Elsa Peña-Suárez

Contingency management is effective across cocaine-dependent outpatients with different socioeconomic status

Contingency management (CM) has demonstrated its efficacy for treating cocaine dependence, but there is still some controversy with regard to its dissemination. Understanding how individual differences affect CM outcomes is important for detecting barriers to its dissemination. The aim of this study is to examine the impact of socioeconomic variables in cocaine-dependent outpatients on the effectiveness of CM in a community setting. Cocaine-dependent outpatients (N=118) were randomized to community reinforcement approach (CRA) treatment or a CRA plus vouchers program. The impact of baseline economic variables, alone and in combination with treatment conditions, on abstinence and retention outcomes after 6 months of treatment was assessed. Results showed that income had no effect on retention or abstinence outcomes after 6 months of treatment in either treatment condition. The addition of a CM component was beneficial for individuals with any socioeconomic status. These results support the generalizability of CM strategies with patients of different socioeconomic status in community settings.

Contingency management improves outcomes in cocaine-dependent outpatients with depressive symptoms.

Despite depressive symptoms being very common among patients seeking treatment for cocaine dependence, few studies have examined the effects of depressive symptoms on cocaine outpatient treatment outcomes, and there is even less research in the context of Contingency Management (CM). The purpose of this study was to assess the main and interactive effects of co-occurring depressive symptoms on CM outcomes. Cocaine-dependent individuals (N = 108) were randomized to Community Reinforcement Approach (CRA) or CRA plus CM in two outpatient community clinical settings. Participants were categorized according to depression symptoms, self-reported by means of the BDI at treatment entry. Outcome measures included treatment retention and documented cocaine abstinence over a 6-month treatment period. Depressive symptoms were more commonly found in females and in unemployed participants, and were associated with more drug-related, social, and psychiatric problems at treatment entry. Individuals with baseline depressive symptoms had poorer treatment outcomes than patients without depressive symptoms. The addition of CM to CRA made the program more effective than with CRA alone, regardless of depressive symptoms. CM was associated with better abstinence treatment outcomes, while the interaction between unemployment and depressive symptoms was associated with negative retention treatment outcomes. This study supports the efficacy of CM for cocaine-dependent outpatients with and without depressive symptoms, and highlights its importance for improving treatment for unemployed and depressed cocaine-dependent individuals.

Skipping breakfast, sedentarism and overweight in children

Abstract To show by use of path analysis how in children of 9 and 10 years of age the known relationship between breakfast and high body mass index (BMI) is mediated by sedentary leisure time activities. A random sample of 291 9-year-old and 10-year-old school children from the Principality of Asturias (Spain) was taken. A transversal design was used, their weight and height were measured and an individual standardized interview was carried out in which they were asked about their breakfast habits and the time they spent each week on sedentary leisure activities. Using path analysis, a model was tested in which breakfast habits and leisure time were the independent variables and the BMI was the dependent variable. The results showed that there was an inverse correlation between number of breakfasts and BMI and a direct correlation between the time spent on sedentary leisure activities and BMI. Path analysis showed that the relationship between the frequency with which breakfast was eaten and BMI was mediated by the time spent on sedentary leisure activities. The above appears to confirm the direct role played by failing to have breakfast in the pandemic of obesity as this habit tends to increase children’s BMI. This relationship is, however, mediated by sedentary leisure. According to the data compiled, being overweight in children can only be prevented by modifying not just one of the habits that have been associated with it, but rather the whole group of habits as these appear to make up an obesogenic cluster in which sedentary leisure and not having breakfast are included.

Relationships between sleeping habits, sedentary leisure activities and childhood overweight and obesity

The aim of this study is to show how sedentary leisure activities and a decrease in hours of sleep interact to lead to an increase in the body mass index (BMI) in children. A random sample of 291 nine-year-old and ten-year-old schoolchildren from Asturias (Spain) was taken. A cross-sectional design was used, the children’s weight and height were measured and an individual interview was carried out. Using path analysis, a model was tested in which bedtime, the number of hours spent sleeping and sedentary leisure activities were the independent variables and the BMI was the dependent variable. The results show that sedentary leisure activities and hours spent sleeping are predictors of a greater BMI in children. Moreover, the effect of the time spent sleeping is mediated by sedentary leisure activities. That is to say, it is those children who go to bed late and who use that extra time to watch the television or play with the computer that tend to have a greater BMI. Attention should be drawn to the importance of this fact and to the implications it may have for education and children’s health.

Organizational climate in Spanish Public Health Services: Administration and Services Staff

The main goal of this research is to explore the organizational climate perceived by administrative and healthcare personnel working in Spanish healthcare services, analyzing the differences according to their health specialization, sex, age and professional status. The sample was made up of 3,787 individuals working in the administrative and healthcare services of the Public Health System of the Principality of Asturias, 88.7% were working in specialist care and 11.3% in primary care. Mean age was 51.88 (standard deviation of 6.28); 79.9% were women and 20.1% men. The organizational climate was assessed with the CLIOR scale. The organizational climate perceived is moderately positive, with a global mean of 3.03 on a scale of 1 to 5 points. The differences are statistically significant (p < .01) according to specialty, age and profession. A better working climate is perceived in primary care than in specialist care, and among older as compared to younger workers. The results indicate that the working climate perceived by administration and services staff employees in the Spanish healthcare context is moderately positive, with a better perceived climate in primary care than in specialist care.

Test Reviewing in Spain.

The proper use of psychological tests requires that the measurement instruments have adequate psychometric properties, such as reliability and validity, and that the professionals who use the instruments have the necessary expertise. In this article, we present the first review of tests published in Spain, carried out with an assessment model developed by the European Test Commission and adapted to the Spanish context. The model permits both qualitative and quantitative assessment of the test. Ten tests were reviewed, selected from among those most widely used by Spanish professionals. Each test was sent to two peer reviewers for its assessment and, based on this assessment, a final report was drawn up. In general, it can be said that the quality of the ten measurement instruments is good, the reports highlighting their strong and weak points. In light of the reviews, some improvements are suggested for future editions of the tests, emphasizing the need to include in the Manuals as much evidence as possible on the validity of the tests. Finally, we discuss the details of the review process and analyze possible future directions for test assessment in Spain.