Search Results (887)

The aim of this study was to analyze and compare the external load demands of players from the Spanish women’s national football teams across the U-17, U-20, and senior categories during their respective FIFA World Cup participations. Key kinematic variables were assessed via global positioning systems (GPS), including total distance (TD), high-speed running (HSR; ≥18 km·h⁻¹), sprint distance (≥21 km·h⁻¹), accelerations (>3 m·s⁻²), decelerations (<–3 m·s⁻²), and high metabolic load distance (HMLD) during 3 world cups (U17, U20 and senior). Significant differences were observed between the senior team and both U-20 and U-17 in nearly all variables, with greater magnitude as the intensity of the metrics increased, showing effect sizes ranging from moderate to very large (d = 0.95 to 4.76). Positional analysis by categories showed that senior full backs (FB) and central midfielders (CM) showed higher demands compared to U-20 and U-17. For TD, senior covered more than U-17 (FB: p = 0.001; d = 1.11 | CM: p = 0.023; d = 0.97), with small differences vs. U-20 (d ≤ 0.54). In HSR, both positions outperformed U-17 and U-20 (FB: p ≤ 0.007; d = 0.87–1.15 | CM: p ≤ 0.031; d = 0.71–1.11). In HMLD, both FB and CM displayed very large differences compared to U-17 and U-20 (all p < 0.001; d = 2.54–6.16). These findings underscore the need for progressive development of locomotor capacities from early stages, considering both age category and playing position, to facilitate a more seamless transition to elite-level football. Full article

Food security is defined as a state in which all people at all times have both physical and economic access to sufficient food to meet their dietary needs for a productive and healthy life. The general objective of this work was to assess the situation of food insecurity and its impact on the quantity and quality of food consumption during lockdown in the first wave of the COVID-19 pandemic and to identify the determinants associated with the different food insecurity (FI) categories on a sample of 2227 people (1168 people from Spain and 1059 people from Morocco). Food insecurity (FI) assessed by the Household Food Insecurity Access Scale (HFIAS) were compared in both countries, controlling for the effect of sociodemographic variables, age, gender, marital status, and education level. The mean HFIAS was 0.53 in the Spanish and 3.55 in the Moroccan samples (p < 0.001). Only 2.1% of the Spanish sample were in a situation of severe insecurity against 15.5% in Morocco (p < 0.001). Moroccans with moderate and severe food insecurity decreased their consumption of meat, fish, eggs, nuts, legumes, and fruits. The risk of food insecurity was higher in men than in women, in separated or divorced people, in people with secondary and middle education, and in younger people. Full article

Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p < 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection. Full article

This online survey aimed to gather consumer opinions on dairy products and production and to identify the potential market for A2 milk (milk containing exclusively β-casein A2, which reduces gastrointestinal discomfort after consumption). The questionnaire included seven sections covering the consumption of dairy products, sociodemographic aspects, awareness and purchase intention of A2 milk, questions about milk as a source of nutrients and health benefits, the environmental impact of milk production, and alternatives to cow milk. Responses from 672 Spanish consumers categorized into clusters (according to their milk consumption and their discomfort after drinking it), gender, age, educational level, and milk taste preference were analyzed using a linear multiple regression model. Dairy consumers not experiencing discomfort after drinking milk (62.6%) and those who preferred the taste of milk over plant-based alternatives (64.0%) demonstrated better knowledge of milk nutrients and its health benefits. Participants’ age, gender, and education level also influenced their perceptions, with older participants, women, and those with university education generally showing better results. In conclusion, clusters impact consumers’ milk perceptions as a nutritional source and its health benefits. The positive perception of milk’s nutritional benefits among dairy consumers experiencing discomfort after drinking milk (17.3%) positions them as a strong target market for A2 milk. Full article

Basketball referees play a crucial role in game management, yet the physical and physiological demands placed on them during a game remain understudied. This study analyzed the workload of 35 group 1 referees during a U-18 Spanish championship, examining the effects of refereeing technique (two referees vs. three referees) and competition sex (male vs. female) across game quarters. Physical and physiological demands were measured using inertial devices and heart rate monitors during 37 matches (18 men’s and 19 women’s). The results revealed that 2-referee teams experienced significantly greater physical demands, covering approximately 25% more total distance and demonstrating higher values in high-intensity running compared to 3-referee teams. Female competition elicited higher demands in specific variables, particularly in the distance covered above 16 km/h and average speed. Analysis across quarters showed distinct temporal patterns, with the first and third quarters presenting the highest demands, especially for 2-referee teams. These findings suggest that basketball referees’ physical preparation should be tailored to the officiating technique and competition sex, with a particular emphasis on developing specific conditioning programs for the 2-referee technique and implementing targeted recovery strategies between quarters to maintain optimal performance throughout the game. Full article

Nursing students often face emotional challenges related to death and dying, affecting their psychological well-being, emotional intelligence, and academic success. Cultural and educational factors may influence how they experience and manage these stressors. This study aimed to compare fear of death, emotional intelligence, coping with death, and academic burnout among second-year nursing students in Spain and Portugal to identify cross-cultural differences. A cross-sectional study was conducted among 174 second-year nursing students from the University of Extremadura (Spain) and the University of Évora (Portugal) during the 2023/2024 academic year. The instruments used included the Collett–Lester Brief Fear of Death Scale, the Trait Meta-Mood Scale—24 ítems, the Bugen’s Coping with Death Scale, and the Maslach Burnout Inventory—Student Survey. Descriptive statistics were calculated, and group comparisons were performed using independent samples t-tests and Welch’s t-tests, depending on variance homogeneity. A two-way ANOVA was also conducted to explore interactions between gender and nationality. The Spanish sample comprised 86 women and 21 men, and the Portuguese sample included 58 women and 9 men. The mean age across the sample was 21.5 years (SD = 4.15). No significant differences were observed in fear of death or emotional intelligence between the two groups. However, Portuguese students showed significantly better coping with death, but also higher academic burnout and cynicism. Spanish students reported greater perceived efficacy. Although emotional intelligence and death anxiety were similar, Portuguese students demonstrated stronger coping skills but experienced more burnout. This suggests that coping alone may not buffer academic stress, emphasizing the need for culturally tailored interventions to enhance emotional readiness and reduce burnout. Full article

This study examines how several gender-encoding strategies in Spanish and social factors influence gender perception, reinforcing or mitigating a sexist male bias. Using an experimental design, we tested four linguistic conditions in a job recruitment context: masculine forms (theoretically generic), gender-splits, epicenes, and non-binary neomorpheme “-e”. After reading a profile in one of these conditions, 837 participants (52% women) selected an image of a woman or man. Results show that masculine forms lead to the lowest selection of female candidates, manifesting a male bias. In contrast, gender-fair language (GFL) strategies, particularly the neomorpheme (les candidates), elicited the highest selection of female images. Importantly, not only did linguistic factors and participants’ gender identity influence results—with male participants selecting significantly more men in the masculine condition, but affinity with feminist movements and LGBTQIA+ communities or positive attitudes towards GFL also modulated responses—increasing female selections in GFL, but reinforcing male selections in the masculine. Additionally, no extra cognitive cost was found for GFL strategies compared to masculine expressions. These findings highlight the importance, not only of linguistic forms, but of social and attitudinal factors in shaping gender perception, with implications for reducing gender biases in language use and broader efforts toward social equity. Full article

Background/Objectives: Pregnancy has been considered a risk factor for severe SARS-CoV-2 infection, as well as for adverse maternal and neonatal outcomes. This study aimed to assess the clinical impact of COVID-19 on pregnant women managed at a Spanish tertiary care hospital across different phases of the pandemic. Methods: A retrospective observational study was conducted at Dr. Balmis General University Hospital (Alicante, Spain) between March 2020 and May 2023. All pregnant women who received hospital care with confirmed SARS-CoV-2 infection were included. Maternal and neonatal outcomes were analyzed and compared with the 6120 total births recorded during the same period. Results: A total of 249 pregnant women with COVID-19 were included, with 30.8%, 25.0%, and 7.9% hospitalized during each respective pandemic phase. The overall incidence of infection was 41 cases per 1000 births. Hospitalized pregnant women showed significantly higher rates of preterm birth, labor induction (70.4% vs. 47.0%; OR: 2.67; 95% CI: 1.12–6.43), and cesarean delivery (46.9% vs. 24.9%, OR: 2.60; 95% CI: 1.27–5.50). Neonatal outcomes included lower Apgar scores, increased admission to the neonatal unit (25.8% vs. 8.2%, p = 0.007), and a higher rate of neonatal complications (23.3% vs. 7.7%, p = 0.015). Maternal obesity and non-Spanish nationality were associated with more severe maternal disease. Vaccination against SARS-CoV-2 significantly reduced the risk of hospitalization due to the infection (OR: 0.30; 95% CI: 0.13–0.69). Conclusions: Pregnant women admitted with COVID-19 had increased risks of adverse obstetric and neonatal outcomes, underscoring the importance of preventive strategies, such as vaccination. Full article

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?” Design: A systematic review and qualitative meta-synthesis were performed. Data Sources: A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods: Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results: The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges, (II) Self-motivation and empowerment, (III) The relationships as a facilitator, (IV) Barriers to change, and (V) Proactive support strategies. Conclusions: Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact: Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies. Full article

This study examines the relationship between fear of failure, entrepreneurial passion, and entrepreneurial self-efficacy among university business students from four emerging Latin American economies: Mexico, Colombia, Peru, and Ecuador. This research addresses the need to understand the psychological factors that influence entrepreneurship, particularly in developing economies. Using non-probability convenience sampling, surveys were distributed between June 2021 and August 2022, and 961 valid responses were obtained. Scales from renowned researchers were used, which were translated and semantically validated in Spanish to measure the three variables. The data were analyzed using structural equation modeling with PLS. The overall results reveal that fear of failure negatively affects entrepreneurial passion, while entrepreneurial passion has a positive and significant relationship with entrepreneurial self-efficacy. Furthermore, entrepreneurial passion has a positive and significant relationship with fear of failure and entrepreneurial self-efficacy, with substantial differences between countries. Gender differences were also identified: in women, all relationships in the model were significant, while in men, the direct effect of fear of failure on entrepreneurial self-efficacy did not reach statistical significance. These findings contribute to the entrepreneurship literature by demonstrating that the relationship between these psychological variables varies by context (country) and gender, contradicting the notion of a universal effect. Full article

Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk. Full article

Invasive pneumococcal disease (IPD) is a serious infection caused by the bacterium Streptococcus pneumoniae (pneumococcus) that can produce a wide spectrum of clinical manifestations. The aim of this study was to analyze the comorbidity factors that influenced the mortality in patients with diabetes (D) according to IPD. A retrospective study to analyze patients with D and IPD was carried out. Based on the discharge reports from the Spanish Minimum Basic Data Set (MBDS) from 1997 to 2022, the Elixhauser Comorbidity Index (ECI) and the Charlson Comorbidity Index (CCI) were calculated to predict in-hospital mortality (IHM) in Spain. A total of 12,994,304 patients with D were included, and 84,601 cases of IPD were identified. The average age for men was 70.23 years and for women 73.94 years. In all years, ECI and CCI were larger for type 2 D than for type 1 D, with men having a higher mean than women. An association was found between risk factors ECI, age, type 1 D, COVID-19, IPD (OR = 1.31; 95% CI: 1.29–1.35; p < 0.001); CCI, age, type 1 D, COVID-19, IPD (OR = 1.45; 95% CI: 1.42–1.49; p < 0.001), and increased mortality. The IHM increased steadily with the number of comorbidities and index scores from 1997 to 2022. D remains a relevant cause of hospitalization in Spain. Comorbidities reflected a great impact on patients with D and IPD, which would mean a higher risk of mortality. Predicting mortality events and length of stay by comparing indices showed that CCI outperforms ECI in predicting inpatient death after IPD. Full article

This article thoroughly examines the multidimensional consequences of intimate partner violence against women (IPVAW) and estimates the monetary costs associated with this kind of violence in Spain for 2022. Based on the accounting model approach, three alternative scenarios are proposed to quantify the direct tangible costs of IPVAW from a microeconomic perspective. Each scenario considers the out-of-pocket expenditures and the opportunity cost of lost income due to IPVAW, borne by the survivor women, their families and relatives, the public sector, and the private organizations. The study utilizes microdata from the latest Spanish Macro-survey on Violence Against Women, conducted in 2019 by the Government Office against Gender-Based Violence (Spanish Government). Results show the costs ranging from EUR 1.38 billion (the most conservative estimate) to EUR 3.01 billion (the highest estimate). Further research is needed to deepen understanding of the mechanisms by which violence affects the various domains and agents of society. Full article

Background: Sleep is a fundamental component of health, and deprivation has been linked to numerous adverse outcomes, including reduced academic and occupational performance, greater risk of accidents, and increased susceptibility to chronic diseases and premature mortality. Dietary and lifestyle behaviors are increasingly recognized as key determinants of sleep quality. Women are particularly susceptible to sleep disturbances due to hormonal fluctuations and psychosocial factors. However, women remain underrepresented in sleep research. This study aims to examine the associations between sleep quality, nutrition, and lifestyle in a large cohort of Spanish women. Methods: A cross-sectional study was conducted with 785 women aged 18–64. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the NutSo-HH questionnaire on dietary and lifestyle behaviors. Descriptive analyses, correlation matrices, Gaussian Graphical Models, and Principal Component Analyses were used to assess relationships between variables. Results: More than half of the participants rated their sleep quality as good or very good, although over 30% experienced frequent nighttime awakenings. Poor sleep quality was significantly associated with higher alcohol consumption, lower vegetable and white fish intake, and lower levels of physical activity. Diets rich in ultra-processed foods correlated moderately with subjective poor sleep and daytime dysfunction. However, no strong associations were found between stimulant consumption, late meals, or dietary patterns (e.g., Mediterranean diet) and sleep. Self-perceived health emerged as a protective factor, while nocturnal lifestyles were linked to longer sleep latency and fragmented sleep. Conclusions: In adult women, better sleep quality is linked to healthy dietary choices, regular physical activity, and a positive perception of general health. In contrast, alcohol use and irregular lifestyles are associated with poor sleep. Individual variability and cultural adaptation may moderate the impact of some traditionally harmful behaviors. Personalized, multidimensional interventions are recommended for promoting sleep health in women. Full article

Background: The aim of this scoping review is to analyze the health status of Roma and Sinti in Europe, highlighting the issues faced by children and women. In addition, we want to examine the access of these groups to health care services and to identify possible interventions to increase their use. Methods: Our research was conducted on Pubmed, Google Scholar, and the Trip Database. We selected articles written in English, Spanish, and Italian published since 2015. Results: Studies have shown that the health status of Roma and Sinti populations is generally worse than that of the rest of the population. Limited access to care is due to several specific factors, such as beliefs, traditions, and the lack of awareness of widespread direct and indirect discrimination against these groups by healthcare professionals. The studies reviewed have shown how mistrust can be broken down through multi-centered interventions linked to information, education, and communication through mediators able to interact with these populations, as well as through appropriate training of the health workers in charge. Conclusions: The health of the Roma and Sinti populations is commonly worse than that of the rest of the population. This is particularly true for the large proportion of people confined to suburban camps. However, the available evidence signals the low quality of life they experience and the need for interventions involving the communities and the establishment of ad hoc orientation or initial care contact points in the segregated areas. This could lead to an improvement in the integration of this population into the National Health Systems’ activities. Full article