Walkability and socio-economic status in relation to walking, playing and sports practice in a representative Spanish sample of youth: The PASOS study.

PURPOSE: Physical activity (PA) provides multiple health-related benefits in children and adolescents, however, at present, the majority of young people are insufficiently physically active. The aim of this study was to evaluate if neighborhood walkability and/or socio-economic status (SES) could affect the practice of walking, play outdoors and sports practice in a representative sample of Spanish children and adolescents. METHODS: A sample of 4092 youth (aged 8-16 years old) from 245 primary and secondary schools in 121 localities from each of the 17 Spanish autonomous communities participated in the study. Walk Score was used to evaluate walkability of the neighborhood and household income was used as an indicator of SES. A 7-item self-reported validated questionnaire, was used to assess PA levels, and in a subsample of 10% of the participants, randomly selected from the entire sample, PA was objectively measured by accelerometers. RESULTS: Youth from more walkable areas reported more minutes walking per day compared with those from less walkable neighborhoods (51.4 vs 48.8 minutes, respectively). The lowest average minutes spent in playing outdoors was found among participants from low-SES and low-walkable neighborhoods. Neighborhood SES influenced on the participation in team sports during the weekend, being this participation higher in high SES neighborhoods. CONCLUSION: Providing high walkable environments seems a good strategy to promote PA regardless SES levels. It seems that improving the walkability is a key component to partially overcome the SES inequalities, especially in urban areas with low SES. High-SES environments can offer better sports facilities and more organized physical activities than low-SES ones.

Nurses' Perceptions Regarding Their Professional Commitment and Development during the COVID-19 Pandemic.

INTRODUCTION: During the pandemic, nurses have undergone a high level of professional burnout, suffering emotional exhaustion, depersonalization, and lack of personal realization. OBJECTIVE: The object of this study is to understand in depth, through a phenomenological study of Giorgi, the perceptions on commitment and professional development of frontline nurses during the first and second waves of the COVID-19 pandemic. METHOD: Qualitative study designed and analyzed using Giorgi's phenomenological focus. For data collection, semi-structured interviews were utilized in a theoretical sample of frontline nurses who worked in public hospitals of Extremadura and Madrid, Spain, until saturation of data. The interviews were conducted between the months of May and December 2020 following an outline of topics. The analysis was based on the phenomenological focus of Giorgi and was supported by the software Atlas-Ti 8.0. RESULTS: A total of 14 nurses participated in this study. Two main themes emerged to explain the perceptions of the nurses: (1) the professional commitment of the nurses during the pandemic and (2) the effects of the pandemic on professional development; seven subcategories were also identified. CONCLUSION: The social and professional development of nurses is important. If nurses feel that they are quality professionals, this will enable them to protect their psychosocial health and increase professional commitment toward their patients in difficult situations such as pandemics. The results of this study may serve as a guide for better understanding the problems and needs of nurses as healthcare providers. This may help administrators in the generation of solutions for the establishment of a safe and reliable work environment, which will in turn promote a healthcare system that can efficiently respond to future catastrophes.

Monitorización flash en pacientes con diabetes mellitus tipo 1: adherencia, complicaciones y parámetros clínicos / Flash monitoring in patients with type 1 diabetes mellitus: treatment adherence, complications and clinical parameters

Objetivos: describir el perfil sociodemográfico y clínico de las personas con diabetes mellitus tipo 1 (DM1), así como el uso del dispositivo de monitorización flash Freestyle Libre (FL) en quienes se lo habían costeado por cuenta propia, y analizar las diferencias (parámetros analíticos, complicaciones de la enfermedad y adherencia al tratamiento) frente a pacientes con DM1 que utilizaban los controles glucémicos tradicionales mediante punción capilar.Método: estudio descriptivo transversal en 206 pacientes con DM1 de un área de salud en la región de Castilla-La Mancha. Variables de estudio: tener dispositivo FL por cuenta propia, variables sociodemográficas y clínicas (incluyendo parámetros analíticos) y el cuestionario validado Self Care Inventory Revised (SCI-R). Se realizaron análisis univariante y bivariante, así como un análisis multivariante de regresión logística (variable dependiente: tener el dispositivo FL por cuenta propia).Resultados: el análisis multivariante mostró que no tener el dispositivo FL era más probable en quienes tenían estudios primarios/sin estudios (OR 4,86 (IC95%: 1,03-22,88); Referencia (Ref): estudios secundarios/universitarios), dislipemia (OR 3,18 (IC95% 1,39-7,26); Ref: no dislipemia), 6 o más hipoglucemias/semana (OR 3,21 (IC95%: 1,44-7,16); Ref: menos de 6) y 4 o más punciones/día (OR: 17,56 (IC95%: 6,09-50,64); Ref: menos de 4). Tanto le media de glucosa basal como la HBA1c eran más bajas (p< 0,001) en quienes tenían el dispositivo, así como mejores puntuaciones en el SCI-R (p< 0,001).Conclusión: el uso de los dispositivos de control glucémico permite un mejor manejo de las complicaciones de la DM1: menor número de hiper e hipoglucemias, punciones y mejor adherencia al tratamiento.(AU)

Objectives: to describe the sociodemographic and clinical profile of persons with Type 1 Diabetes Mellitus (T1D), as well as the use of the FreeStyle Libre (FL) flash monitoring device in those who had paid for it out of their own pocket, and to analyse the differences (lab test parameters, disease complications and treatment adherence) vs. T1D patients using traditional glycemic monitoring through finger prick.Method: a descriptive cross-sectional study in 206 patients with T1D from a health area in the Castilla-La Mancha region. Study variables: to have a FL device purchased out of pocket, sociodemographic and clinical variables (including lab test parameters) and the validated Self Care Inventory Revised (SCI-R) questionnaire. Univariate and bivariate analyses were conducted, as well as multivariate logistical regression analysis (dependent variable: to have purchased the FL out of pocket).Results: the multivariate analysis showed that not having the FL device was more likely among those with primary education / no education (OR 4.86 (CI95%: 1.03-22.88); Reference (Ref): secondary / university education, dyslipidemias (OR 3.18 (CI95% 1.39-7.26); Ref: no dyslipidemia, 6 or more hypoglycaemias/ week (OR 3.21 (CI95%: 1.44-7.16); Ref: less than 4, or more finger pricks/day (OR: 17.56 (CI95%: 6.09-50.64); Ref: less than 4. Both the mean baseline glucose and the HBA1c were lower (p< 0.001) among those who had the device, who also had better scores in the SCI-R questionnaire (p< 0.001).Conclusion: the use of the glycemic control devices allows better management of TDI complications: a lower number of hyper and hypoglycaemias and finger pricks, and better treatment adherence.(AU)

Accidentes biológicos entre sanitarios durante la pandemia por sars-cov-2: 2019-2021 / Biological accidents among healthcare professionals during the sars-CoV-2 pandemic: 2019 to 2021

Objetivo: describir la tendencia de las exposiciones biológicas accidentales entre sanitarios durante los años 2019-2021. Método: estudio epidemiológico descriptivo retrospectivo con 400 accidentes biológicos de trabajadores del Departamento de Salud Clínico-Malvarrosa (Valencia) de 2019 a 2021. La información fue recogida por el Servicio de Prevención de Riesgos Laborales gracias a las bases de datos REBA y EOLAS. Se recogieron variables del tipo de accidente, entorno en que se produjo, características del trabajador afectado, medidas de seguridad tomadas y parámetros serológicos de la fuente y el trabajador. Resultados: la distribución de accidentes por año fue de n= 132 en 2019 (33%), n= 121 en 2020 (30,25%) y n= 147 en 2021 (36,75%). Los profesionales más accidentados en todos los años fueron los de Enfermería, concretamente con < 5 años de experiencia, edad de 25-34 años y con contrato eventual. Los servicios que más accidentes reportaron fueron Atención Primaria y Cirugía en todos los años, especialmente en turno de mañana. Más del 20% de los trabajadores no usaba guantes en el momento del accidente en ninguno de los tres años. El uso de la mascarilla aumentó de un 24% en 2019 a un 100% en 2021, así como las medidas de protección facial que aumentaron de un 0% a un 7%. El 96% de los accidentes pudo ser filiados sin casos de seroconversión entre los trabajadores expuestos en ningún año. Conclusiones: aparentemente la pandemia por COVID-19 no ha alterado la tendencia de las exposiciones biológicas accidentales entre sanitarios. Las fluctuaciones más notables podrían deberse a la reducción de actividad quirúrgica durante 2020.(AU)

Objective: to describe the tendency of biological exposures among healthcare professionals during the years 2019-2021. Method: a retrospective descriptive epidemiological study with 400 biological accidents among the staff of the Clínico-Malvarrosa Health Department (Valencia) from 2019 to 2021. The information was collected by the Occupational Risk Prevention Service through the REBA and EOLAS databases. The type of variables collected were: type of accident, setting where it occurred, characteristics of the worker involved, safety measures applied, and serological parameters of source and worker. Results: the distribution of accidents per year was n= 132 in 2019 (33%), n= 121 in 2020 (30.25%) and n= 147 in 2021 (36.75%). The professionals who experienced more accidents in all years were nurses, specifically those with <5 years of experience, 25-to-34-year old, and under temporary contract. The services that reported more accidents were Primary Care and Surgery in all these years, particularly the morning shifts. Over 20% of the staff were not wearing gloves at the time of the accident in any of these three years. There was an increase in the use of face masks from 24% in 2019 to 100% in 2021, as well as an increase in facial protection measures from 0% to 7%. Of these accidents, 96% could be recorded without seroconversion cases among workers exposed in any of these years. Conclusions: apparently, the COVID-19 pandemic has not altered the tendency towards accidental biological exposures among healthcare workers. The most significant fluctuations could be due to the reduction in surgical activity during 2020.(AU)

Nurses' Perceptions of Ethical Conflicts When Caring for Patients with COVID-19.

The COVID-19 pandemic has caused ethical challenges and dilemmas in care decisions colliding with nurses' ethical values. This study sought to understand the perceptions and ethical conflicts faced by nurses working on the frontline during the first and second waves of the COVID-19 pandemic and the main coping strategies. A qualitative phenomenological study was carried out following Giorgi's descriptive phenomenological approach. Data were collected through semi-structured interviews until data saturation. The theoretical sample included 14 nurses from inpatient and intensive care units during the first and second waves of the pandemic. An interview script was used to guide the interviews. Data were analyzed following Giorgi's phenomenological method using Atlas-Ti software. Two themes were identified: (1) ethical conflicts on a personal and professional level; and (2) coping strategies (active and autonomous learning, peer support and teamwork, catharsis, focusing on care, accepting the pandemic as just another work situation, forgetting the bad situations, valuing the positive reinforcement, and humanizing the situation). The strong professional commitment, teamwork, humanization of care, and continuous education have helped nurses to deal with ethical conflicts. It is necessary to address ethical conflicts and provide psychological and emotional support for nurses who have experienced personal and professional ethical conflicts during COVID-19.

Lifestyle Behaviours Profile of Spanish Adolescents Who Actively Commute to School.

The aim of this study was to study different 'healthy profiles' through the impact of multiple lifestyle behaviours (sleep patterns, screen time and quality diet) on active commuting to school (ACS) in adolescents. Sixteen secondary schools from four Spanish cities were randomly selected. All participants filled in an "Ad-Hoc" questionnaire to measure their mode of commuting and distance from home to school and their lifestyle behaviours. A multivariate logistic regression model was performed to analyse the main predictor variables of ACS. The final sample was 301 adolescents (50.2% girls; mean age ± SD: 14.9 ± 0.48 years). The percentage of ACS was 64.5%. Multiple logistic regressions showed: boys were more active commuters than girls [OR = 2.28 (CI 95%: 1.12−4.64); p = 0.02]; adolescents who lived farther had lower probability to ACS [OR = 0.74 (CI 95%: 0.69−0.80); p < 0.001]; adolescents who met sleep duration recommendations were more likely to ACS [OR = 3.05 (CI 95%: 1.07−8.69); p = 0.04], while with each hour of sleep, the odds of ACS was reduced [OR = 0.51 (CI 95%: 0.30−0.89); p = 0.02]; higher odds were shown to ACS in adolescents who have more adherence to MD [OR = 1.16(CI 95%: 1.00−1.33); p = 0.05]; and habitual breakfast consumption was inversely associated with ACS [OR = 0.41 (CI: 95%: 0.18−0.96); p = 0.04]. ACS was associated with being a boy, living at a shorter distance to school, a daily sleep time ≥ 8 h and presented a higher adherence to MD.

Longitudinal study of the flash glucose monitoring system in type 1 diabetics: An mHealth ally in times of COVID-19.

AIMS AND OBJECTIVES: The aim of this study was to assess the effect of the FreeStyle Libre device implantation in adult type 1 diabetics in a Health Area of Castilla La Mancha (Spain) during the COVID-19 pandemic. BACKGROUND: FreeStyle Libre is a so-called mHealth device that supports health care. During COVID-1 confinement, diabetic patients could have improved their glycaemic monitoring thanks to these devices, although health care in these patients may have been limited due to confinement. METHODS: A 12-month longitudinal study in which a total of 206 type I diabetics participated, belonging to a single health area. Sociodemographic and analytical data and the Self Care Inventory Revised questionnaire (SCI-R) were collected. STROBE checklist was followed. RESULTS: The analysis showed differences related to the use of the sensor. After the study period, patients obtained better levels of basal glucose, glycosylated haemoglobin, creatinine, cholesterol, triglycerides and LDL. In addition, a significant increase in the total score of the SCI-R questionnaire was observed after the use of the monitor (MD -7.77; 95% CI -10.43, -8.29). The same occurred with different SCI-R items such as diet (MD -2.995; 95% CI -3.24, -2.57), glucose determination (MD -3.21; 95% CI -3.52, -2.91), medication administration (MD -2.58; 95% CI -2.53, -1.96) and hypoglycaemic episodes (MD -1.07; 95% CI -1.21, -0.93). In the analysis by groups, worse values of glycosylated haemoglobin and adherence to treatment (p < .05) were observed in overweight/obese subjects versus those with normal weight after one year of study. CONCLUSION: The use of flash monitoring is related to better adherence to most of the recommended habits in diabetes. Nevertheless, there seems to be no relationship with an improvement in physical exercise and preventive aspects of diabetes. A good nursing intervention to support physical exercise and the use of mHealth devices could improve the control of diabetic patients. RELEVANCE TO CLINICAL PRACTICE: The use of this mHealth device has shown positive results and reduced complications. Despite less contact with healthcare facilities due to the pandemic, type 1 diabetic patients have improved their blood results and adherence after using the device for one year. Nursing staff should focus on promoting physical activity and routine disease care in type 1 diabetics.

Associations among Active Commuting to School and Prevalence of Obesity in Adolescents: A Systematic Review.

Active commuting to school (ACS) seems to be one of the means to increase physical activity (PA) levels in youth, but it is unclear if ACS reduces the prevalence of obesity, protecting and improving their health. Most of the previous research has been conducted on children or youth (i.e., children with adolescents together), and there is a paucity of research in adolescents only. The purpose of this review was to assess the association between ACS with overweight/obesity parameters in adolescents aged 11 to 19 years. We used PubMed, WOS and SPORTDiscus as electronics databases. All steps of the process followed the recommendations of the PRISMA flow-diagram. Fifteen articles (68.18%) found a consistent association between ACS and body composition and seven studies (31.82%) showed no differences in body composition between active and passive commuters to school. Fourteen studies observed that active commuters to school had a more favorable body composition and one study reported that ACS was associated with unfavourable body composition. ACS could be the steppingstone to improve PA promotion in adolescence but whether ACS is associated with improved body composition and prevention of obesity requires further research.

Psychosocial factors related to physical activity in frail and prefrail elderly people.

BACKGROUND: Increased physical activity (PA) is a very important factor in a healthy aging lifestyle. Psychosocial factors have also a main role in the initiation and maintenance of this behavior, but nowadays its implications for frailty elderly people are unknown, therefore, the aim of this study was to identify the psychosociological variables of behavior change that influence the practice of (PA) in frail and prefrail elderly. METHODS: A total of 103 frail and pre-frail elderly people (72 females) participated in this cross-sectional study, on the framework of the EXERNET-Elder3.0 project. Age ranged from 68-94 years (mean = 80.4 ± 5.9 years). Individualized face-to-face interviews according to the constructs of the Transtheoretical Model of Change (TTM) [(decisional balance (DB) and self-efficacy (SE)], social support (SS) (family and friends) and outcome expectations (OE) were administered to all participants. RESULTS: Significant differences were found in DB, perceived benefits (PBn), SE, family-related SS and OE as a function of stages of change (SoC) (p < 0.005), but no significant were found in perceived barriers (PBrr) (p = 0.259) and friends-related SS (p = 0.068). According to the Scheffé post-hoc test, those in advanced SoC (Action-Maintenance), scored higher than those in lower SoC (Precontemplation-Contemplation and Preparation). CONCLUSION: The scores obtained from the study variables differed according to the SoC, supporting the external validity for the use of the TTM in frailty elderly. Further research is needed to determine the impact of PBrr and friends-related SS on this people, as well as to identify the validity of this model in the long-term in this population.

Physical Activity Adherence Related to Body Composition and Physical Fitness in Spanish Older Adults: 8 Years-Longitudinal EXERNET-Study.

Introduction: The multiple benefits of physical activity (PA) compared to the current lack of adherence to this behavior in older people makes it necessary to identify the factors related to its long-term dropout, therefore, the aim of this study was: (i) to study the evolution of behavior change for PA through stages of change (SoC) after 8 years and, to identify the associated factors related to the worsening of SoC for PA. Methods: A total of 714 Spanish older adults (>65 years) participated in the Longitudinal elderly EXERNET study 8 years follow-up. SoC for PA from Transtheoretical model of behavior change (TTM), body composition [BMI, fat mass, lean mass, waist circumference (WC), and hip circumference (HC)] and physical fitness (EXERNET battery fitness tests) were recorded. A multivariate binary logistic regression model was used to identify the potential predictive factors of worsening SoC for PA. Results: Three hundred and sixty participants (50.4%) worsening their SoC for PA after 8 years. Predictors factors associated with worsening of SoC were: HC (OR = 1.022; 95% CI: 1.001, 1.044), Lower body strength (OR = 0.940; 95% CI: 0.887, 0.997) and aerobic endurance at the 6 min-walk test (OR = 0.997; 95% CI: 0.995, 0.999). Conclusion: This study highlights that we need to identify adults with high HC, lower body strength and lower aerobic endurance to design a tailored PA program. Identifying the determinants of losing adherence to PA will help in the creation, design, and evaluation of exercise programs with the goal of reducing older adults' drop-outs rates.

Impacto del confinamiento en el estilo de vida: profesionales sanitarios y población general / Impact of lockdown on lifestyle: healthcare professionals and overall population

Objetivo: explorar los efectos del confinamiento por la pandemia COVID-19 en el estilo de vida de la población general y profesionales sanitarios (PS). Método: estudio descriptivo transversal. Se realizó muestreo no probabilístico por bola de nieve a través de WhatsApp. Se difundió un cuestionario realizado ad hoc previamente pilotado sobre variables sociodemográficas, clínicas y hábitos de vida durante el confinamiento. Para el análisis se utilizaron las pruebas paramétricas t de Student-Fisher, Chi cuadrado de Pearson y odds ratio (OR) con IC95%. Resultados: participaron 184 PS y 460 no sanitarios. La muestra tenía una media de 40,4 (DE: 12,8) años, principalmente eran mujeres (66,9%) con formación universitaria (65,8%). Más PS contaron con una prueba positiva para COVID-19, OR= 17,1 (9,1-32,1) o síntomas compatibles con COVID-19, OR= 2,1 (1,4-3,1). La repercusión psicológica del confinamiento fue superior en PS, OR= 1,5 (1,0-2,1). No se hallaron diferencias significativas en las actividades efectuadas durante la cuarentena exceptuando el teletrabajo (p< 0,001). El 68,0% de la población no sanitaria autorrefirió su grado de preocupación como “Muy preocupado” y “Fuertemente preocupado”, similar a los PS (65,8%) (p= 0,218). Los hábitos saludables se mantuvieron durante el confinamiento, a excepción del ejercicio físico que empeora en ambos grupos (66,3% de sanitarios y 66,4% de no sanitarios). El consumo de tabaco y/o alcohol aumentó entre un 20 y un 30% en ambos grupos. Conclusiones: se perciben cambios entre PS y no sanitarios en cuanto a la ocupación durante el confinamiento, el impacto psicológico o la tendencia al contagio. Es imprescindible introducir recursos para el cuidado de la salud mental, especialmente en PS.(AU)

Objective: to explore the effects of lockdown for the COVID-19 pandemic on the lifestyles of the overall population and healthcare professionals (HCPs). Method: a cross-sectional descriptive study. Non-probability snowball sampling was conducted through WhatsApp. After the pilot survey, an ad-hoc questionnaire was distributed on sociodemographic, clinical and lifestyle variables during lockdown. The parametric tests used for analysis were Student-Fisher’s t and Pearson’s Chi-squared test, and odds ratio with CI95%. Results: the study included 184 HCPs and 460 non-HCPs. The median age of the sample was 40.4 (SD: 12.8) years, they were mostly women (66.9%) with university education (65.8%). More HCPs had positive test results for COVID-19, OR= 17.1 (9.1-32.1) or symptoms compatible with COVID-19, OR= 2.1 (1.4-3.1). The psychological impact of lockdown was higher in HCPs, OR= 1.5 (1.0-2.1). There were no significant differences in the activities carried out during quarantine, except for telework (p< 0.001). The degree of concern self-reported by 68.0% of the non-HCP population was “Very concerned” and “Highly concerned”, similarly to HCPs (65.8%) (p= 0.218). Healthy lifestyles were maintained during lockdown, except for physical exercise which was worse in both groups (66.3% of HCPs and 66.4% of non-HCPs). Smoking and/or alcohol intake increased between 20 and 30% in both groups. Conclusions: changes were perceived among HCPs and non-HCPs regarding occupation during lockdown, psychological impact or tendency to get infected. It is essential to introduce resources for mental healthcare, particularly for HCPs.(AU)

Differences among Sociodemographic Variables, Physical Fitness Levels, and Body Composition with Adherence to Regular Physical Activity in Older Adults from the EXERNET Multicenter Study.

The aim of this study was to explore the differences among between adherence to physical activity (PA) and sociodemographic variables, body composition, and physical fitness levels in older adults (>65 years). A number of 2712 participants (2086 female; 76.92%) ranging from 65 to 92 years, participated in the study. Stages of change (SoC) for PA from the transtheoretical model of change (TTM), together with different sociodemographic variables, physical fitness tests (Senior Fitness Test), and waist and hip circumferences were evaluated. Significant differences were found in age, gender, educational level, current income, physical fitness test, and body composition (all of them, p < 0.05), according to the different SoC. Greater adherence to PA practice (action and maintenance stages) was related to better academic level, higher economic income, the male gender, better results in the physical fitness test, and healthier anthropometrics perimeters. Future research is needed to identify the relationship between these variables longitudinally.

Food Preferences in Undergraduate Nursing Students and Its Relationship with Food Addiction and Physical Activity.

The transition to college is a decisive stage for the acquisition of eating habits that continue into adulthood. The aim of this study is to assess the consumption of healthy elements of the Mediterranean diet in a group of university students and to evaluate whether the consumption pattern was related to sex, Body Mass Index (BMI), food addiction or the amount of physical activity performed. A total of 515 nursing students participated. The Mediterranean diet adherence questionnaire (PREDIMED), the food addiction scale (YFAS 2.0) and the International Physical Activity Questionnaire (IPAQ) were completed. For data analysis, multivariate analysis was performed with multiple linear regression and adjusted for sex, age, and BMI. The results showed that females consumed various types of meats (white/red, processed) in a healthier proportion (p < 0.05). Students that consumed more than one per day (unhealthy) of red/processed meats (mean difference (MD) = −0.49; 95% CI: −0.83; −0.15), soft drinks (MD = −0.82; 95% CI: 82−1.36; −0.27) and pastries (MD = −0.63; 95% CI: −0.97; −0.30) displayed higher food addiction scores. In addition, students who skipped breakfast also scored higher on food addiction (MD = 0.75; 95% CI: 0.31−1.19). Higher values of physical activity were observed in those who presented a healthy consumption of vegetables (MD = 140.86; 95% CI: 72.71−209.02), fruit (MD = 145.78; 95% CI: 69.35−222.21), legumes (MD = 136.46; 95% CI: 60.43−212.50) and nuts (MD = 74.36; 95% CI: 14.23−134.49). Students who consumed more red or processed meats, more pastries and more soft drinks had higher values of food addiction, while those who consumed more vegetables, fruits, legumes, and nuts had more minutes of physical activity per week. These findings invite us to insist on expanding knowledge regarding the health benefits of consuming a Mediterranean-type diet as a whole. The healthy consumption of fish, fruit and legumes should also be emphasized, especially among university students.

Experiences and Perceptions of Nursing Students during the COVID-19 Crisis in Spain.

In the early stages of the 2019 coronavirus pandemic in Spain, the Spanish health system was overwhelmed, mainly due to a lack of personnel, and many hospital centers collapsed by following avalanche of patients with COVID-19; this meant that the National System of Health called for fourth-year nursing students to come to the hospital as health care personnel. Our aim was to describe the perceptions and experiences of a sample of nursing students during the early stages of the outbreak. We conducted a qualitative study with an empirical-phenomenological approach. Twenty nursing students in their final year of study in Spain were recruited using purposive and snowball sampling. They participated in in-depth interviews between 20 April and 10 May 2020. The interviews were transcribed and then analyzed using Haase's adaptation of Colaizzi's phenomenological method. Four main themes emerged from data analysis: "social responsibility and pride as a health worker", "pressure caused by working with COVID-19 patients", "feeling defenseless and let down", and "personal growth as a health worker". These main themes were further divided into 11 theme categories. Due to an intense work day for several days in a row, the students were tired and mentally exhausted. Even so, they managed to overcome any difficulties, demonstrating their professional dedication and resilience. Greater preparatory support should be provided to safeguard the well-being of these future healthcare providers. More intensive preparatory training is necessary for health sciences students to facilitate crisis preparedness and effective crisis management. It is necessary to implement support from healthcare systems, including sufficient personal protective equipment, as well as contracts that accurately reflect the work they do. It is necessary for nursing supervisors to have effective communication in the performance of their functions with nursing students; this dialogue helps to clearly explain which are the functions that students must perform when they are carrying out their internships. There is also a need for preparatory training in managing infectious diseases such as COVID-19.

Gender-Differentiated Analysis of the Correlation between Active Commuting to School vs. Active Commuting to Extracurricular Physical Activity Practice during Adolescence.

Active commuting to school in children and adolescents can help achieve compliance with the World Health Organization (WHO) recommendations for physical activity. This study aimed to evaluate the relationship between the mode of transport used to go to school and the mode of transport used to go to extracurricular sports practice. Multistage random cluster sampling was conducted to include 128 schools with the participation of 11,017 students between the ages of 5 and 19. Participants completed the survey of sports habits designed by the National Sports Council. The results revealed that the mode of transport used to go to school is significantly related to the mode of transport used to go to sports practice. A total of 54.3% of students aged 5 to 19 years walk to school. A total of 23.7% of boys walk and 7.9% bike to extracurricular physical activities vs. 24.1% of girls who walk. The fact that girls only walk to extracurricular physical activities implies that the organized sports activities were nearby. Therefore, it seems crucial to have a wide range of physical activities on offer locally to promote extracurricular physical activity participation for girls.

Food Addiction and Lifestyle Habits among University Students.

The prevalence of overweight and obesity is increasing in our society, with a complex, multifactorial origin, and associated with greater morbidity and mortality in the population. Food addiction (FA) is a common disorder in overweight/obese people, which appears to be increasingly common in young people. This study analyzed food addiction in a group of young university students and to examine its association with body composition, quality of sleep, adherence to the Mediterranean diet, physical activity/sedentary habits, tobacco or alcohol consumption, and health status. A total of 536 undergraduate nursing students participated in a questionnaire that included the Yale Food Addiction Scale (YFAS 2.0). Up to 6.4% of the students presented FA. Statistically significant associations were observed in the variables for sleep quality odds ratio (OR) 4.8 (95% confidence interval (CI): 1.66-13.87), anxiety/depression OR 8.71 (95% CI: 3.93-19.27), body mass index (BMI) OR 8.32 (95% CI: 3.81-18.15) and sedentary lifestyle OR 2.33 (95% CI: 1.09-5.01). A predictive model was developed after binary logistic regression (area under the ROC curve 0.84 (95% CI: 0.77-0.91). Students with FA presented higher BMI values, worse sleep quality, anxiety or depression problems, and more time spent in sedentary behaviors.

Nursing students' experience and training in healthcare aid during the COVID-19 pandemic in Spain.

BACKGROUND: During the COVID-19 pandemic health crisis, in some countries such as Spain, nursing students have offered to provide health assistance, but the role they have played, their degree of preparedness to face the situation, and what must be improved in their training to be ready for these situations is unknown. OBJECTIVE: Describe the experience and perceptions of students of the Nursing university degree during their participation as health support in the COVID-19 health crisis in Spain. DESIGN: We conducted a cross-sectional survey study. METHOD: 503 students enrolled in the 4th course of the Nursing degree in Spain during the months of March and April 2020. An online questionnaire was developed, based on a pilot study and distributed through the Nursing Association, students' unions and students' associations. Variables were used to describe their participation, degree of preparedness and training needs to determine how to improve training through descriptive statistics, as well as nonparametric tests to analyse the relationship between training and degree of preparedness nursing students. Results are reported according to the STROBE Statement. RESULTS: 73.2% (368) of students offered to participate in healthcare aid, of which 225 were actively involved. 27.8% carried out nursing tasks without supervision, and 47.7% assisted COVID-19 patients as any other nurse. Only 3.4% felt very prepared to work in the field of intensive care, finding that those students who perceived a higher degree of preparedness had received previous training in personal protective equipment and mechanical ventilation (p < 0.005). The highest scores for training activities that may improve their preparedness were simulations to improve levels of anxiety and stress when managing critical patients, simulation in ventilatory support and mandatory practices in services where ventilators are used. CONCLUSIONS: Although three out of four students were willing to provide health assistance, they recognise that they were not specially prepared in the field of intensive care and demand training with simulation to improve anxiety and stress levels in the management of critical patients and simulation in ventilatory support. RELEVANCE TO CLINICAL PRACTICE: Students have been vital resources for our health system and society when they have been needed. It is now up to us, both teachers and health authorities, to share their efforts by implementing the necessary improvements in training and safety measures not only because these affects the health and safety of the patient, but because they will be essential parts in future pandemics.

Transtheoretical Model for Physical Activity in Older Adults: Systematic Review.

Healthy aging makes the practice of physical activity (PA) a necessity. However, PA guidelines achievement in older adults is scarce. The use of behavioral theories such as Transtheoretical Model (TTM), helps in older adults PA promotion. The aim of this review was to identify the use of TTM for PA in older adults (>60 years). PubMed, SPORTdiscus, and Medline databases were used to conduct the search. All steps of the process followed the recommendations of the PRISMA flow-diagram. We identified eight studies: Six were descriptive cross-sectional studies, one prospective-cohort study and one with a quasi-experimental design. Only two papers evaluated the four behavior change dimensions within the same study, three evaluated the processes of change and the decisional balance, four evaluated the exercise self-efficacy and all assessed the stages of change for PA behavior. From this review, we can conclude that TTM is a useful and suitable behavior model in creating, developing, and evaluating interventions with the aim of acquiring and improving PA habits in the older adults. However, there is paucity of research in this area, and more studies including the four behavioral change dimensions are needed to analyze the effect of TTM on the promotion of PA in the older adults.

Physical Activity and Sedentary Lifestyle in University Students: Changes during Confinement Due to the COVID-19 Pandemic.

Regular physical activity is related to many factors in a university student's environment. The coronavirus pandemic and the resulting lockdown have restricted many elements of our environment. The aim of this study was to evaluate students' physical activity and sedentary behaviour at two points in time: before and during the coronavirus lockdown. As a secondary aim, we also wanted to look at changes resulting from other factors (alcohol, tobacco, diet, stages of change, symptoms of anxiety/depression and sociodemographic characteristics). We conducted an observational, cross-sectional, pre-post study with two cut-off points. Two hundred and thirteen students took part in the study. The main dependent variables were physical activity and sitting time, measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Parametric and non-parametric tests were used for paired and unpaired data, as well as group-stratified analysis. During lockdown, both weekly physical activity (MD: -159.87; CI: -100.44, -219.31) and weekly sitting time increased (MD: -106.76; CI: -71.85, -141.67). In the group analysis, differences were observed in relation to gender, year of study, BMI, alcohol consumption, tobacco use, symptoms of anxiety/depression, Mediterranean diet, living situation and stage of change. The results showed an increase in both physical activity and sitting time globally and by group.

School and Family Environment is Positively Associated with Extracurricular Physical Activity Practice among 8 to 16 Years Old School Boys and Girls.

Extracurricular physical activity in children and adolescents can help achieve compliance with the World Health Organization (WHO) recommendations for physical activity. The purpose of this study was to evaluate factors in school and family environments of children and adolescents in Spain that could be related to the practice of extracurricular physical activity. Multistage random cluster sampling was conducted to include 128 schools with the participation of 10,096 students between the ages of 7 and 16. Participants completed the survey of sports habits designed by the National Sports Council. The results revealed a higher participation in extracurricular sports activities among boys (OR: 1.67 (1.5-1.9)) and students in primary education (up to 12 years old) (OR: 1.8 (1.7-2.0)). Likewise, a statistically significant relationship (p < 0.005) was observed between families where another family member practiced sports and lower number of screen time hours, improved academic performance, and better self-perceived health. Participation of children and adolescents in extracurricular sports activities seems to be associated with their immediate environment. It is therefore essential to emphasize the importance of establishing physical activity habits from an early age in family and school environments.