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Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.

In recent years, interest in finding alternatives for the evaluation of mobility has increased. Inertial measurement units (IMUs) stand out for their portability, size, and low price. The objective of this study was to examine the accuracy and repeatability of a commercially available IMU under controlled conditions in healthy subjects. A total of 36 subjects, including 17 males and 19 females were analyzed with a Wiva Science IMU in a corridor test while walking for 10 m and in a threadmill at 1.6 km/h, 2.4 km/h, 3.2 km/h, 4 km/h, and 4.8 km/h for one minute. We found no difference when we compared the variables at 4 km/h and 4.8 km/h. However, we found greater differences and errors at 1.6 km/h, 2.4 km/h and 3.2 km/h, and the latter one (1.6 km/h) generated more error. The main conclusion is that the Wiva Science IMU is reliable at high speeds but loses reliability at low speeds.

Background: In children and adolescents, chronic low-grade inflammation has been implicated in the pathogenesis of co- and multi-morbid conditions to mental health disorders. Diet quality is a potential mechanism of action that can exacerbate or ameliorate low-grade inflammation; however, the exact way dietary intake can regulate the immune response in children and adolescents is still to be fully understood. Methods: Studies that measured dietary intake (patterns of diet, indices, food groups, nutrients) and any inflammatory biomarkers in children and adolescents aged 2 to19 years and published until November 2020 were included in this systematic review, and were selected in line with PRISMA guidelines through the following databases: Academic Search Complete, CINAHL, Global Health, Medline COMPLETE andWeb of Science-Core Collection. A total of 53 articles were identified. Results: Results show that adequate adherence to healthful dietary patterns such as the Mediterranean diet, or food groups such as vegetables and fruit, or macro/micro nutrients such as fibre or vitamin C and E, are associated with decreased levels of pro-inflammatory biomarkers, mainly c-reactive protein (CRP), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), whereas adherence to aWestern dietary pattern, as well as intake of food groups such as added sugars, macro-nutrients such as saturated fatty acids or ultra-processed foods, is associated with higher levels of the same pro-inflammatory biomarkers. Conclusions: This is the first systematic review examining dietary intake and biological markers of inflammation in both children and adolescents. A good quality diet, high in vegetable and fruit intake, wholegrains, fibre and healthy fats ameliorates low-grade inflammation, and therefore represents a promising therapeutic approach, as well as an important element for disease prevention in both children and adolescents., A.B. and C.M.P. are funded by the UK Medical Research Council (grants MR/L014815/1, MR/J002739/1and MR/N029488/1), the European Commission Horizon 2020 (grant SC1-BHC-01- 2019) and the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London; they have also received research funding from Johnson and Johnson for research on depression and inflammation, but this paper is independent from this funding. In addition, C.M.P. is funded by the Wellcome Trust strategy award to the Neuroimmunology of Mood Disorders and Alzheimer’s Disease (NIMA) Consortium (104025), which is also funded by Janssen, GlaxoSmithKline, Lundbeck and Pfizer, but, again, this paper is independent from this funding.

Background: Affect and physical fitness play an important role in psychological and physical health; however, the association between those variables in youth remains unknown. The aim of the present study was to examine the influence of physical fitness on positive and negative affect in Spanish children and adolescents. Method: Healthy young Spanish people (n = 1,490) were recruited for the present study: 542 children (n = 272 girls; mean age 9.6 years) and 948 adolescents (n = 454 girls; mean age 14.1 years) with complete baseline data on health-related fitness tests (20 m shuttle run test, 4 × 10 m test, muscular fitness index, and physical fitness index), and positive and negative affect (Positive and Negative Affect Schedule). Results: Higher performance on physical fitness components was associated with positive affect (β = -0.176-0.118, all P < 0.05). There was no association between all physical fitness components and negative affect (β = -0.100-0.15, all P > 0.05). There were differences on positive affect between the lowest and the highest quartile of the physical fitness index in boys (P = 0.037, Cohen's d 0.60) and girls (P = 0.004, Cohen's d = 0.69), and between the lowest and the highest quartile of muscular fitness index in girls (P < 0.001, Cohen's d = 0.76). Conclusions: Promoting physical activity during the school years, including strength exercises to increase muscular fitness, could improve positive affect levels and thus psychological health. Sin financiación 1.617 JCR (2021) Q4, 104/130 Pediatrics 0.415 SJR (2021) Q2, 148/320 Pediatrics, Perinatology and Child Health No data IDR 2021 UEM

To analyze whether there is an association between conformity to male and female gender norms and the Edinburgh Postnatal Depression Scale (EPDS) score as an indicator of depression during pregnancy, a cross-sectional study was made to a sample of 200 pregnant women being seen at any of the public primary care centers in Segovia (Spain) for the prenatal care. A score of 13 points or higher on the Spanish version of the EPDS is considered to be an indicator of antenatal depression. The Conformity to Feminine Norms Inventory (CFNI-84) and the Conformity to Masculine Norms Inventory (CMNI-94) were used to determine the degree of conformity to gender norms. Descriptive and inferential statistics, as well as multivariate analysis, were carried out. Logistic regression analysis showed the Nice in Relationships Subscale score to be associated with a decreased risk of depression (OR = 0.88; 95%CI 0.79–0.98; p = 0.029). In addition, the CMNI total score, as well as the Self-Reliance subscale, were associated with an increased risk of depression (OR = 1.04; 95%CI 1.01–1.07; p = 0.022; OR = 1.30; 95%CI 1.08–1.55; p = 0.004, respectively). An association between conformity to male gender norms and nonconformity to some female gender norms in pregnant women and a score on the EPDS indicating depression during pregnancy was found. Particularly, an increase in the CMNI total score was associated to increased risk of suffering depression in the pregnant women studied. Castile and León Health Authority (SACyL) - GRS 1287/B/16 2.500 JCR (2019) Q3, 78/155 Psychiatry 1.176 SJR (2019) Q1, 30/185 Obstetrics and Gynecology, 112/545 Psychiatry and Mental Health No data IDR 2019 UEM

Background Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. Methods A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. Results Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05–0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. Discussion The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding. Los beneficios de la lactancia materna en la salud de los niños, las madres y la sociedad son ampliamente conocidos. Sin embargo, las tasas de lactancia materna varían según la población estudiada. Las mujeres de origen chino que han inmigrado a países desarrollados muestran tasas muy bajas de lactancia materna. Los objetivos de la investigación son comparar las tasas de lactancia materna exclusiva tras el parto, al alta del hospital, entre mujeres de origen chino y de origen español, y evaluar la influencia de variables biológicas, socioeconómicas, relacionadas con el trabajo y culturales sobre las tasas de lactancia materna. Estudio descriptivo transversal con comparación entre grupos. Se incluyó a 73 puérperas (33 de origen chino y 40 españolas). La asociación entre lactancia materna y país de origen se evaluó utilizando regresión logística. Resultados: Las mujeres españolas mostraron una mayor prevalencia de lactancia materna exclusiva (80%) en comparación con las mujeres de origen chino (36,4%), ajustando por nivel socioeconómico, nivel educativo de los padres, edad de la madre, parto por cesárea y peso al nacer). Sin embargo, al construir otros modelos de regresión logística en los que se incluyó variables relacionadas con el trabajo de la madre, o la actitud respecto a la lactancia materna, las diferencias pasaban a ser no significativas. Discusión: Las variables clásicas biológicas y socioeconómicas no explican la diferencia en las tasas de lactancia materna entre mujeres de origen chino y españolas. Sin embargo, parece que esas diferencias están relacionadas con las condiciones laborales de las mujeres chinas (trabajan más mujeres, por cuenta propia, incorporándose antes al mundo laboral tras el parto...) y con aspectos culturales (actitud menos positiva hacia la lactancia materna). Sin financiación 2.239 JCR (2019) Q2, 33/82 Obstetrics & Gynecology 1.275 SJR (2019) Q1, 19/185 Obstetrics and Gynecology No data IDR 2019 UEM

The present study examined the association between high-quality diet (using the Mediterranean diet (MD) as an example) and well-being cross-sectionally and prospectively in Spanish children and adolescents. Participants included 533 children and 987 adolescents at baseline and 527 children and 798 adolescents at 2-year follow-up, included in the UP&DOWN study (follow-up in schoolchildren and adolescents with and without Down’s syndrome). The present study excluded participants with Down’s syndrome. Adherence to an MD was assessed using the KIDMED index. Well-being was measured using the Positive and Negative Affect Schedule and the KIDSCREEN-10 questionnaire. Associations between MD adherence and well-being were assessed using multi-level, mixed-effects linear regression. At baseline, MD adherence was positively related to health-related quality of life in secondary school girls and boys (β=0·41, se 0·10, P, The UP&DOWN study was supported by the DEP 2010-21662-C04-00 grant from the National Plan for Research, Development and Innovation (R + D + i) MICINN. I. E.-C. is supported by a grant from the Alicia Koplowitz Foundation

In 2015, the Universidad Europea de Madrid started the first interprofessional education program in Spain. Nursing students undergo different interprofessional education activities in all 4 academic years, covering various aspects of the following 3 competencies: interprofessional communication, role clarification (definition, interaction and defense), and authority models and decision making. In second year, they integrate these activities with students from psychology, pharmacy and medicine. We assessed the self-perception of second year nursing students with an adapted and validated IPEC questionnaire, in four different transversal moments of the academic year 2015-16. Differences in mean values were analyzed with the Kruskal-Wallis test and post-hoc Mann-Whitney tests with Bonferroni corrections in case of statistical significance. Results showed that this IPE program improves the self-perception second year students have about their competence in interprofessional communication, especially in the dimensions of oral expression, active listening, communication tools and interprofessional conflict resolution. Sin financiación 1.772 JCR (2018) Q3, 46/82 Health Policy & Services, 61/98 Health Care Sciences & Services 0.864 SJR (2018) Q2, 712/2844 Medicine (miscellaneous) No data IDR 2018 UEM

Background Maternal breastfeeding is a practice that is associated with multiple health benefits for mothers and children. One of the lowest rates of breastfeeding has been observed among Chinese women who immigrate to high income countries. At present, there is a lack of comparative information between this group and that of Spanish-born women. Considering the relationship between the attitude of women towards breastfeeding and the initiation of breastfeeding, the aim of the study was to determine whether the attitude towards breastfeeding among Chinese postpartum women who have immigrated to Spain differs from that of Spanish-born postpartum women. Methods Cross-sectional study, with between-group comparison, of 73 postpartum Spanish-born and Chinese immigrant women admitted to the maternity units of “12 de Octubre” Hospital (Spain) between April and November 2016. Attitudes toward breastfeeding were analyzed using the Spanish or Chinese version of the Iowa Infant Feeding Attitude Scale (IIFAS). A wide set of socioeconomic, biological, working and attitudinal conditions were considered as covariates. The association between IIFAS and country of origin was assessed by three multiple linear regression models (B, SE, and 95% confidence interval were calculated). Results All Chinese women were first generation immigrants. Chinese-born women were four years younger than Spanish-born mothers, had a lower educational level, more frequently had a paid job (mainly self-employed), and planned to return to work almost two months earlier than Spanish-born mothers did. Most Chinese women did not breastfeed exclusively. Chinese immigrant women obtained scores of approximately 9 points less in the Iowa Infant Feeding Attitude Scale (IIFAS) when compared to Spanish-born women [95% CI -15.59, -2.48], after adjusting for the different socioeconomic, educational and work-related factors. Conclusions Chinese-born women resident in Spain present a lower score on the IIFAS, when compared to Spanish-born women, which implies a more negative attitude towards breastfeeding. The between-groups difference is consistent, even when adjusting for known confounders and other factors which could affect the attitude of the mothers. It is therefore striking that, despite being in Spain, Chinese-born women maintain these preferences/attitudes regarding breastfeeding, compared with Spanish-born women, who obtain overall high scores.

Prior studies have identified a link between length of residence and overweight (including obesity) in immigrant populations. However, this link has not been confirmed in Europe. This study compares overweight prevalences in native Spanish and immigrant adolescents living in the Madrid region (Spain), and whether length of residence affects the risk of immigrant adolescents being overweight. The study population was a representative sample of adolescents aged 13–17 years (n = 2,081, 1,055 girls) who lived in Madrid. Data were collected from November 2007 to February 2008 through a cross-sectional survey in which self-reported height and weight were used to calculate BMI. Overall, no significant difference was detected in overweight risk between the Spanish and immigrant adolescents. However, immigrant adolescents residing in Spain for 6 years or under did show a higher overweight risk than both the Spanish adolescents (OR 1.57) and immigrants who had lived in Spain for longer than 6 years (OR 1.98). Changes in lifestyle associated to a longer duration of residence in Spain seems to have a slightly protective effect on the risk of being overweight in immigrant adolescents., The AFINOS Study was supported by Grant DEP2006-56184-C03-01-02-03/PREV from the Spanish Ministry of Education and Science and co-funded by FEDER funds from the European Union.