International adaptation of Meaning-Centered Psychotherapy for Latinos: Providers' views on pre-implementation.

Background: This qualitative study aims to identify facilitators of and barriers to the implementation of Meaning-Centered Psychotherapy (MCP) by providers of mental health services to Latinos in the US and Latin America using the practical, robust implementation and sustainability model (PRISM). This information will be used to increase usability and acceptability of MCP for Latino patients with cancer and their providers in Latin America and the US. Methods: A total of 14 Latino cancer patient mental health providers completed in-depth semi-structured interviews. Participants were recruited from 9 countries and 12 different sites. They provided feedback about barriers to and facilitators of implementation of MCP at the patient, provider, and clinic levels in their clinical setting. The qualitative data from the interviews was coded according to PRISM domains. Three analysts independently coded the transcripts; discrepancies between analysts were resolved through discussion and consensus. Results: Based on PRISM, themes were: clinic environment (protected time for training and supervision), intervention characteristics (adapt the intervention using more simple language, include more visual aids, include more family-oriented content), patient (develop materials for the identification and screening of patients, provide educational materials, increase motivation and knowledge about psychotherapy, assess commitment to psychotherapy, adapt for the inpatient vs. outpatient setting), provider (receive interactive/participatory training, educational materials, ongoing supervision, have flexibility of delivering the intervention in a less structured manner, theoretical framework of the provider) and external environment (work at policy level to integrate services for oncology patients). Conclusion: These qualitative data revealed potential facilitators and barriers of this intervention (MCP) on an international scale. Identified cultural, contextual, and healthcare systems factors illustrated the importance of examining pre-implementation needs prior to implementing a trial. We will design and plan a future RCT using the PRISM framework and these pre-implementation data. Plain Language Summary: This study integrates frameworks of implementation science and cultural adaptation through the examination of pre-implementation contextual issues at the preparation phase of a cultural adaptation of a psychotherapeutic intervention, Meaning-Centered Psychotherapy (MCP), for Latinos with advanced cancer. By examining implementation needs early in the implementation process, during preparation, the intervention can be adapted in a way that attends to and addresses the providers' most cited challenges in implementation: having a rigid protocol/structure, complexity of the intervention, disease burden preventing adherence to the intervention, transportation, and competing demands, and limited clinic space to offer the intervention.

Usefulness of ultrasound in sub-Saharan patients with a serological diagnosis of schistosomiasis.

OBJECTIVE: To evaluate the usefulness of ultrasound examination in patients with just a serological diagnosis of schistosomiasis but no other evidence of active infection. METHODS: 346 sub-Saharan patients with possible schistosomiasis that presented at a Tropical Medicine Unit between 2008 and 2019 were retrospectively selected. Possible schistosomiasis was considered in those patients with a positive serology for schistosomasis in the absence of direct microbiological isolates, hematuria and/or eosinophilia. Data from ultrasound examinations before and after treatment with praziquantel were collected and categorized following the World Health Organization-Niamey score to standardize the use of ultrasonography for the assessment of schistosomiasis-related morbidity. RESULTS: Ultrasound examinations were abnormal in only ten patients (2.89%). Main findings were focal thickening of the bladder wall (n = 6), ureteral dilatation (n = 3) and grade I hydronephrosis (n = 1). No malignant lesions, hepatic lesions nor hepatobiliary related disorders were found. After treatment, the S. haematobium global score (5 vs 3.4, p = 0.06) and the urinary bladder score (2 vs 1, p = 0.059) showed a trend towards improvement after treatment. In three patients the score after treatment dropped to 0, and in another three it remained the same although with signs of improvement. No worsening of the score was observed in any case. CONCLUSION: For those patients with a diagnosis of schistosomiasis based solely in a positive serology, the ultrasound examination could safely be spared due to the low prevalence of pathological findings and its response to treatment anyway.

Predictors of health service use by family caregivers of persons with multimorbidity.

BACKGROUND: Informal caregivers of patients with multiple chronic conditions are socially good, promoting the sustainability of a large part of home care provision. However, this very demanding activity causes health problems that increase their own need for health services. This study analyses the use of health services by informal carers, comparing it with the use made by the general population with similar characteristics. METHODOLOGY: Cross-sectional analytical study carried out in the Malaga-Valle Guadalhorce Primary Health Care District (Spain). Healthcare demand and perceived health were measured in the family caregivers, compared to the general population. Strobe Statement for observational studies has been used to strength the report of the results. RESULTS: Final sample consisted of 314 family caregivers together with a subsample of 2.290 non-caregivers taken from data of the National Health Survey. This subsample was paired by gender with our sample. Formal caregivers make fewer annual visits to the health services, with respect to the general population, regardless of the perceived level of health. The difference of the means between those who perceive their health as very poor was 0.11 (95% CI: 0.01 to 0.20) consultations with the family doctor, 0.21 (95% CI: 0.15 to 0.26) consultations with medical specialists and 1.70 (95% CI: 1.52 to 1.87) emergency room attention. Three independent factors were identified that predispose to the increased use of health services: background of greater education achievement (OR 8.13, 95% CI: 1.30 to 50.68), non-cohabitation with the care recipient (OR 3.57, 95% CI: 1.16 to 11.11) and a more positive physical quality of life component (OR 1.06; 95% CI: 1.03 to 1.09). DISCUSSION AND IMPLICATIONS: Intrinsic components of the caregiver reveal their independent relationship with the provision of informal care and the use of health services. A broader vision is needed for the factors that influence the health of these caregivers to develop multipurpose interventions and improve the consistency and effectiveness of the health services offered to the caregiver.

Single-Nucleotide Polymorphism 309T>G in the MDM2 Promoter Determines Functional Outcome After Stroke.

Background and Purpose- The E3 ubiquitin ligase MDM2 (murine double minute 2) is the main negative regulator of the p53 protein-a key player in neuronal apoptosis after ischemia. A functional single-nucleotide polymorphism in the human MDM2 gene promoter (rs2279744) regulates MDM2 protein expression. We investigated whether the MDM2 SNP309, by controlling p53-mediated apoptosis, determines functional outcome after stroke. Methods- Primary cortical neurons were subjected to oxygen and glucose deprivation. Mice were subjected to ischemic (transient middle cerebral artery occlusion) or hemorrhagic (collagenase injection) stroke models. Protein and mRNA levels of MDM2 and p53 were measured in both neuronal and brain extracts. The interaction of MDM2 with p53 was disrupted by neuronal treatment with nutlin-3a. siRNA was used to knockdown MDM2 expression. We analyzed the link between the MDM2 SNP309 and functional outcome, measured by the modified Rankin Scale scores, in 2 independent hospital-based stroke cohorts: ischemic stroke cohort (408 patients) and intracerebral hemorrhage cohort (128 patients). Results- Experimental stroke and oxygen and glucose deprivation induced the expression of MDM2 in the brain and neurons, respectively. Moreover, oxygen and glucose deprivation promoted MDM2 binding with p53 in neurons. Disruption of the MDM2-p53 interaction with nutlin-3a, or MDM2 knockdown by siRNA, triggered p53 accumulation, which increased neuronal susceptibility to oxygen and glucose deprivation-induced apoptosis. Finally, we showed that patients harboring the G allele in the MDM2 promoter had higher MDM2 protein levels and showed better functional outcome after stroke than those harboring the T/T genotype. The T/T genotype was also associated with large infarct volume in ischemic stroke and increased lesion volume in patients with intracerebral hemorrhage. Conclusions- Our results reveal a novel role for the MDM2-p53 interaction in neuronal apoptosis after ischemia and show that the MDM2 SNP309 determines the functional outcome of patients after stroke.

Characteristics, consequences and prevention of falls in institutionalised older adults in the province of Malaga (Spain): a prospective, cohort, multicentre study.

OBJECTIVES: Falls are an important adverse event among institutionalised persons. It is in this clinical setting where falls occur more frequently than in any other, despite the measures commonly taken to prevent them. This study aimed to determine the characteristics of a typical institutionalised elderly patient who suffers a fall and to describe the physical harms resulting from this event. We then examined the association between falls and the preventive measures used. METHODS: This was a prospective cohort study in 37 nursing homes in Spain. The participants were all the nursing home residents institutionalised in these centres from May 2014 to July 2016. Participants were followed up for 9 months. During this period, two observations were made to evaluate the preventive measures taken and to record the occurrence of falls. RESULTS: 896 residents were recruited, of whom 647 completed the study. During this period, 411 falls took place, affecting 213 residents. The injuries caused by the falls were mostly minor or moderate. They took place more frequently among women and provoked 22 fractures (5.35%). The most commonly used fall prevention measure was bed rails (53.53% of cases), followed by physical restraint (16.79%). The latter measure was associated with a higher incidence of injuries not requiring stitches (OR=2.06, 95% CI 1.01 to 4.22, P=0.054) and of injuries that did require stitches (OR=3.51, 95% CI 1.36 to 9.01, P=0.014) as a consequence of falls. Bed rails protected against night-time falls. CONCLUSIONS: Falls are a very common adverse event in nursing homes. The prevention of falls is most commonly addressed by methods to restrain movement. The use of physical restraints is associated with a greater occurrence of injuries caused by a fall.

Double or nothing: red flag symptoms of critical carotid stenosis, a case report.

BACKGROUND: Detailed knowledge of every possible manifestation of Internal Carotid Artery (ICA) disease is important. For improving detection and a timely adoption of secondary prevention procedures or treatments. Transient oculomotor nerve palsies have been described associated with stenosis or occlusion of the ICA. CASE PRESENTATION: We described a patient that develop a sequential combination of transient monocular loss of vision followed by binocular diplopia secondary to an unstable atherosclerotic preocclusive stenosis of an internal carotid artery previously treated with radiotherapy. CONCLUSIONS: The peculiar sequence of transient monocular vision that give rise later into a transient binocular diplopia (double or nothing) should be kept in mind as a possible manifestation of critical stenosis of ICA.

Diagnostic validity of the STRATIFY and Downton instruments for evaluating the risk of falls by hospitalised acute-care patients: a multicentre longitudinal study.

BACKGROUND: Falls are major adverse events in hospitals. The appropriateness of using risk assessment instruments for falls in hospitals has recently been questioned, although the research performed in this respect presents some methodological shortcomings. The purpose of the present study is to evaluate the accuracy of the Downton and STRATIFY instruments to determine the risk of falls and to predict their incidence in acute care hospitals in the public health system in Andalusia (Spain). METHODS: A longitudinal, multicentre prospective study was made of a cohort of patients recruited between May 2014 and March 2016. The risk of falls was assessed using each of the above instruments during the first 24 h after hospital admittance, with later re-evaluations every 72 h until discharge. Descriptive statistics were obtained, bivariate and multivariate analysis were performed. The diagnostic validity of the process was assessed by calculations of sensitivity, specificity, positive and negative predictive values and ratios of positive and negative likelihood. ROC curve analysis was performed for both instruments. RESULTS: For this study, 1247 patients were recruited, of whom 977 completed all the follow-up assessments. Twenty-three of these patients (2.35%) suffered 24 falls. ROC curve analysis showed that the optimal cut-off point for each assessment instrument was below that described by the authors: AUC STRATIFY = 0.69 (95% CI: 0.57-0.8); AUC Downton = 0.6 (95% CI: 0.48-0.72). With a cut-off point of 1, the sensitivity of STRATIFY was 47.6% and its specificity, 85%. With a cut-off point of 2, Downton presented a sensitivity of 66.7% and a specificity of 55.3%. CONCLUSIONS: The Downton and STRATIFY falls risk assessment instruments presented little utility as means of detecting the risk of falls among a sample of adult patients admitted to acute care hospitals. Fall prevention in hospitals should be based on the study of individual risk factors.

Neovascularization and functional recovery after intracerebral hemorrhage is conditioned by the Tp53 Arg72Pro single-nucleotide polymorphism.

Intracerebral hemorrhage (ICH) is a devastating subtype of stroke that lacks effective therapy and reliable prognosis. Neovascularization following ICH is an essential compensatory response that mediates brain repair and modulates the clinical outcome of stroke patients. However, the mechanism that dictates this process is unknown. Bone marrow-derived endothelial progenitor cells (EPCs) promote endothelial repair and contribute to ischemia-induced neovascularization. The human Tp53 gene harbors a common single-nucleotide polymorphism (SNP) at codon 72, which yields an arginine-to-proline amino-acidic substitution (Arg72Pro) that modulates the apoptotic activity of the p53 protein. Previously, we found that this SNP controls neuronal susceptibility to ischemia-induced apoptosis in vitro. Here, we evaluated the impact of the Tp53 Arg72Pro SNP on vascular repair and functional recovery after ICH. We first analyzed EPC mobilization and functional outcome based on the modified Rankin scale scores in a hospital-based cohort of 78 patients with non-traumatic ICH. Patients harboring the Pro allele of the Tp53 Arg72Pro SNP showed higher levels of circulating EPC-containing CD34+ cells, EPC-mobilizing cytokines - vascular endothelial growth factor and stromal cell-derived factor-1α - and good functional outcome following ICH, when compared with the homozygous Arg allele patients, which is compatible with increased neovascularization. To assess directly whether Tp53 Arg72Pro SNP regulated neovascularization after ICH, we used the humanized Tp53 Arg72Pro knock-in mice, which were subjected to the collagenase-induced ICH. The brain endothelial cells of the Pro allele-carrying mice were highly resistant to ICH-mediated apoptosis, which facilitated cytokine-mediated EPC mobilization, cerebrovascular repair and functional recovery. However, these processes were not observed in the Arg allele-carrying mice. These results reveal that the Tp53 Arg72Pro SNP determines neovascularization, brain repair and neurological recovery after ICH. This study is the first in which the Pro allele of Tp53 is linked to vascular repair and ability to functionally recover from stroke.

Adaptación para futbolistas (CPRD-F) del cuestionario "características psicológicas relacionadas con el rendimiento deportivo" (CPRD) / Adaptation for footballer (CPRD-F) of "psychological characteristics related to the sport performance" questionnaire (CPRD) / Analises dos processos grupais em função do gênero em um contexto esportivo semiprofissional

El objetivo de este estudio es el de validar y adaptar al fútbol el cuestionario Características Psicológicas relacionadas con el Rendimiento Deportivo (CPRD), ampliamente utilizado en numerosos estudios previos. Para el cálculo de la validez de constructo se utilizó el análisis factorial de componentes principales con rotación varimax, estableciendo valores de .30 como mínimo criterio de saturación. Se calcularon los estimadores de adecuación muestral de Kaiser-Meyer-Olkin (KMO= .951) y de significación estadística de Bartlett (p=.001). La fiabilidad del cuestionario se comprobó mediante el análisis de la consistencia interna, para lo que se utilizó el coeficiente Alfa de Cronbach. El resultado es el CPRD-f, un instrumento que reduce a 40 el cuestionario original de 55 ítems, que mantiene cinco subescalas, aunque la denominación cambia, eliminándose alguna y apareciendo otras nuevas. Los resultados muestran una alta fiabilidad del instrumento (.85) (AU)

The aim of this study is to validate and adapt to soccer population the Psychological Characteristics related to the Sport Performance (CPRD) questionnaire, widely used in numerous previous works. In order to get a construct validation, a Principal Component Analysis (Varimax rotation) with a .30 as minimum value of saturation index, was made. The sample estimation was calculated by means of the Kaiser-Meyer-Olkin index (KMO= .951) and the Barlet´s statistic significance test. To measure the internal consistency or reliability, Cronbach´s alpha coefficient was used. The result is CPRD-f, an instrument that reduce to 40 the original 55 item questionnaire, which conserves 5 subscales, although changing the names, hiding some of them and appearing other news. The results show a high reliability of the whole questionnaire (.85) (AU)

O objetivo de este estudo é de validar e adaptar ao futebol o questionário de Características Psicológicas relacionadas com o Rendimento Esportivo (CPRD), amplamente utilizado em vários estudos prévios. Para o calculo da validez do construto, foi utilizado a analises fatorial de componentes principais com rotação varimax, estabelecendo valores de .30 como mínimo critério de saturação. Foram calculados os estimadores de adequação de mostra de Kaiser-Meyer-Olkin (KMO= .951) e de significação estatística de Bartlett (p=.001). A fiabilidade do questionário foi comprovada mediante analises da consistência interna, para isso foi utilizado o coeficiente Alfa de Cronbach. O resultado CPRD-f, um instrumento que reduz a 40 o questionário original de 55 itens, que mantém cinco subescalas, mesmo que altera a denominação, eliminando alguma e surgindo outras. Os resultados mostram uma alta fiabilidade do instrumento (.85) (AU)

Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis.

BACKGROUND: Falls are a serious problem for hospitalized patients, reducing the duration and quality of life. It is estimated that over 84% of all adverse events in hospitalized patients are related to falls. Some fall risk assessment tools have been developed and tested in environments other than those for which they were developed with serious validity discrepancies. The aim of this review is to determine the accuracy of instruments for detecting fall risk and predicting falls in acute hospitalized patients. METHODS: Systematic review and meta-analysis. Main databases, related websites and grey literature were searched. Two blinded reviewers evaluated title and abstracts of the selected articles and, if they met inclusion criteria, methodological quality was assessed in a new blinded process. Meta-analyses of diagnostic ORs (DOR) and likelihood (LH) coefficients were performed with the random effects method. Forest plots were calculated for sensitivity and specificity, DOR and LH. Additionally, summary ROC (SROC) curves were calculated for every analysis. RESULTS: Fourteen studies were selected for the review. The meta-analysis was performed with the Morse (MFS), STRATIFY and Hendrich II Fall Risk Model scales. The STRATIFY tool provided greater diagnostic validity, with a DOR value of 7.64 (4.86 - 12.00). A meta-regression was performed to assess the effect of average patient age over 65 years and the performance or otherwise of risk reassessments during the patient's stay. The reassessment showed a significant reduction in the DOR on the MFS (rDOR 0.75, 95% CI: 0.64 - 0.89, p = 0.017). CONCLUSIONS: The STRATIFY scale was found to be the best tool for assessing the risk of falls by hospitalized acutely-ill adults. However, the behaviour of these instruments varies considerably depending on the population and the environment, and so their operation should be tested prior to implementation. Further studies are needed to investigate the effect of the reassessment of these instruments with respect to hospitalized adult patients, and to consider the real compliance by healthcare personnel with procedures related to patient safety, and in particular concerning the prevention of falls.

Entrepreneurship: introduction / Emprendimiento: introducción

Many investigators from diverse perspectives focus their studies on the area of entrepreneurship due to its important role as an engine of economic and social development. The aim of this monograph is to provide an overview of the state of entrepreneurship research. It presents the controversy about the domain of the study and whether entrepreneurship can be considered a legitimate field of knowledge. We study the aspects that differentiate people who are entrepreneurs from those who are not from the perspective of cognitive psychology and we discuss the role of entrepreneurial education. The work is also an attempt to understand the factors that determine the durability of a company such as resources, location, personality traits, strategies, organizational systems, etc. Lastly, we examine the reality of entrepreneurship research in Spain (AU)

Emprendimiento: introducción. El área del emprendimiento está siendo el centro de estudio de diversos investigadores provenientes de diferentes perspectivas debido a su importante papel como motor de desarrollo económico y social. El objetivo de este monográfico es ofrecer una visión global del estado de la investigación sobre emprendimiento. Se plantea la controversia existente sobre el dominio de estudio del emprendimiento y sobre si puede considerarse un campo de conocimiento legítimo. Se pretenden comprender aquellos aspectos que marcan la diferencia entre personas que son emprendedoras y aquellas que no lo son desde la perspectiva de la psicología cognitiva y se analiza el papel de la educación en el contexto del emprendimiento. También se busca conocer los factores que determinan la durabilidad de una empresa, como los recursos, localización, rasgos de personalidad, estrategias, sistemas organizacionales, etc. Finalmente, se analiza la realidad de la investigación emprendedora en España (AU)

Entrepreneurship as a legitimate field of knowledge / El emprendimiento como un campo legítimo del conocimiento

Entrepreneurship as a research topic has been approached from disciplines such as economics, sociology or psychology. After justifying its study, we define the domain of the fi eld, highlighting what has currently become its dominant paradigm, the process of the discovery, assessment and exploitation of opportunities. We then describe the main perspectives and offer an integrated conceptual framework that will allow us to legitimize the study of entrepreneurship as a field of knowledge in its own right. We believe that this framework will help researchers to better recognize the relations among the many factors forming part of the study of entrepreneurship. Lastly, we conclude with some brief reflections on the potential value of the framework presented (AU)

La investigación del emprendimiento se ha abordado desde disciplinas como la economía, la sociología o la psicología. Después de justificar su estudio, definimos el dominio del emprendimiento haciendo hincapié en lo que hoy se ha convertido en el paradigma dominante, el proceso de descubrimiento, evaluación y explotación de oportunidades. A continuación, describiremos las principales perspectivas con el objetivo de ofrecer un marco conceptual integrado que nos permitirá legitimar el estudio de la iniciativa empresarial como un campo de conocimiento en su propio derecho. Creemos que este marco ayudará a los investigadores a reconocer mejor las relaciones entre los muchos factores que forman parte del estudio de la iniciativa empresarial. Por último, se concluye con unas breves reflexiones sobre el valor potencial del marco que se presenta (AU)

The entrepreneur from a cognitive approach / El emprendedor desde una orientación cognitiva

The cognitive approach to entrepreneurship is a response to the limitations of the trait approach. Its aim is to explain entrepreneurial behavior through cognitions. The main body of research has studied cognitive elements such as scripts, self-efficacy, cognitive styles and heuristics. Understanding entrepreneurial cognition represents a potential and productive fi eld of research that, to date, has received little attention. In this article, we review and highlight the most important contributions of Cognitive Psychology to the fi eld of entrepreneurship; we point out some of the limitations and suggest new avenues of enquiry (AU)

El enfoque cognitivo del estudio del emprendedor surge como respuesta a las limitaciones de la orientación de los rasgos. Su objetivo es explicar la conducta emprendedora a través de las cogniciones. Entender el pensamiento emprendedor representa un campo de estudio fértil aún no muy explotado. Las principales investigaciones destacan el papel de los scripts, la autoeficacia, los estilos de pensamiento y los heurísticos en la acción de crear una empresa. En este artículo se revisan y se señalan las contribuciones más relevantes de la Psicología cognitiva al campo del emprendimiento, se señalan algunas de las limitaciones y se apuntan nuevas líneas de investigación (AU)

Entrepreneurship research in Spain: developments and distinctiveness / La investigación del emprendimiento en España: desarrollos y características propias

This article presents a review of research on entrepreneurship in Spain, paying particular attention to its beginnings, nature and main focus of interest. We have developed a database based on the review of 471 works produced between 1977 and 2009, including articles published in national and international journals and dissertations (read in Spain) that allowed us to extract the following results. There is a preference for qualitative methods, conceptual contributions and the entrepreneurial process as the privileged research theme. There is also a strong focus of interest on micro and small enterprises. These characteristics of Spanish research in areas of entrepreneurship can make a distinctive contribution to international research. However, the dissemination of knowledge and inadequate strategies for international publication limit the diffusion of Spanish research in entrepreneurship. Lastly, we discuss the implications for future research (AU)

Este artículo presenta una revisión de la investigación realizada en España sobre emprendimiento, prestando especial atención a sus comienzos, naturaleza y principales focos de interés. La revisión de 471 trabajos producidos entre 1977 y 2009, entre artículos publicados en revistas nacionales e internacionales y tesis doctorales, leídas en España, nos aporta una base de datos que nos ha permitido extraer los siguientes resultados. Existe una preferencia por métodos cualitativos, por contribuciones conceptuales y por el proceso emprendedor como tema de investigación principal. Existe también un fuerte interés por estudiar las micro y pequeñas empresas. Estas características de la investigación española en temas de emprendimiento pueden hacer una contribución distintiva a la investigación internacional. No obstante, la diseminación del conocimiento y las insuficientes estrategias orientadas a la publicación internacional limitan la difusión de la investigación española en emprendimiento. Se discuten las implicaciones para futuras investigaciones (AU)

Entrepreneurship: introduction.

Many investigators from diverse perspectives focus their studies on the area of entrepreneurship due to its important role as an engine of economic and social development. The aim of this monograph is to provide an overview of the state of entrepreneurship research. It presents the controversy about the domain of the study and whether entrepreneurship can be considered a legitimate field of knowledge. We study the aspects that differentiate people who are entrepreneurs from those who are not from the perspective of cognitive psychology and we discuss the role of entrepreneurial education. The work is also an attempt to understand the factors that determine the durability of a company such as resources, location, personality traits, strategies, organizational systems, etc. Lastly, we examine the reality of entrepreneurship research in Spain.

The entrepreneur from a cognitive approach.

The cognitive approach to entrepreneurship is a response to the limitations of the trait approach. Its aim is to explain entrepreneurial behavior through cognitions. The main body of research has studied cognitive elements such as scripts, self-efficacy, cognitive styles and heuristics. Understanding entrepreneurial cognition represents a potential and productive field of research that, to date, has received little attention. In this article, we review and highlight the most important contributions of Cognitive Psychology to the field of entrepreneurship; we point out some of the limitations and suggest new avenues of enquiry.

Entrepreneurship as a legitimate field of knowledge.

Entrepreneurship as a research topic has been approached from disciplines such as economics, sociology or psychology. After justifying its study, we define the domain of the field, highlighting what has currently become its dominant paradigm, the process of the discovery, assessment and exploitation of opportunities. We then describe the main perspectives and offer an integrated conceptual framework that will allow us to legitimize the study of entrepreneurship as a field of knowledge in its own right. We believe that this framework will help researchers to better recognize the relations among the many factors forming part of the study of entrepreneurship. Lastly, we conclude with some brief reflections on the potential value of the framework presented.

Entrepreneurship research in Spain: developments and distinctiveness.

This article presents a review of research on entrepreneurship in Spain, paying particular attention to its beginnings, nature and main focus of interest. We have developed a database based on the review of 471 works produced between 1977 and 2009, including articles published in national and international journals and dissertations (read in Spain) that allowed us to extract the following results. There is a preference for qualitative methods, conceptual contributions and the entrepreneurial process as the privileged research theme. There is also a strong focus of interest on micro and small enterprises. These characteristics of Spanish research in areas of entrepreneurship can make a distinctive contribution to international research. However, the dissemination of knowledge and inadequate strategies for international publication limit the diffusion of Spanish research in entrepreneurship. Lastly, we discuss the implications for future research.

The human Tp53 Arg72Pro polymorphism explains different functional prognosis in stroke.

The functional outcome after stroke is unpredictable; it is not accurately predicted by clinical pictures upon hospital admission. The presence of apoptotic neurons in the ischemic penumbra and perihematoma area may account for poor prognosis, but whether the highly variable stroke outcome reflects differences in genetic susceptibility to apoptosis is elusive. The p53 tumor suppressor protein, an important transcriptional regulator of apoptosis, naturally occurs in humans in two variants with single nucleotide polymorphisms resulting in Arg or Pro at residue 72. We show that poor functional outcome after either ischemic or hemorrhagic stroke was linked to the Arg/Arg genotype. This genotype was also associated with early neurological deterioration in ischemic stroke and with increased residual cavity volume in intracerebral hemorrhage. In primary cultured neurons, Arg(72)-p53, but not Pro(72)-p53, interacted directly with mitochondrial Bcl-xL and activated the intrinsic apoptotic pathway, increasing vulnerability to ischemia-induced apoptotic cell death. These results suggest that the Tp53 Arg/Arg genotype governs neuronal vulnerability to apoptosis and can be considered as a genetic marker predicting poor functional outcome after stroke.