Search Results (1,436)

Background: Central sensitization syndromes (CSSs) are associated with a high incidence of traumatic events; however, few studies have examined the potential mechanisms linking post-traumatic stress disorder (PTSD) and pain. Objectives: The present research aims to clarify this association by exploring the presence of trauma, PTSD, and related clinical variables in participants with CSSs compared to healthy controls and those with medical problems. Methods: A large sample of both sexes of the Spanish general population (n = 1542; aged 18–84 years) completed an online survey assessing the presence of traumatic experiences (psychological trauma, physical trauma, physical and sexual abuse), PTSD, and other clinical measures (central sensitization, pain, sleep quality, anxiety, depression, perceived stress, and emotional regulation). Results: The CSS group (n = 467) showed a higher incidence of repeated trauma, PTSD, and dissociative symptoms compared to the medical pathologies (n = 214) and healthy (n = 861) groups. The CSS group also showed greater clinical impairment than the other groups, especially the CSS subgroup with PTSD. In this subgroup, PTSD symptoms were significantly correlated with the remaining clinical measures, and sleep dysfunction, pain catastrophizing, and emotional dysregulation mediated the relationship between PTSD and pain, accounting for 55.3% of the variance. Conclusions: CSS represents a major therapeutic challenge. An integrated treatment addressing both trauma and pain, with an emphasis on sleep quality, pain catastrophizing, and emotional regulation, could improve the effectiveness of the current therapeutic approaches. Full article

Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases. Full article

Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values >0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application. Full article

The population dynamics and exploitation ratios of the narrow-barred Spanish mackerel (Scomberomorus commerson, Lacépède, 1800) were investigated from August 2020 to February 2023, with data collected from three landing sites (Bushehr, Bandar Abbas, and Chabahar) of Iran waters. During the study period, only length was measured for 6504 specimens and both the length and weight were measured for 504 specimens. The mean fork length of the samples was 86 ± 20 cm, and the mean weight was 6230 ± 3742 g. The relationship between length and weight for the total samples was described by the equation W = 0.022 × CL^2.76 (n = 504, R² = 0.90, 95% C.I. for b = 2.52–2.91). The population dynamics indices for S. commerson were as follows: infinite length (Linf) = 173 cm, natural mortality (M) = 0.47 per year, growth coefficient (K) = 0.52 per year, total mortality (Z) = 1.42 ± 0.06 (95% C.I. = 1.36–1.48), fishing mortality (F) = 0.95 per year, and exploitation coefficient (E) = 0.67. The exploitation rate (U) and total stock at the beginning of the year (B₀) were 0.6 and 48,333 tons, respectively. The annual average standing stock (B_t) was estimated at 30,526 tons. The exploitation ratio for maximum sustainable yield (E_MSY) was 0.50, and fishing mortality at maximum sustainable yield (F_MSY) was 1.5. The estimated range for maximum sustainable yield (MSY, in 1000 tons), the B/B_MSY ratio, F/F_MSY ratio, and saturation (S) ratio of S. commerson in the Iranian part of the Persian Gulf and the Sea of Oman was 20 (17–25), 1.55 (1.25–1.73), 0.90 (0.8–1.12), and 0.45, respectively. The stock of S. commerson is approaching overfishing in Iran waters, imposing immediate management actions to reduce catch and fishing effort. Full article

Eating disorders are characterised by concerns about food, body image, and weight control and/or reduction. They are more frequently described in women, and emotion regulation plays a central role in both their development and persistence. The aim of this study was to analyse the sensitivity and specificity of emotion regulation in predicting disordered eating symptoms in a sample of female university students. Non-probabilistic sampling was used to recruit 558 female university students, with a mean age of 20.63 years (SD = 1.88). An adaptation in Spanish of the Difficulties in Emotion Regulation Scale (DERS) and the Spanish version of the Eating Disorder Examination Questionnaire (S-EDE-Q) were administered. The findings suggested that scores related to emotion dysregulation, emotional rejection, and emotional interference may help distinguish women with disordered eating symptoms associated with food restriction and eating concerns. It is important to have sensitive tools that can identify at-risk populations as well as relevant psychological constructs linked to eating disorders when developing intervention programmes. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a prevalent condition with high morbidity and mortality, often accompanied by comorbidities such as alcohol use disorder (AUD). A thorough understanding of the interaction between COPD and AUD is crucial for improving patient outcomes and addressing management challenges. Objectives: This study analyzed temporal trends, clinical characteristics, and hospital outcomes associated with AUD among adults hospitalized with COPD in Spain between 2016 and 2023. Methods: A population-based cohort study was conducted using the Spanish Hospital Discharge Registry. We included adults aged ≥40 years with a diagnosis of COPD. AUD was identified through ICD-10 codes. Temporal trends in AUD prevalence were evaluated using Joinpoint regression, stratified by sex. We also assessed clinical characteristics including pneumonia, obesity, asthma, obstructive sleep apnea (OSA), supplemental oxygen use, long-term steroid use, and mechanical ventilation. Outcomes analyzed included ICU admission and in-hospital mortality (IHM). Results: Among 2,545,151 COPD hospitalizations, 263,568 (10.35%) had an AUD diagnosis. AUD prevalence rose from 8.66% in 2016 to 12.57% in 2023, with a sharper increase in women. Patients with AUD were younger and had higher rates of tobacco use (84.11% vs. 49.33%; p < 0.001) and psychiatric disorders. Multivariable analysis showed male sex, substance use, psychiatric illness, and external cause admissions were independently associated with AUD. Although overall IHM was lower in AUD patients (7.46% vs. 8.2%; p < 0.001), it increased with age, pneumonia, COVID-19, and higher comorbidity. IHM rose progressively, peaking in 2023 (15.6%). Conclusions: AUD prevalence in COPD hospitalizations increased significantly, especially in women. IHM also rose over time. These results highlight the need for integrated approaches targeting mental health and substance use in COPD management. Full article

Background: Physical exercise can improve certain musculoskeletal conditions, but adherence remains low due to intimidating environments, limited government support, and financial constraints faced by many individuals. Home-based exercise is a potential strategy to treat that population. Objective: Discuss the main home-based resistance exercise protocols that have been studied and implemented for six highly prevalent musculoskeletal disorders. Methods: A narrative literature review was conducted, using the PubMed database to search for six highly prevalent musculoskeletal conditions: shoulder impingement syndrome (SIS), nonspecific low back pain (NSLBP), greater trochanteric pain syndrome (GTPS), knee osteoarthritis (OA), patellofemoral pain syndrome (PFPS), and Achilles tendinopathy (AT). The strategy included the listed pathologies and the keywords “physical exercise” or “physiotherapy”. Clinical trials, reviews, and retrospective studies from the last 30 years published in English, Portuguese, or Spanish were included. Only studies with sufficient details on the training protocols used and outcome measures were included in the analysis. Results: In SIS, exercise protocols have been more effective in the long term than in the short term. In PFPS and GTPS, strengthening the quadriceps and hip muscles helps reduce pain and improve function. For NSLBP, exercises like Pilates and core training demonstrate pain relief. In knee osteoarthritis, physical exercise improves pain, function, and quality of life both immediately and over time. Eccentric training promotes type I collagen formation in the tendons of patients with Achilles tendinopathy. Conclusions: Home-based resistance exercises studied and implemented in this review offer several general health benefits, including pain reduction, improved functionality, increased muscle strength, and enhanced motor control. Full article

Background/Objectives: Children with neurodevelopmental disorders (NDDs) frequently present with feeding challenges that can lead to inadequate fruit and vegetable consumption, which can increase their risk of nutritional deficiencies and related health issues. The aim of this scoping review was to describe the main interventions focused on promoting fruit and vegetable consumption in children with NDDs. Methods: Two authors carried out a search strategy in PubMed, Scopus, EMBASE, Web of Science, and PsycINFO using the following terms: “autism OR autistic OR asperger OR rett OR pervasive OR disintegrative OR ‘neurodevelopmental disorder’ OR ‘attention deficit disorder with hyperactivity’”; and the outcome (O): “fruit OR vegetable”. We included all randomized or non-randomized studies, published in English or Spanish, which assessed children’s fruit and vegetable consumption. Results: We included seven articles that applied different interventions, such as a mobile health and behavioral modification program (n = 1), repeated food exposure programs (n = 2), a play-based program with parental training (n = 1); the implementation of Dietary Approaches to Stop Hypertension diet (n = 1); an intensive interdisciplinary mealtime behavioral treatment (n = 1); and restrictive diets (n = 1). Conclusions: Parent-led behavior changes supported by multidisciplinary teams using play, positive reinforcement, and food modification strategies were the main interventions used to increase fruit and vegetable consumption in children with NDDs. This review supports designing evidence-based approaches to improve feeding challenges in this population. Full article

Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m² or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden. Full article

Background/Objectives: The assessment of motor development in early ages is considered fundamental for the early identification of alarm signs that indicate the possibility of a child suffering from a developmental disorder. To this end, it is necessary to use reliable evaluation tools that have been specifically validated in the target population. The main aim of the current review was to examine the existing motor development assessment tools validated in Spanish populations of children aged 0–18 months. Methods: A systematic review was carried out following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) declaration criteria, and it was registered in PROSPERO. A bibliographic search was conducted in the PubMed, Scopus, Web of Science, and Cochrane databases, using terms related to motor development, assessment tools, and validation. The COSMIN verification list was employed to evaluate the quality of the included scales, and the QUADAS-2 instrument was used to analyse the quality of the included studies. Results: A total of 7 studies were included in the review, all of which were validation studies of motor development assessment tools in Spanish populations of children aged 0–18 months. Moreover, they all show heterogeneity with respect to their characteristics, such as target population, sample size, and metric properties. Conclusions: The present systematic review provides relevant information about the characteristics and methodological quality of motor development assessment tools validated in Spanish populations. There are currently very few of these evaluation tools, as well as limitations in regard to theories that support them, their metric properties, and the methodological quality of their validation studies. Therefore, we confirm the need for validating updated motor development tools to improve the detection, prognosis, and evaluation of children with developmental disorders or at risk of suffering from them. Full article

Humor plays a vital role in human well-being and communication and is increasingly recognized as a beneficial resource in healthcare contexts. While prior studies have explored humor in general university populations, limited research has focused on nursing students, who face distinct interpersonal and emotional demands during their training. This pilot study aimed to describe multidimensional sense of humor among first-year nursing students in Spain using the validated Spanish version of the Multidimensional Sense of Humor Scale (MSHS), which includes a three-dimension model: humor competence, humor as a coping mechanism, and social attitudes toward humor. A total of 78 students completed the MSHS questionnaire via an online survey. The overall mean score was 66.8 (SD = 13.1) out of 96, with the highest mean observed in the dimension of humor as a coping mechanism (mean = 22.2, SD = 4.0). Individual item analysis revealed strong agreement with positively worded statements such as “I like a good joke” (mean = 3.36, SD = 0.82) and “Humor is a lousy coping mechanism” (reverse scored; mean = 3.69, SD = 0.67). These findings suggest that humor is a relevant personal and interpersonal resource among future healthcare professionals. Incorporating humor-related competencies in nursing education may support student resilience and enhance patient-centered care. Further research is needed to examine humor’s longitudinal development and its role in clinical practice. Full article

Background: Cystic fibrosis (CF) is a multisystemic disorder caused by CFTR gene mutations, leading to impaired protein function and affecting pulmonary, gastrointestinal, hepatobiliary, skeletal, and nutritional health. The advent of CFTR modulators—especially the triple therapy elexacaftor/tezacaftor/ivacaftor (ETI)—has revolutionized clinical management, offering genotype-specific benefits beyond pulmonary outcomes. Pediatric gastroenterologists must now recognize and address emerging gastrointestinal and nutritional challenges introduced by modulator therapy. Methods: A narrative review was conducted to assess the impact of CFTR modulators on gastrointestinal function, nutritional status, bone health, and hepatobiliary involvement in pediatric patients. A structured literature search was performed using PubMed, EMBASE, and Scopus databases. Filters included articles in English or Spanish. Following full-text review based on relevance and quality, 68 articles were selected for inclusion in this review. Results: CFTR modulators have demonstrated potential improvements in gastrointestinal function, nutrient absorption, weight gain, and bone mineral density. In pediatric populations, ETI therapy has been associated with early increases in lean mass, enhanced vitamin levels, and promising trends in bone microarchitecture. However, variable outcomes regarding liver function and bone mineral density highlight the need for careful monitoring. Conclusions: While CFTR modulators present novel opportunities for systemic improvement in CF, their long-term impact on digestive and skeletal health in children remains under investigation. Pediatric gastroenterologists play a pivotal role in monitoring nutritional and hepatobiliary outcomes, optimizing treatment plans, and guiding personalized care strategies in the era of CFTR modulation. Full article

Background: Hospitalized patients’ expectations about their treatment play a key role in therapeutic adherence, satisfaction with care, and clinical outcomes. However, there is a lack of brief, psychometrically validated instruments in Spanish-speaking contexts that adequately assess this construct. Objective: The objective of this study is to culturally adapt and validate the Hospitalized Patients’ Expectations for Treatment Scale-Patient Version (HOPE-P) in a Peruvian population. Methods: A methodological, cross-sectional study was conducted with 277 hospitalized patients aged 18 to 85 years (M = 45.87; SD = 17.09). The adaptation process included translation, back-translation, expert review, and pilot testing. Confirmatory factor analysis (CFA) was performed to assess the factor structure, and reliability and validity indices were calculated. Results: The bifactorial model showed good fit (CFI = 0.97, TLI = 0.94, RMSEA = 0.06). One item with a low factor loading was removed to improve the model. Convergent and discriminant validity were confirmed through acceptable values of Average Variance Extracted (0.60 and 0.55) and inter-factor correlation (φ² = 0.23). Internal consistency was strong for both dimensions (α = 0.76–0.77; ω = 0.76–0.77). Conclusions: The Spanish version of the HOPE-P is a valid, reliable, and culturally appropriate instrument for evaluating treatment expectations in hospitalized Peruvian patients. Its implementation in clinical settings could enhance physician–patient communication, support shared decision-making, and contribute to better therapeutic outcomes, especially in high-demand healthcare environments. Full article

Background: Food addiction is a new clinical entity that is beginning to be linked to obesity and eating disorders. The present study aims to investigate the association between the risk of food addiction in children and the presence of obesity. It also explores the relationship between food addiction, the development of eating disorders, and body image dissatisfaction. Material and methods: A matched case-control study was conducted in a Spanish pediatric population (cases have obesity, and controls have normal weight). The main outcome measures were evaluation of food addiction (S-YFAS-C), child feeding attitudes (ChEAT), and evaluation of body image (CDRS). Additionally, sociodemographic and anthropometric data were gathered. Results: A total of 62 children were evaluated (31 cases with age 11 ± 0.7 years and BMI Z-score 2.89 ± 1.33; 31 controls with age 10.7 ± 0.8 years and BMI Z-score −0.05 ± 0.52). For all items on the S-YFAS-C scale, significant differences were observed between the two groups (∧ = 0.252, p = 0.002). Food addiction was diagnosed in 32.3% of cases (2.06 ± 1.7 symptoms) and 22.6% of controls (1.61 ± 1.6 symptoms), although no statistically significant differences were observed between groups. A statistically significant correlation exists between all the scores of the scales studied in the children. Conclusions: Children with obesity have a higher number of food addiction symptoms compared to those with normal weight. In general, as food addiction scores increase, higher scores are observed for the risk of developing eating disorders and body image dissatisfaction. Full article

The growing complexity of financial markets, driven by globalization and digitalization, has increased the need for individuals to make informed financial decisions. In this context, financial education and personal finance have become crucial areas of study. This systematic review aimed to identify and analyze the existing scientific evidence on these topics, determine the countries contributing to the literature, and extract key conclusions and lessons. A comprehensive search was conducted across the Scopus, Scielo, and La Referencia databases using keywords in Spanish. The initial query yielded 97 documents, which were filtered using seven inclusion and exclusion criteria, resulting in a final sample of 19 relevant articles. The reviewed studies highlight that financial education is a key factor in promoting economic well-being, reducing over-indebtedness, supporting entrepreneurship, and enhancing social inclusion. The effectiveness of financial education depends on equitable access to information, the use of digital tools, tailored approaches for diverse populations, and systematic program evaluation. The findings suggest that collaborative efforts between governments, educational institutions, and the financial sector are necessary to develop inclusive and practical financial education strategies, particularly for vulnerable populations. Financial education must be approached as a continuous, adaptive process to effectively respond to evolving economic challenges. Full article