Human adaptation to heat in the context of climate change: A conceptual framework.

Climate change is causing serious damage to natural and social systems, as well as having an impact on human health. Among the direct effects of climate change is the rise in global surface temperatures and the increase in the frequency, duration, intensity and severity of heat waves. In addition, understanding of the adaptation process of the exposed population remains limited, posing a challenge in accurately estimating heat-related morbidity and mortality. In this context, this study seeks to establish a conceptual framework that would make it easier to understand and organise knowledge about human adaptation to heat and the factors that may influence this process. An inductive approach based on grounded theory was used, through the analysis of case studies connecting concepts. The proposed conceptual framework is made up of five components (climate change, vulnerability, health risks of heat, axes of inequality and health outcomes), three heat-adaptation domains (physiological, cultural and political), two levels (individual and social), and the pre-existing before a heat event. The application of this conceptual framework facilitates the assistance of decision-makers in planning and implementing effective adaptation measures. Recognizing the importance of addressing heat adaptation as a health problem that calls for political solutions and social changes. Accordingly, this requires a multidisciplinary approach that would foster the participation and collaboration of multiple actors for the purpose of proposing effective measures to address the health impact of the rise in temperature.

Defining the maximum nitrogen surplus in water management plans to recover nitrate polluted aquifers in Spain.

Nitrate pollution in aquifers is a global concern. Spain has developed a national strategy to recover nitrate polluted aquifers aligned with the European Union (EU) policies, specifically through the water planning under the EU Water Framework Directive. River basin management plans use PATRICAL model results to define the maximum nitrogen surplus in each polluted aquifer for the first time. The maximum nitrogen surplus allows to reach the good status in each aquifer and the model provides the number of years required. Around 30% of the aquifers in Spain is currently heavily polluted by nitrates. Model results show that 90% of these aquifers can be recovered in next 6-12 years by increasing nitrogen use efficiency and reducing nitrogen losses around 50%, which is in line with the EU Farm to Fork Strategy. The remaining aquifers require additional reductions to achieve the good status. In Spain this increase in nitrogen efficiency can be obtained with different measures including 30% reduction of current fertilization.

Effect of climate change on the water quality of Mediterranean rivers and alternatives to improve its status.

Surface water (SW) quality is particularly vulnerable to increased concentrations of nutrients, and this issue may be exacerbated by climate change. Knowledge of the effects of temperature and rainfall on SW quality is required to take the necessary measures to achieve good SW status in the future. To address this, the aims of this study were threefold: (1) to assess how a changing climate may alter the nitrate, ammonium, phosphorus and biological oxygen demand status (BOD5) of SW; (2) assess the relationship between water quality and flow; and (3) simulate diffuse and point source pollution reduction scenarios in the Júcar River Basin District in the Mediterranean region. A regionalised long-term climate scenario was used following one Representative Concentration Pathway (RCP8.5) with the data incorporated into the coupling of hydrological and water quality models. According to these climate change scenarios, SW with poor nitrate, ammonium, phosphorus and BOD5 status are expected to increase in the future by factors of 1.3, 1.9, 4 and 4, respectively. Furthermore, median ammonium and phosphorus concentration may be doubled in months with low flows. Additional measures are required to maintain current status in the water bodies, and it is necessary to reduce at least 25% of diffuse nitrate pollution, and 50% of point loads of ammonium, phosphorus, and BOD5.

Pathophysiology of Cerebellar Degeneration in Mitochondrial Disorders: Insights from the Harlequin Mouse.

By means of a proteomic approach, we assessed the pathways involved in cerebellar neurodegeneration in a mouse model (Harlequin, Hq) of mitochondrial disorder. A differential proteomic profile study (iTRAQ) was performed in cerebellum homogenates of male Hq and wild-type (WT) mice 8 weeks after the onset of clear symptoms of ataxia in the Hq mice (aged 5.2 ± 0.2 and 5.3 ± 0.1 months for WT and Hq, respectively), followed by a biochemical validation of the most relevant changes. Additional groups of 2-, 3- and 6-month-old WT and Hq mice were analyzed to assess the disease progression on the proteins altered in the proteomic study. The proteomic analysis showed that beyond the expected deregulation of oxidative phosphorylation, the cerebellum of Hq mice showed a marked astroglial activation together with alterations in Ca2+ homeostasis and neurotransmission, with an up- and downregulation of GABAergic and glutamatergic neurotransmission, respectively, and the downregulation of cerebellar "long-term depression", a synaptic plasticity phenomenon that is a major player in the error-driven learning that occurs in the cerebellar cortex. Our study provides novel insights into the mechanisms associated with cerebellar degeneration in the Hq mouse model, including a complex deregulation of neuroinflammation, oxidative phosphorylation and glutamate, GABA and amino acids' metabolism.

Reductions in kinesiophobia and distress after pain neuroscience education and exercise lead to favourable outcomes: a secondary mediation analysis of a randomized controlled trial in primary care.

ABSTRACT: Pain neuroscience education combined with exercise (PNE + exercise) is an effective treatment for patients with chronic spinal pain. Yet, however, little is known about its underlying therapeutic mechanisms. Thus, this study aimed to provide the first insights by performing a novel mediation analysis approach in a published randomized controlled trial in primary care where PNE + exercise was compared with standard physiotherapy. Four mediators (catastrophizing, kinesiophobia, central sensitization-related distress, and pain intensity) measured at postintervention and 3 outcomes (disability, health-related quality of life, and pain medication intake) measured at 6-month follow-up were included into the analysis. The postintervention measure of each outcome was also introduced as a competing candidate mediator in each respective model. In addition, we repeated the analysis by including all pairwise mediator-mediator interactions to allow the effect of each mediator to differ based on the other mediators' values. Postintervention improvements in disability, medication intake, and health-related quality of life strongly mediated PNE + exercise effects on each of these outcomes at 6-month follow-up, respectively. Reductions in disability and medication intake were also mediated by reductions in kinesiophobia and central sensitization-related distress. Reductions in kinesiophobia also mediated gains in the quality of life. Changes in catastrophizing and pain intensity did not mediate improvements in any outcome. The mediation analyses with mediator-mediator interactions suggested a potential effect modification rather than causal independence among the mediators. The current results, therefore, support the PNE framework to some extent as well as highlight the need for implementing the recent approaches for mediation analysis to accommodate dependencies among the mediators.

Fertigation to recover nitrate-polluted aquifer and improve a long time eutrophicated lake, Spain.

Use of nitrogen and phosphorus in agriculture increases agricultural production but also generates important environmental problems around the world, such as high nitrate levels in aquifers and an increase in eutrophication of waters. A set of tools and models are used, ENVIRO-GRO and PATRICAL models, to analyse the effect of large irrigation system modernization, 13,700 ha, from traditional flood irrigation to modernized drip irrigation, in the aquifer nitrate levels and in the phosphorus inputs to a 50-years eutrophicated RAMSAR lake, Albufera lake. Based on data collected from end users, modernized irrigation system reduces the amount of nitrogen applied from 25 % to 45 % and phosphorus applied around 90-95 %, so phosphorus content on soil, phosphorus legacy, is reducing by time. Obtained results indicate that nitrogen leaching as nitrate is reduced by 70 % to 83 % and surface runoff during irrigation events disappear, hence phosphorus contributions to surface waters are eliminated. Nitrate polluted aquifer will be recovered in 5-6 years after complete implement of measures and phosphorus inputs to the lake are reduced around 20 % contributing to improve the status of the eutrophicated Albufera lake. Results show great agreement with the European Strategy to reduce the use of fertilizers and how the fertilizers technical management in fertigation can contribute to greater efficiency in it use and improvement of the environment.

Psychological Implicit Motives Construct as an Emergent Fractal Attractor from Intermittent Neurophysiological Responses: Simulation and Entropy-like Characterization.

Implicit Motives are non-conscious needs that drive human behavior towards the achievement of incentives that are affectively incited. Repeated affective experiences providing satisfying rewards have been held responsible for the building of Implicit Motives. Responses to rewarding experiences have a biological basis via close connections with neurophysiological systems controlling neurohormone release. We propose an iteration random function system acting in a metric space to model experience-reward interactions. This model is based on key facts of Implicit Motive theory reported in a broad number of studies. The model shows how (random) responses produced by intermittent random experiences create a well-defined probability distribution on an attractor, thus providing an insight into the underlying mechanism leading to the emergence of Implicit Motives as psychological structures. Implicit Motives' robustness and resilience properties appear theoretically explained by the model. The model also provides uncertainty entropy-like parameters to characterize Implicit Motives which hopefully might be useful, beyond the mere theoretical frame, when used in combination with neurophysiological methods.

Territory Differences in Adaptation to Heat among Persons Aged 65 Years and Over in Spain (1983-2018).

Climate change is currently regarded as the greatest global threat to human health, and its health-related consequences take different forms according to age, sex, socioeconomic level, and type of territory. The aim of this study is to ascertain the differences in vulnerability and the heat-adaptation process through the minimum mortality temperature (MMT) among the Spanish population aged ≥65 years by territorial classification. A retrospective, longitudinal, ecological time-series study, using provincial data on daily mortality and maximum daily temperature across the period 1983-2018, was performed, differentiating between urban and nonurban populations. The MMTs in the study period were higher for the ≥65-year age group in urban provinces, with a mean value of 29.6 °C (95%CI 29.2-30.0) versus 28.1 °C (95%CI 27.7-28.5) in nonurban provinces. This difference was statistically significant (p < 0.05). In terms of adaptation levels, higher average values were obtained for nonurban areas, with values of 0.12 (95%CI -0.13-0.37), than for urban areas, with values of 0.09 (95%CI -0.27-0.45), though this difference was not statistically significant (p < 0.05). These findings may contribute to better planning by making it possible to implement more specific public health prevention plans. Lastly, they highlight the need to conduct studies on heat-adaptation processes, taking into account various differential factors, such as age and territory.

Heat Adaptation among the Elderly in Spain (1983-2018).

The capacity for adaptation to climate change is limited, and the elderly rank high among the most exposed population groups. To date, few studies have addressed the issue of heat adaptation, and little is known about the long-term effects of exposure to heat. One indicator that allows the ascertainment of a population's level of adaptation to heat is the minimum mortality temperature (MMT), which links temperature and daily mortality. The aim of this study was to ascertain, firstly, adaptation to heat among persons aged ≥ 65 years across the period 1983 to 2018 through analysis of the MMT; and secondly, the trend in such adaptation to heat over time with respect to the total population. A retrospective longitudinal ecological time series study was conducted, using data on daily mortality and maximum daily temperature across the study period. Over time, the MMT was highest among elderly people, with a value of 28.6 °C (95%CI 28.3-28.9) versus 28.2 °C (95%CI 27.83-28.51) for the total population, though this difference was not statistically significant. A total of 62% of Spanish provinces included populations of elderly people that had adapted to heat during the study period. In general, elderly persons' level of adaptation registered an average value of 0.11 (°C/decade).

Metrics of progression and prognosis in untreated adults with thymidine kinase 2 deficiency: An observational study.

This historical cohort study evaluated clinical characteristics of progression and prognosis in adults with thymidine kinase 2 deficiency (TK2d). Records were available for 17 untreated adults with TK2d (mean age of onset, 32 years), including longitudinal data from 6 patients (mean follow-up duration, 26.5 months). Pearson's correlation assessed associations between standard motor and respiratory assessments, clinical characteristics, and laboratory values. Longitudinal data were assessed by linear regression mixed models. Respiratory involvement progressed at an annual rate of 8.16% decrement in forced vital capacity (FVC). Most patients under noninvasive ventilation (NIV) remained ambulant (12/14, 86%), reduced FVC was not associated with concomitant decline in 6-minute walk test (6MWT), and 6MWT results were not correlated with FVC. Disease severity, assessed by age at NIV onset, correlated most strongly at diagnosis with: creatinine levels (r = 0.8036; P = 0.0009), followed by FVC (r = 0.7265; P = 0.0033), mtDNA levels in muscle (r = 0.7933; P = 0.0188), and age at disease onset (r = 0.7128; P = 0.0042). This population of adults with TK2d demonstrates rapid deterioration of respiratory muscles, which progresses independently of motor impairment. The results support FVC at diagnosis, mtDNA levels in muscle, and age at disease onset as prognostic indicators. Creatinine levels may also be potentially prognostic, as previously reported in other neuromuscular disorders.

Muscle MRI in McArdle Disease: A European Multicenter Observational Study.

BACKGROUND AND OBJECTIVES: Glycogen storage disease type V (GSDV) or McArdle disease is a muscle glycogenosis that classically manifests with exercise intolerance and exercise-induced muscle pain. Muscle weakness and wasting may occur but is typically mild and described as located around the shoulder-girdle in elderly patients. Paraspinal muscle involvement has received little attention in the literature. The present study aimed to quantify fat-replacement of paraspinal, shoulder and lower limb muscles by magnetic resonance imaging in a European cohort of GSDV patients. METHODS: This observational study included patients with verified GSDV and healthy controls (HC). Whole-body MR-images and clinical data were collected. The degree of muscle fat-replacement was evaluated on T1-weighted images with the semi-quantitative visual Mercuri-scale, and on Dixon-images where individual muscle fat fractions (FF) were quantitatively calculated. RESULTS: MR-images and clinical data from a total of 57 GSDV patients (age 44.3±15.2 years) from five European centers were assessed and compared to findings in 30 HC (age 42.4±14.8 years). Patients with GSDV had significantly more fat-replacement of theparaspinal muscles compared to HC on all levels investigated detected both by the Mercuri and the Dixon methods (Dixon, paraspinal composite-FF (GSDV vs HC), at the cervical-: 31.3±13.1 vs 15.4±7.8; thoracic-: 34.5±19.0 vs 16.9±8.6 and lumbar-level: 43.9±19.6 vs 21.8±10.2 (p<0.0001)). Patients with GSDV also had significantly more fat-replacement of the shoulder muscles (evaluated by the Mercuri-scale), along with significantly, but numerically less, fat-replacement of thigh- and calf muscles compared to HC (Dixon, lower limb composite-FF (GSDV vs HC) at the thigh-: 12.0±5.6 vs 8.8±2.7 and calf-level: 13.1±6.7 vs 9.1±2.9 (p≤0.05)). DISCUSSION: The primary findings are that patients with GSDV exhibit severe fat-replacement of the paraspinal muscles, which can have important implications for the future management of patients with GSDV, and also significant fat-replacement of shoulder-girdle muscles as previously described. The clinical relevance of the discrete increases in lower limb FF is uncertain. The changes were found to be age-related in both groups, but an accelerated effect was found in GSDV, probably due to continuous muscle damage.

Multicentric Standardization of Protocols for the Diagnosis of Human Mitochondrial Respiratory Chain Defects.

The quantification of mitochondrial respiratory chain (MRC) enzymatic activities is essential for diagnosis of a wide range of mitochondrial diseases, ranging from inherited defects to secondary dysfunctions. MRC lesion is frequently linked to extended cell damage through the generation of proton leak or oxidative stress, threatening organ viability and patient health. However, the intrinsic challenge of a methodological setup and the high variability in measuring MRC enzymatic activities represents a major obstacle for comparative analysis amongst institutions. To improve experimental and statistical robustness, seven Spanish centers with extensive experience in mitochondrial research and diagnosis joined to standardize common protocols for spectrophotometric MRC enzymatic measurements using minimum amounts of sample. Herein, we present the detailed protocols, reference ranges, tips and troubleshooting methods for experimental and analytical setups in different sample preparations and tissues that will allow an international standardization of common protocols for the diagnosis of MRC defects. Methodological standardization is a crucial step to obtain comparable reference ranges and international standards for laboratory assays to set the path for further diagnosis and research in the field of mitochondrial diseases.

Expectations and Experiences of Spanish Primiparous Women Who Decide to Breastfeed Their Infants and Strategies for Change in 2020-A Qualitative Study.

To describe the experiences and expectations of Spanish women regarding breastfeeding and the support they receive from healthcare professionals, family, and friends during the breastfeeding journey, A qualitative study using an empirical-phenomenological approach was conducted. Primiparous women that had already given birth were interviewed using a purposive and snowball sampling. In-depth interviews were conducted between 1 January and 30 April 2020. The interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. We recruited 14 women who had recently become mothers. Three major themes describing experiences of infant feeding by maternal lactation were identified-institutional influences, establishing breastfeeding, and cessation of breastfeeding-as well as the following 10 categories: hospital routines, lactation concerns (amount and infant nutrition), antenatal breastfeeding decision, embarrassment to breastfeed, and normalisation of breastfeeding. Prior education and support were identified as key elements in possible breastfeeding support strategies.

Apoptosis-Inducing Factor Deficiency Induces Tissue-Specific Alterations in Autophagy: Insights from a Preclinical Model of Mitochondrial Disease and Exercise Training Effects.

We analyzed the effects of apoptosis-inducing factor (AIF) deficiency, as well as those of an exercise training intervention on autophagy across tissues (heart, skeletal muscle, cerebellum and brain), that are primarily affected by mitochondrial diseases, using a preclinical model of these conditions, the Harlequin (Hq) mouse. Autophagy markers were analyzed in: (i) 2, 3 and 6 month-old male wild-type (WT) and Hq mice, and (ii) WT and Hq male mice that were allocated to an exercise training or sedentary group. The exercise training started upon onset of the first symptoms of ataxia in Hq mice and lasted for 8 weeks. Higher content of autophagy markers and free amino acids, and lower levels of sarcomeric proteins were found in the skeletal muscle and heart of Hq mice, suggesting increased protein catabolism. Leupeptin-treatment demonstrated normal autophagic flux in the Hq heart and the absence of mitophagy. In the cerebellum and brain, a lower abundance of Beclin 1 and ATG16L was detected, whereas higher levels of the autophagy substrate p62 and LAMP1 levels were observed in the cerebellum. The exercise intervention did not counteract the autophagy alterations found in any of the analyzed tissues. In conclusion, AIF deficiency induces tissue-specific alteration of autophagy in the Hq mouse, with accumulation of autophagy markers and free amino acids in the heart and skeletal muscle, but lower levels of autophagy-related proteins in the cerebellum and brain. Exercise intervention, at least if starting when muscle atrophy and neurological symptoms are already present, is not sufficient to mitigate autophagy perturbations.

Sing4Health: Randomised controlled trial of the effects of a singing group program on the subjective and social well-being of older adults.

Group singing may be an optimal intervention strategy to promote active ageing and well-being; however, evidence with experimental validity is scarce. This study aims to fill this gap by analysing the effects of a 34-session singing group programme (SGP) on participants' subjective and social well-being and the mediating roles of social identification with the singing group and of self-esteem. An RCT with intervention (n = 89) and active waiting-list control (n = 60) conditions was conducted, and a mixed method quantitative and qualitative data collection and analysis were performed. Participants were mostly elderly day-care centre users (M = 76.66 years old; SD = 8.79) with low average levels of education and income. Structured measures of life satisfaction, positive and negative affect, self-esteem, loneliness, social identification and social well-being were collected, as well as interviews on the perceived benefits of participating in the SGP. Results showed significant effects of the SGP on the positive affect, social well-being and marginally on the self-esteem of the participants. The observed effects were sustained at the follow-up. Qualitative analysis corroborated the quantitative results. Mediation analysis showed indirect effects of social identification with the singing group on loneliness and social identification with the social care institution group; and of self-esteem on positive and negative affect.

Routines, Time Dedication and Habit Changes in Spanish Homes during the COVID-19 Lockdown. A Large Cross-Sectional Survey.

Many countries chose to establish social distancing as lockdowns after the COVID-19 outbreak. Households had to adapt their day-to-day lifestyles to new circumstances, affecting routines and time dedication to tasks. This national study was carried out to find out how the confinement by COVID-19 affected Spanish households on the perceived habit changes during this period, in relation to their socio-demographic characteristics and household composition. An online questionnaire was launched during the COVID-19 lockdown, from 30 April to 22 June 2020. Descriptive statistics were analyzed, stratified by gender, on time dedication, routine, home leaving, and habit change variables. Chi-square tests were used to explore the relations of significance with socio-demographic characteristics and home composition. All contrast analyses were performed for a 95% confidence level (significance considered for p < 0.05). In total, 1673 respondents participated from different age groups, educational level, employment status and household composition. Sixty percent of respondents maintained their routines. A third tried to establish a new one, being related to women, young people, not a university student, and living with others, including minors. Regarding dedication to tasks, adults aged 35-54 years, with more cohabitants, especially women, devoted themselves intensively to the home or to care, while those under 35 were dedicated more to rest, leisure, television or reading. People with university studies were more related to teleworking. The frequency of going outside was related to gender, age, educational level and living with elders, specifically for grocery shopping and taking out garbage. Changes in habits, routines and time dedication in confinement were strongly linked to the sociodemographic and coexistence conditions in Spanish homes. The greatest impacts were suffered by women, people with children, and adults between 35-54 years of age, especially on care and domestic chores.

Distal phalangeal erythema in an infant with biallelic PDSS1 mutations: Expanding the phenotype of primary Coenzyme Q10 deficiency.

We report a detailed clinical examination in a patient with primary coenzyme Q10 deficiency caused by biallelic mutations in the PDSS1 gene who presented clinical features of mitochondrial encephalopathy associated with pulmonary hypertension, livedo reticularis and particularly, chronic distal phalangeal erythema. Laboratory testing showed elevated plasma lactate and 3-methyl-glutaconic and tricarboxylic aciduria. Supplementation with high dose of coenzyme Q10 was not effective to control disease progression and the patient died at the age of 3 years old because of a progressive multisystem disorder. Cutaneous involvement in mitochondrial disease is heterogenous, including proliferative, inflammatory, and dystrophic changes among others. The coexistence in our case of phalangeal erythema, livedo reticularis, and pulmonary hypertension suggests microvascular dysfunction as a possible underlying mechanism. This is the first reported patient with PDSS1 mutations presenting with 3-methyl-glutaconic aciduria and distal phalangeal erythema, expanding the phenotype of primary coenzyme Q10 deficiency.

Effects of the pandemic crisis on entrepreneurship and sustainable development.

The COVID-19 pandemic has caused an economic crisis in advanced economies greater than the 2008 economic crisis, as the latest Organisation for Economic Co-operation and Development (OECD) forecasts indicate. Entrepreneurship activity is an important factor to be considered to reduce this negative. The objective of this paper is to analyze the factors that favor entrepreneurship in the COVID-19 pandemic situation and explore the relationship between entrepreneurship and sustainable development. Monetary, fiscal, competitiveness, and business expectations are factors to consider. To achieve this objective, we reviewed the specialized literature and proposed an economic model to verify the relationships between the relevant variables. The estimation of this model uses the Partial Least Squares (PLS) method. This study looks at select OECD countries where data on entrepreneurial activity are available and there are calculations by the OECD for the economic projections for 2020.

Toward a Better Understanding of the Intention to Use mHealth Apps: Exploratory Study.

BACKGROUND: An increasing number of mobile health (mHealth) apps are becoming available for download and use on mobile devices. Even with the increase in availability and use of mHealth apps, there has still not been a lot of research into understanding the intention to use this kind of apps. OBJECTIVE: The purpose of this study was to investigate a technology acceptance model (TAM) that has been specially designed for primary health care applications. METHODS: The proposed model is an extension of the TAM, and was empirically tested using data obtained from a survey of mHealth app users (n=310). The research analyzed 2 additional external factors: promotion of health and health benefits. Data were analyzed with a PLS-SEM software and confirmed that gender moderates the adoption of mHealth apps in Spain. The explanatory capacity (R2 for behavioral intention to use) of the proposed model was 76.4%. Likewise, the relationships of the external constructs of the extended TAM were found to be significant. RESULTS: The results show the importance of healthy habits developed by using mHealth apps. In addition, communication campaigns for these apps should be aimed at transferring the usefulness of eHealth as an agent for transforming attitudes; additionally, as more health benefits are obtained, ease of use becomes greater. Perceived usefulness (PU; ß=.415, t0.001;4999=3.442, P=.001), attitude toward using (ß=.301, t0.01;499=2.299, P=.02), and promotion of health (ß=.210, t0.05;499=2.108, P=.03) were found to have a statistically significant impact on behavior intention to use eHealth apps (R2=76.4%). Perceived ease of use (PEOU; ß=.179, t0.01;499=2.623, P=.009) and PU (ß=.755, t0.001;499=12.888, P<.001) were found to have a statistically significant impact on attitude toward using (R2>=78.2%). Furthermore, PEOU (ß=.203, t0.01;499=2.810, P=.005), health benefits (ß=.448, t0.001;499=4.010, P<.001), and promotion of health (ß=.281, t0.01;499=2.393, P=.01) exerted a significant impact on PU (R2=72.7%). Finally, health benefits (ß=.640, t0.001;499=14.948, P<.001) had a statistically significant impact on PEOU (R2=40.9%), while promotion of health (ß=.865, t0.001;499=29.943, P<.001) significantly influenced health benefits (R2=74.7%). CONCLUSIONS: mHealth apps could be used to predict the behavior of patients in the face of recommendations to prevent pandemics, such as COVID-19 or SARS, and to track users' symptoms while they stay at home. Gender is a determining factor that influences the intention to use mHealth apps, so perhaps different interfaces and utilities could be designed according to gender.

Adaptation of the Beliefs about Well-Being Scale to the Spanish population / Adaptación de la Escala de Creencias sobre el Bienestar a la población española

The study of happiness and well-being is receiving increased attention in different fields. Recent research into well-being has focused on delving deeper into the individual's conception about the experience of well-being. McMahan and Estes (2011a) created a scale that assesses lay conceptions of well-being based on four dimensions: the experience of pleasure, avoidance of negative experience, self-development and contribution to others. The goal of this study was to adapt this scale, the Beliefs about Well-Being Scale (BWBS), to the Spanish population. The sample consisted of 1,024 participants from the general population ranging in age interval from 17 to 87 years old. The confirmatory factorial analysis results in a structure of four dimensions, similar to the original scale, although in the adaptation of the scale the items decrease from 16 to 12. The results of the reliability analysis reveal indexes similar to those of the original scale. These results confirm the validity of Beliefs about Well-Being Scale with general population in a cultural context different from the original study. This will allow cross-cultural studies to analyze the influence of culture in the perception of well-being

El estudio de la felicidad y el bienestar está recibiendo cada vez más atención en diferentes campos. Las investigaciones recientes sobre el bienestar se han centrado en profundizar en la concepción del individuo sobre la experiencia del bienestar. McMahan y Estes (2011a) crearon una escala que evalúa las concepciones legas del bienestar en base a cuatro dimensiones: la experiencia de placer, la evitación de la experiencia negativa, el autodesarrollo y la contribución a los demás. El objetivo de este estudio fue adaptar esta escala, Beliefs about Well-Being Scale (BWBS), a la población española. La muestra estuvo formada por 1.024 participantes de la población general con un intervalo de edad entre 17 y 87 años. El análisis factorial confirmatorio da como resultado una estructura de cuatro dimensiones, similar a la escala original, aunque en la adaptación de la escala los ítems disminuyen de 16 a 12. Los resultados del análisis de fiabilidad revelan índices similares a los de la escala original. Estos resultados confirman la validez de la Escala de Creencias sobre el Bienestar con población general en un contexto cultural diferente al del estudio original. Esto permitirá realizar estudios transculturales para analizar la influencia de la cultura en la percepción del bienestar