educating in antimicrobial resistance awareness: adaptation of the Small World Initiative program to service-learning.

The Small World Initiative (SWI) and Tiny Earth are a consolidated and successful education programs rooted in the USA that tackle the antibiotic crisis by a crowdsourcing strategy. Based on active learning, it challenges young students to discover novel bioactive-producing microorganisms from environmental soil samples. Besides its pedagogical efficiency to impart microbiology content in academic curricula, SWI promotes vocations in research and development in Experimental Sciences and, at the same time, disseminates the antibiotic awareness guidelines of the World Health Organization. We have adapted the SWI program to the Spanish academic environment by a pioneering hierarchic strategy based on service-learning that involves two education levels (higher education and high school) with different degrees of responsibility. Throughout the academic year, 23 SWI teams, each consisting of 3-7 undergraduate students led by one faculty member, coordinated off-campus programs in 22 local high schools, involving 597 high school students as researchers. Post-survey-based evaluation of the program reveals a satisfactory achievement of goals: acquiring scientific abilities and general or personal competences by university students, as well as promoting academic decisions to inspire vocations for science- and technology-oriented degrees in younger students, and successfully communicating scientific culture in antimicrobial resistance to a young stratum of society.

Validity of the EQ-5D-5L and reference norms for the Spanish population.

BACKGROUND AND OBJECTIVE: The EuroQol 5 dimensions 5 levels (EQ-5D-5L) is the new version of EQ-5D, developed to improve its discriminatory capacity. This study aims to evaluate the construct validity of the Spanish version and provide index and dimension population-based reference norms for the new EQ-5D-5L. METHODS: Data were obtained from the 2011/2012 Spanish National Health Survey, with a representative sample (n = 20,587) of non-institutionalized Spanish adults (≥ 18 years). The EQ-5D-5L index was calculated by using the Spanish value set. Construct validity was evaluated by comparing known groups with estimators obtained through regression models, adjusted by age and gender. Sampling weights were applied to restore the representativeness of the sample and to calculate the norms stratified by gender and age groups. We calculated the percentages and standard errors of dimensions, and the deciles, percentiles 5 and 95, means, and 95% confidence intervals of the health index. RESULTS: All the hypotheses established a priori for known groups were confirmed (P < 0.001). The EQ-5D-5L index indicated worse health in groups with lower education level (from 0.94 to 0.87), higher number of chronic conditions (0.96-0.79), probable psychiatric disorder (0.94 vs 0.80), strong limitations (0.96-0.46), higher number of days of restriction (0.93-0.64) or confinement to bed (0.92-0.49), and hospitalized in the previous 12 months (0.92 vs 0.81). CONCLUSIONS: The EQ-5D-5L is a valid instrument to measure perceived health in the Spanish-speaking population. The representative population-based norms provided here will help improve the interpretation of results obtained with the new EQ-5D-5L.

Clonality, virulence determinants, and profiles of resistance of clinical Acinetobacter baumannii isolates obtained from a Spanish hospital.

INTRODUCTION: Acinetobacter baumannii is a nosocomial pathogen that is showing increasing rates of carbapenem resistance. Multi-Drug Resistant (MDR) International Clones (ICs), associated with certain oxacillinases, are being reported globally. This organism also harbors numerous virulence determinants. In this study, we aim at characterizing A. baumannii isolated from a Spanish hospital in terms of antimicrobial susceptibility, clonality, carbapenemase genes harbored, and virulence determinants expressed. MATERIALS AND METHODS: Fifty nine clinical bloodstream isolates were obtained from 2009 until 2013. Antimicrobial Susceptibility Testing was performed according to the CLSI guidelines. PFGE and tri-locus PCR typing were then performed in order to determine local and international clonality. PCRs for the detection of common carbapenemases were also performed. Production of hemolysis, biofilms, siderophores, surface motility, and proteolysis were determined phenotypically. Doubling times for selected strains were also calculated. Finally, statistical analysis for detecting associations between these factors was conducted. RESULTS AND DISCUSSION: Carbapenem non-susceptibility was 84.75%, suggesting the immediate need for intervention. PFGE showed the distribution of the majority of the isolates among 7 clusters. Although all three ICs were detected, IC II was predominant at 71.19%. blaOXA-24-like was the most prevalent carbapenemase (62.71%), followed by blaOXA-58-like (13.56%), and blaOXA-23-like (11.86%). Strains pertaining to IC II, and those harboring blaOXA-24-like, were positively associated with α-hemolysis, production of strong biofilms, and siderophore production. Harboring blaOXA-23-like and blaOXA-58-like was associated with attenuated virulence. These associations suggest that an interplay exists between these factors that could be locally exploited. CONCLUSIONS: An alarmingly high rate of carbapenem non-susceptibility has been detected in this study. There was a predominance of IC II and blaOXA-24-like, and those factors were associated with heightened expression of virulence determinants. This association could be exploited for modifying treatment regimens and for improving on infection control protocols in this hospital.

A novel mutation in pmrB mediates colistin resistance during therapy of Acinetobacter baumannii.

Acinetobacter baumannii is a highly versatile nosocomial pathogen. Multidrug resistance among A. baumannii isolates led to the use of colistin, subsequently giving rise to colistin-resistant strains. In this study, the genetic and phenotypic profiles of two colistin-resistant A. baumannii isolates were investigated. Two A. baumannii isolates were obtained from Patient 1 (C071 and C440) and three isolates were obtained from Patient 2 (C080, C314 and C428). Susceptibility profiles were determined by VITEK®2 and Etest. Clonality was determined by RAPD analysis and trilocus multiplex PCR. The pmrCAB operon was sequenced and common carbapenemase genes were screened for by PCR. Doubling times, haemolysis, surface motility, biofilm formation, siderophore production and proteolytic activity were phenotypically determined. Finally, whole-genome sequencing was performed for all five isolates. Isolates C440 and C428 were resistant to colistin and were clonally identical to their sensitive counterparts. The cause of colistin resistance was traced to the previously described P233S mutation in pmrB of C440 and to a novel ΔI19 mutation in pmrB of C428. blaOXA-58-like and blaGES-5 from the strains of Patients 1 and 2, respectively, were also detected. C440 had attenuated proteolytic activity and was positive for siderophore production compared with C071. No difference in in vitro virulence was detected between isolates C080, C314 and C428. In conclusion, one common and one novel mutation were encountered in pmrB from two distinct colistin-resistant A. baumannii isolates. These mutations caused colistin resistance during therapy in two distinct clones, and only one of them had altered in vitro virulence.

Consumer-Brand Relationships under the Marketing 3.0 Paradigm: A Literature Review.

Consumer-brand relationships encompass several dimensions, most of which have attracted growing research attention during the last years. Building these relationships is especially important in the marketing 3.0 era, where it is suggested that customers will choose those brands that satisfy their deepest needs. With these ideas in mind, this article provides a review of two key concepts implied in such relationships: brand love and customer engagement. Although both conceptions focus on different stages of consumer-brand relationships, they actually cover different perspectives on the same process. Moreover, they come from diverse conceptual paradigms: whilst brand love comes from the psychology discipline, engagement derives from diverse areas of the marketing field (e.g., the service-dominant logic perspective). However, their further empirical developments have taken place in marketing. Besides, both terms appear to be applied to different empirical perspectives: brand love is usually linked to the Fast Moving Consumer Goods industry and customer engagement to services.

Acinetobacter baumannii Isolated from Lebanese Patients: Phenotypes and Genotypes of Resistance, Clonality, and Determinants of Pathogenicity.

Introduction:Acinetobacter baumannii is a nosocomial pathogen that usually affects critically ill patients. High mortality rates have been associated with MDR A. baumannii infections. Carbapenem resistance among these isolates is increasing worldwide and is associated with certain International Clones (ICs) and oxacillinases (OXAs). Moreover, this organism possesses a wide range of virulence factors, whose expression is not yet fully understood. In this study, clinical A. baumannii isolates are characterized in terms of antibiotic resistance, mechanisms of carbapenem resistance, clonality, and virulence. Materials and Methods:A. baumannii clinical isolates (n = 90) where obtained from a tertiary care center in Beirut, Lebanon. API 20NE strips in addition to the amplification of blaOXA-51-like were used for identification. Antibiotic susceptibility testing by disk diffusion was then performed in addition to PCRs for the detection of the most commonly disseminated carbapenemases. Clonality was determined by tri-locus PCR typing and doubling times were determined for isolates with varying susceptibility profiles. Biofilm formation, hemolysis, siderophore production, proteolytic activity, and surface motility was then determined for all the isolates. Statistical analysis was then performed for the determination of associations. Results and Discussion: 81 (90%) of the isolates were resistant to carbapenems. These high rates are similar to other multi-center studies in the country suggesting the need of intervention on a national level. 74 (91.3%) of the carbapenem resistant isolates harbored blaOXA-23-like including two that also harbored blaOXA-24-like. 88.9% of the A. baumannii isolates pertained to ICII and three other international clones were detected, showing the wide dissemination of clones into geographically distinct locations. Virulence profiles were highly diverse and no specific pattern was observed. Nevertheless, an association between motility, siderophore production, and biofilm formation was detected (p < 0.05). Conclusions: A very high rate of carbapenem resistance was detected, showing the need for immediate intervention. IC II and OXA-23-like were the most disseminated, reflecting their international dissemination. No specific associations were made between virulence and resistance, but instead associations among certain virulence factors were found. Investigating a more clonally diverse pool of isolates could help in the determination of associations between virulence and resistance.

Assessment of a Novel Vaccine Against Rabbit Hemorrhagic Disease Virus in Young Rabbits.

Rabbit hemorrhagic disease virus (RHDVb) is the new variant of the classical RHDV, a virulent pathogen responsible for an acute disease in young rabbits. The virus invades internal organs, especially the liver, spleen, kidneys, and gut; prevents coagulation; and causes liver necrosis. This eventually leads to quick death of the animal because of hemorrhage. In this study, we evaluated the effects of a new vaccine against RHDVb in rabbits at a young age, after experimental infection using four different viral isolates. Our findings show that the vaccine had a protective effect with survival rates reaching 80-100% against the different isolates. These results suggest that this vaccine, when applied to young animals, is an effective tool to protect against the disease caused by RHDVb in rabbitries.

Association of antidepressant treatment with emergency admission to medical units for patients 65 years or older. / Tratamiento antidepresivo y asociación con el ingreso urgente en unidades médicas en pacientes de 65 años o mayores.

INTRODUCTION: There is increasing evidence relating the presence of depression in seniors and the risk of hospital admission in medical departments from the Emergency Services. OBJECTIVE: To determine the impact of antidepressant treatment (ATD) as a protective factor for emergency hospitalization in older people. METHOD: All patients aged 65 and over who required urgent attention for medical reasons at the Emergency Department of the Corporació Sanitària i Universitària Parc Taulí (Sabadell, Barcelona, Spain) for the period between January and October 2012 were included in the study. Sociodemographic variables, alcohol and tobacco use, medical history and psychopharmacological treatment were obtained. The necessary sample size was calculated and a simple randomization was performed. Subsequently, a descriptive statistical analysis and parametric tests were conducted. RESULTS: A total of 674 patients (53% women) were evaluated, with a mean age of 78.45 years, and 27.6% of the cases (71% women) were receiving ATD. Among the 333 admitted patients (50%), 83 individuals (24.6%) had previously received ATD; this contrasts with the 103 cases (30.6%) of prior ATD treatment among the patients who were not admitted. After comparative analysis, the relationship between previous use of ATD and being admitted to hospital was not statistically significant in our global sample. This relationship was only statistically significant among the group aged 75 and over (neg. sig. 0.012). CONCLUSIONS: In our study, ATD was associated with a decreased risk of hospital admission for urgent medical conditions in people aged 75 and over. Treating depression may protect the elderly against admission to the Emergency department and may potentially be a quality criterion in preventing complications in this population.

Culturable aerobic and facultative bacteria from the gut of the polyphagic dung beetle Thorectes lusitanicus.

Unlike other dung beetles, the Iberian geotrupid, Thorectes lusitanicus, exhibits polyphagous behavior; for example, it is able to eat acorns, fungi, fruits, and carrion in addition to the dung of different mammals. This adaptation to digest a wider diet has physiological and developmental advantages and requires key changes in the composition and diversity of the beetle's gut microbiota. In this study, we isolated aerobic, facultative anaerobic, and aerotolerant microbiota amenable to grow in culture from the gut contents of T. lusitanicus and resolved isolate identity to the species level by sequencing 16S rRNA gene fragments. Using BLAST similarity searches and maximum likelihood phylogenetic analyses, we were able to reveal that the analyzed fraction (culturable, aerobic, facultative anaerobic, and aerotolerant) of beetle gut microbiota is dominated by the phyla Proteobacteria, Firmicutes, and Actinobacteria. Among Proteobacteria, members of the order Enterobacteriales (Gammaproteobacteria) were the most abundant. The main functions associated with the bacteria found in the gut of T. lusitanicus would likely include nitrogen fixation, denitrification, detoxification, and diverse defensive roles against pathogens.

[The study of social inequalities in child and adolescent health in Spain]. / El estudio de las desigualdades sociales en la salud infantil y adolescente en España.

OBJECTIVE: To identify and describe studies on social inequalities in child and adolescent health conducted in Spain with special emphasis on social determinants. METHODS: In July 2012, we conducted a systematic review in the PubMed, MEDES, SCOPUS and COCHRANE databases. We included studies on social inequalities in child and adolescent health in Spain published between 2000 and 2012. A total of 2147 abstracts were reviewed by two researchers and 80 manuscripts were fully reviewed by three researchers. Risk of bias was assessed. Seventy-two articles were finally included. RESULTS: A total of 83% of the studies were cross-sectional and the most frequently studied age group consisted of 13-15-year-olds. More than 20 individual or group determinants were identified. The most frequently analyzed determinants were the most advantaged educational level and occupation of the mother or the father. In 38% of the studies analyzing education and occupation, there was no definition of the determinant. Social inequalities were detected in dental health with all determinants and in all age groups (9% of studies with a high risk of bias). Social inequalities were also detected in obesity, physical activity and mental health with some determinants. Specific data were missing for younger children. No social inequalities were found in the use of health services, excluding dental care. Few studies analyzed immigration and 42% of them had a high risk of bias. CONCLUSION: Wide diversity was found in the measurement of social determinants, with a lack of studies in preschoolers and of studies with longitudinal designs. The results of this study confirm social inequalities in some aspects of health.

First identification of Salmonella Urbana and Salmonella Ouakam in humans in Africa.

INTRODUCTION: Salmonella infections are increasing worldwide, but there are few reports on Salmonella surveillance in African countries and other developing countries. This has made it difficult to estimate the actual burden of salmonellosis, especially in Africa. This study was conducted in a neglected Northern Region of Ghana where there are no previous data on Salmonella serotypes. METHODOLOGY: Standard microbiological tests were used for isolation, identification, and serotyping. Micro-dilution was used for the antimicrobial susceptibility tests. RESULTS: Four serotypes of Salmonella were identified: S. Urbana, S. Ouakam, S. Senftenberg, and S. Stanleyville. All the serotypes were susceptible to the 20 antibiotics used in the susceptibility test. S. Urbana and S. Ouakam were identified in humans for the first time in Africa. CONCLUSION: This study may serve as a baseline study for future investigations on Salmonella in the region and may assist public health officials to take the appropriate measures in case of a disease outbreak caused by Salmonella in the area. The article may also give health officials a fair idea of the resistance level of these serotypes in the region.

Mass balance modeling to elucidate historical and continuing sources of dioxin into an urban estuary.

Polychlorinated dibenzo-p-dioxins and dibenzofurans (dioxins) are typically found in sediment, water and tissue as in the case of the Houston Ship Channel and Upper Galveston Bay (HSC-UGB) in Texas studied in this research. While hydrodynamic and fate and transport models are important to understand dioxin distribution in the various media, it is difficult to assimilate modeling results into a decision framework without appropriate tools that can aid in the interpretation of the simulated data. This paper presents the development of a mass-balance modeling tool linked to RMA2 and WASP models of the HSC-UGB system for 2002-2005. The mass-balance tool was used to aggregate modeling results spatially and temporally and estimate the relative contribution of sediments to dioxin loading into the Channel in comparison to runoff, deposition, and permitted effluent discharges. The total sediment associated-dioxin load into the system calculated using the mass balance model was 2.34 × 10(7) ng d(-1) (almost 86% of the toxic equivalent load), and the re-deposited load to the sediment from the water column was 1.48 × 10(7)ng-TEQd(-1), such that 8.6 × 10(6)ng-TEQ d(-1) or approximately 69% of the average daily dioxin flux is transported between model segments as sediment. The external loads to the system contribute approximately 3.83 × 10(6)ng-TEQ d(-1), a value that is an order of magnitude smaller when compared to the contribution from sediment. These findings point to the need for sediment remediation strategies that take into account the spatial locations within the system that serve as sediment sources to dioxin in the water column.

Klebsiella pneumoniae sequence type 11 from companion animals bearing ArmA methyltransferase, DHA-1 ß-lactamase, and QnrB4.

Seven Klebsiella pneumoniae isolates from dogs and cats in Spain were found to be highly resistant to aminoglycosides, and ArmA methyltransferase was responsible for this phenotype. All isolates were typed by multilocus sequence typing (MLST) as ST11, a human epidemic clone reported worldwide and associated with, among others, OXA-48 and NDM carbapenemases. In the seven strains, armA was borne by an IncR plasmid, pB1025, of 50 kb. The isolates were found to coproduce DHA-1 and SHV-11 ß-lactamases, as well as the QnrB4 resistance determinant. This first report of the ArmA methyltransferase in pets illustrates their importance as a reservoir for human multidrug-resistant K. pneumoniae.