Long-Term Impact of an Educational Antimicrobial Stewardship Program on Hospital-Acquired Candidemia and Multidrug-Resistant Bloodstream Infections: A Quasi-Experimental Study of Interrupted Time-Series Analysis.

BACKGROUND: The global crisis of bacterial resistance urges the scientific community to implement intervention programs in healthcare facilities to promote an appropriate use of antibiotics. However, the clinical benefits or the impact on resistance of these interventions has not been definitively proved. METHODS: We designed a quasi-experimental intervention study with an interrupted time-series analysis. A multidisciplinary team conducted a multifaceted educational intervention in our tertiary-care hospital over a 5-year period. The main activity of the program consisted of peer-to-peer educational interviews between counselors and prescribers from all departments to reinforce the principles of the proper use of antibiotics. We assessed antibiotic consumption, incidence density of Candida and multidrug-resistant (MDR) bacteria bloodstream infections (BSIs) and their crude death rate per 1000 occupied bed days (OBDs). RESULTS: A quick and intense reduction in antibiotic consumption occurred 6 months after the implementation of the intervention (change in level, -216.8 defined daily doses per 1000 OBDs; 95% confidence interval, -347.5 to -86.1), and was sustained during subsequent years (average reduction, -19,9%). In addition, the increasing trend observed in the preintervention period for the incidence density of candidemia and MDR BSI (+0.018 cases per 1000 OBDs per quarter; 95% confidence interval, -.003 to .039) reverted toward a decreasing trend of -0.130 per quarter (change in slope, -0.029; -.051 to -.008), and so did the mortality rate (change in slope, -0.015; -.021 to -.008). CONCLUSIONS: This education-based antimicrobial stewardship program was effective in decreasing the incidence and mortality rate of hospital-acquired candidemia and MDR BSI through sustained reduction in antibiotic use.

[Torrance Tests of Creative Thinking (TTCT): elements for construct validity in Portuguese adolescents]. / Tests de pensamiento creativo de Torrance (TTCT): elementos para la validez de constructo en adolescentes portugueses.

The aim of this work is to study the unidimensional and multidimensional nature of creativity when assessed through divergent thinking tasks, as proposed in Torrance's battery (Torrance Creative Thinking Test, TTCT). This battery is made up of various tasks with verbal and figurative content, aimed at estimating the level of creativity according to the dimensions or cognitive functions of fluency, flexibility, originality and elaboration of the individuals' ideas. This work used a sample of 595 Portuguese students from 5th and 6th grade. The results of confirmatory factor analysis reveals that the unidimensional model (a general factor of creativity) and the model of factors as a function of the cognitive dimensions of creativity, based on task content, do not fit well. The model with the best fit has a hierarchical factor structure, in which the first level comprises the factors for each of the subtests applied and the second level includes verbal or figurative content. The difficulty to verify the structural validity of the TTCT is noted, and the need for further studies to achieve, in practice, better individual creativity scores.

Influence of Emotional Intelligence, Motivation and Resilience on Academic Performance and the Adoption of Healthy Lifestyle Habits among Adolescents.

Included among the basic objectives of Physical Education (PE) classes is the consolidation of habits of a healthy lifestyle among adolescents. However, the main studies in this field have focused on cognitive aspects related to students during these classes, yet they ignore the role that emotions can play in the adoption of future habits. OBJECTIVES: To analyze how emotions (emotional intelligence and emotional state) can influence the resilience and motivation of adolescents, as well as academic performance and adoption of healthy lifestyle habits. METHODOLOGY: 615 secondary school students between the ages of 14 and 19 participated (M = 16.02; SD = 1.57) in the study. A structural equations model was developed using the main variables and by applying some of the principles of Self-Determination Theory. The results show that emotional intelligence is positively related to positive emotions and negatively related to negative emotions. Positive emotions positively predict both self-motivation towards physical education classes and resilience. Resilience positively predicts self-motivation. Finally, self-motivation acts as a predictor of both academic performance and regular participation in physical activity. CONCLUSIONS: This study successfully shows the importance of focusing on emotions in PE classes inasmuch as emotion increases the tendency to get good grades and maintain active lifestyle habits. In this sense, focusing on the emotions of students in PE could prove quite beneficial.

[Internal structure and standardised scores of the Torrance Test of Creative Thinking]. / Estructura interna y baremación del Test de Pensamiento Creativo de Torrance.

The present work sets out to study the internal structure of the Torrance Test of Creative Thinking (TTCT) and to establish standardised scores that will enable the test to be used in both a diagnostic and educational context. 649 students (319 girls and 330 boys), aged 5 to 12 years from various schools in Murcia and Alicante (SE Spain), took part in the study. The findings suggest that the psychometric characteristics of TTCT are satisfactory, and its internal structure can be attributed to three factors that are responsible for a high percentage of the variance (73.8%). The standardised score tables, which are provided for first time in this context, will be useful in the evaluation of creativity and the identification of students with high intellectual abilities.

Structural invariance of multiple intelligences, based on the level of execution.

The independence of multiple intelligences (MI) of Gardner's theory has been debated since its conception. This article examines whether the one- factor structure of the MI theory tested in previous studies is invariant for low and high ability students. Two hundred ninety-four children (aged 5 to 7) participated in this study. A set of Gardner's Multiple Intelligence assessment tasks based on the Spectrum Project was used. To analyze the invariance of a general dimension of intelligence, the different models of behaviours were studied in samples of participants with different performance on the Spectrum Project tasks with Multi-Group Confirmatory Factor Analysis (MGCFA). Results suggest an absence of structural invariance in Gardner's tasks. Exploratory analyses suggest a three-factor structure for individuals with higher performance levels and a two-factor structure for individuals with lower performance levels.