Comparison of the Psychometric Properties of the EQ-5D-3L-Y and EQ-5D-5L-Y Instruments in Spanish Children and Adolescents.

OBJECTIVES: The study aimed to assess the reliability and validity of EQ-5D-5L-Y and to compare the performance of EQ-5D-5L-Y with EQ-5D-3L-Y in children and adolescents. METHODS: The Spanish versions of the 3L and 5L of EQ-5D for youths, were administered to children and adolescents from the general population. Feasibility and reliability were determined for the EQ-5D-5L-Y. The EQ-5D-5L-Y and EQ-5D-3L-Y were evaluated in terms of ceiling effects, informativity, and correlations with other generic measurements of health-related quality of life. RESULTS: A total of 714 healthy children and adolescents (10.7 ± 2.1 years old) from the general population participated in the study. Most of the sample reported full health status. The feasibility and reliability for the EQ-5D-5L-Y were acceptable, but the questionnaire showed a low convergent validity. Absolute informativity (Shannon index) showed a slight increase in all dimensions of the 5L compared with the 3L; nevertheless, there were only statistically significant differences between 5L and 3L in the dimension "feeling worried, sad, or unhappy" and also on the overall system. Relative informativity (Shannon evenness index) showed a decrease in the 5L compared with 3L for all dimensions, except for "looking after myself." Correlations with other health measurements, in both 3L and 5L, showed similar results to those observed in the international EQ-5D-3L-Y validation study. CONCLUSION: The results show that EQ-5D-5L-Y is feasible, consistent, and reliable, but there are minor differences in the ceiling effect and informativity between the EQ-5D-5L-Y and EQ-5D-3L-Y versions in the general population.

Effects of an exercise program linked to primary care on depression in elderly: fitness as mediator of the improvement.

PURPOSE: The present study aimed to analyse the effects of 12 months of participation in a public physical activity program linked to primary care on depression level and fitness, and to determine which fitness components were responsible for the improvement in depression using mediation analysis. METHODS: Participants of this program were 2768 middle-aged and older adults from 67 municipalities throughout the Spanish region of Extremadura. In the analysis only participants with depression and without any missing values for fitness variables were included. This sample was 303 for exercise group and 74 for control group. Socio-demographic data, Geriatric Depression Scale and some fitness tests were applied at baseline and 1 year later. Exercise group performed the program 3 days/week for 50-60 min per session involving brisk walking with intermittent flexibility, strength and balance activities/exercises. Socializing within the group was encouraged in all sessions. Data analysis included analysis of covariance, chi-squared and effect size statistics. Additionally, a parallel model of mediation analysis was performed to determine the indirect effect of the participation in the exercise program on depression through improvements in fitness. RESULTS: A considerable reduction from mild, moderate or severe depression to non-depression were obtained for exercise group (68%) P-value < .05. The parallel mediation analysis showed that flexibility (sit-and-reach [ß - 0.04 (- 0.07 to - 0.01)], back scratch [ß - 0.06 (- 0.12 to - 0.02)]) and cardiorespiratory fitness (6-min walk [ß - 0.09 (- 0.15 to - 0.04)]) were mediators of the reduction in depression. CONCLUSION: This exercise program was effective in improving depression in older adults. Integrating aerobic and flexibility exercises in a group-based program of physical activity programs could improve the severity of depression in this population.

The global burden of falls: global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017.

BACKGROUND: Falls can lead to severe health loss including death. Past research has shown that falls are an important cause of death and disability worldwide. The Global Burden of Disease Study 2017 (GBD 2017) provides a comprehensive assessment of morbidity and mortality from falls. METHODS: Estimates for mortality, years of life lost (YLLs), incidence, prevalence, years lived with disability (YLDs) and disability-adjusted life years (DALYs) were produced for 195 countries and territories from 1990 to 2017 for all ages using the GBD 2017 framework. Distributions of the bodily injury (eg, hip fracture) were estimated using hospital records. RESULTS: Globally, the age-standardised incidence of falls was 2238 (1990-2532) per 100 000 in 2017, representing a decline of 3.7% (7.4 to 0.3) from 1990 to 2017. Age-standardised prevalence was 5186 (4622-5849) per 100 000 in 2017, representing a decline of 6.5% (7.6 to 5.4) from 1990 to 2017. Age-standardised mortality rate was 9.2 (8.5-9.8) per 100 000 which equated to 695 771 (644 927-741 720) deaths in 2017. Globally, falls resulted in 16 688 088 (15 101 897-17 636 830) YLLs, 19 252 699 (13 725 429-26 140 433) YLDs and 35 940 787 (30 185 695-42 903 289) DALYs across all ages. The most common injury sustained by fall victims is fracture of patella, tibia or fibula, or ankle. Globally, age-specific YLD rates increased with age. CONCLUSIONS: This study shows that the burden of falls is substantial. Investing in further research, fall prevention strategies and access to care is critical.

Fitness as mediator between weight status and dimensions of health-related quality of life.

BACKGROUND: There is evidence that overweight and obesity in children is associated with poor Physical Fitness and consequently lower Health-related Quality of Life (HRQoL). However, this linear-causal relationship between Weight Status → Physical Fitness → HRQoL is not enough to fully understand this phenomenon. Therefore, need to know, through mediation analysis, how operate the Physical Fitness between weight status and HRQoL dimensions. PURPOSE: The aim of this study was to determine which HRQoL dimensions are mediated through Physical Fitness in obese (including overweight) and normal weight children. The study also examined the association between Physical Fitness, Body Mass Index (BMI) and HRQoL. METHODS: A total of 233 overweight/obese children and 105 normal-weight children participated in the study. Children were recruited from public educational centers and a public weight loss program. BMI, Physical Fitness (upper limb, central body and lower limb strength; agility and range of motion) and HRQoL (PedsQL and VAS) were measured. Simple mediation analyses by gender, through PROCESS macro developed by Preacher and Hayes, were performed in order to analyze whether Physical Fitness computed as z-score, is a mediator in the relation between weight status (normal weight or overweight/obesity) and HRQoL dimensions. \itionally, unequal-variances t statistics were executed to know differences in BMI, Physical Fitness components and HRQoL dimensions between groups, and correlations to know the associations between weight status, Physical Fitness z-score and HRQoL. RESULTS: Our results, indicated association between the Physical Fitness z-score and HRQoL dimensions in overweight/obese children. Regarding to mediation analysis, the results showed that the negative association between overweight/obesity and HRQoL is softened by the level of Physical Fitness. Therefore Physical Fitness is a mediator in the relationship between overweight/obesity children and the most of dimensions of HRQoL, except the School functioning in boys and the School and Emotional functioning in girls. CONCLUSIONS: The negative effect of overweight or obesity on HRQoL inn children, is mitigated by Physical Fitness. Consequently, the Physical Fitness is a mediator on HRQoL in most dimensions, especially daily living, in schoolchildren.

Does anthropometric and fitness parameters mediate the effect of exercise on the HRQoL of overweight and obese children/adolescents?

BACKGROUND: There is sufficient evidence about the effects of physical exercise programs on health-related quality of life (HRQoL) in obese and overweight children. OBJECTIVES: The purpose of this study was to observe the effects on physical fitness and HRQoL in overweight and obesity children and their parents and find out whether the effect of intervention on anthropometric and physical fitness parameters mediated the improvements found in the proxies' perception of participant quality of life. METHODS: 151 overweight and obese children (106 intervention and 45 control) participated in a public exercise program. Anthropometrics characteristics, physical fitness, and HRQoL (EQ-5D-Y) were measured. Analysis of Covariance and effect size were performed to analyze the improvement. Mediation analyzed with bootstrap to observe whether anthropometric or physical fitness improvements mediate of the changes in the proxies' assessment of HRQoL. RESULTS: Significant improvements were found in waist circumference, physical fitness, and HRQoL. The improvement of waist circumference showed a significant indirect effect on the change in the proxy perception of quality of life. CONCLUSION: The reduction of waist circumference mediates the change on proxies' perception of quality of life and not by the improvement in physical fitness. TRIAL REGISTRATION: ISRCTN97887613.

Effects of a minor surgery on health related quality of life in children from different perspectives / Efectos de una intervención quirúrgica menor sobre la calidad de vida en niños desde diferentes perspectivas.

Objective: To compare the health related quality of life (HRQoL) perceptions in parents and physician regarding the patient undergoing ambulatory surgery, and to analyse the evolution of HRQoL before and after the ambulatory surgery. Method: 36 patients underwent ambulatory surgical interventions taken part in this study. The questionnaires EQ-5D-Y were administered to the patients and questionnaires EQ-5D-Y proxy to parents and physicians. Variable TTO was used. Results: Statistical differences were found at baseline between answers of patients and physicians (p < 0.05). However, after surgery, answers of patients and proxies were similar. Conclusions: Paediatric patients undergone to a minor surgery improve HRQoL after the operation and this improvement goes on a month after the surgery.

Objetivo: Comparar la percepción de la calidad de vida relacionada con la salud (CVRS) de padres y médico con respecto al paciente en población infantil sometida a una intervención quirúrgica menor, y analizar la progresión de la CVRS tras un mes de someterse a la intervención. Método: Participaron 36 pacientes sometidos a intervenciones quirúrgicas menores. Se les administró el cuestionario EQ-5D-Y, y su versión proxy correspondiente a los padres y al médico. Se utilizó la variable TTO. Resultados: Los pacientes refirieron un peor estado de salud, sobre todo en la dimensión de preocupación/tristeza, que los médicos en el preoperatorio (p < 0.05), pero la percepción postoperatoria fue similar en pacientes y adultos, atribuible al efecto techo por buena salud postoperatoria. Conclusiones: Los pacientes pediátricos sometidos a cirugía menor mejoran su CVRS tras la intervención, y esta mejora se mantiene tras un mes de la cirugía.

"Fibromyalgia and quality of life: mapping the revised fibromyalgia impact questionnaire to the preference-based instruments".

BACKGROUND: The revised version of the Fibromyalgia Impact Questionnaire (FIQR) is one of the most widely used specific questionnaires in FM studies. However, this questionnaire does not allow calculation of QALYs as it is not a preference-based measure. The aim of this study was to develop mapping algorithm which enable FIQR scores to be transformed into utility scores that can be used in the cost utility analyses. METHODS: A cross-sectional survey was conducted. One hundred and 92 Spanish women with Fibromyalgia were asked to complete four general quality of life questionnaires, i.e. EQ-5D-5 L, 15D, AQoL-8D and SF-12, and one specific disease instrument, the FIQR. A direct mapping approach was adopted to derive mapping algorithms between the FIQR and each of the four multi-attribute utility (MAU) instruments. Health state utility was treated as the dependent variable in the regression analysis, whilst the FIQR score and age were predictors. RESULTS: The mean utility scores ranged from 0.47 (AQoL-8D) to 0.69 (15D). All correlations between the FIQR total score and MAU instruments utility scores were highly significant (p < 0.0001) with magnitudes larger than 0.5. Although very slight differences in the mean absolute error were found between ordinary least squares (OLS) estimator and generalized linear model (GLM), models based on GLM were better for EQ-5D-5 L, AQoL-8D and 15D. CONCLUSION: Mapping algorithms developed in this study enable the estimation of utility values from scores in a fibromyalgia specific questionnaire.

[Health-related quality of life in Chilean patients with chronic obstructive pulmonary disease]. / Calidad de vida relacionada con la salud en personas chilenas con enfermedad pulmonar obstructiva crónica.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has a relevant impact on health-related quality of life (HRQoL). Short Form 6 dimensions (SF-6D) quality of life tool allows researchers to calculate preference-based utilities using data from SF-12 or SF-36 questionnaires. AIM: To provide normative values of SF-6D derived from SF-12 for Chilean patients with COPD. MATERIAL AND METHODS: SF-6D utility index was calculated using data from the 2009/2010 Chilean National Health Survey. Sixty-nine male and 120 female patients with COPD participated in the survey. Data was stratified by gender, age, region, marital status, smoking status, monthly incomes, educational level and area. RESULTS: The mean (± SD) SF-6D utility index for Chilean patients with COPD was 0.65 ± 0.15. The scores for men and women were 0.68 ± 0.15 and 0.64 ± 0.15, respectively. Patients with high incomes and educational level reported higher SF-6D scores. Ceiling effect was not a limitation when SF-6D was used in these Chilean patients. CONCLUSIONS: The current study provides normative values of SF-6D derived from SF-12 for Chilean patients with COPD.

Using a dry electrode EEG device during balance tasks in healthy young-adult males: Test-retest reliability analysis.

BACKGROUND: The analysis of brain activity during balance is an important topic in different fields of science. Given that all measurements involve an error that is caused by different agents, like the instrument, the researcher, or the natural human variability, a test-retest reliability evaluation of the electroencephalographic assessment is a needed starting point. However, there is a lack of information about the reliability of electroencephalographic measurements, especially in a new wireless device with dry electrodes. OBJECTIVE: The current study aims to analyze the reliability of electroencephalographic measurements from a wireless device using dry electrodes during two different balance tests. METHOD: Seventeen healthy male volunteers performed two different static balance tasks on a Biodex Balance Platform: (a) with two feet on the platform and (b) with one foot on the platform. Electroencephalographic data was recorded using Enobio (Neuroelectrics). The mean power spectrum of the alpha band of the central and frontal channels was calculated. Relative and absolute indices of reliability were also calculated. RESULTS: In general terms, the intraclass correlation coefficient (ICC) values of all the assessed channels can be classified as excellent (>0.90). The percentage standard error of measurement oscillated from 0.54% to 1.02% and the percentage smallest real difference ranged from 1.50% to 2.82%. CONCLUSION: Electroencephalographic assessment through an Enobio device during balance tasks has an excellent reliability. However, its utility was not demonstrated because responsiveness was not assessed.

Can adult weights be used to value child health states? Testing the influence of perspective in valuing EQ-5D-Y.

PURPOSE: To test whether or not adults assign the same values to hypothetical health states that describe health in adults as when those same descriptions refer to the health of a child. METHODS: A two-part self-completion questionnaire was designed in which respondents were asked firstly to rate a fixed set of EQ-5D-Y health states on a 0-100 visual analogue scale as if they themselves were in these states. Two versions of the questionnaire were produced each with a different second part. One version instructed respondents to value the same states but to imagine them describing another adult. The second version required respondents to value these states as if they applied to a 10-year-old child. Questionnaires were distributed to adults recruited in three countries (Germany, Spain and England) using convenience sampling methods. RESULTS: A total of 1085 questionnaires were completed. Despite some significant differences in the characteristics of the achieved samples in the three countries involved, the rank order of health states was largely consistent across each adult/child reference perspective. In all countries, the mean values were lower when health states described children rather than adults. Significant differences were found for 16/24 states when values for those states applied to adult respondent themselves were compared with the values for those states applied to a 10-year-old child. A near-uniform pattern was found across all three countries in which health state values for children were found to be lower than for adults. CONCLUSIONS: Values for health states when ascribed to adults are higher than when those same states are associated with children. Were EQ-5D-3L values for adults applied to EQ-5D-Y health states, then this would effectively lead to an misrepresentation of the value assigned to a health status in children.

Changes in HRQoL after 12 months of exercise linked to primary care are associated with fitness effects in older adults.

PURPOSE: To analyse the effects of 1 year of participation in a physical activity (PA) program linked to a health-care setting on physical fitness (PF) and health-related quality of life (HRQoL) and to determine the relationships between PA, PF and HRQoL in middle-aged and older adults. METHODS: In total, 3214 participants were recruited from a health-care setting. Sociodemographic data, HRQoL questionnaires and PF tests were applied by 37 employees at baseline and 1 year later. The participants were placed in an exercise group (EG) (n = 2614) and the remaining participants (n = 600) were placed in the control group (CG). EG performed the program 3 days/week for 50-60 minutes per session involving brisk walking with intermittent flexibility, strength and balance activities/exercises.CG participants were asked to continue with their usual activities. Data analysis included repeated measures analysis of variance, linear regression and contingency analysis. RESULTS: EG showed significant mild-moderate improvement in all PF and HRQoL outcomes, especially in adjusted models. Changes in several PF variables were predictive of HRQoL changes. EG exhibited either improvements or no change in HRQoL dimensions. CG exhibited no change or declines in all dimensions. CONCLUSIONS: PF is positively related with HRQoL. PA significantly improved PF, especially the PF components more impaired at baseline.

[Translation and cultural adaptation of the Composite Physical Function for its use in Chile]. / Traducción y adaptación cultural del cuestionario de independencia física Composite Physical Function para su uso en Chile.

UNLABELLED: Aging is directly related with loss of physical independency. Composite Physical Function questionnaire (CPF) assess, throw 12 items, a range of daily life activities in order to determine dependency levels in elderly. However, there is not a Spanish version of this instrument. AIM: To translate and culturally adapt the CPF to Spanish for its use in Chilean elderly. METHOD: Standardized international methodology was used in this study, which consisted in double direct translation to Spanish, harmonization of versions and back-translation to English. Acceptability and familiarity of the obtained version was analyzed using probing and paraphrasing methods using a sample of 20 older adults aged from 65 to 80 years old. RESULTS: All items were clear and understandable, although minor adaptations needed to be done in order to improve the understandability of two items. These adaptations consisted in adding information in brackets at the end of the sentence. CONCLUSION: Spanish version of the CPF questionnaire was obtained to its use in Chile. This questionnaire has been proved to be understandable and adapted to its use in Chilean older adults. Its ease of use makes this questionnaire potentially useful in future researches and surveys.

Analysis of the use of public open spaces and physical activity levels in children and adolescents from Rivera (Uruguay).

This study aimed to analyze the use of public open spaces and physical activity levels among children and adolescents in the city of Rivera, Uruguay. A total of 88 target areas located in 29 public open spaces were observed using the System for Observing Play and Recreation in Communities (SOPARC). Systematic observations were made at different times of the day, covering both weekdays and weekends, for a total of 792 records in each public open spaces. Characteristics of the users were recorded according to gender (male and female), age group (infancy to early childhood 0-5 years, middle childhood 6-12 years, adolescence 13-18 years) and physical activity level (sedentary, moderate, or vigorous activity). Logistic regression was employed, considering variables such as day, period, type, and conditions, to assess factors associated with user presence and activity, with separate analyses by gender. Most of the users were adolescents (59.8%) between 13 and 18 years, 67.2% were male and half of the users were sedentary (50.1%). Furthermore, the majority of participants used the target areas on weekends (96.2%), particularly in the evening (99.2%). Multivariate analyses revealed elevated odds of having active girls and boys in the target area during the afternoon and evening, particularly in organized and equipped areas, compared to the morning. Based on this information, it is worth proposing the need to promote the active use of public open spaces in the city of Rivera (Uruguay).

Intermittent Hypoxic Training Increases and Prolongs Exercise Benefits in Adult Untrained Women.

Alba Camacho-Cardenosa, Marta Camacho-Cardenosa, Johannes Burtscher, Pedro R. Olivares, Guillermo Olcina, and Javier Brazo-Sayavera. Intermittent hypoxic training increases and prolongs exercise benefits in adult untrained women. High Alt Med Biol. 00:00-00, 2024. Background: Exercising in hypoxia may confer multiple health benefits, but the evidence for specific benefits is scarce. Methods: We investigated effects of intermittent hypoxic training (IHT) on the quality of life and functional fitness of healthy adult women, in a double-blind, randomized, placebo-controlled study. Subjects performed 36 sessions of IHT (experimental group, n = 41; fraction of inspired oxygen [FIO2]: 0.17) or the same training in normoxia (control group, n = 41; FIO2: 0.21). Health-related quality of life, fitness tests, and hemoglobin levels were assessed before (T1), directly after (T2), and 4 weeks after (T3) cessation. Results: At T2, upper body strength (+14.96%), lower body strength (+26.20%), and agility (-4.94%) increased significantly in the experimental group compared to baseline but not in controls. The experimental group improved lower body strength more (by 9.85%) than controls at T2 and performed significantly better in walking (by 2.92%) and upper body strength testing (by 16.03%), and agility (by 4.54%) at T3. Perceived general health and vitality was significantly greater in the experimental group at T2 and T3 compared with T1. None of these improvements were observed in the control group. Conclusions: IHT is a promising strategy to induce long-lasting fitness benefits in healthy adult women.

Applicability and test-retest reliability of isokinetic shoulder abduction and adduction in women fibromyalgia patients.

OBJECTIVE: To investigate the applicability and reliability of isokinetic strength measurements during concentric and eccentric actions of the shoulder muscles in fibromyalgia (FM) patients. DESIGN: Test-retest reliability study. SETTING: University laboratory. PARTICIPANTS: Women with FM (N=25) aged 37 to 69. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Two isokinetic tests of the shoulder were repeated after an interval of 7 days. Each test involved 3 repetitions of abduction and adduction performed at a rate of 60°/s. The first test involved 2 concentric muscle actions (concentric/concentric test). The second test involved concentric abduction followed by eccentric adduction (concentric/eccentric test). Unilateral peak torque (Nm) and average work (J) were measured. Applicability was calculated as the proportion of participants who were able to complete every test. Reliability was analyzed by intraclass coefficient (ICC), standard error of measurement, and smallest real difference (SRD). RESULTS: Applicability was 84% for the concentric/concentric test and 52% for the concentric/eccentric test. The main factor influencing applicability was age. In the concentric/eccentric test, measurement of peak torque showed high reliability for the abduction (ICC=.88; standard error of measurement=1.82; SRD=5.05) and adduction (ICC=.89; standard error of measurement=3.83; SRD=10.62) phases. In the concentric/concentric test, measurement of peak torque showed low reliability in the abduction phase (ICC=.29; standard error of measurement=6.45; SRD=17.87) and excellent reliability in the adduction phase (ICC=.92; standard error of measurement=5.95; SRD=16.50). CONCLUSIONS: The applicability of shoulder isokinetic tests in FM patients who are women may be affected by age. In comparison, the concentric/concentric test was more applicable and less reliable than the concentric/eccentric test during abduction and adduction. These findings will facilitate the clinical interpretation of changes in isometric and isokinetic shoulder adduction and abduction tests in women with FM.

Normative Values and Psychometric Properties of EQ-5D-Y-3L in Chilean Youth Population among Different Weight Statuses.

BACKGROUND: This study aimed to provide population norms among children and adolescents in Chile using the EQ-5D-Y-3L questionnaire and to examine its feasibility and validity among body weight statuses. METHODS: This was a cross-sectional study in which 2204 children and adolescents (aged 8-18 years) from Chile completed a set of questionnaires providing sociodemographic, anthropometric and health-related quality of life (HRQoL) data using the five EQ-5D-Y-3L dimensions and its visual analogue scale (EQ-VAS). Descriptive statistics of the five dimensions and the EQ-VAS were categorized into body weight status groups for the EQ-5D-Y-3L population norms. The ceiling effect, feasibility and discriminant/convergent validity of the EQ-5D-Y-3L were tested. RESULTS: The dimensions of the EQ-5D-Y-3L questionnaire presented more ceiling effects than the EQ-VAS. The validity showed that the EQ-VAS could discriminate among body weight statuses. However, the EQ-5D-Y-3L index (EQ-Index) demonstrated a non-acceptable discriminant validity. Furthermore, both the EQ-Index and the EQ-VAS presented an acceptable concurrent validity among weight statuses. CONCLUSIONS: The normative values of the EQ-5D-Y-3L indicated its potential use as a reference for future studies. However, the validity of the EQ-5D-Y-3L for comparing the HRQoL among weight statuses could be insufficient.

Bullying and Self-Concept, Factors Affecting the Mental Health of School Adolescents.

Bullying is an aggressive and repetitive behavior, where one person or several people physically, socially, or emotionally harm a vulnerable person and provokean imbalance of power in a school setting. Several factors such as age, sex, school performance, psychological factors, and ethnicity have been associated with bullying and more are being sought. Thus, the objectives of this study were as follows: (1) analyze the differences in bullying (victimization and aggression) and self-concept (academic, social, emotional, family, and physical) with respect to sex, school location, and educational level among Spanish adolescents; (2) explore the associations of bullying and self-concept with these sociodemographic dimensions. A cross-sectional study was designed with a total of 1155 participants (between 12 and 18 years old); there were 48.8% boys and 51.2% girls, where 75.9% studied compulsory secondary education (CSE) and 24.1% Baccalaureate, and 31.9% were students from rural schools and 68.1% were from urban schools. Medium and inverse correlations were shown between victimization and self-concept at the general level, for both sexes, both types of school, and both educational stages. For the aggression dimension, the correlations with self-concept were inverse at the general level (low), in girls (low), in rural students (medium), and in compulsory secondary education students (medium). For academic self-concept and family self-concept, the associations were medium and inverse with bullying in all variables. For emotional self-concept the correlation with bullying was direct and medium in all variables; in physical self-concept, the correlations with bullying were inverse in almost all variables except in boys. Self-concept may be a protective factor for bullying and interventions should aim at adolescents building a positive multidimensional self-concept that prevents and protects them from bullying either as aggressor or victim.

Fibromyalgia, Pain, and Physical Activity: A Bibliometric Analysis.

Fibromyalgia (FM) is a rheumatic disease characterized by pain, fatigue, low-quality sleep, depression, anxiety, stiffness, fall risk, mood disturbance, cognitive impairment, poor physical condition, and other symptoms leading to a worse quality of life. Physical activity (PA) and exercise are effective methods to reduce FM symptoms, including pain. This study presents the first bibliometric study on FM, pain, and PA. An advanced search of the Web of Science (WoS) Core Collection database performed on this topic using was carried out traditional bibliometric laws. A total of 737 documents were found. Annual publications presented an exponentially growing trend (R2 = 85.3%). Rheumatology International, Kaisa Mannerkorpi, and the USA were the journal, co-author, and country most productive, respectively. The exponential growth of annual publications on FM, PA, and pain shows the high interest of researchers and publishers in this topic. The document "Fibromyalgia A Clinical Review" was the most cited. Moreover, Kaisa Mannerkorpi was the most prolific co-author, Rheumatology International was the most prolific journal, "Fibromyalgia: a clinical review" was the most highly cited document, and Daniel Clauw was the most cited co-author.

Normative fitness performance scores of community-dwelling older adults in Spain.

A cross-sectional descriptive study was designed to obtain normative age-specific fitness scores for the general population of community-dwelling older adults in Spain. In total, 6,449 participants (5,610 women and 839 men) age 60-99 yr who lived in the region of Extremadura were recruited. Compared with the cohorts of similar studies in other countries, this cohort had more physically inactive elderly participants and participants with a higher body-fat percentage. All test results declined as age increased. Sex differences in the age-related decline in fat and body mass were observed. Women scored better in the flexibility tests, and men performed better in the other tests. These data may be highly useful for the age-specific assessment of the fitness performance of older adults and the design of programs that promote functional ability in older adults.

Psychometric Properties of the Spanish Versions of EQ-5D-Y-3L and EQ-5D-Y-5L in Children with Cancer: A Comparative Study.

(1) Background: The recent published version with five levels of response of EQ-5D-Y needs to be studied in children with chronic illness. For this, the aim of the present study was to assess and compare the psychometric properties of EQ-5D-Y-3L and EQ-5D-Y-5L in terms of feasibility, ceiling effect, redistribution properties, informativity and inconsistence responses in children with cancer. (2) Methods: A core set of self-report tools, including the Spanish version of EQ-5D-Y-3L and EQ-5D-Y-5L, were administered to children drawn from the population with cancer. EQ-5D-Y-3L and EQ-5D-Y-5L were evaluated in terms of feasibility, ceiling effects, redistribution properties and differences in absolute and relative informativity. (3) Results: A total of 73 children (9.7 ± 2.3 years old) from the population with cancer participated in the study. No missing data in the new EQ-5D-Y-5L were visualized, so the feasibility was acceptable. EQ-5D-Y-5L showed a low ceiling effect in all dimensions with relative changes from EQ-5D-Y-3L to EQ-5D-Y-5L of between 15.3% and 42.4% for the dimensions and 44.6% for the overall system. Compared to EQ-5D-Y-3L, EQ-5D-Y-5L provided a better distribution of the severity of the problem in the five levels of response. The absolute informativity (Shannon's index) did not show statistically significant differences between EQ-5D-Y-3L and EQ-5D-Y-5L in all dimensions and the overall system. (4) Conclusions: EQ-5D-Y-5L is feasible, presenting a low ceiling effect and high discriminative power.