Does pregnancy have an impact on the subgingival microbiota?

BACKGROUND: We investigated clinical and subgingival microbiologic changes during pregnancy in 20 consecutive pregnant women > or =18 years not receiving dental care. METHODS: Bacterial samples from weeks 12, 28, and 36 of pregnancy and at 4 to 6 weeks postpartum were processed for 37 species by checkerboard DNA-DNA hybridization. Clinical periodontal data were collected at week 12 and at 4 to 6 weeks postpartum, and bleeding on probing (BOP) was recorded at sites sampled at the four time points. RESULTS: The mean BOP at week 12 and postpartum was 40.1% +/- 18.2% and 27.4% +/- 12.5%, respectively. The corresponding mean BOP at microbiologic test sites was 15% (week 12) and 21% (postpartum; not statistically significant). Total bacterial counts decreased between week 12 and postpartum (P <0.01). Increased bacterial counts over time were found for Neisseria mucosa (P <0.001). Lower counts (P <0.001) were found for Capnocytophaga ochracea, Capnocytophaga sputigena, Eubacterium saburreum, Fusobacterium nucleatum naviforme, Fusobacterium nucleatum polymorphum, Leptotrichia buccalis, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Prevotella intermedia, Prevotella melaninogenica, Staphylococcus aureus, Streptococcus anginosus, Streptococcus intermedius, Streptococcus mutans, Streptococcus oralis, Streptococcus sanguinis, Selenomonas noxia, and Veillonella parvula. No changes occurred between weeks 12 and 28 of pregnancy. Counts of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), and Treponema denticola did not change. Counts of P. gingivalis and T. forsythia at week 12 were associated with gingivitis (P <0.001). CONCLUSIONS: Subgingival levels of bacteria associated with periodontitis did not change. P. gingivalis and T. forsythia counts were associated with BOP at week 12. A decrease was found in 17 of 37 species from week 12 to postpartum. Only counts of N. mucosa increased.

Restoration margins in young adolescents: a clinical and radiographic study of Swiss Army recruits

PURPOSE: The aim of the present study was to report the radiographical prevalence of overhanging fillings in a group of Swiss Army recruits in 2006 and to relate the dimensions of the overhangs to clinical parameters. MATERIALS AND METHODS: A total of 626 Swiss Army recruits were examined for their periodontal conditions, prevalence of caries, and stomatological and functional aspects of the masticatory system and halitosis. In particular, the present report deals with the presence or the absence of fillings, the presence or the absence of overhangs and their relation to clinical and radiographic parameters. RESULTS: A total of 16,198 interdental sites were evaluated on bitewing radiographs. Of these sites, 15,516 (95.8%) were sound and 682 (4.2%) were filled. Amalgam restorations were found in 94.1% and resin composite fillings in 5.9% of the sites. Of these 682 sites, 96 (14.1%) yielded overhanging margins of various sizes. This low prevalence of fillings represents not only a substantial reduction when compared with a similar Swiss Army study (Lang et al, 1988), but also an improvement in the quality of dental care delivery to young Swiss males. Plaque Index and Gingival Index increased statistically significantly with the presence of fillings, when compared with healthy non-filled sites. Clinical parameters that were significantly associated with the presence of overhangs included clinical attachment loss. Moreover, between 1985 and 2006 the prevalence of fillings was significantly reduced from 20.0% to 4.2% of all surfaces. Furthermore, the marginal fit of the fillings improved from 33.0% with overhangs to 14.1%. CONCLUSIONS: A significant improvement was observed in the periodontal and dental conditions of young Swiss males that was shown to have taken place within the previous two decades. From 1985 to 2006, the prevalence of fillings was reduced fourfold and that of overhanging margins twofold, documenting an improvement in the quality of restorative dentistry.

[Gerodontology consultation in geriatric facilities: general health status (I)]

Dental undertreatment is often seen in the older population. This is particularly true for the elderly living in nursing homes and geriatric hospitals. The progression of chronic diseases results in loss of their independence. They rely on daily support and care due to physical or mental impairment. The visit of a dentist in private praxis becomes difficult or impossible and is a logistic problem. These elderly patients are often not aware of oral and dental problems or these are not addressed. The geriatric hospital Bern, Ziegler, has integrated dental care in the concept of physical rehabilitation of geriatric patients. A total of 139 patients received dental treatment in the years 2005/2006. Their mean age was 83 years, but the segment with > 85 years of age amounted to 46%. The general health examinations reveald multiple and complex disorders. The ASA classification (American Society of Anesthesiologists, Physical Status Classification System) was applied and resulted in 15% = P2 (mild systemic disease, no functional limitation), 47% = P3 (severe systemic disease, definite functional limitations) and 38% = P4 (severe systemic disease, constant threat to life). Eighty-seven of the patients exhibited 3 or more chronic diseases with a prevalence of cardiovascular diseases, musculoskelettal disorders and dementia. Overall the differences between men and women were small, but broncho-pulmonary dieseases were significantly more frequent in women, while men were more often diagnosed with dementia and depression. Verbal communication was limited or not possible with 60% of the patients due to cognitive impairment or aphasia after a stroke. Although the objective treatment need is high, providing dentistry for frail and geriatric patients is characterized by risks due to poor general health conditions, difficulties in communication, limitations in feasibility and lack of adequate aftercare. In order to prevent the problem of undertreatment, elderly independently living people should undergo dental treatment regularly and in time. Training of nurses and doctors of geriatric hospitals in oral hygiene should improve the awareness. A multidisciplinary assessment of geriatric patients should include the oral and dental aspect if they enter the hospital.

Detecting outlying studies in meta-regression models using a forward search algorithm.

When considering data from many trials, it is likely that some of them present a markedly different intervention effect or exert an undue influence on the summary results. We develop a forward search algorithm for identifying outlying and influential studies in meta-analysis models. The forward search algorithm starts by fitting the hypothesized model to a small subset of likely outlier-free studies and proceeds by adding studies into the set one-by-one that are determined to be closest to the fitted model of the existing set. As each study is added to the set, plots of estimated parameters and measures of fit are monitored to identify outliers by sharp changes in the forward plots. We apply the proposed outlier detection method to two real data sets; a meta-analysis of 26 studies that examines the effect of writing-to-learn interventions on academic achievement adjusting for three possible effect modifiers, and a meta-analysis of 70 studies that compares a fluoride toothpaste treatment to placebo for preventing dental caries in children. A simple simulated example is used to illustrate the steps of the proposed methodology, and a small-scale simulation study is conducted to evaluate the performance of the proposed method. Copyright © 2016 John Wiley & Sons, Ltd.

Employment Situation of Parents of Long-Term Childhood Cancer Survivors.

BACKGROUND Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment. METHODS As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years). Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry. RESULTS We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers). Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007). However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002), which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07) were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71) increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73) and >2 children (OR = 0.48, CI:0.30-0.75); and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36). CONCLUSION Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education, additional children, and whose child had a more severe cancer disease could improve their long-term employment situation.

A STUDY ON THE EPIDEMIOLOGY OF POSITIVE PHYSICAL HEALTH (NHANES I)

HANES 1 detailed sample data were used to operationalize a definition of health in the absence of disease and to describe and compare the characteristics of the normal (healthy) group versus an abnormal (unhealthy) group.^ Parallel screening gave a 3.8 percent prevalence proportion of physical health, with a female:male ratio of 2:1 and younger ages in the healthy group. Statistically significant Mantel-Haenszel gender-age-adjusted odds ratios (MHOR) were estimated among abnormal non-migrants (1.53), skilled workers/unemployed (1.76), annual family incomes of less than $10,000 (1.56), having ever smoked (1.58), and started smoking before 18 years of age (1.58). Significant MHOR were also found for abnormals for health promoting measures: non-iodized salt use (1.94), needed dental care (1.91); and for fair to poor perceived health (4.28), perceiving health problems (2.52), and low energy level (1.68). Significant protective effects for much to moderate recreational exercise (MHOR 0.42) and very active to moderate non-recreational activity (MHOR 0.49) were also obtained. Covariance analysis additive models detected statistically significant higher mean values for abnormals than normals for serum magnesium, hemoglobin, hematocrit, urinary creatinine, and systolic and diastolic blood pressures, and lower values for abnormals than normals for serum iron. No difference was detected for serum cholesterol. Significant non-additive joint effects were found for body mass index.^ The results suggest positive physical health can be measured with cross-sectional survey data. Gender differentials, and associations between ecologic, socioeconomic, hazardous risk factors, health promoting activities and physical health are in general agreement with published findings on studies of morbidity. Longitudinal prospective studies are suggested to establish the direction of the associations and to enhance present knowledge of health and its promoting factors. ^

Family Preservation: The Parents’ Perceptions

This research documents the perspective of 100 parents who had an open case with the Department of Children and Family Service’s (DCFS) regarding their family’s well-being, reasons for referral and satisfaction with services. Two DCFS services, Family Preservation (FP) and routine Family Maintenance (FM) were examined using standardized instruments. Parents’ responses regarding reasons for involvement with the system differed from DCFS administrative data. FP parents had more children, were more likely to be monolingual Spanish speakers, and perceived greater improvement in discipline and emotional care of children and housing than FM parents. FP parents reported being satisfied with services. Implications include supporting community based culturally competent FP programs.

Targeting Special Populations for Family Preservation: The Influence of Worker Competence and Organizational Culture

Today there are approximately 581,000 children in the United States foster care system. Children of color, one special population group, are disproportionately represented in the foster care system. Family preservation, a program that aims to improve family functioning and thus decrease the need for foster care, has been examined closely. Some researchers believe that family preservation programs have failed partly due to practitioners' inability to target appropriate families (Feldman, 1990; Schuerman, Rzepnicki & Littell, 1994). Additionally, research confirms that children of color are not the target of family preservation services (Denby, Curtis, & Alford, 1998). Improvements in the effectiveness of family preservation will require many types of reform both internal and external to the program. Among the types of internal reform needed is accurate "targeting of services. " Given the overrepresentation of children of color in the foster care system, this group must be among those who are targeted for services. The results of a national survey of 254 family preservation workers reveal a "profile" of the worker who is likely to target special populations, including children of color, for family preservation services. A case is made for service improvements and training to facilitate the "profiled" workers' competencies.

Prevención de complicaciones orales en personas con discapacidad severa

La salud, como derecho primordial de toda persona, adquiere una connotación especial cuando la persona tiene una discapacidad. El término Discapacidad describe una restricción o ausencia, debido a una deficiencia, de la capacidad de realizar una actividad en la forma o dentro del margen que se considera normal para el ser humano. Si nos referimos concretamente a la salud bucal, podemos decir, que presentan alta incidencia de patologías por lo que constituyen un grupo de riesgo con una gran necesidad de cuidados dentales. Es importante destacar que gran parte de las personas con Discapacidad, no pueden expresar en palabras o determinar claramente su proceso patológico y así toleran importantes dolores demostrados mediante el aumento de la irritabilidad, la inactividad, la pérdida de apetito, los problemas de sueño, la autoagresión, etc. Esta falta de certeza y reacciones adversas genera una situación familiar de alteración de la vida cotidiana y desconcierto, además de comenzar a realizar una serie de consultas a psiquiatra, otorrinolaringólogo, neurólogo, clínico, entre otros especialistas. Dicha situación puede ser previsible mediante controles odontológicos periódicos, derivación temprana a exámenes bucales por parte de médicos y/u otros especialistas tratantes, interconsulta con odontólogo ante cambios de conducta o autoagresión. La prevención y el cuidado de la salud dental en los pacientes con discapacidad favorecen el mantenimiento de la salud general y proporcionan una mayor calidad de vida. La intervención del odontólogo en patologías ya instaladas consiste en la eliminación de la sintomatología, detención y tratamiento de las lesiones, restauración de la función y la estética.

La música asociada a una mejor atención odontológica de la persona con discapacidad : experiencia de motivación desde la vivencia del odontólogo

Se puede definir a una persona portadora de discapacidad como aquella que padece una alteración funcional permanente o prolongada; motora, sensorial o mental, las cuales la hacen dependiente total o parcialmente de otros para sus necesidades básicas, implicando esto desventajas considerables para su integración familiar, social, educacional o laboral. La motivación del paciente con discapacidad es un paso importante en el abordaje y tratamiento, resultando un verdadero desafío. Las estrategias que existen en la actualidad son muy variadas y diversas pero muchas veces el odontólogo es reacio a utilizar metodologías innovadoras. El presente trabajo intenta mostrar una experiencia motivacional a partir de la música, donde el odontólogo es el protagonista. La meta que se persigue es lograr que la herramienta musical pueda ser utilizada con frecuencia en la atención odontológica del paciente.

Guidance in the diversity: a glance from Latin America

Guidance and Diversity, for the majority of the European countries and North America , are related to the attention to children and young people with special necessities, that are attend in an educative institution and for those who are elaborated educative programs directed to obtain one better adaptation to the prevailing social system. In most of the cases is considered that the problematic of the special necessities is imputable to genetic or personal factors that only respond to internal factors to the individuals that display them avoiding the external factors that in some cases can be more decisive determinants at the time of the conductual manifestation. In this work is pleaded because the professionals of the Guidance, as much private or public scenes of the European countries, make more specific considerations at the time of taking care of children, young people and adults, as immigrants, coming of Latin America . In an ample sense one sets out to make Guidance in the Diversity more than Guidance for the Diversity under the conception of a Guidance for All which implies the elimination of the expression "special necessities", whose connotation in our countries is not most appropriate, and than it includes the idea of an Ethnic Guidance. Perhaps the best way of boarding of these conceptions is promoting a process of Guidance from the School and not only in the School.

Guidance in the diversity: a glance from Latin America

Guidance and Diversity, for the majority of the European countries and North America , are related to the attention to children and young people with special necessities, that are attend in an educative institution and for those who are elaborated educative programs directed to obtain one better adaptation to the prevailing social system. In most of the cases is considered that the problematic of the special necessities is imputable to genetic or personal factors that only respond to internal factors to the individuals that display them avoiding the external factors that in some cases can be more decisive determinants at the time of the conductual manifestation. In this work is pleaded because the professionals of the Guidance, as much private or public scenes of the European countries, make more specific considerations at the time of taking care of children, young people and adults, as immigrants, coming of Latin America . In an ample sense one sets out to make Guidance in the Diversity more than Guidance for the Diversity under the conception of a Guidance for All which implies the elimination of the expression "special necessities", whose connotation in our countries is not most appropriate, and than it includes the idea of an Ethnic Guidance. Perhaps the best way of boarding of these conceptions is promoting a process of Guidance from the School and not only in the School.

Guidance in the diversity: a glance from Latin America

Guidance and Diversity, for the majority of the European countries and North America , are related to the attention to children and young people with special necessities, that are attend in an educative institution and for those who are elaborated educative programs directed to obtain one better adaptation to the prevailing social system. In most of the cases is considered that the problematic of the special necessities is imputable to genetic or personal factors that only respond to internal factors to the individuals that display them avoiding the external factors that in some cases can be more decisive determinants at the time of the conductual manifestation. In this work is pleaded because the professionals of the Guidance, as much private or public scenes of the European countries, make more specific considerations at the time of taking care of children, young people and adults, as immigrants, coming of Latin America . In an ample sense one sets out to make Guidance in the Diversity more than Guidance for the Diversity under the conception of a Guidance for All which implies the elimination of the expression "special necessities", whose connotation in our countries is not most appropriate, and than it includes the idea of an Ethnic Guidance. Perhaps the best way of boarding of these conceptions is promoting a process of Guidance from the School and not only in the School.

Barreras para la práctica de actividad física y deportiva en las personas adultas de la Comunidad de Madrid. Desarrollo y validación de un instrumento

El propósito de este estudio fue la construcción y validación de un instrumento de medición de barreras a la práctica de la actividad física y deportiva por parte de las personas adultas desde la teoría ecológico social y analizar la presencia de las diferentes barreras así como las innovaciones y alternativas de conciliación a las barreras relacionadas con el empleo, el cuidado de hijos e hijas y las tareas del hogar, identificando las posibles diferencias existentes en función del género y del tipo de demanda en la población adulta de la Comunidad de Madrid. Se ha realizado un estudio cuantitativo, descriptivo y transversal en una muestra representativa de la población residente en la Comunidad de Madrid entre 30 y 64 años. El tipo de muestreo fue probabilístico, de tipo polietápico según tamaño demográfico de municipio y género, con un margen de error del ± 5,27% y un intervalo de confianza del 95,5%. El tamaño de la muestra final fue de 360 personas (50,3% mujeres, 49,7% hombres), quienes completaron un cuestionario estructurado mediante entrevista personal cara a cara en su domicilio entre octubre y diciembre de 2011, que incluía una escala de barreras específica, así como sub-cuestionarios de innovaciones y alternativas de conciliación vinculados a los tres ítems relacionados con el empleo, cuidado de hijos e hijas y hogar de la escala de barreras. La escala de barreras fue completada por las personas practicantes de actividad física y deportiva que deseaban realizar otra actividad, es decir, por la Demanda Establecida, así como por las personas no practicantes pero deseosas de hacerlo o Demanda Latente, y las personas no practicantes no interesadas en practicar o Demanda Ausente (n=246). Las personas que alcanzaron elevadas puntuaciones en los tres ítems de la escala de barreras vinculados al empleo, cuidado de hijos e hijas y hogar, completaron sub-cuestionarios específicos de innovaciones y alternativas de conciliación vinculados a estas barreras. Para el estudio métrico de los ítems y la dimesionalidad de la escala de barreras se llevaron a cabo análisis descriptivos de los ítems, análisis correlacionales y análisis factoriales exploratorios (AFE). Como resultado se obtuvo una escala de barreras constituida por 13 ítems que explicaron el 59,1% de la variabilidad total de los datos, agrupados en cuatro dimensiones denominadas: Barreras Interpersonales (2 ítems), Barreras Individuales (4 ítems), Barreras Comunidad-Institucionales (4 ítems) y Barreras Obligaciones-Tiempo (3 ítems). Los datos de la escala de barreras y los sub-cuestionarios de innovaciones y alternativas de conciliación fueron analizados con el SPSS v. 18. Para la comparación de variables cuantitativas y ordinales se utilizaron ANOVAS de dos factores (género por tipo de demanda), el tamaño del efecto para esta prueba se cuantificó mediante eta cuadrado. Los resultados se expresaron como porcentajes para las variables nominales y como medias y desviaciones típicas para las variables ordinales y cuantitativas. El nivel de riesgo se fijó en 0,05. El instrumento presentó una fiabilidad aceptable (α=0,58) en consonancia con el modelo ecológico social presentando dimensiones que explicaron los niveles de influencia de las diferentes esferas. Los resultados obtenidos permitieron avalar tanto la adecuación de las propiedades psicométricas de los ítems, así como la validez y fiabilidad de la escala de barreras para la práctica de actividad física y deportiva. Los distintos análisis realizados han aportado evidencia de la validez de una estructura de cuatro dimensiones acorde a los planteamientos teóricos previos de los modelos ecológicos sociales. En la dimensión barreras Individuales se identificaron diferencias según el tipo de demanda (F2,237=40,28; p<0,001; η2=0,25) y el género (F1,237=8,72; p<0,01; η2=0,84). En la dimensión barreras Interpersonales se identificaron diferencias de género (F1,239 =14,9; p<0,01; η2=0,06) pero no entre demandas (F2,239=2,35; p>0,05; 1-β=0,47). En la dimensión Barreras Obligaciones-Tiempo se identificaron diferencias en función del tipo de demanda (F2,239=3,88; p<0,05; η2=0,03) sin presentar diferencias entre hombres y mujeres (F1,239=1,06; p>0,05; 1-β=0,18). Por último, en la dimensión Comunidad Institucionales, se identificaron diferencias en función del tipo de demanda (F2,240=5,69; p<0,01; η2=0,045) y no hubo diferencias en función del género (F1,240=0,65; p>0,05; 1-β=0,13). Las innovaciones y alternativas de conciliación relacionadas con el empleo más valoradas fueron la de flexibilidad en los horarios de trabajo y adecuación de horarios; las más valoradas relacionadas con la barrera cuidado de hijos fueron que en la instalación deportiva se ofertaran actividades físicas conjuntas, en las en las que pudiesen participar madres e hijos y que la instalación deportiva ofreciera, en el mismo horario, actividades para ellos y sus hijos, y, por último, las más valoradas en relación con las tareas del hogar, una mayor implicación de la pareja seguida por una mayor implicación de los hijos. ABSTRACT The objectives of this study were to build and validate an instrument to measure the barriers of adult people to the practice of sport and physical activities from the perspective of the social-ecological theory, analyse the presence of the different barriers, as well as the innovations and alternatives regarding conciliation with work and the care of children and home as barriers, identifying the possible differences that exist based on gender and the type of demand of the adult population within the Community of Madrid. For this, a quantitative, descriptive and transversal study was carried out on a representative sample of the resident population of the Community of Madrid, ages ranging from 30 to 64 years old. Given that is an infinite or very large population, and working with an interval of confidence of the 95,5%, and assuming in the population variance, the worst case of p equal to q, the margin of sampling error was ± 5,27. The sample consisted of 360 people (50,3% women, 49,7% men), who completed a questionnaire during face-to-face personal interviews between October and December 2011. The questionnaire included a scale of specific barriers, as well as sub-questionnaires on the innovations and alternatives linked to the three items regarding work, the care of children and home of the barriers scale. The barriers scale was completed by people who practice physical and sport activities and wanted to do other activities, i.e. by the Established Demand; by people who do not practice these activities but would like to do so, i.e. Latent Demand; and by people who do not practice these activities and have no desire to do so, i.e. Absent Demand (n=246). The people who peaked on the three items of the barriers scale regarding work, the care of children and home, then completed specific sub-questionnaires on the innovations and alternatives for conciliation related to these barriers. The metric study of the items and the dimensionality of the barriers scale was carried out through descriptive analyses of the items, as well as correlation analyses and exploratory factor analyses (EFA). This resulted in a barriers scale composed of 13 items that explained 59,1% of the total variability of the data, grouped in four dimensions as follows: Interpersonal Barriers (2 items), Individual Barriers (4 items), Community-Institutional Barriers (4 items) and Obligations-Time Barriers (3 items). The data obtained from the barriers scale and sub-questionnaires on the innovations and alternatives for conciliation were analyzed using software SPSS v. 18. Two-way ANOVA (gender by type of demand) was used for the comparison of quantitative and ordinal variables, and the effect size for this test was quantified with eta squared. The results were expressed as percentages for nominal variables, and as means and standard deviations for quantitative and ordinal variables. The level of risk was set at 0,05. The instrument showed an acceptable reliability (α=0,58) in line with the social-ecological model, providing dimensions that explained the influence levels of the different spheres. The results obtained establish both the adaptation of the psychometric properties of the items, and the validity and reliability of the barriers scale for the practice of physical and sport activities. The different analyses have supported the validity of a four-dimensional structure consistent with the previous theoretical approaches on the social-ecological models, while showing adequate statistical indices. The differences identified in the Individual Barriers dimension were based on the type of demand (F2,237=40,28; p<0,001; η2=0,25) and gender (F1,237=8,72; p<0,01; η2=0,84). The differences identified in the Interpersonal Barriers dimension were based on gender (F1,239 =14,9; p<0,01; η2=0,06) but not on demand (F2,239=2,35; p>0,05; 1-β=0,47). The differences identified for the Obligations-Time Barriers dimension were based on the type of demand (F2,239=3,88; p<0,05; η2=0,03) and did not show differences between men and women (F1,239=1,06; p>0,05; 1-β=0,18). Finally, the differences identified for the Community-Institutional Barriers dimension were based on the type of demand (F2,240=5,69; p<0,01; η2=0,045) and provided no differences based on gender (F1,240=0,65; p>,05; 1-β=0,13). The most valued innovations and alternatives for conciliation regarding work were the adaptation and flexibility of working hours and timetables; the most valued related to the care of children were the offer of joint activities for adults and children in sport centres, as well as separate activities within the same timetable; and, finally, the most valued regarding the home was a higher degree of participation and involvement on the part of the spouse or partner, followed by a higher degree of participation and involvement on the part of the children.