Prevalence of halitosis in young male adults: a study in swiss army recruits comparing self-reported and clinical data

BACKGROUND: Sound epidemiologic data on halitosis are rare. We evaluated the prevalence of halitosis in a young male adult population in Switzerland using a standardized questionnaire and clinical examination. METHODS: Six hundred twenty-six Swiss Army recruits aged 18 to 25 years (mean: 20.3 years) were selected as study subjects. First, a standardized questionnaire focusing on dental hygiene, self-reported halitosis, smoking, and alcohol consumption was filled out by all participants. In the clinical examination, objective values for the presence of halitosis were gathered through an organoleptic assessment of the breath odor and the measurement of volatile sulfur compounds (VSCs). Additionally, tongue coating, plaque index, and probing depths were evaluated for each recruit. RESULTS: The questionnaire revealed that only 17% of all included recruits had never experienced halitosis. The organoleptic evaluation (grades 0 to 3) identified eight persons with grade 3, 148 persons with grade 2, and 424 persons with grade 1 or 0. The calculation of the Pearson correlation coefficient to evaluate the relationship among the three methods of assessing halitosis revealed little to no correlation. The organoleptic score showed high reproducibility (kappa = 0.79). Tongue coating was the only influencing factor found to contribute to higher organoleptic scores and higher VSC values. CONCLUSIONS: Oral malodor seemed to pose an oral health problem for about one-fifth of 20-year-old Swiss males questioned. No correlation between self-reported halitosis and organoleptic or VSC measurements could be detected. Although the organoleptic method described here offers a high reproducibility, the lack of correlation between VSC values and organoleptic scores has to be critically addressed. For further studies assessing new organoleptic scores, a validated index should always be included as a direct control.

Type D Personality, Self-Efficacy, and Medication Adherence Following an Acute Coronary Syndrome

Objective: To assess the relationship among Type D personality, self-efficacy, and medication adherence in patients with coronary heart disease. Methods: The study design was prospective and observational. Type D personality, self-efficacy for illness management behaviors, and medication adherence were measured 3 weeks after hospitalization for acute coronary syndrome in 165 patients (mean [standard deviation] age = 61.62 [10.61] years, 16% women). Self-reported medication adherence was measured 6 months later in 118 of these patients. Multiple linear regression and mediation analyses were used to address the study research questions. Results: Using the original categorical classification, 30% of patients with acute coronary syndrome were classified as having Type D personality. Categorically defined patients with Type D personality had significantly poorer medication adherence at 6 months (r = j0.29, p G .01). Negative affectivity (NA; r = j0.25, p = .01) and social inhibition (r = j0.19, p = .04), the components of Type D personality, were associated with medication adherence 6 months after discharge in bivariate analyses. There was no evidence for the interaction of NA and social inhibition, that is, Type D personality, in the prediction of medication adherence 6 months after discharge in multivariate analysis. The observed association between NA and medication adherence 6 months after discharge could be partly explained by indirect effects through self-efficacy in mediation analysis (coefficient = j0.012; 95% bias-corrected and accelerated confidence interval = j0.036 to j0.001). Conclusions: The present data suggest the primacy of NA over the Type D personality construct in predicting medication adherence. Lower levels of self-efficacy may be a mediator between higher levels of NA and poor adherence to medication in patients with coronary heart disease.

Ar diffusion in K-feldspar: present and absent

The mechanisms of Ar release from K-feldspar samples in laboratory experiments and during their geological history are assessed here. Modern petrology clearly established that the chemical and isotopic record of minerals is normally dominated by aqueous recrystallization. The laboratory critique is trickier, which explains why so many conflicting approaches have been able to survive long past their expiration date. Current models are evaluated for self-consistency; especially Arrhenian non-linearity leads to paradoxes. The models’ testable geological predictions suggest that temperature-based downslope extrapolations often overestimate observed geological Ar mobility substantially. An updated interpretation is based on the unrelatedness of geological behaviour to laboratory experiments. The isotopic record of K-feldspar in geological samples is not a unique function of temperature, as recrystallisation promoted by aqueous fluids is the predominant mechanism controlling isotope transport. K-feldspar should therefore be viewed as a hygrochronometer. Laboratory degassing proceeds from structural rearrangements and phase transitions such as are observed in situ at high temperature in Na and Pb feldspars. These effects violate the mathematics of an inert Fick’s Law matrix and preclude downslope extrapolation. The similar upward-concave, non-linear shapes of Arrhenius trajectories of many silicates, hydrous and anhydrous, are likely common manifestations of structural rearrangements in silicate structures.

Affinity retardation chromatography: characterization of the method and its application. The description of low affinity laminin self-interactions.

Affinity retardation chromatography (ARC), a method for the examination of low-affinity interactions, is mathematically described in order to characterize the method itself and to estimate binding coefficients of self-assembly domains of basement membrane protein laminin. Affinity retardation was determined by comparing the elutions on a "binding" and on a "nonreacting" column. It depends on the binding coefficient, the concentrations of both ligands, and the nonbinding elution position. Half maximal binding of the NH2-terminal domain of laminin B1-short arm to the A- and/or B2-short arms was estimated to occur at 10-17 microM for noncooperative and at < or = 3 microM for cooperative binding. A model of the laminin polymerization, postulating two levels of cooperative binding behavior, is described.

Assessment of smoking behaviour in a dental setting: a 1-year follow-up study using self-reported questionnaire data and exhaled carbon monoxide levels.

OBJECTIVES This study analyses the changes in smoking habits over the course of 1 year in a group of patients referred to an oral medicine unit. MATERIALS AND METHODS Smoking history and behaviour were analysed at baseline and after 1 year based on a self-reported questionnaire and on exhaled carbon monoxide levels [in parts per million (ppm)]. During the initial examination, all smokers underwent tobacco use prevention and cessation counselling. RESULTS Of the initial group of 121 patients, 98 were examined at the follow-up visit. At the baseline examination, 33 patients (33.67 %) indicated that they were current smokers. One year later, 14 patients (42.24 % out of the 33 smokers of the initial examination) indicated that they had attempted to stop smoking at least once over the follow-up period and 15.15 % (5 patients) had quit smoking. The mean number of cigarettes smoked per day by current smokers decreased from 13.10 to 12.18 (p = 0.04). The exhaled CO level measurements showed very good correlation with a Spearman's coefficient 0.9880 for the initial visit, and 0.9909 for the follow-up examination. For current smokers, the consumption of one additional cigarette per day elevated the CO measurements by 0.77 ppm (p < 0.0001) at the baseline examination and by 0.84 ppm (p < 0.0001) at the 1-year follow-up. CONCLUSIONS In oral health care, where smoking cessation is an important aspect of the treatment strategy, the measurement of exhaled carbon monoxide shows a very good correlation with a self-reported smoking habit. CLINICAL RELEVANCE Measurement of exhaled carbon monoxide is a non-invasive, simple and objective measurement technique for documenting and monitoring smoking cessation and reduction.

Diffusion-weighted magnetic resonance imaging detects significant prostate cancer with high probability

PURPOSE We prospectively assessed the diagnostic accuracy of diffusion-weighted magnetic resonance imaging for detecting significant prostate cancer. MATERIALS AND METHODS We performed a prospective study of 111 consecutive men with prostate and/or bladder cancer who underwent 3 Tesla diffusion-weighted magnetic resonance imaging of the pelvis without an endorectal coil before radical prostatectomy (78) or cystoprostatectomy (33). Three independent readers blinded to clinical and pathological data assigned a prostate cancer suspicion grade based on qualitative imaging analysis. Final pathology results of prostates with and without cancer served as the reference standard. Primary outcomes were the sensitivity and specificity of diffusion-weighted magnetic resonance imaging for detecting significant prostate cancer with significance defined as a largest diameter of the index lesion of 1 cm or greater, extraprostatic extension, or Gleason score 7 or greater on final pathology assessment. Secondary outcomes were interreader agreement assessed by the Fleiss κ coefficient and image reading time. RESULTS Of the 111 patients 93 had prostate cancer, which was significant in 80 and insignificant in 13, and 18 had no prostate cancer on final pathology results. The sensitivity and specificity of diffusion-weighted magnetic resonance imaging for detecting significant PCa was 89% to 91% and 77% to 81%, respectively, for the 3 readers. Interreader agreement was good (Fleiss κ 0.65 to 0.74). Median reading time was between 13 and 18 minutes. CONCLUSIONS Diffusion-weighted magnetic resonance imaging (3 Tesla) is a noninvasive technique that allows for the detection of significant prostate cancer with high probability without contrast medium or an endorectal coil, and with good interreader agreement and a short reading time. This technique should be further evaluated as a tool to stratify patients with prostate cancer for individualized treatment options.

Low correlation between self-report and medical record documentation of urinary tract infection symptoms.

BACKGROUND Correlations between symptom documentation in medical records and patient self-report (SR) vary depending on the condition studied. Patient symptoms are particularly important in urinary tract infection (UTI) diagnosis, and this correlation for UTI symptoms is currently unknown. METHODS This is a cross-sectional survey study in hospitalized patients with Escherichia coli bacteriuria. Patients were interviewed within 24 hours of diagnosis for the SR of UTI symptoms. We reviewed medical records for UTI symptoms documented by admitting or treating inpatient physicians (IPs), nurses (RNs), and emergency physicians (EPs). The level of agreement between groups was assessed using Cohen κ coefficient. RESULTS Out of 43 patients, 34 (79%) self-reported at least 1 of 6 primary symptoms. The most common self-reported symptoms were urinary frequency (53.5%); retention (41.9%); flank pain, suprapubic pain, and fatigue (37.2% each); and dysuria (30.2%). Correlation between SR and medical record documentation was slight to fair (κ, 0.06-0.4 between SR and IPs and 0.09-0.5 between SR and EDs). Positive agreement was highest for dysuria and frequency. CONCLUSION Correlation between self-reported UTI symptoms and health care providers' documentation was low to fair. Because medical records are a vital source of information for clinicians and researchers and symptom assessment and documentation are vital in distinguishing UTI from asymptomatic bacteriuria, efforts must be made to improve documentation.

Self-consistent, nonlocal electron heat flux at arbitrary ion charge number

A single, nonlocal expression for the electron heat flux, which closely reproduces known results at high and low ion charge number 2, and “exact” results for the local limit at all 2, is derived by solving the kinetic equation in a narrow, tail-energy range. The solution involves asymptotic expansions of Bessel functions of large argument, and (Z-dependent)order above or below it, corresponding to the possible parabolic or hyperbolic character of the kinetic equation; velocity space diffusion in self-scattering is treated similarly to isotropic thermalization of tail energies in large Z analyses. The scale length H characterizing nonlocal effects varies with Z, suggesting an equal dependence of any ad hoc flux limiter. The model is valid for all H above the mean-free path for thermal electrons.

Self-consistent relativistic band structure of the CH3NH3PbI3 perovskite

The electronic structure and properties of the orthorhombic phase of the CH 3 NH 3 PbI 3 perovskite are computed with density functional theory. The structure, optimized using a van der Waals functional, reproduces closely the unit cell volume. The experimental band gap is reproduced accurately by combining spin-orbit effects and a hybrid functional in which the fraction of exact exchange is tuned self-consistently to the optical dielectric constant. Including spin-orbit coupling strongly reduces the anisotropy of the effective mass tensor, predicting a low electron effective mass in all crystal directions. The computed binding energy of the unrelaxed exciton agrees with experimental data, and the values found imply a fast exciton dissociation at ambient temperature. Also polaron masses for the separated carriers are estimated. The values of all these parameters agree with recent indications that fast dynamics and large carrier diffusion lengths are key in the high photovoltaic efficiencies shown by these materials.

Influencia de la adición de nanosílice y microsílice en el comportamiento mecánico, microestructural y durable de un hormigón autocompactante

Desde mediados de la década de los 80 se está investigando sobre el hormigón autocompactante. Cada día, su uso en el mundo de la construcción es más común debido a sus numerosas ventajas como su excelente fluidez ya que puede fluir bajo su propio peso y llenar encofrados con formas complicadas y muy armados sin necesidad de compactaciones internas o externas. Por otra parte, la búsqueda de materiales más resistentes y duraderos, ha dado lugar a la incorporación de adiciones en materiales a base de cemento. En las últimas dos décadas, los ensayos con los nanomateriales, ha experimentado un gran aumento. Los resultados hasta ahora obtenidos pueden asumir no sólo un aumento en la resistencia de estos materiales, pero un cambio es su funcionalidad. Estas nanopartículas, concretamente la nanosílice, no sólo mejoran sus propiedades mecánicas y especialmente sus propiedades durables, sino que pueden implicar un cambio sustancial en las condiciones de uso y en su ciclo de vida. Este trabajo tiene como principal objetivo el estudio de las propiedades mecánicas, características microestructurales y durables de un hormigón autocompactante cuando se le agrega como adición nanosílice, microsílice y mezcla binarias de ambas, como adición al cemento. Para ello se han realizado 10 mezclas de hormigón. Se utilizó como referencia un hormigón autocompactante obtenido con cemento, caliza, árido, aditivo modificador de viscosidad Se han fabricado tres hormigones con la misma dosificación pero con diferentes contenidos de nanosílice. 2,5%, 5% y 7,5% Tres dosificaciones con adición de microsílice 2,5%, 5% y 7,5% y las tres restantes con mezclas binarias de nanosílice y microsílice con respectivamente2,5%-2,5%, 5%-2,5% y 2,5%-5%, sobre el peso del cemento. El contenido de superplastificante se modificó para conseguir las características de autocompactabilidad. Para observar los efectos de las adiciones añadidas al hormigón, se realiza una extensa campaña experimental. En ella se evaluaron en primer lugar, las características de autocompactabilidad del material en estado fresco, mediante los ensayos prescritos en la Instrucción Española del hormigón estructural EHE 08. Las propiedades mecánicas fueron evaluadas con ensayos de resistencia a compresión, resistencia a tracción indirecta y módulo de elasticidad. Las características microestructurales fueron analizadas mediante porosimetría por intrusión de mercurio, el análisis termogravimétrico y la microscopía electrónica de barrido. Para el estudio de la capacidad durable de las mezclas se realizaron ensayos de resistividad eléctrica, migración de cloruros, difusión de cloruros, carbonatación acelerada, absorción capilar y resistencia al hielo-deshielo. Los resultados ponen de manifiesto que la acción de las adiciones genera mejoras en las propiedades resistentes del material. Así, la adición de nanosílice proporciona mayores resistencias a compresión que la microsílice, sin embargo las mezclas binarias con bajas proporciones de adición producen mayores resistencias. Por otra parte, se observó mediante la determinación de las relaciones de gel/portlandita, que las mezclas que contienen nanosílice tienen una mayor actividad puzolánica que las que contienen microsílice. En las mezclas binarias se obtuvo como resultado que mientras mayor es el contenido de nanosílice en la mezcla mayor es la actividad puzolánica. Unido a lo anteriormente expuesto, el estudio de la porosidad da como resultado que la adición de nanosílice genera un refinamiento del tamaño de los poros mientras que la adición de microsílice disminuye la cantidad de los mismos sin variar el tamaño de poro medio. Por su parte, en las micrografías, se visualizó la formación de cristales procedentes de la hidratación del cemento. En ellas, se pudo observar, que al adicionar nanosílice, la velocidad de hidratación aumenta al aumentar la formación de monosulfoaluminatos con escasa presencia de etringita. Mientras que en las mezclas con adición de microsílice se observan mayor cantidad de cristales de etringita, lo que confirma que la velocidad de hidratación en estos últimos fue menor. Mediante el estudio de los resultados de las pruebas de durabilidad, se observó que no hay diferencias significativas entre el coeficiente de migración de cloruros y el coeficiente de difusión de cloruros en hormigones con adición de nano o microsílice. Aunque este coeficiente es ligeramente menor en mezclas con adición de microsílice. Sin embargo, en las mezclas binarias de ambas adiciones se obtuvo valores de los coeficientes de difusión o migración de cloruros inferiores a los obtenidos en mezclas con una única adición. Esto se evidencia en los resultados de las pruebas de resistividad eléctrica, de difusión de cloruros y de migración de cloruros. Esto puede ser debido a la suma de los efectos que producen el nano y micro adiciones en la porosidad. El resultado mostró que nanosílice tiene un papel importante en la reducción de los poros y la microsílice disminuye el volumen total de ellos. Esto permite definir la vida útil de estos hormigones a valores muy superiores a los exigidos por la EHE-08, por lo que es posible reducir, de forma notable, el recubrimiento exigido en ambiente de alta agresividad asegurando un buen comportamiento en servicio. Por otra parte, la pérdida de masa debido a los ciclos de congelación-descongelación es significativamente menor en los hormigones que contienen nanosílice que los que contienen microsílice. Este resultado está de acuerdo con el ensayo de absorción capilar. De manera general, se puede concluir que son las mezclas binarias y más concretamente la mezcla con un 5% de nanosílice y 2,5% de microsílice la que presenta los mejores resultados tanto en su comportamiento resistente con en su comportamiento durable. Esto puede ser debido a que en estas mezclas la nanosílice se comporta como un núcleo de activación de las reacciones puzolánicas rodeado de partículas de mayor tamaño. Además, el extraordinario comportamiento durable puede deberse también a la continuidad en la curva granulométrica por la existencia de la microsílice, el filler calizo, el cemento, la arena y la gravilla con tamaños de partículas que garantice mezclas muy compactas que presentan elevadas prestaciones. Since the middle of the decade of the 80 is being investigated about self-consolidating concrete. Every day, its use in the world of construction is more common due to their numerous advantages as its excellent fluidity such that it can flow under its own weight and fill formworks with complicated shapes and congested reinforcement without need for internal or external compactions. Moreover, the search for more resistant and durable materials, has led to the incorporation of additions to cement-based materials. In the last two decades, trials with nanomaterials, has experienced a large increase. The results so far obtained can assume not only an increase in the resistance of these materials but a change is its functionality. These nano particles, particularly the nano silica, not only improve their mechanical properties and especially its durable properties, but that may imply a substantial change in the conditions of use and in their life cycle. This work has as its main objective the study of the mechanical properties, the microstructural characteristics and durability capacity in one self-compacting concrete, when added as addition to cement: nano silica, micro silica o binary mixtures of both. To this effect, 10 concrete mixes have been made. As reference one with a certain amount of cement, limestone filler, viscosity modifying additive and water/binder relation. Furthermore they were manufactured with the same dosage three mix with addition of 2.5%, 5% and 7.5% of nano silica by weight of cement. Other three with 2.5%, 5% and 7.5% of micro silica and the remaining three with binary mixtures of 2.5%-2.5%, 5%-2.5% and 2.5%-5% of silica nano-micro silica respectively, b weight of cement, varying only the amount of superplasticizer to obtain concrete with characteristics of self-compactability. To observe the effects of the additions added to the concrete, an extensive experimental campaign was performed. It assessed, first, the characteristics of self-compactability of fresh material through the tests prescribed in the Spanish Structural Instruction Concrete EHE 08. The mechanical properties were evaluated by compression strength tests, indirect tensile strength and modulus of elasticity. The microstructural properties were analyzed by mercury intrusion porosimetry, thermogravimetric analysis and scanning electron microscopy. To study the durability, were performed electrical resistivity tests, migration and diffusion of chlorides, accelerated carbonation, capillary suction and resistance to freeze-thaw cycles. The results show that the action of the additions generates improvements in the strength properties of the material. Specifically, the addition of nano silica provides greater resistance to compression that the mix with micro silica, however binary mixtures with low addition rates generate higher strengths. Moreover, it was observed by determining relationships gel/portlandite, that the pozzolanic activity in the mixtures with nano silica was higher than in the mixtures with micro silica. In binary mixtures it was found that the highest content of nano silica in the mix is the one with the highest pozzolanic activity. Together with the foregoing, the study of the porosity results in the mixture with addition of nano silica generates a refinement of pore size while adding micro silica decreases the amount thereof without changing the average pore size. On the other hand, in the micrographs, the formation of crystals of cement hydration was visualized. In them, it was observed that by adding nano silica, the speed of hydration increases with increasing formation monosulfoaluminatos with scarce presence of ettringite. While in mixtures with addition of micro silica, ettringite crystals are observed, confirming that the hydration speed was lower in these mixtures. By studying the results of durability testing, it observed that no significant differences between the coefficient of migration of chlorides and coefficient of diffusion of chlorides in concretes with addition of nano or micro silica. Although this coefficient is slightly lower in mixtures with addition of micro silica. However, in binary mixtures of both additions was obtained values of coefficients of difusion o migration of chlorides lower than those obtained in mixtures with one of the additions. This is evidenced by the results of the tests electrical resistivity, diffusion of chlorides and migration of chlorides. This may be due to the sum of the effects that produced the nano and micro additions in the porosity. The result showed that nano silica has an important role in the pores refining and the micro silica decreases the total volume of them. This allows defining the life of these concretes in values to far exceed those required by the EHE-08, making it possible to reduce, significantly, the coating required in highly aggressive environment and to guarantee good behavior in service. Moreover, the mass loss due to freeze-thaw cycles is significantly lower in concretes containing nano silica than those containing micro silica. This result agrees with the capillary absorption test. In general, one can conclude that the binary mixture and more specifically the mixture with 5% of nano silica and 2.5% silica fume is which presents the best results in its durable behavior. This may be because in these mixtures, the nano silica behaves as cores activation of pozzolanic reactions. In addition, the durable extraordinary behavior may also be due to the continuity of the grading curve due to existence of micro silica, limestone filler, cement, sand and gravel with particle sizes that guarantees very compact mixtures which have high performance.

Microtubule self-organization is gravity-dependent

Although weightlessness is known to affect living cells, the manner by which this occurs is unknown. Some reaction-diffusion processes have been theoretically predicted as being gravity-dependent. Microtubules, a major constituent of the cellular cytoskeleton, self-organize in vitro by way of reaction-diffusion processes. To investigate how self-organization depends on gravity, microtubules were assembled under low gravity conditions produced during space flight. Contrary to the samples formed on an in-flight 1 × g centrifuge, the samples prepared in microgravity showed almost no self-organization and were locally disordered.

Involvement of a cytosine side chain in proton transfer in the rate-determining step of ribozyme self-cleavage

Ribozymes of hepatitis delta virus have been proposed to use an active-site cytosine as an acid-base catalyst in the self-cleavage reaction. In this study, we have examined the role of cytosine in more detail with the antigenomic ribozyme. Evidence that proton transfer in the rate-determining step involved cytosine 76 (C76) was obtained from examining cleavage activity of the wild-type and imidazole buffer-rescued C76-deleted (C76Δ) ribozymes in D2O and H2O. In both reactions, a similar kinetic isotope effect and shift in the apparent pKa indicate that the buffer is functionally substituting for the side chain in proton transfer. Proton inventory of the wild-type reaction supported a mechanism of a single proton transfer at the transition state. This proton transfer step was further characterized by exogenous base rescue of a C76Δ mutant with cytosine and imidazole analogues. For the imidazole analogues that rescued activity, the apparent pKa of the rescue reaction, measured under kcat/KM conditions, correlated with the pKa of the base. From these data a Brønsted coefficient (β) of 0.51 was determined for the base-rescued reaction of C76Δ. This value is consistent with that expected for proton transfer in the transition state. Together, these data provide strong support for a mechanism where an RNA side chain participates directly in general acid or general base catalysis of the wild-type ribozyme to facilitate RNA cleavage.

Self-organized criticality: sandpiles, singularities, and scaling.

We present an overview of the statistical mechanics of self-organized criticality. We focus on the successes and failures of hydrodynamic description of transport, which consists of singular diffusion equations. When this description applies, it can predict the scaling features associated with these systems. We also identify a hard driving regime where singular diffusion hydrodynamics fails due to fluctuations and give an explicit criterion for when this failure occurs.

The Spanish version of the Prenatal Breast-feeding Self-efficacy Scale: Reliability and validity assessment

Background: Only a minority of infants are exclusively breastfed for the recommended 6 months postpartum. Breast-feeding self-efficacy is a mother's confidence in her ability to breastfeed and is predictive of breastfeeding behaviors. The Prenatal Breast-feeding Self-efficacy Scale (PBSES) was developed among English-speaking mothers to measure breastfeeding self-efficacy before delivery. Objectives: To translate the PBSES into Spanish and assess its psychometric properties. Design: Reliability and validity assessment. Setting: A public hospital in Yecla, Spain. Participants: A convenience sample of 234 pregnant women in their third trimester of pregnancy. Methods: The PBSES was translated into Spanish using forward and back translation. A battery of self-administered questionnaires was completed by participants, including a questionnaire on sociodemographic variables, breastfeeding experience and intention, as well as the Spanish version of the PBSES. Also, data on exclusive breastfeeding at discharge were collected from hospital database. Dimensional structure, internal consistency and construct validity of the Spanish version of PBSES were assessed. Results: Confirmatory factor analysis suggested the presence of one construct, self-efficacy, with four dimensions or latent variables. Cronbach's alpha coefficient for internal consistency was 0.91. Response patterns based on decision to breastfeed during pregnancy provided evidence of construct validity. In addition, the scores of the Spanish version of the PBSES significantly predicted exclusive breastfeeding at discharge. Conclusions: The Spanish version of PBSES shows evidences of reliability, and contrasting group and predictive validity. Confirmatory factor analysis indicated marginal fit and further studies are needed to provide new evidence on the structure of the scale. The Spanish version of the PBSES can be considered a reliable measure and shows validity evidences.

The cultivation of Castanea sativa (Mill.) in Europe, from its origin to its diffusion on a continental scale

The history of Castanea sativa (sweet chestnut) cultivation since medieval times has been well described on the basis of the very rich documentation available. Far fewer attempts have been made to give a historical synthesis of the events that led to the cultivation of sweet chestnut in much earlier times. In this article we attempt to reconstruct this part of the European history of chestnut cultivation and its early diffusion by use of different sources of information, such as pollen studies, archaeology, history and literature. Using this multidisciplinary approach, we have tried to identify the roles of the Greek and Roman civilizations in the dissemination of chestnut cultivation on a European scale. In particular, we show that use of the chestnut for food was not the primary driving force behind the introduction of the tree into Europe by the Romans. Apart from the Insubrian Region in the north of the Italian peninsula, no other centre of chestnut cultivation existed in Europe during the Roman period. The Romans may have introduced the idea of systematically cultivating and using chestnut. In certain cases they introduced the species itself; however no evidence of systematic planting of chestnut exists. The greatest interest in the management of chestnut for fruit production most probably developed after the Roman period and can be associated with the socio-economic structures of medieval times. It was then that self-sufficient cultures based on the cultivation of chestnut as a source of subsistence were formed.