Lifestyle Clusters of Diet Quality, Sleep, and Screen Time and Associations with Weight Status in Children from Madrid City: ENPIMAD Study.

BACKGROUND: Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors. METHODS: A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status. RESULTS: Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity. CONCLUSION: These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.

High-Protein Processed Foods: Impact on Diet, Nutritional Status, and Possible Effects on Health.

Proteins are macronutrients with multiple health benefits, but excessive consumption can negatively affect health. This study aimed to evaluate the characteristics of a sample of high-protein processed foods (HPPFs), describe how their consumption affects dietary balance, and acquire knowledge of the consumption patterns of these products in a Spanish population. A sample of HPPFs available in supermarkets and on websites was collected. The contribution to recommended protein intakes was calculated using national and international references and considering the single consumption of the HPPFs and the product plus 150 g of meat. Furthermore, an online survey was conducted among a convenience sample. A total of 36 enriched protein products were evaluated. The percentage of proteins in these products ranges from 10 to 88%. The contribution of the protein recommended intake was within a range of 87.4-306.6% and 66.4-232.8% (women and men, respectively), only considering the additional proteins from 150 g of meat. One hundred thirty-nine participants completed the survey; 67.6% affirmed that they had consumed HPPFs, and half consumed them without following any consumption control. Since these products are accessible to everyone in supermarkets and protein intake is generally higher than the recommended limits, regulating the mass sale of HPPFs is essential to ensure they do not lead to protein overconsumption.

A semi-automatic mHealth system using wearable devices for identifying pain-related parameters in elderly individuals.

BACKGROUND: Mobile health systems integrating wearable devices are emerging as promising tools for registering pain-related factors. However, their application in populations with chronic conditions has been underexplored. OBJECTIVE: To design a semi-automatic mobile health system with wearable devices for evaluating the potential predictive relationship of pain qualities and thresholds with heart rate variability, skin conductance, perceived stress, and stress vulnerability in individuals with preclinical chronic pain conditions such as suspected rheumatic disease. METHODS: A multicenter, observational, cross-sectional study was conducted with 67 elderly participants. Predicted variables were pain qualities and pain thresholds, assessed with the McGill Pain Questionnaire and a pressure algometer, respectively. Predictor variables were heart rate variability, skin conductance, perceived stress, and stress vulnerability. Multiple linear regression analyses were conducted to examine the influence of the predictor variables on the pain dimensions. RESULTS: The multiple linear regression analysis revealed that the predictor variables significantly accounted for 27% of the variability in the affective domain, 14% in the miscellaneous domain, 15% in the total pain rating index, 10% in the number of words chosen, 14% in the present pain intensity, and 16% in the Visual Analog Scale scores. CONCLUSION: The study found significant predictive values of heart rate variability, skin conductance, perceived stress, and stress vulnerability in relation to pain qualities and thresholds in the elderly population with suspected rheumatic disease. The comprehensive integration of physiological and psychological stress measures into pain assessment of elderly individuals with preclinical chronic pain conditions could be promising for developing new preventive strategies.

Role of Satisfaction with Life, Sex and Body Mass Index in Physical Literacy of Spanish Children.

Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing life satisfaction (LS) given its positive relationship with physical activity. A single-measure cross-sectional correlational study was carried out, involving 135 children aged 8-12 years from Extremadura. They were administered the SWLS questionnaire and the Canadian assessment of physical literacy (CAPL-2). Significantly higher levels of PL (p = 0.010) were found in normal-weight children compared to overweight and obese children, due to the physical competence domain score (p < 0.001). PL was directly related to SWLS (p < 0.001), but inversely related to BMI (p = 0.018). The daily physical activity behaviour domain was explained by SWLS (p < 0.001) and sex (p < 0.001). Physical competence was described by SWLS (p < 0.001) and BMI (p = 0.045). Finally, the motivation and confidence domain were only significantly associated with SWLS (p < 0.001). It was concluded that boys and girls of normal weight achieved higher levels of PL and LS than those with overweight and obesity, establishing a negative relationship of PL with BMI and positive with LS.

[Nutrition in breast cancer genesis]. / El papel de la nutrición en la génesis del cáncer de mama.

Introduction: Breast cancer is the most prevalent tumor in women, ranking first in incidence and mortality in many countries. Although the causes of breast cancer are complex and multifactorial, nutritional factors and those related to nutritional status play an important role in the development of the disease. In this way, factors that increase breast cancer risk have been identified, such as weight gain, the amount of adipose tissue, waist circumference, alcohol consumption or the consumption of red meat and processed meat, while other factors have been identified that reduce the risk, such as eating fruits and vegetables. Nutritional factors or factors that depend on the state of nutrition are modifiable and preventable, so they must be considered when designing effective prevention programs.

Introducción: El cáncer de mama es el tumor más prevalente en las mujeres y ocupa el primer lugar en incidencia y en mortalidad en muchos países. Si bien las causas del cáncer de mama son complejas y multifactoriales, los factores nutricionales y aquellos relacionados con el estado nutricional juegan un papel importante en el desarrollo de la enfermedad. De esta forma, se han identificado algunos factores que aumentan su riesgo, como el aumento de peso, la cantidad de tejido adiposo, la circunferencia de cintura, el consumo de alcohol, etc., o bien, que lo reducen, como el consumo de frutas y verduras. Los factores nutricionales o que dependen del estado de nutrición son modificables y prevenibles, por lo que deben tenerse en cuenta al diseñar programas de prevención eficaces.

[Food sustainability: keys for the consumer, advantages and disadvantages]. / Sostenibilidad alimentaria: claves para el consumidor, ventajas e inconvenientes.

Introduction: To meet the food and nutritional needs of a growing population and, at the same time, guarantee natural and productive resources, food systems must undergo changes in production models and consumption patterns, adopting more sustainable diets. The recommendations of different organizations and institutions are aimed at adopting a varied and balanced dietary pattern, with a greater predominance of plant-based food and a lower presence of animal food, to improve the state of health and well-being, while reducing the environmental impact. These types of diets have important health benefits, especially if diets are well planned and foods are properly combined. However, in some stages of life (schoolchildren, adolescents, elders) and in some special physiological situations (pregnancy, athletes), special attention should be paid to the increase of certain nutritional requirements that could compromise the health status if a correct dietary planning is not carried out. Therefore, well-designed strategies should be put in place to facilitate the transition to a sustainable diet, including nutrition education programs for consumers with specific instructions on the most appropriate food choices to increase the nutritional value of the diet. In addition, in specific physiological situations, where meeting nutritional requirements may be compromised, the consumption of fortified foods and/or supplementation could be considered.

Introducción: Para atender las necesidades alimentarias y nutricionales de una población creciente y garantizar los recursos naturales y productivos, los sistemas alimentarios deben experimentar cambios adoptando dietas más sostenibles. Diferentes organismos e instituciones recomiendan patrones de dieta variada y equilibrada, con predominio de alimentos de origen vegetal y menor presencia de alimentos de origen animal, para mejorar el estado de salud y bienestar y reducir el impacto medioambiental. Este tipo de dietas presentan beneficios en la salud, sobre todo si están bien planificadas y los alimentos se combinan adecuadamente. Sin embargo, en algunas etapas de la vida (escolares, adolescentes, ancianos) y en situaciones fisiológicas especiales (embarazadas, deportistas) se debe prestar atención a los requerimientos nutricionales, que podrían verse comprometidos en caso de no llevar a cabo una correcta planificación dietética, lo que podría derivar en problemas para la salud. Por ello, para facilitar la transición de los consumidores a una dieta sostenible, se deben promover estrategias bien diseñadas que incluyan programas de educación nutricional con instrucciones específicas acerca de las elecciones y combinaciones de alimentos más adecuadas para aumentar el valor nutricional de la dieta. Además, en situaciones fisiológicas específicas en las que alcanzar los requerimientos nutricionales pudiera estar comprometido, podría considerarse el consumo de alimentos enriquecidos y/o la administración de suplementos.

[Nutritional problems in cis and trans women]. / Problemática nutricional de mujeres cis y trans.

Introduction: Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender women need individualized attention. Transgender women are at greater risk of suffering heart attacks or ischemic accidents, among other diseases, and are also at greater risk of developing eating disorders, poorer weight control and poorer perception of their image. Hormone therapy for gender reaffirmation in trans women modifies their body composition, and may also increase the risk of suffering from some pathologies. The nutritional needs of cisgender women are different from those of men, and trans women also have special needs, which may depend on whether or not they follow hormone therapy. Dietary studies, although scarce, suggest that transgender women have poor dietary habits and lifestyle. It is necessary to deepen the study of the nutritional situation of the female group, considering its diversity, and to develop standards and references appropriate to each case that allow better attention to the needs of these groups.

Introducción: El colectivo femenino merece una especial atención debido a los diferentes requerimientos que tienen en comparación con el colectivo masculino. De la misma manera, se necesita atender de manera individualizada al colectivo transgénero. En concreto, las mujeres trans tienen más riesgo de sufrir infartos o accidentes isquémicos, entre otras enfermedades, y también tienen mayor riesgo de desarrollar trastornos del comportamiento alimentario y peor control de peso y percepción de su imagen. La terapia hormonal de reafirmación de género en mujeres trans modifica su composición corporal y también puede aumentar el riesgo de padecer algunas patologías. Las necesidades nutricionales de las mujeres cisgénero son diferentes a las de los varones, y también tienen necesidades especiales las mujeres trans, que pueden depender del seguimiento o no de un tratamiento hormonal. Los estudios dietéticos, aunque escasos, sugieren que las mujeres transgénero tienen unos hábitos dietéticos y un estilo de vida menos saludables. Es necesario profundizar en el estudio de la situación nutricional del colectivo femenino, atendiendo a la diversidad del mismo, y desarrollar estándares y referencias adecuadas a cada caso que permitan una mejor atención de las necesidades de estos colectivos.

[Protocol of action in the dietary and nutritional approach in patients with dysphagia]. / Protocolo de actuación en el abordaje dietético y nutricional en pacientes con disfagia.

Introduction: Introduction: dysphagia is classified under "symptoms and signs involving the digestive system and abdomen" in the International Classification of Diseases (ICD-10, code R13). It is defined as obstruction in the region of the pharynx, sternum or xiphoid because of obstruction of the passage of food from the mouth to the stomach or cardia, and has become one of the most important causes affecting the adequate intake of energy and nutrients. An optimal dietary and nutritional approach plays a crucial role in the management of dysphagia. The main goal of such an approach is to ensure safe and sufficient nutrition to prevent malnutrition and complications associated with dysphagia. Objectives: to establish an action protocol for an effective dietary and nutritional approach in patients with dysphagia based on the existing scientific evidence. Methods: a review of the scientific literature on the dietary-nutritional approach to dysphagia was carried out. Results: the dietary and nutritional approach in patients with dysphagia requires a multidisciplinary and personalized approach and is essential to improve the quality of life of patients with dysphagia. Through the implementation of an evidence-based action protocol, it is possible to guarantee preventing aspiration and ensuring safe swallowing and modification of textures of different foods (thus promoting adequate intake of nutrients and fluids to avoid malnutrition and dehydration). Conclusion: adequate and protocolized management, from a dietary and nutritional point of view, can have a significant impact on the quality of life of patients, improving their well-being and preventing complications associated with this condition.

Introducción: Introducción: la disfagia se clasifica dentro de los "síntomas y signos que involucran el sistema digestivo y el abdomen" en la Clasificación Internacional de Enfermedades (CIE-10, código R13). Dicho síntoma produce en la región de la faringe, el esternón o el xifoides como resultado de la obstrucción del paso de alimentos de la boca al estómago o al cardias, y se ha convertido en una de las causas más importantes que afecta a la ingesta adecuada de energía y nutrientes. Un abordaje dietético y nutricional óptimo desempeña un papel crucial en el manejo de la disfagia. El objetivo principal de dicho abordaje es garantizar una alimentación segura y suficiente para prevenir la desnutrición y las complicaciones asociadas a la disfagia. Objetivos: establecer un protocolo de actuación para realizar, de forma eficaz, el abordaje dietético y nutricional en pacientes con disfagia en base a la evidencia científica existente. Métodos: se llevó a cabo una revisión de la literatura científica sobre el abordaje dietético-nutricional de la disfagia. Resultados: el abordaje dietético y nutricional en pacientes con disfagia requiere un enfoque multidisciplinar y personalizado, y es fundamental para mejorar la calidad de vida de los pacientes con disfagia. A través de la implementación del protocolo de actuación basado en la evidencia, se puede garantizar: prevenir la aspiración y asegurar una deglución segura y, modificación de texturas de los diferentes alimentos (promoviendo de esta forma la ingesta adecuada de nutrientes y líquidos para evitar la desnutrición y la deshidratación). Conclusión: un manejo adecuado y protocolizado, desde el punto de vista dietético y nutricional, puede llegar a tener un impacto significativo en la calidad de vida de los pacientes, mejorando su bienestar y previniendo complicaciones asociadas a esta condición.

Association between Mineral Intake and Cognition Evaluated by Montreal Cognitive Assessment (MoCA): A Cross-Sectional Study.

BACKGROUND: Mineral intake may protect against cognitive impairment (CI) and all-cause dementia, which affects a large number of adults worldwide. The aim of this study was to investigate the association between mineral intake and Montreal Cognitive Assessment (MoCA), which is a sensitive and specific test. METHODS: In total, 201 adults were included in a cross-sectional study. They completed a three-day dietary record to estimate their average daily intake of minerals. Contributions to dietary reference intakes (DRIs) were also calculated. The participants were divided into tertiles according to their mineral intake. CI classifications were determined via the MoCA (score < 26). Apolipoprotein E (APOE) genotyping was carried out, and the patients' anthropometric measurements and physical activity, health and personal data were collected. RESULTS: The prevalence of CI in this selective sample was 54.2% (34.3% females and 19.9% males). In women, being in the third tertiles of iron and manganese intake was associated with lower odds of having CI (OR [95% CI]: 0.32 [0.11 ± 0.93]; 0.33 [0.12 ± 0.93], p < 0.05). No significant differences were observed for any of the nutrients studied in men. CONCLUSIONS: These findings suggest that a low mineral intake, especially low iron and manganese intake in women, is associated with a worse cognition as assessed by MoCA.

A scientometrics analysis of physical activity and transcranial stimulation research.

BACKGROUND: The search for alternatives to improve physical performance is rising, and in recent years has been focused on the brain. No bibliometric study analyzing research on physical activity (PA) and transcranial stimulation has been found in the scientific literature. Aims: To provide an overview of the existing scientific research on PA and transcranial brain stimulation in healthy and sports participants, using a bibliometric analysis and graphic mapping of the references in the field. To do this, we analyze annual publication trends in this area, identifying the most productive and cited authors, journals and countries with the highest number of publications, and the most cited documents and keywords. METHODS: Those publications related to this area, published in journals indexed in the web of science main collection were retrieved and analyzed using the traditional laws of bibliometrics. RESULTS: A total of 305 documents were found. Annual publications followed an exponential growth trend (R2 = 94.2%); with A. J. Pearce (9 documents) is the most productive coauthor and M.C. Ridding, H. Theoret and M. Lassonde as the most prominent (with 5 most cited papers). The USA (67 papers) and the journal Frontiers in Human Neuroscience (12 papers) were the most productive country and journal respectively. The paper "Action anticipation and motor resonance in elite basketball players" was the most cited paper and "transcranial magnetic stimulation" was the most used keyword. CONCLUSION: There are extensive research networks throughout the world, with the USA leading the production. Publications on the issue are of high interest in the scientific community as an exponential increase in publications over the last few years was found. The contribution of these findings is to offer a complete picture of the relationship between PA and transcranial brain stimulation in healthy individuals and athletes. Therefore, this comprehensive analysis provides fruitful information for sports researchers and policymakers to make future correct decisions about how to better design and implement training interventions in these groups of individuals.

The Impact of Upper Limb Apraxia on General and Domain-Specific Self-Efficacy in Post-Stroke Patients.

BACKGROUND: Upper limb apraxia (ULA) is a neurological syndrome characterized by the inability to perform purposeful movements. ULA could impact individuals' perceptions, including perceived self-efficacy. The aim of this study is to investigate whether ULA is related to general self-efficacy and self-efficacy for managing symptoms in post-stroke patients. METHODS: A cross-sectional study was conducted involving 82 post-stroke patients. Regression analyses were implemented using a stepwise model including seven dimensions of ULA: imitation (non-symbolic, intransitive, and transitive), pantomime (non-symbolic, intransitive, and transitive), and dimension of apraxic performance in activities of daily living. These dimensions were independent variables, while general self-efficacy and symptom management self-efficacy dimensions were dependent variables. RESULTS: The findings revealed that intransitive imitation accounted for 14% of the variance in general self-efficacy and 10% of self-efficacy for managing emotional symptoms. Transitive imitation explained 10% of the variance in self-efficacy for managing global symptoms and 5% for social-home integration symptoms. The combination of intransitive imitation, non-symbolic pantomime, and alterations in activities of daily living performance associated with ULA explained 24% of the variance in cognitive self-efficacy. CONCLUSIONS: Hence, ULA dimensions seem to be related to the levels of general perceived self-efficacy and self-efficacy for managing symptoms among post-stroke patients.

Nanomedicine and epigenetics: New alliances to increase the odds in pancreatic cancer survival.

Pancreatic ductal adenocarcinoma (PDAC) is among the deadliest cancers worldwide, primarily due to its robust desmoplastic stroma and immunosuppressive tumor microenvironment (TME), which facilitate tumor progression and metastasis. In addition, fibrous tissue leads to sparse vasculature, high interstitial fluid pressure, and hypoxia, thereby hindering effective systemic drug delivery and immune cell infiltration. Thus, remodeling the TME to enhance tumor perfusion, increase drug retention, and reverse immunosuppression has become a key therapeutic strategy. In recent years, targeting epigenetic pathways has emerged as a promising approach to overcome tumor immunosuppression and cancer progression. Moreover, the progress in nanotechnology has provided new opportunities for enhancing the efficacy of conventional and epigenetic drugs. Nano-based drug delivery systems (NDDSs) offer several advantages, including improved drug pharmacokinetics, enhanced tumor penetration, and reduced systemic toxicity. Smart NDDSs enable precise targeting of stromal components and augment the effectiveness of immunotherapy through multiple drug delivery options. This review offers an overview of the latest nano-based approaches developed to achieve superior therapeutic efficacy and overcome drug resistance. We specifically focus on the TME and epigenetic-targeted therapies in the context of PDAC, discussing the advantages and limitations of current strategies while highlighting promising new developments. By emphasizing the immense potential of NDDSs in improving therapeutic outcomes in PDAC, our review paves the way for future research in this rapidly evolving field.

Effects of a 4-Week After-School Physical Literacy Program on Health-Related Quality of Life and Symptomatology in Schoolchildren with ADHD: A Study Protocol.

Research has shown that physical activity programs led to improvements in children with Attention Deficit Hyperactivity Disorder (ADHD). However, no study evaluating the impact of a physical literacy (PL) program has been conducted. This study aims to examine PL and the effects of an after-school PL program on Health-related quality of life (HRQoL) and ADHD symptomatology including quality and sustained attention. A parallel-group randomised controlled trial will be conducted assessing PL, HRQoL and ADHD symptomatology, both at the beginning and the end of the PL after-school program implementation. The program will last 4 weeks, including two sessions per week lasting 55 min. Sessions will be divided into several parts: greeting (5 min), block I (20 min), block II (20 min) and relaxation and feedback (10 min). Block I will focus on the acquisition of content that contributes to the development of the domains of knowledge and understanding and daily activity; and block II, in addition to favouring physical competence, will seek to improve motivation. If this program proves its effectiveness, it could be an alternative to be included in educational systems, representing a scientific breakthrough regarding physical activity adherence and inactivity-related disease prevention, HRQoL and management of ADHD-associated symptomatology.

Adherence to 24-h movement guidelines in Spanish schoolchildren and its association with insulin resistance: a cross-sectional study.

Introduction: Being more active, being less sedentary, and sleeping enough are associated with adequate body weight and adiposity in children. However, few researchers have analyzed these different lifestyle behaviors and the adherence to 24 h movement guidelines with respect to insulin resistance (IR) at school age. Therefore, we aimed to analyse the association between the adherence to 24 h movement guidelines (physical activity, sedentary time, sleep) and IR in Spanish schoolchildren. Methods: A cross-sectional study of 839 children (8-13 years, 51.1% girls) were studied. Anthropometric, biochemical, and lifestyle behavioral data were collected. IR was defined as HOMA-IR>3.16. Compliance with the 24 h movement guidelines were defined as ≥60 min/day of moderate and/or vigorous physical activity, < 120 min/day of screen time, and 9-11 h/day of sleep time. Associations between adherence to the 24 h movement guidelines and IR were performed by multivariate logistic regression analyses. Results: The IR in our sample was 5.0%, being higher in girls. Compliance with physical activity or screen time, but not with sleep recommendations, was associated with lower fasting glucose, fasting insulin, and HOMA-IR values. A low adherence to 24 h movement guidelines was associated with a higher risk of IR (odds ratio (95% CI): 2.150 [1.089-4.247]), especially in girls (odds ratio (95% CI): 2.800 [1.180-6.645]). Conclusion: Higher physical activity levels and lower screen times were associated with a lower risk of IR in schoolchildren, underlining the importance of adhering to as many healthy lifestyle recommendations as possible.

A Bibliometric Analysis of Physical Literacy Studies in Relation to Health of Children and Adolescents.

Regular physical activity (PA) is an essential component of maintaining good health, thereby improving the physical and psychological well-being of the population. PA performed during childhood and adolescence can have repercussions in adulthood, contributing to the prevention of chronic activities and improving quality of life. Given its high relationship with PA, physical literacy could play a crucial role in valuing and participating in a physically active lifestyle, thus addressing low rates of PA participation from an early age. This bibliometric analysis provides a globalized view of physical literacy (PL) and its relationship with health, pathologies, prevention, or intervention among children and adolescents. Publications registered on Web of Science were analyzed using bibliometrics based on data from 141 documents published between 2014 and 2022, while the VOSviewer software v. 1.6.18. was used for the processing and visualization of the data and metadata. The results show an exponential growth in scientific research over the last 8 years, with an accumulation of documents in four journals and a distribution of publications spanning thirty-seven countries and regions. The network of researchers consists of 500 researchers, with the largest number of publications corresponding to 18 co-authors with at least 5 publications. The principal purpose of this research was to identify the most prolific co-authors, most-cited journals and co-authors, and the most relevant keywords.

Bibliometric Analysis of Nature-Based Therapy Research.

Unrestrained urbanisation and natural space loss are reducing contact with nature in today's society, producing negative consequences for people's mental and physical health and wellbeing. Nature-based therapies, such as physical activity in natural settings, forest bathing, therapeutic hiking, or experiential learning, reduce anxiety and depressive symptoms and improve the quality of life in both general and specific populations. A bibliometric analysis of research on nature-based therapies was performed by applying the traditional laws of bibliometrics (exponential growth law, Bradford's concentration law, Lotka's law, Zipf's law, etc.) to documents published in journals indexed in the Core Collection of the Web of Science (WoS). Graphical visualisation was performed using the VOSviewer software. Annual publications between 2006 and 2021 presented an exponential growth trend (R2 = 91%). The International Journal of Environmental Research and Public Health (MDPI) and Urban Forestry & Urban Greening (Elsevier) were the most productive and cited journals. Ikei, Miyazaki, and Song are the most cited prolific authors. The USA and South Korea were the countries with the highest scientific production. In recent years, there has been a growing interest in adventure, nature, and forest therapies among researchers. Nature-based therapies have experienced a growing interest in recent years. Positive effects on mental, physical, and emotional health have been found in different populations and research lines, although more studies with different designs and populations are needed.

Depression, Anxiety and Antidepressants and Anxiolytics Use in Spanish Informal Caregivers according to the Physical Activity Frequency: EHSS 2014-2020.

Depression and anxiety are two of the most common mental diseases both in formal and nonformal caregivers. Physical activity during leisure time seems to have benefits on their practitioner's mental health. This study aimed to analyze the associations between physical activity frequency (PAF) and depression and anxiety status, as well as antidepressant and anxiolytic use in Spanish nonformal caregivers. A cross-sectional study with data from the 2014 and 2020 European Health Interview Surveys in Spain (EHSS) including 4520 Spanish nonformal caregivers was carried out. The PAF was found to be related to depression and anxiety, as well as antidepressants and anxiolytics use (p < 0.001), with the highest proportions of these variables found in the inactive population (p < 0.05), while the active and very active populations showed the lowest proportions (p < 0.05). Weak but statistically significant correlations were found between all variables of interest (p < 0.001). Being female, older, and dedicating more hours per week to caregiving and caring for nonfamily members were found to have increased risks of depression, anxiety and antidepressants or anxiolytics use. Nonformal caregivers who were not physically active during their leisure time had higher mental disorders and psychotropic drug use proportions than the active and very active caregivers. Thus, increasing nonformal caregivers' PAF could be a protective tool.

Evolution of antibody titers after two doses of mRNA Pfizer-BioNTech vaccine and effect of the third dose in nursing home residents.

OBJECTIVES: We evaluated the IgG antibody titer against SARS-CoV-2 in 196 residents of a Spanish nursing home after the second dose of the BNT162b2 vaccine and the evolution of this titer over time. The role of the third dose of the vaccine on immune-response is also analysed in 115 of participants. METHODS: Vaccine response was evaluated 1, 3 and 6 months after second dose of Pfizer-BioNTech COVID-19 Vaccine and 30 days after booster vaccination. Total anti-RBD (receptor binding domain) IgG immunoglobulins were measured to assess response. Six month after the second dose of vaccine and previously to the booster, T-cell response was also measured in 24 resident with different antibody levels. T-spot Discovery SARS-CoV-2 kit was used to identify cellular immunogenicity. RESULTS: As high as 99% of residents demonstrated a positive serological response after second dose. Only two patients showed no serologic response, two men without records of previous SARS-CoV-2 infection. A higher immune response was associated with prior SARS-CoV-2 infection regardless of the gender or age. The anti-S IgG titers decreased significantly in almost all the participants (98.5%) after six months of vaccination whatever previous COVID-infection. The third dose of vaccine increased antibody titers in all patients, although initial vaccination values were not restored in the majority of cases. CONCLUSION: The main conclusion of the study is that vaccine resulted in good immunogenicity in this vulnerable population. Nevertheless more data are needed on the long-term maintenance of antibody response after booster vaccination.

Diversity of immune responses in children highly exposed to SARS-CoV-2.

Background: Children are less susceptible than adults to symptomatic COVID-19 infection, but very few studies addressed their underlying cause. Moreover, very few studies analyzed why children highly exposed to the virus remain uninfected. Methods: We analyzed the serum levels of ACE2, angiotensin II, anti-spike and anti-N antibodies, cytokine profiles, and virus neutralization in a cohort of children at high risk of viral exposure, cohabiting with infected close relatives during the lockdown in Spain. Results: We analyzed 40 children who were highly exposed to the virus since they lived with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected relatives during the lockdown for several months without taking preventive measures. Of those, 26 reported mild or very mild symptoms. The induced immune response to the virus was analyzed 3 months after the household infection. Surprisingly, only 15 children had IgG anti-S (IgG+) determined by a sensitive method indicative of a past infection. The rest, negative for IgG anti-N or S in various tests, could be further subdivided, according to IgM antibodies, into those having IgM anti-S and IgM anti-N (IgG-IgMhigh) and those having only IgM anti-N (IgG-IgMlow). Interestingly, those two subgroups of children with IgM antibodies have strikingly different patterns of cytokines. The IgMhigh group had significantly higher IFN-α2 and IFN-γ levels as well as IL-10 and GM-CSF than the IgMlow group. In contrast, the IgMlow group had low levels of ACE2 in the serum. Both groups have a weaker but significant capacity to neutralize the virus in the serum than the IgG+ group. Two children were negative in all immunological antibody tests. Conclusions: A significant proportion of children highly exposed to SARS-CoV-2 did not develop a classical adaptive immune response, defined by the production of IgG, despite being in close contact with infected relatives. A large proportion of those children show immunological signs compatible with innate immune responses (as secretion of natural antibodies and cytokines), and others displayed very low levels of the viral receptor ACE2 that may have protected them from the virus spreading in the body despite high and constant viral exposure.

Effects of a Multicomponent Programme for Improving Physical and Psychological Health in Victims of Intimate Partner Violence: Study Protocol for a Randomised Control Trial.

Intimate partner violence (IPV) is a public health problem that psychologically and physically affects the women who suffer from it. In this article, we propose an intervention protocol based on therapeutic tourism through adventure physical activities and psychological therapy that could improve the psychological and physical health of women participants. We propose a randomized study where participants will be separated into two groups, control and experimental, and we will perform measurements including self-concept, self-image, depression, and perceived stress, combining these with physiological measurements of stress level by determining stress-related hormones (Cortisol and DHEA), as well as the overall cost-effectiveness of the program. All data collected at the end of the protocol will be statistically analysed. If the final data are positive and it is feasible, this protocol could be proposed as a measure for the treatment of the sequelae of victims of gender violence.