In June 2020, 486 students completed the program and collected a mean share of 16% (SD=10) of their required credits by choosing to learn with these materials. Conclusion Developing virtual patients based on three types of clinical activities to prepare students for the transition to workplace based learning proved successful and allowed rapid development of learning materials. The presented online quiz format and webinar format showed high acceptance and interest among students.In order to protect patients and students during the Covid 19 pandemic, the third section of the medical examination (M3) in Halle (Saale) was conducted in a modified form in accordance with the "Verordnung zur Abweichung von der Approbationsordnung für Ärzte bei einer epidemischen Lage von nationaler Tragweite" [1]. The one-day examination took place at the Dorothea Erxleben Learning Center (DELH) of the Martin Luther University Halle-Wittenberg on standardized simulation subjects. In contrast to previous years, all examiners were examined individually in internal medicine, surgery and their elective subject of the practical year. In the evaluations carried out, the standardized cases were assessed as consistent and fair by examiners and exam takers. Approximately 90% of the examiners could imagine to test a state examination with simulated patients again. After successful pilot testing, a study will be conducted in the coming exam to determine whether the substitution of real patients with simulated patients in the M3 exam can contribute to better standardization and objectivity while maintaining the same high level of acceptance in the exam. Whether the high acceptance will remain constant can only be checked in the course of the study.In the wake of the Covid-19 pandemic, people over 65 or suffering from certain conditions were deemed at high risk and asked to isolate themselves. This led to the simulated patient (SP) program at the University of Bern being depleted of middle-aged and elderly SP. Meanwhile, an OSCE had to be delivered using adapted cases that minimized physical contact between candidates and SP. Short of suitable cases at such short notice, the case of an elderly patient with postural instability had to be added to the exam blueprint. With elderly SP off the roster, it was decided to use makeup effects to achieve visual authenticity. A combination of wigs (grey hair, hairdo), 3D Probondo transfers (forehead wrinkles), old age stipple (crow's feet), and colouring (age spots) were used to achieve the old-age effects, while SPs wore scarves to cover their neckline. The lower face was covered with protective face masks in accordance with the exam's Covid-19 hygiene protocol. Case-related feedback from candidates and examiners 9 prevents elderly SP from participating.Background Due to the corona pandemic, we conducted the Heidelberg module of the Master of Medical Education (MME) study program, which focuses on teaching and assessment of communicative and interpofessional skills, digitally for the first time. Method We outsourced the teaching to a pre-module phase in the weeks upfront. During the module week, the lecturers picked up again and deepened the topics and the participants created, revised and simulated a virtual OSCE course. Results/Conclusion Evaluation and reflection of the module showed that the digital implementation including an OSCE examination can be an appropriate alternative to a classroom-based training. However, important elements of the MME program that provide networking possibilities and personal exchange can only be replicated in the digital environment to a limited extent. In the future, sensibly applied digital components can be used to enrich the study program.Objective Primary outcome of this retrospective study was the comparison of state examination results under simulated treatment conditions in times of Covid-19 versus patient treatment under non-pandemic conditions. Additionally, correlation analysis was performed between students' self- and examiners' assessment of the treatment results. Methods Within 4 hours, 22 examinees each had to place a multi-surface adhesive anterior and posterior restoration, performed an endodontic treatment on a maxillary premolar and a periodontal debridement of one quadrant. All treatments were performed on a model fixed in a phantom head. https://www.selleckchem.com/products/pha-848125.html Compliance with the prescribed hygiene and social distancing guidelines and self-assessment of the practical performance was part of the practical examination as well. One examiner per examination part evaluated anonymously the final results. The historical control was based on the exam results of a cohort from 2019. Mean values (standard deviation), non-parametric correlations (Spearman's Rhounder phantom conditions in the future.Introduction In order to promote training and further education on topics related to the digitization of medicine, the HiGHmeducation consortium is developing online learning modules. These modules could also be offered across locations. For students of human medicine, an elective for the acquisition of data literacy has been implemented. Originally designed as a blended learning offer, the elective was then carried out completely online due to the Covid-19 pandemic. Despite the lack of classroom teaching, the aim was to achieve intensive cooperation between the students. Project description In the elective, the students worked on a total of 14 learning tasks, so-called e-tivities, which stimulate collaborative work and thus promote the examination of the learning content. These asynchronous learning activities were supplemented by video conferences, in which the students also took on the role of presenters. The teachers accompanied this learning process as e-moderators. Results In April/May 2020, the elective course was carried out with 12 students entirely online. Despite a workload that was experienced as high, the elective was rated very well by the students. Discussion The didactic concept of the elective enabled an active engagement with the learning material and the social interaction between the learners. With the digital learning offers, the learners were able to gain new experiences which are also of professional relevance. Conclusion The didactic concept of the elective can be transferred to other courses. Future studies must show which long-term learning effects can be generated by digital teaching based on teamwork, communication and exchange.

pnoea perception.
Several studies suggest that statins, besides reducing cardiovascular disease, have anti-inflammatory properties which might provide a benefit in downregulating the immune response after a respiratory viral infection (RVI) and, hence, decreasing subsequent complications. We aim to analyse the effect of statins on mortality after RVI.

A single-centre, observational and retrospective study was carried out including all adult patients with a RVI confirmed by PCR tests from October 2, 2017 to May 20, 2018. Patients were divided between statin users and non-statin users and followed-up for 1 year, and all causes of death were recorded. In order to analyse the effect of statin treatment on mortality after RVI we planned two different approaches, a multivariate Cox regression model with the overall population and a univariate Cox model with a propensity-score matched population.

We included 448 patients, 154 (34.4%) of whom were under statin treatment. Statin users had a worse clinical profile (older population with more comorbidities). During the 1-year follow-up, 67 patients died, 17 (11.0%) in the statin group and 50 (17.1%) in the non-statin group. Multivariate Cox analysis showed that statins were associated with mortality benefit (HR 0.47, 95% CI 0.26-0.83; p=0.01). In a matched population (101 statins users and 101 non-statins users) statins also remained associated with mortality benefit (HR 0.32, 95% CI 0.14-0.72; p=0.006). Differences were mainly driven by non-cardiovascular mortality (HR 0.31, 95% CI 0.13-0.73; p=0.004).

Chronic statin treatment was associated with reduced 1-year mortality in patients with laboratory-confirmed RVI. Further studies are needed to determine the exact role of statin therapy after RVI.
Chronic statin treatment was associated with reduced 1-year mortality in patients with laboratory-confirmed RVI. Further studies are needed to determine the exact role of statin therapy after RVI.
Delivery of continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnoea in children and adults. Treatment adherence is a major challenge, as many patients find the CPAP mask uncomfortable. The study aim was to demonstrate the feasibility of delivered CPAP through customised nasal masks by assessing mask leak and comfort of customised masks compared to commercially available CPAP masks.

Six healthy adult volunteers participated in a crossover study including commercial masks in three different sizes (petite, small/medium and large) from the same supplier and a customised mask fabricated for each subject using three-dimensional facial scanning and modern additive manufacturing processes. Mask leak and comfort were assessed with varying CPAP levels and mask tightness. Leak was measured in real time using an inline low-resistance Pitot tube flow sensor, and each mask was ranked for comfort by the subjects.

Mask leak rates varied directly with CPAP level and inversely with mask tightness. https://www.selleckchem.com/products/ms4078.html When ranked for comfort, three subjects favoured the customised mask, while three favoured a commercial mask. The petite mask yielded the highest mask leaks and was ranked least comfortable by all subjects. Relative mask leaks and comfort rankings for the other commercial and customised masks varied between individuals. Mask leak was comparable when comparing the customised masks with the highest ranked commercial masks.

Customised masks successfully delivered target CPAP settings in all six subjects, demonstrating the feasibility of this approach.
Customised masks successfully delivered target CPAP settings in all six subjects, demonstrating the feasibility of this approach.The #COVID19 pandemic crisis requires the collaboration of all healthcare providers. Every contribution is welcome to gain time during the phase of "system state" superposition. https//bit.ly/3m4SBxY.
The aim of this study was to determine the association between type 2 diabetes (T2D) and pulmonary function tests.

After conducting an exhaustive literature search, we performed a meta-analysis. We employed the inverse variance method with a random-effects model to calculate the effect estimate as the mean difference (MD) and 95% confidence interval (CI). We calculated the heterogeneity with the I
statistic and performed a meta-regression analysis by sex, body mass index (BMI), smoking and geographical region. We also conducted a sensitivity analysis according to the studies' publication date, size of the T2D group and the study quality, excluding the study with the greatest weight in the effect.

The meta-analysis included 66 studies (one longitudinal, two case-control and 63 cross-sectional), with 11 134 patients with T2D and 48 377 control participants. The pooled MD (95% CI) for the predicted percentage of forced expiratory volume in 1 s (FEV
), forced vital capacity (FVC), forced expiratory flow re needed to investigate outcomes for patients with T2D and impaired pulmonary function.
Inhibition of the epithelial sodium channel (ENaC) represents a mutation-agnostic therapeutic approach to restore airway surface liquid hydration and mucociliary clearance in patients with cystic fibrosis. BI 1265162 is an inhaled ENaC inhibitor with demonstrated preclinical efficacy.

Three phase I trials of BI 1265162 in healthy male subjects are presented NCT03349723 (single-rising-dose trial evaluating safety, tolerability and pharmacokinetics (PK)); NCT03576144 (multiple-rising-dose trial evaluating safety, tolerability and PK); and NCT03907280 (absolute bioavailability trial).

BI 1265162 single doses ≤1200 µg and multiple doses of 600 µg were well tolerated. Adverse events were balanced across treatment groups, were of mainly mild or moderate intensity and resolved by trial-end. One subject discontinued from trial medication on day 7 (asymptomatic hyperkalaemia adverse event; recovered day 8). One subject experienced a serious adverse event (neuropathia vestibularis) leading to hospitalisation and on. Accumulation was minimal. Twice-daily dosing is supported for future development.
Improved pneumonia diagnostics are needed, particularly in resource-constrained settings. Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing pneumonia. The objective was to explore LUS patterns associated with paediatric pneumonia.

We conducted a prospective, observational study among children aged 2 to 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at two district hospitals in Mozambique and Pakistan. We assessed LUS and chest radiograph (CXR) examinations, and viral and bacterial nasopharyngeal carriage, and performed a secondary analysis of LUS patterns.

LUS demonstrated a range of distinctive patterns that differed between children with and without pneumonia and between children in Mozambique
Pakistan. The presence of LUS consolidation or interstitial patterns was more common in children with chest-indrawing pneumonia than in those without pneumonia.

Background Tobacco smoking cigarettes is a number one community wellness issue and is probably the most avoidable cause of morbidity and death internationally. Sportspeople are not any exemption and people who smoke cigarettes tend to be predisposed into the same hazardous wellness results once the general public, in addition to the possible results it might probably have to their sporting overall performance. Aims We aimed to see the prevalence of cigarette consumption in a sporting population. We also endeavoured to quantify the employment of E-cigarettes and assess exposure to passive smoking cigarettes. Design Observational research. Practices A web-based e-questionnaire was distributed to individuals from various sports across Ireland between November 2017 and January 2018, and data had been analysed utilizing SPSS. Outcomes 546 sportspeople finished the survey with more than doubly numerous male respondents. 16% of members had been existing smokers, with guys a lot more more likely to smoke cigarettes (p less then 0.001). 26% of Rugby players were present cigarette smokers that was notably greater in comparison to other activities (p less then 0.01). 10% of all of the members were exposed to second-hand smoke for over an hour a day. 2% of all participants were current people of E-cigarettes. Conclusions The prevalence of smoking cigarettes in our study population had been more than various other literary works reports. Further researches are crucial to judge the potential negative effects this can be having on wearing performance, career development and indeed injury occurrence/rehabilitation. it's crucial to deal with the matter of smoking cigarettes in athletes, not only for public health problems but also thinking about these are typically important role designs within our society.Background The adjuvanted recombinant zoster vaccine (RZV) is very immunogenic and effective in grownups ≥50 years (Y) of age (YOA). We evaluated (1) long-term immunogenicity of a short 2-dose RZV routine by following-up adults vaccinated at ≥60 YOA and also by modeling, and (2) immunogenicity of 2 extra doses administered 10Y post-initial vaccination. Methods Persistence of humoral and cell-mediated resistant (CMI) reactions to 2 preliminary RZV doses was assessed through 10Y post-initial vaccination, and modeled through 20Y utilizing a Piecewise, Power legislation and Fraser design. Immunogenicity and safety of 2 additional RZV amounts had been also evaluated (NCT02735915). Outcomes Seventy adults were enrolled. 10 years post-initial vaccination, humoral and CMI answers were ~6-fold and ~3.5-fold above pre-initial vaccination levels, correspondingly. Predicted resistant persistence through 20Y post-initial vaccination had been similar over the 3 designs. Sixty-two participants (82.6±4.4 YOA) received at the least 1 extra RZV dose. Powerful anamnestic humoral and CMI responses had been elicited by 1 extra dose, without additional increases after an extra additional dosage. Conclusions Immune answers to a short 2-dose RZV course persisted for many years in older grownups. Strong anamnestic resistant reactions can be induced by additional dosing 10Y after the preliminary 2-dose course.Background Transmission of M. tuberculosis in medical options is a preventable motorist associated with the worldwide tuberculosis epidemic. We aimed to assess the evidence for illness control interventions, including coughing etiquette, manufacturing and private breathing protection measures, to prevent transmission of M. tuberculosis in health care options. Techniques Three separate organized reviews had been performed utilizing six databases and medical trials sites. Randomized studies, cohort researches, before-after researches and case-control scientific studies had been included. Searches were performed for managed researches assessing respiratory hygiene, manufacturing and private breathing protection steps. Outcome actions included the incidence of tuberculosis infection and illness. Scientific studies involving transmission to either humans or animals had been included. Results valuation of respiratory hygiene and cough etiquette interventions identified four personal researches, with 22,855 individuals, and one guinea pig research. Scientific studies in humans assessed the results of several concurrent interventions. Patient use of surgical masks decreased disease by 14.8per cent, and tuberculosis infection had been decreased by between 0.5per cent and 28.9%. Engineering and ecological interventions were examined in 10 studies of people, including 31,776 human being individuals, and two guinea pig scientific studies. Mechanical ventilation was associated with between 2.9per cent and 14% less infection. Nine scientific studies of personal breathing protection were included, including 33,913 individuals. Infection was decreased by between 0% and 14.8% in researches where particulate respirators were utilized. The product quality of included researches had been assessed as low. Conclusion Respiratory hygiene, engineering https://endocrinologyinhibitors.com/directed-transportation-regarding-symmetrically-regular-program-caused/ and ecological disease settings and private respiratory security treatments were connected with reduced transmission of M. tuberculosis and paid down TB infection in health configurations.Using a material that optimizes limited seal when using a margin height process to handle deep class II cavities should enhance clinical outcomes.Mycosis fungoides (MF) is a slowly modern cutaneous T-cell lymphoma (CTCL) for which there's absolutely no cure.

How to Buy a Driving License in the United States

In the United States, buying a driving license isn't truly common since cops can quickly validate if a license is legitimate if pulled over. Plus, you still need to pay fees and take a test.

The type of license you require depends on your state's laws and driving rules. For https://dempsey-ravn.thoughtlanes.net/the-most-common-buy-a-driving-license-debate-doesnt-have-to-be-as-black-and-white-as-you-may-think , some states provide junior licenses that have extra limitations for young motorists.
Get the Documents

A driving license is a crucial document that enables you to drive legally and is a widely accepted form of identification. To get a New York driving license, you will need to send particular documents, take tests (written and visual), and pay an application cost. In addition, you need to show your legal existence in the United States and have a valid address. To prevent any hold-ups, you must examine the DMV's document guide before checking out a local branch workplace.

You must likewise have a copy of the NYS Driver's Manual, which will assist prepare you for your written test. You can get this from a DMV workplace or online. Make certain to study it completely, as a failure of the composed test will need you to repeat the process (which indicates paying more charges). You need to also have proofs of identity and date of birth. The list of appropriate files is developed by the DMV, and it may change at any time. Once you have all the essential documents, set up a visit online to go to a DMV office. This will prevent waiting in long lines and speed up the service procedure. You can likewise pick a day and time that fits your schedule, but make certain you arrive in lots of time to avoid stress.
Schedule an Appointment

If you're looking to buy a driving license, you'll need to schedule a visit with the New York DMV. While you can do some transactions online, a lot of require a physical visit to a DMV office or local center. You can make an appointment online or over the phone, and you'll need to offer your name, date of birth, and contact info. You'll also require to offer the type of automobile you own, proof of insurance coverage, and a completed application.

When you're prepared to schedule an appointment, go to the DMV website and choose the type of service you require, such as a roadway test or driver's license renewal. You'll then be asked to choose a date and time that works for you. You'll get a verification consultation or e-mail. If you're unable to go to the visit, you can cancel or reschedule it.

During the COVID-19 pandemic, you'll need to follow safety procedures when visiting the DMV, including wearing masks and using hand sanitizer. You'll likewise require to follow social distancing protocol to avoid contact with other individuals. It's recommended that you make a consultation and bring all required files with you.

You can also reserve a consultation on the DMV's mobile app. It will help you save time by preventing unnecessary lines. You can likewise inspect the status of specific DMV offices and the types of services they offer. You can even find out which workplace offers online deals and which ones don't.



If you have a visit, attempt to get here early for your DMV go to. During busy times, you may need to wait in line for as much as an hour or more. Nevertheless, it's important to note that booking an appointment does not guarantee that you will be served promptly.

You can also bypass the DMV completely and complete a number of services from the comfort of your home. Some of these include submitting your driver's license application, paying fees, and examining the status of your license or registration. You can also inspect your driving record for impressive tickets and fines, which are typically required to be solved before you can restore your license.
Take the Test

A driving test is a crucial part of the New York State driver's license application process. The inspector will ask you a series of concerns associated with roadway security, guidelines and laws. It is necessary to study the New York State driver's handbook to get ready for your test. You can also take practice tests to get a feel for the test format and assess your efficiency.

On the day of your test, make sure to bring all essential documents with you, consisting of a legitimate student's permit and a certified driver who can supply proof of liability insurance coverage. It is also an excellent idea to bring any files you might require to finish a driver's education or pre-licensing course, consisting of the certificate of conclusion. Last but not least, ensure your automobile remains in excellent working order, consisting of checking the headlights and horn. It is also a good idea to have a clean windshield and to appropriately change mirrors for maximum exposure.

https://notes.io/wMhWX will be asked to carry out numerous maneuvers throughout your test, such as turning and lane modifications. Make sure to examine your mirrors and blind areas often, particularly when changing lanes. You will likewise be asked to park in a parking area or on the side of the roadway, so practicing these maneuvers before your test can help you feel more comfy performing them throughout your test.

After finishing your test, the inspector will inform you of whether you passed. If you pass, your permanent license will be sent out to you by the DMV in a few weeks. If you do not pass, the inspector will offer you feedback on locations where you can improve and offer you with the opportunity to reschedule your test for another time.

It is not unusual to fail your driving test on the very first effort, however it is very important to stay favorable and reschedule your test for as soon as possible. The $10 cost you pay with your New York State driver's license application covers up to 2 roadway test retakes, so don't be dissuaded if you fail your first test.
Financing Your Vehicle

Buying an automobile is often the most expensive purchase you'll ever make, so it makes sense to carefully consider your alternatives before making any commitments. This consists of not just investigating the vehicles you're interested in, however also examining whether or not you can manage your preferred month-to-month payments. Shannon Bradley covers vehicle loans and other automotive topics for NerdWallet. She previously worked as an author and content supervisor in the financial services industry. She holds a bachelor's degree in journalism and interactions.

Many immigrants are susceptible to varicella on arrival to Canada because of different transmission dynamics in their countries of origin and scarcity of vaccination. Universal childhood vaccination programmes decrease varicella incidence rates through herd immunity, but the accumulating number of susceptible adult immigrants could remain at risk for severe varicella. Our aim was to describe the epidemiology of varicella among immigrants and non-immigrants before and after childhood varicella vaccination.

We did a population-based, retrospective cohort study of all varicella cases in Quebec, Canada, diagnosed between 1996 and 2014 in administrative health databases linked to immigration data. Cases of varicella met diagnostic codes in the International Classification of Diseases, Ninth and Tenth Revision Canadian modifications. Cases with a co-occurring zoster diagnostic code and immigrants from Australia, New Zealand, the USA, and western European countries were excluded. Vaccination periods included pre0 years had higher varicella rates than non-immigrants, with relative risk ranging from 1·53 (95% CI 1·37-1·72) to 4·64 (3·90-5·53) with the highest risk in adolescents and young adults, and people from Latin America and the Caribbean (age-specific incidence rate ratio [aIRR]
pre-vaccination 2·19 and post-vaccination aIRR
6·07) and south Asia (aIRR
pre-vaccination 3·41 and aIRR
post-vaccination 4·46) and in childbearing women (15-40 years; IRR
2·48).

Immigrant adolescents, young adults, and women of childbearing age had higher age-standardised rates of varicella than non-immigrants, with increasing disparities following vaccine introduction. Immigrants younger than 50 years of age would benefit from targeted vaccination upon arrival to host countries.

The Canadian Institutes of Health Research and The Department of Medicine, Jewish General Hospital, Montreal, QC, Canada.
The Canadian Institutes of Health Research and The Department of Medicine, Jewish General Hospital, Montreal, QC, Canada.
The risk of vertical and perinatal transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, which causes COVID-19), the most appropriate management, and the neonate's risk of developing COVID-19 during the perinatal period are unknown. Therefore, we aimed to elucidate best practices regarding infection control in mother-newborn dyads, and identify potential risk factors associated with transmission.

In this observational cohort study, we identified all neonates born between March 22 and May 17, 2020, at three New York Presbyterian Hospitals in New York City (NY, USA) to mothers positive for SARS-CoV-2 at delivery. Mothers could practice skin-to-skin care and breastfeed in the delivery room, but had to wear a surgical mask when near their neonate and practice proper hand hygiene before skin-to-skin contact, breastfeeding, and routine care. Unless medically required, neonates were kept in a closed Giraffe isolette in the same room as their mothers, and were held by mothers for feeding af Our data suggest that perinatal transmission of COVID-19 is unlikely to occur if correct hygiene precautions are undertaken, and that allowing neonates to room in with their mothers and direct breastfeeding are safe procedures when paired with effective parental education of infant protective strategies.

None.
None.Country-led control measures to contain the spread of the novel coronavirus, COVID-19, have been diverse. https://www.selleckchem.com/products/zasocitinib.html Originating in Wuhan, China, in December, 2019, the COVID-19 outbreak was declared a pandemic by WHO on March 11, 2020. In recognition of the severity of the outbreak, and having the longest shared border with China, the Government of Mongolia activated the State Emergency Committee in January, 2020, on the basis of the 2017 Disaster Protection Law. As a result, various public health measures have been taken that led to delaying the first confirmed case of COVID-19 until March 10, 2020, and with no intensive care admissions or deaths until July 6, 2020. These measures included promoting universal personal protection and preventions, such as the use of face masks and handwashing, restricting international travel, suspending all training and educational activities from kindergartens to universities, and banning major public gatherings such as the celebration of the national New Year holiday. These measures have been accompanied by active infection surveillance and self-isolation recommendations. The Mongolian case shows that with robust preventive systems, an effective response to a pandemic can be mounted in a low-income or middle-income country. We hereby examine the emergency preparedness experience, effectiveness, and challenges of the early outbreak policies on COVID-19 prevention in Mongolia, as well as any unintended consequences.
There are a large number of studies in the literature on burnout and its negative consequences for health and psychological wellbeing. Use of the burnout index in the academic context has increased to the point of identifying even the adolescent population. Nevertheless, at the present time there is no validated instrument for evaluating this syndrome in Spanish high school students. In view of this, our study attempted to evaluate the factor structure and reliability of the Spanish version of the Maslach Burnout Inventory-Student Survey (MBI-SS) in a sample of high school adolescents.

The sample included 1,209 students in the autonomous region of Andalusia (Spain), of whom 47.1% were boys and 52.9% girls, with a mean age of M=15.07, SD=1.174).

The exploratory and confirmatory factor analyses supported a model with 12 items showing good fit, distributed across three factors emotional exhaustion, cynicism and academic efficacy.

These results demonstrate that the proposed instrument has an excellent factor structure and internal consistency, and is useful for evaluating academic burnout in the adolescent Spanish high school population.
These results demonstrate that the proposed instrument has an excellent factor structure and internal consistency, and is useful for evaluating academic burnout in the adolescent Spanish high school population.