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This study focused on the specific challenges of university students in the face of the COVID-19 pandemic and examined similarities and differences in COVID-related concerns and difficulties in functioning in samples of undergraduate students in five countries. A sample of 4306 undergraduate university students (43.8% males, 56.2% females) from Israel, Kosovo, Ukraine, Cyprus and Germany participated in an anonymous online survey during the first wave of the pandemic, between March and June 2020. Study variables included the assessment of the exposure to COVID-19, perceived health status, specific COVID-related concerns and functional difficulties, social support, and the perceived level of coping. Similar concerns about the uncertainty regarding the termination of the health crisis and worry for the health of family members were identified as the most common concerns in the five countries. Challenges in online learning and financial difficulties were rated as the most central difficulties. Both COVID-related concerns and COVID-related difficulties predicted lower levels of perceived coping. Greater social support was associated with better perceived coping. Policymakers should be informed by the accumulating research showing the substantive relationships between academic difficulties and perceived COVID-related distress and coping.

Antecedentes y objetivo: Existen múltiples variables que influyen en el miedo a la muerte, así como en las actitudes ante ella, incluyendo la edad, la religiosidad, los aspectos emocionales o los culturales. Debido a la cercanía con la muerte, el estudio de las actitudes y de los niveles de ansiedad y de las variables que influyen en ellas en población mayor tiene una gran relevancia. El objetivo del presente trabajo fue comparar los niveles de ansiedad ante la muerte, así como el miedo, las actitudes ante la muerte y aspectos emocionales asociados (ansiedad y depresión) en adultos mayores procedentes de 2 culturas diferentes, la occidental y la árabe. Materiales y método: Tomaron parte un total de 91 personas mayores de 60 años que se dividieron en 2 grupos, uno de personas nacidas en España (n = 46) y otro de personas nacidas en Egipto (n = 45). En una evaluación individualizada los participantes completaron los cuestionarios DAS, PRAM y las subescalas de ansiedad y depresión del SCL-90-R. Resultados: Se observaron diferencias estadísticamente significativas entre los grupos en el miedo a la muerte, la aceptación y los aspectos emocionales. Las variables predictoras de la ansiedad y del miedo a la muerte fueron diferentes en cada uno de los grupos. Conclusión: Los resultados evidencian la importancia de tener en cuenta los aspectos culturales, religiosos y emocionales en la evaluación del miedo y las actitudes ante la muerte en población mayor. Background and objective: There are multiple variables that influence fear of death, as well as attitudes towards it, including age, religiosity, emotional and cultural aspects. Due to the proximity to death, the study of attitudes and death-related anxiety and the variables that influence it in the elderly population is of great relevance. The aim of the present study was to compare the levels of death anxiety, fear of death, attitudes towards death and associated emotional aspects (anxiety and depression) in older adults from 2 different cultures, Western and Arab. Materials and method: A total of 91 people over 60 years old took part and were divided into 2 groups, one of people born in Spain (n = 46) and the other of people born in Egypt (n = 45). In an individualised assessment, participants completed the DAS, PRAM and the anxiety and depression subscales of the SCL-90-R questionnaires. Results: Statistically significant differences between groups were observed in fear of death, acceptance and emotional aspects. Predictors of anxiety and fear of death were different for each group. Conclusion: The results show the importance of taking into account cultural, religious and emotional aspects in the evaluation of fear and attitudes towards death in the elderly population.

The authors thank the professionals and the families of the VALE association for their participation in this research., Background: Health professionals present a greater vulnerability to the effects of COVID-19 on their mental health, especially those who work with vulnerable groups such as those who suffer from intellectual disability (ID). The objective of the present research was to develop and verify the effectiveness of a psychological intervention for professionals in the field of ID to improve their mental health during this health crisis. Methods: A total of 32 professionals participated. The variables measured were: post-traumatic growth, mental health, burnout, coping strategies, resilience, life satisfaction, optimism, and cognitive and affective empathy. Results: The results revealed statistically significant differences in the post-traumatic growth variable. In the rest of the variables (mental health, burnout, coping strategies, resilience, vital satisfaction, optimism, and empathy), no significant differences between groups were found. Conclusions: An increase in the levels of post-traumatic growth was observed in the intervention group after a brief online psychological intervention. However, given the small sample size, these results should be taken with caution. Institutions should foster and promote interventions aimed at reducing the high emotional impact produced by COVID-19 in professionals that care for people diagnosed with ID.

Previous studies have reported dysbiosis in the gut microbiota (GM) of children with autism spectrum disorders (ASD), which may be a determining factor on child development through the microbiota-gut-brain axis. However, it is not clear if there is a specific group of dysbiotic bacteria in ASD. The aim of this study was to carry out a meta-analysis on the studies that analyze GM in children with ASD. 18 studies fulfilled our selection criteria. Our results showed a lower relative abundance of Streptococcus (SMD(+) = - 0.999; 95% CI - 1.549, - 0.449) and Bifidobacterium genera (SMD(+) = - 0.513; 95% CI - 0.953, - 0.073) in children with ASD. Overall, the Bifidobacterium genera is involved. However, differences found between studies are attributed to factors such as reporting bias.

Purpose: To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries. Methods: Cross-sectional design. We recruited 1,555 participants ages 13–16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence—dating violence, bullying, cyberbullying, abuse in childhood—and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex. Results: Acceptance of violence was higher for those who had lower perceived social support from parents (βgirls = −154, p < .001; βboys = −.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (βgirls = .067, p = .035; βboys = .225, p < .001; (βgirls = .118, p < .001; βboys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys. Conclusions: Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence. The project “Lights, Camera and Action against Dating Violence” (Ligts4Violence) was funded by the European Commission Directorate-General Justice and Consumers Rights, Equality and Citizen Violence Against Women Program 2016 for the period 2017–2019 to promote healthy dating relationship assets among secondary school students from different European countries, under grant agreement No. 776905. It was also cosupported by the CIBER of Epidemiology and Public Health of Spain for its aid to the Gender-based Violence and Youth Research Program. info:eu-repo/semantics/publishedVersion

Artificial intelligence techniques have been increasingly applied in healthcare to help in many areas, from assisting clinical diagnoses to preventing diseases. In this paper, a machine learning approach to predict cholesterol levels using non-invasive and easy-to-collect data is presented. Specifically, it uses clinical and anthropometric data gathered by nutritionists during weight loss intervention (dieting) periods. The prediction power analysis of different patient variables is aimed at improving both non-invasive diagnosis quality and screening of associated diseases. Moreover, a clustering analysis has been carried out to identify different groupings of patients that might share some characteristics that have so far remained inconspicuous but might contain a valuable diagnosis or prognosis information for clinical experts.The experiments show a mean absolute percentage error rate (MAPE) of 4.39% in cholesterol estimation via regression, as well as clustering of patients within four profiles in which variable values share commonalities among cluster members. This work was supported by the Spanish State Research Agency (AEI) under grant PID2020-119144RB-I00 funded by MCIN/AEI/10.13039/501100011033.

There is a need to improve psychological interventions in women experiencing intimate partner violence (IPV) and reduce its long-term sequelae. The objective of this qualitative study was to explore the needs of female IPV survivors, the support they receive, and their strategies for coping with this experience over the long term. During 2017, 53 female IPV survivors participated in the study, of whom 38 (71.7%) were recruited from women’s associations against gender violence from three Andalusia provinces (Southern Spain). In a semi-structured interview, the women responded to four open-ended questions about the effects of IPV on their life and how they coped with this situation. Four main themes were identified: (1) changes after the experience, (2) support during recovery, (3) perceived needs and obstacles, and (4) current situation. The survivors considered formal and informal social support to be critical to their recovery and emotional well-being. They also highlighted the need for continuity in support programs and for specialist interventions to address long-term psychological sequelae. These findings reinforce the need for psychological programs more tailored to the needs of these women.

Las intervenciones centradas en cambios de conducta, sumadas a la escasa evidencia de mapeo y dinamización de activos en Universidades Promotoras de Salud (UPS), hacen necesario potenciar enfoques integrales y sistémicos que contribuyan al bienestar y empoderamiento de sus integrantes. El objetivo de este artículo es explorar propuestas de acción que contribuyan a fortalecer activos en una comunidad universitaria chilena. Se desarrolló un estudio cualitativo con 72 hombres/77 mujeres (estudiantes, trabajadores, jubilados y exestudiantes). Se realizaron 48 entrevistas individuales y 14 grupos focales. Se efectuó un análisis de contenido utilizando el software QRS NVivo 12. Las propuestas identificadas se agruparon en: desarrollo de la participación e inclusión, promoción de la salud mental, mantenimiento y mejora de áreas verdes e infraestructura, y fortalecimiento del acceso a actividades deportivas, culturales y de extensión universitaria. Las mujeres valoraron la difusión de activos comunitarios y el cuidado de las personas y el entorno. Y los hombres, el fortalecimiento del capital social, la docencia y la transferencia de conocimiento. Las propuestas de acción tienen una orientación colectiva que favorece el vínculo de las personas con su entorno y el desarrollo del sentido de comunidad. Desde una perspectiva de género, se observa reproducción de roles y estereotipos arraigados en el sistema patriarcal. Esto constituye un desafío para potenciar las UPS en tanto política pública, considerando los principios de participación, justicia social y equidad. Este estudio se enmarca dentro del proyecto VRID 217.089.007-1.0IN financiado por la Vicerrectorría de Investigación y Desarrollo de la Universidad de Concepción, Chile.

IntroductionPregnancy is a transcendent period for the mother and the fetus, characterized by an increase on energy requirements. Mediterranean diet (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy and protect from the development of obstetric pathologies.ObjectiveTo know the relationship between adherence to the MD and its maternal-fetal benefits.MethodologyA systematic review was conducted by identifying articles in the PubMed and Cochrane databases. The publication date of the studies was between 2010 and 2020, and the inclusion criteria established were that the articles were written in English and Spanish and were accessible in full text. Studies concerning assisted reproduction, gene modulation, conference abstracts, systematic reviews, and pilot studies were excluded.ResultsFinally, a total of 14 studies were included in the review. The association between the MD and the reduction of some pathologies of pregnancy, such as gestational diabetes, overweight or obesity, sleep quality, complications of childbirth, urinary tract infections (UTIs), and alterations in fetal growth was demonstrated, as well as perinatal problems, including birth weight, prematurity, gastroschisis, and other childhood problems.ConclusionThe MD is an optimal diet to consume during pregnancy.

Background Sexism results in a number of attitudes and behaviors that contribute to gender inequalities in social structure and interpersonal relationships. The objective of this study was to evaluate the effectiveness of Lights4Violence, an intervention program based on promoting health assets to reduce sexist attitudes in young European people. Methods We carried out a quasi-experimental study in a non-probabilistic population of 1146 students, aged 12–17 years. The dependent variables were the difference in the wave 1 and wave 2 values in the subscales of the Ambivalent Sexism Inventory: benevolent sexism (BS) and hostile sexism (HS). The effect of the intervention was evaluated through linear regression analyses stratified by sex. The models were adjusted by baseline subscales scores, socio-demographic and psychological variables. Results In girls, we observed a decrease in BS in the intervention group compared to the control group (β = − 0.101; p = 0.006). In the wave2,, BS decreased more in the intervention group compared to the control group in girls with mothers with a low level of education (β = − 0.338; p = 0.001), with a high level of social support (β = − 0.251; p p p Conclusions The implementation of the Lights4Violence was associated with a significant reduction in BS in girls, which highlights the potential of interventions aimed at supporting the personal competencies and social support. It is necessary to reinforce the inclusion of educational contents that promote reflection among boys about the role of gender and the meaning of the attributes of masculinity. Trial registration Clinicaltrials.gov : NCT03411564. Unique Protocol ID: 776905. Date registered: 26-01-2018.

The prevalence of mild cognitive impairment (MCI) has significantly increased in recent years. No specific instruments are available in Spanish for assessing health‐related quality of life (HRQoL) in people with MCI. The aim of this study was to adapt transculturally and validate the mild cognitive impairment questionnaire (MCQ) in Spanish people with MCI. A standardized transcultural adaptation process was carried out, and the structural equivalence of the Spanish version of the scale was examined. In addition, we studied the reliability and construct validity of the instrument. The sample comprised 100 people with MCI, with a mean age of 79.5 years. In a confirmatory factor analysis, we found the instrument had a one‐factor structure and adequate internal consistency. Related to the construct validity, we found meaningful relationships with measures of HRQoL and depression. Our results indicate that the Spanish version of the MCQ is a reliable and valid tool for measuring HRQoL in Spanish patients with MCI. The availability of specific tools, such as the MCQ allows nurses to evaluate new intervention strategies to improve the HRQoL of these patients. Furthermore, this scale can be used by researchers and clinicians to improve the standards of care provided to this population.

Mixed-effects models can be used to examine the association between a categorical moderator and the magnitude of the effect size. Two approaches are available to estimate the residual between-studies variance, s 2res —namely, separate estimation within each category of the moderator versus pooled estimation across all categories. We examine, by means of a Monte Carlo simulation study, both approaches for s 2res estimation in combination with two methods, the Wald-type X 2 and F tests, to test the statistical significance of the moderator. Results suggest that the F test using a pooled estimate of s 2res across categories is the best option in most conditions, although the F test using separate estimates of s 2res is preferable if the residual heterogeneity variances are heteroscedastic.

Un meta-análisis de generalización de confiabilidad (MA GF) es un método para integrar estadísticamente las estimaciones de fiabilidad obtenidas en diferentes aplicaciones de un test. El MA GF permite a los investigadores caracterizar la fiabilidad promedio de las puntuaciones obtenida en un test en múltiples estudios y situaciones y estimar el grado de variabilidad en los coeficientes de fiabilidad en diferentes tipos de medidas, muestras y contextos. Por lo tanto, sus resultados permiten ofrecer pautas a los investigadores y profesionales aplicados sobre qué escalas son más fiables para evaluar un constructo y en qué circunstancias. Así pues, los investigadores y profesionales necesitan saber qué son los MA GF, cómo se hacen y, lo que es más importante, cómo podemos hacer valoraciones críticas de ellos. El propósito de este artículo es presentar los MA GF, así como una guía orientativa sobre cómo hacer una lectura crítica de ellos. Para ello, un reciente MA GF es utilizado para ilustrar las guías propuestas. Finalmente, presentamos algunas observaciones finales. A reliability generalization meta-analysis (RG MA) is a suitable method to statistically integrate the reliability estimates obtained in different applications of a test. RG MA allows researchers to characterize the average reliability of scores obtained by a test across multiple studies and situations and estimate the degree of variability in reliability coefficients across different types of measures, samples, and contexts. Therefore, its results enable us to offer guidelines to applied researchers and practitioners about which scales are more reliable for assessing a constructe and in what circumstances. Thus, applied researchers and practitioners need to know what RG MAs are, how they are done and, most importantly, how we can carry out critical appraisal of RG MAs. The purpose of this article is to present RG MAs, together with some guidelines to warrant a critical reading of them. For this, a recent reliability generalization metaanalysis is used to illustrate the guidelines proposed. Finally, some concluding remarks are presented. Este trabajo fue apoyado con fondos del Ministerio de Economía y Competitividad del Gobierno de España y por el Fondo Europeo de Desarrollo Regional (FEDER) Proyecto No. PSI2016-77676-P.

Funding This work was supported by grants UGP-18-255, UGP-19-253, and UGP-20-038 from ISABIAL and PI17/00328 from the Carlos III Health Research Institute (ISCIII) belonging to the Spanish Ministry of Health, and by FEDER (A way of making Europe) project funds., Introduction: Congruence, understood as the agreement between the patient’s preferred place of death and their actual place of death, is emerging as one of the main variables indicating the quality of end-of-life care. The aim of this research was to conduct a systematic literature review on levels and determinants of congruence in palliative patients over the period 2010–2021. Method: A systematic review of the literature in the databases of PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cuiden, the Cochrane Library, CSIC Indexes, and IBECS. Information was extracted on research characteristics, congruence, and associated factors. Results: A total of 30 studies were identified, mainly of retrospective observational design. The congruence values varied substantially between the various studies, ranging from 21 to 100%. The main predictors of congruence include illness-related factors (functional status, treatments and diagnosis), individual factors (age, gender, marital status, and end of life preferences), and environmental factors (place of residence, availability of health, and palliative care services). Conclusion: This review, in comparison with previous studies, shows that treatment-related factors such as physical pain control, marital status, having a non-working relative, age, discussing preferred place of death with a healthcare professional, and caregiver’s preference have been associated with higher levels of congruence. Depending on the study, other factors have been associated with either higher or lower congruence, such as the patient’s diagnosis, gender, or place of residence. This information is useful for designing interventions aimed towards greater congruence at the end of life., Carlos III Health Research Institute (ISCIII) UGP-18-255 UGP-19-253 UGP-20-038 PI17/00328, FEDER (A way of making Europe)

After the paper Cognition or genetics. Predicting progression to Alzheimer's disease with practice effects, APOE genotype and brain metabolism [Neurobiol Aging, 2018; 71:234-240] was published, we identified a coding error of one of the variables analyzed. To correct, update and expand the previous work, this study compared simple and complex regression-based Reliable Change Index (RCIRB) to identify individuals at risk of progression to AD (AD-risk) after six years using either delayed recall or recognition scores. Auditory Verbal Learning Test (AVLT) scores at six months for 394 individuals with normal cognition (NC) from the Alzheimer's Disease Neuroimaging Initiative database were regressed on baseline AVLT scores only (simple RCIRB), or with age, sex and education (complex RCIRB). Standardized residuals were used to classify 816 individuals with amnestic mild cognitive impairment (aMCI) as showing low practice effects (PE-) when the discrepancy between observed and predicted scores was found in fewer than 5% of NC. RCIRB for delayed recall scores were not significant to predict AD-risk. For recognition scores, the AD-risk was associated with age (P=.012), brain metabolism (P

The COVID-19 pandemic has caused several changes in society, especially in the educational context, where several learning methodologies and social interactions have been modified significantly. This fact could have had a negative impact on academic stress levels of students and the classroom climate, especially in the university context. The main aim of the present study was to identify changes in academic stress and the perceived classroom climate caused by COVID-19 in a sample of Spanish university students. Academic stress was evaluated trough the Stressor Academic Scale (SAS) and perceived classroom climate employing the Perceived Classroom Responsibility Climate (PCRC) questionnaire. A longitudinal study was conducted. 135 students (97 females and 38 males) from the Gastronomy (n = 31) and Criminology (n = 104) degrees were evaluated before and after the COVID-19 lockdown in Spain. Academic stress levels and perceived classroom climate were analyzed before (Time 1) and after (Time 2) the lockdown declaration. An increase in academic stress was found, especially in the categories regarding Teachers’ Methodological Deficiencies, Academic Over-Burden and Beliefs About Performances. Females and final year students suffered higher levels of academic stress. No differences were found between Time 1 and 2 in perceived classroom climate. The obtained results point out a significant increase of academic stress in university students due to the COVID-19 pandemic in Spain. The implemented educational changes and the uncertainty that resulted from the pandemic could have a significant negative impact on mental health in this population, resulting in higher levels of academic stress, especially in females and final year students. Future studies should analyze the strategies that students are employing to cope with these educational challenges and intervention strategies to promote them in the context of higher education. This research was supported by the Program of Networks-I3CE of Investigation in University Teaching (Program Networks) from the Vice-Rectorate of Quality and Educational Innovation and Education Sciences Institute of the University of Alicante (2019–2020). Ref.: (4913).

El programa «Filmémonos para vernos en un nuevo presente» constituye una aportación a la promoción de las relaciones de pareja equitativas y saludables, y, en concreto, a la prevención de la violencia de género. El programa se basa en potenciar los activos personales y del entorno del alumnado. Esta propuesta se enmarca dentro del modelo de «Desarrollo positivo de la juventud», centrado en el potencial que las personas, las familias y las comunidades tienen para mejorar la salud, el bienestar, y la promoción de actitudes de rechazo frente al sexismo y a la violencia en las relaciones de pareja. El programa parte de la premisa de que la adolescencia y la juventud son un período crítico para la construcción de relaciones de pareja equitativas, de la misma manera que la infancia es una etapa clave para el desarrollo de competencias emocionales y habilidades personales. Por esta razón, la intervención temprana puede ser determinante en la calidad, la igualdad y el respeto mutuo en las relaciones de pareja futuras. Esta iniciativa adopta metodologías características de la educación vivencial y trabaja desde la participación activa del alumnado, reservando para el profesorado y personas dinamizadoras un rol de acompañante en el proceso de aprendizaje. La intervención en el aula se orienta a facilitar que el alumnado pueda expresar su visión sobre las relaciones de pareja equitativas y saludables. El programa propone que el alumnado sea protagonista en la elaboración de un argumento o de una videocápsula que ponga el foco en aquello que caracteriza las relaciones de pareja saludables y equitativas entre jóvenes. El programa está diseñado como una herramienta de apoyo para profesionales del ámbito educativo, que pueden fácilmente integrar los conceptos y actividades que se proponen en el currículo educativo. Esperamos que este manual sea una guía útil para profesionales que trabajan en el ámbito de la promoción de las relaciones equitativas y, en concreto, la prevención de la violencia de género, especialmente en el entorno escolar. Proyecto multicéntrico de «Promoción de activos protectores de la violencia de género en la adolescencia y pre-adolescencia» (PI18/00590; PI18/00544) FINANCIADO POR Instituto de Salud Carlos III, como organismo intermedio del Fondo Europeo de Desarrollo Regional (FEDER) y del Fondo Social Europeo (FSE). Adicionalmente, se cuenta con la ayuda del CIBER de Epidemiología y Salud Pública a través del Subprograma sobre Prevención de la Violencia de Género del Programa de Determinantes Sociales de la Salud.

El consumo de drogas por parte de los jóvenes constituye en la actualidad uno de los problemas más importantes de salud pública (Sitnick et al., 2014). Aunque las últimas encuestas mundiales sobre el uso de sustancias tóxicas ilegales (National Council on Crime and Delinquency (NCCD), indican un descenso o estabilización generalizada del consumo en Estados Unidos y Europa, una proporción significativa de jóvenes continúa expuesto a los efectos nocivos de las drogas (UNODC, 2017). Sin embargo, de acuerdo a las cifras registradas en el último informe publicado por la United Nations Office on Drugs and Crime (UNODC, 2021), en el año 2018, cerca de 269 millones de personas, de 15 a 64 años de edad, había consumido algún tipo de droga en el año anterior. Estas cifras suponen un incremento del 30% del consumo en los últimos 10 años, y es particularmente significativo en el caso de drogas legales, entre las que se encuentra el tabaco y el alcohol, y en algunos países, el cannabis (UNODC, 2019). En Europa, y España en particular, el consumo de drogas sigue siendo un problema ampliamente extendido entre los jóvenes de 15 a 34 años. La evidencia científica señala que el consumo de sustancias se concentra principalmente en esta franja de edad con 20 millones de adultos jóvenes (de 15 a 34 años) que han consumido drogas en el último año. El riesgo de iniciación del consumo es más acusado en el período de la adolescencia temprana, entre los 14 y 17 años de edad (European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2020). El consumo de drogas durante la adolescencia se relaciona con un gran número de problemas de salud incluido el riesgo de enfermedad mental, desempleo, conductas sexuales de riesgo, violencia y la disminución de la esperanza de vida (Currie et al., 2009; Fletcher et al., 2008; Miller y Plant, 1999; Samdal et al., 2000; Shekhtmeyster et al., 2011). Dada la alta prevalencia del consumo de drogas en adolescentes en Europa y en España en particular, la presente Tesis Doctoral analizó los efectos adversos derivados del consumo de drogas y otras conductas de riesgo en adolescentes. Este trabajo consta de 8 capítulos articulados en los siguientes apartados: a) introducción, b) estudios empíricos publicados, c) estudios empíricos no publicados, d) discusión general, limitaciones de los estudios y perspectivas de futuro, y d) conclusiones. Los estudios empíricos que conforman este trabajo se han centrado fundamentalmente en dos vías de investigación: Por un lado, dada la alta incidencia del consumo de cannabis y alcohol entre los adolescentes, en esta Tesis Doctoral se analizan las conductas de riesgo asociadas al consumo de alcohol que tienen un impacto significativo en la familia, los comportamientos sexuales de riesgo y conductas de riesgo en la escuela. También se evalúa la relación entre el uso del cannabis y los comportamientos de riesgo asociados a su consumo como son sufrir un accidente de tráfico, agredir físicamente a alguien o ser agredido o ir de copiloto con alguna persona que haya consumido cannabis. Por otro lado, esta Tesis evaluó la efectividad que los programas de intervención temprana ejercen en la disminución de las conductas de drogas y otros comportamientos de riesgo en la adolescencia. Desde esta perspectiva, se analizó la efectividad del programa de intervención Reasoning and Rehabilitation V2, uno de los programas cognitivo-conductuales más sólidos hasta la fecha, basado en el enfoque de la psicología positiva. Este programa está enfocado en la promoción de actitudes prosociales, valores y desarrollo de habilidades personales como la autoestima, la resolución de conflictos, la empatía y las habilidades sociales como ejes de intervención en adolescentes vulnerables hacia el consumo de drogas y otros comportamientos de riesgo para la salud. Teniendo en cuenta la investigación previa acerca de la efectividad de este programa en diferentes poblaciones y contextos culturales, en la presente Tesis Doctoral analizamos su efectividad en adolescentes que presentan fracaso escolar y están en riesgo de exclusión social. Esta Tesis por tanto contribuye a la literatura científica demostrando evidencia de la aplicación del programa Reasoning and Rehabilitation V2 en España, y más concretamente, en un colectivo que hasta la fecha no había sido analizado. En este sentido, se han determinado cuatro objetivos fundamentales de investigación, cada uno de los cuáles deriva en un estudio empírico. Dos estudios de carácter longitudinal y dos estudios transversales que suponen una continuación de la línea de investigación sobre prevención de consumo de drogas y otras conductas de riesgo en adolescentes. Los principales resultados de cada uno de los estudios aparecen recogidos en los capítulos del 3-6. En el primer estudio analizamos la asociación entre la edad, el sexo, el nivel socioeconómico, el consumo de alcohol y los comportamientos de riesgo en el ámbito personal, familiar y escolar en una muestra de 757 adolescentes de 14 a 19 años edad de edad. Para ello, los participantes cumplimentaron la Encuesta Estatal sobre Uso de Drogas (ESTUDES) y el cuestionario socioeconómico familiar Family Affluence Scale – II (FAS). Nuestro estudio identificó la asociación entre el nivel socioeconómico alto y el riesgo de consumir alcohol en los últimos 12 meses. Nuestros resultados mostraron que un 65% de los adolescentes entre 14 y 19 años referían haber consumido alcohol en los últimos 12 meses. Asimismo, se encontró una relación significativa entre el consumo de alcohol y situaciones problemáticas, entre las que se incluye, un mayor riesgo de tener conflictos o discusiones familiares, dificultades para recordar lo que ocurrió la noche anterior o manifestar problemas de concentración en la escuela. Además, el consumo de alcohol también estuvo asociado con una mayor probabilidad de ser expulsado del colegio, ser víctima de acoso escolar o ejercer violencia en el ámbito educativo, tener relaciones sexuales sin preservativo o arrepentirse de haber tenido relaciones sexuales. En el segundo estudio evaluamos la influencia del consumo del cannabis como factor predisponente de conductas de alto riesgo para la salud. En particular, analizamos la probabilidad de sufrir accidentes de tráfico y experimentar actos de violencia bajo los efectos del cannabis en adolescentes. En este estudio, 648 estudiantes adolescentes de 14 a 19 años de edad cumplimentaron la Encuesta Estatal sobre Uso de Drogas (ESTUDES) y la escala CAST (Cannbis Abuse Screening Test) para la detección de consumo problemático del cannabis. Nuestros resultados mostraron que un 37,5% de los adolescentes refería haber consumido cannabis alguna vez en la vida. De los consumidores de cannabis entre el 2,6% y el 4% presentaba un patrón de adicción moderado o severo. Además, nuestro estudio identificó que el consumo de cannabis durante la adolescencia estaba relacionado con el número de agresiones físicas, con la conducción bajo los efectos del cannabis y con ir de copiloto con otros adolescentes que habían consumido cannabis en las dos horas previas a la conducción. No se encontró un efecto significativo entre el consumo de cannabis y riesgo de accidentes de tráfico. En el tercer estudio, examinamos la efectividad de la versión española del Programa de Intervención Reasoning and Rehabilitation (R&R2) como eje de intervención para la adquisición de habilidades emocionales y sociales en adolescentes de Formación Profesional Básica (FPB). Estos ciclos formativos están destinados a adolescentes que manifiestan fracaso escolar y están en riesgo de exclusión social. Para ello, analizamos una muestra de 142 adolescentes de FPB de 13 a 17 años de edad, asignados aleatoriamente a dos condiciones experimentales (68 particpantes al grupo experimental y 74 al grupo control). Los participantes del grupo experimental recibieron 12 sesiones de intervención del progrma R&R V2 de 120 minutos de duración. Los efectos del programa fueron analizados en tres tiempos (línea base, después de la intervención y tras 6 meses de seguimiento) a lo largo de 18 meses de duración. Los resultados de este estudio mostraron que controlando la edad y las puntuciones basales, los estudiantes del grupo experimental mostraron mejoras significativas en las competencias emocionales y sociales, con un tamaño del efecto medio-alto. En particular, se encontró un efecto significativo del programa en los participantes del grupo experimental en las variables: habilidades sociales, autoestima, capacidad de empatía y la subescala racional de resolución de conflictos. No se encontró evidencia de la efectividad del programa en las subescalas de resolución de problemas dirigidos a mejorar la orientación positiva, orientación negativa, estilo evitativo y estilo impulsivo de resolución de problemas. Estos resultados pueden deberse al efecto de la edad, debido a que los participantes del estudio pueden considerarse cognitivamente inmaduros para generar este tipo de estrategias de resolución de conflictos. Esto puede ser debido, a que la capacidad de resolución de conflictos se relaciona con la función ejecutiva cerebral, la cual alcanza su madurez en torno a los 21 años de edad. Por tanto, estos resultados ponen de manifiesto la importancia de considerar la variable edad en las intervenciones escolares dirigidas a mejorar este tipo de competencias en los/las adolescentes. Por último, en el cuarto estudio, evaluamos el efecto indirecto del Programa de Intervención Reasoning and Rehabilitation (R&R2) en la disminución del consumo de alcohol, tabaco y cannabis en la muestra del estudio 3. Los resultados del estudio, mostraron que el programa Reasoning and Rehabilitation también tuvo un efecto significativo en la reducción del consumo de sustancias en estudiantes de FPB. La exposición al programa R&R2 redujo un 26% el consumo de tabaco, un 36% el consumo de alcohol y el 11,6% del consumo de cannabis a lo largo de 6 meses de intervención. Sin embargo, se observó un repunte del consumo de tabaco y alcohol 6 meses después de la intervención. Estos resultados indican, por tanto, que aunque este tipo de intervenciones pueden ser exitosas en el ámbito educativo, es necesario monitorizar los cambios a lo largo del tiempo, realizando actividades de refuerzo sobre los principales componentes del programa y las habilidades que favorecen el rechazo a las drogas. En el capítulo 7, discutimos los principales resultados obtenidos en cada uno de los estudios llevados a cabo y destacamos las limitaciones y perspectivas de futuro que abren nuevas vías de investigación. Por último, en el capítulo 8, se presentan las conclusiones derivadas de la presente Tesis Doctoral.

Los actuales mecanismos y herramientas utilizados para la investigación de personas desaparecidas resultan insuficientes para abordar el amplio número de denuncias existentes, como también para poder otorgar una solución satisfactoria a dichas investigaciones. Por lo que, mediante el presente trabajo, se pretende poner a disposición de las fuerzas del orden y de la administración una posible respuesta ante las abundantes cifras de desaparecidos. Para ello, resulta imperioso dar a conocer el estado de la cuestión actual sobre personas desaparecidas, así como aplicar un correcto método de investigación mediante el uso de la autopsia psicológica del que puedan servirse todos los profesionales de la comunidad científica. Gracias a dicha herramienta se prevé el establecimiento de los principales perfiles, y detectar posibles factores de riesgo para una adecuada predicción de ser víctima de estos sucesos. Así como abordar una serie de propuestas y perspectivas de mejora como la implementación de las nuevas tecnologías, sirviéndose de algoritmos de inteligencia artificial que permitan dilucidar el cambio de rasgos fisionómicos de desaparecidos o como también la inclusión en el Estatuto de la Víctima a los familiares de las personas desaparecidas.

La presente tesis doctoral se enmarca en la línea de investigación “Calidad de vida y evaluación de resultados”. Este trabajo consta de 9 secciones articuladas en los siguientes apartados: a) introducción, b) objetivos, c) estudios empíricos publicados, d) estudios empíricos no publicados, e) discusión general, f) limitaciones y perspectivas de futuro, g) conclusiones, h) referencias bibliográficas y, i) anexos. Asimismo, la presente tesis doctoral sigue el formato por compendio de publicaciones, en los que se han incluido seis artículos, tres de ellos publicados en revistas de alto factor de impacto Journal Citation Report; JCR Q1 y Q2. En segundo lugar, otros dos artículos también se encuentran bajo proceso de revisión en revistas de alto factor de impacto. Por último, el artículo restante se encuentra en proceso de análisis y escritura final para ser enviado a una revista de similares características a las anteriores. El diagnóstico de discapacidad intelectual (DI) es una afección que sigue creciendo a lo largo del tiempo ya que en los últimos años, se ha observado el incremento de nuevos casos de personas que sufren dicho diagnóstico a nivel mundial. Además de este aumento en el número de diagnósticos, encontramos que, gracias a la mejora en los servicios sociales y sanitarios, su esperanza de vida ha crecido exponencialmente, es decir, la población con un diagnóstico de DI está envejeciendo. El hecho de que las personas con DI vivan más años, conlleva inevitablemente, un aumento en la probabilidad de que sufran un mayor número de pérdidas a lo largo de su vida, así como que experimenten duelos complicados o patológicos en algún momento. Durante mucho tiempo se consideraba que las personas con DI no podrían ser capaces de experimentar procesos de duelo ante pérdidas de sus seres queridos, puesto que algunos autores pensaban que este colectivo no tenía la comprensión necesaria para entender el concepto de muerte y que, además, no eran capaces de establecer relaciones significativas con los demás. Sin embargo, actualmente, los estudios realizados revelan que, las personas con DI también reconocen la ausencia de un ser querido, y por lo tanto, experimentan y elaboran duelos de forma similar a otras poblaciones. Dentro de los factores de riesgo específicos de la población con DI que pueden facilitar el desarrollo de un duelo complicado (DC), encontramos la conspiración de silencio (ocultarles noticias sobre enfermedad y/o fallecimientos de seres queridos), la escasa participación en los rituales asociados a la pérdida, las dificultades de comunicación, los déficits cognitivos relacionados con la discapacidad, la comprensión limitada del concepto muerte, y, la existencia de un fuerte apego a sus principales cuidadores/as. Asimismo, la DI resulta una condición limitante también para los cuidadores/as familiares que les atienden. La noticia del diagnóstico de DI de su familiar, produce un fuerte impacto emocional en la familia, derivándose en la mayoría de los casos, en sentimientos de pérdida o procesos de duelo desautorizados, y además de ello, se generan, frecuentemente, una serie de consecuencias en su salud física y mental, y por tanto, una reducción en su calidad de vida (CV) y bienestar. Por último y en relación a lo anteriormente expuesto, encontramos que los/as profesionales que atienden a personas con DI, desconocen a menudo, la forma óptima de actuación ante situaciones de pérdida que sufren sus usuarios/as así como el modo de afrontamiento a las dificultades socioemocionales que se le presentan. Es por todo ello, que la presente tesis doctoral se dirige al estudio de tres temáticas fundamentales: a) el estudio del concepto de muerte, procesos de duelo y su intervención, en personas con DI; b) la complejidad del proceso de duelo y los cambios vitales que sufren los/as cuidadores/as principales tras el diagnóstico de DI de su familiar; y c) el estudio de las experiencias y dificultades en procesos de duelo y situaciones críticas, con las que se encuentran los/as profesionales que trabajan en el ámbito de la DI.

La alta sensibilidad aparece descrita por primera vez en los años 90 por Elaine Aron. Describe a los individuos que poseen el rasgo de personalidad llamado sensibilidad de procesamiento sensorial y que constituye el 15%-20% de la población. Se caracteriza por un procesamiento profundo, sobreestimulación, emociones fuertes y sensibilidad a las sutilezas. Debido a sus características, este rasgo tiene una influencia directa en la calidad de vida laboral y en la aparición del Síndrome del Burnout. El presente trabajo tiene como objetivo una revisión bibliográfica de investigaciones científicas relacionadas con el tema. La calidad de vida de las personas con una alta sensibilidad está más afectada en las áreas física, cognitiva, emocional y social. Se ven más afectadas por las condiciones físicas y emocionales del lugar de trabajo, por lo que necesitan más tiempo de recuperación tras verse expuestos a los estímulos. La facilidad de excitación y el umbral sensorial bajo de las personas altamente sensibles se relaciona con un mayor descontento laboral. El 75% de estos individuos declara haber sufrido el Síndrome del Burnout en su trabajo. La alta sensibilidad es vista como predictor de este síndrome y está relacionada con peores síntomas de agotamiento y desconexión del trabajo.

El objetivo de este trabajo fue realizar una revisión bibliográfica de la literatura acerca de la influencia del maltrato infantil como mediador de cambios epigenéticos y sus posibles alteraciones neurobiológicas. Para ello, se analizaron 20 artículos científicos recogidos de las bases de datos Proquest, Sopus, Scielo, Pubmed y Medline, relativos al estudio de las alteraciones neuroendocrinas, alteraciones estructurales y neuropsicológicas que están relacionadas con el maltrato infantil. Los principales resultados mostraron que la vivencia de una experiencia traumática o estresante, como resulta el maltrato infantil, durante un periodo de gran plasticidad neuronal, provoca una serie de disrupciones en la expresión genética, modificando las características del ADN, así como distintas alteraciones neurobiológicas a niveles endocrino; estructural y neuropsicológico. Estos resultados ponen de manifiesto la importancia de la epigenética y de las distintas alteraciones neurológicas en el estudio de la influencia del maltrato infantil y otras conductas aversivas, ya que puede contribuir a explicar las causas del desarrollo de posibles trastornos de la personalidad y su posible relación con la manifestación de conductas violentas.

Una de las labores de la medicina legal o medicina forense consiste en el empleo de los conocimientos médicos como medida de asistencia para la aplicación de justicia. Es precisamente en el ámbito de la patología forense donde se encuentra uno de los mayores retos de dicha disciplina: determinar la edad de una herida, es decir, resolver si una lesión ha sido producida antemortem o postmortem; una tarea que, en muchos casos, puede resultar decisiva en la reconstrucción de las escenas de crímenes y en la identificación y castigo de los presuntos acusados. Las técnicas que han permitido a los profesionales de la Medicina Legal estimar la vitalidad de la herida y fijar el lapso de tiempo transcurrido han ido evolucionando a lo largo de la historia de la ciencia. En el presente trabajo se desarrollan, desde el estudio histopatológico, las alteraciones histológicas inherentes a la inflamación tras ocasionarse una lesión con el fin de posibilitar el registro en la fase en que se hallen; así como los métodos validados (tradicionales e innovadores) que permiten evaluar la edad de la herida. Finalmente, una vez fijada la situación actual, se plantea una visión de futuro, un “hacia dónde se dirige” la patología forense, que sirva como punto de inflexión para los avances venideros.

El programa «Filmémonos para vernos en un nuevo presente» constituye una aportación a la promoción de las relaciones de pareja equitativas y saludables, y, en concreto, a la prevención de la violencia de género. El programa se basa en potenciar los activos personales y del entorno del alumnado y en los presentes en su entorno. Este programa se enmarca dentro del modelo de «Desarrollo positivo de la juventud», centrado en el potencial que las personas, las familias y las comunidades tienen para mejorar la salud, el bienestar, y la promoción de actitudes de rechazo frente al sexismo y a la violencia en las relaciones de pareja. El programa parte de la premisa de que la adolescencia y la juventud son un período crítico para la construcción de relaciones de pareja equitativas, de la misma manera que la infancia es una etapa clave para el desarrollo de competencias emocionales y habilidades personales. Por esta razón, la intervención temprana puede ser determinante en la calidad, la igualdad y el respeto mutuo en las relaciones de pareja futuras. Este programa adopta metodologías características de la educación vivencial y trabaja desde la participación activa del alumnado, reservando para el profesorado y personas dinamizadoras un rol de acompañante en el proceso de aprendizaje. La intervención en el aula se orienta a facilitar que el alumnado pueda expresar su visión sobre las relaciones de pareja equitativas y saludables. El programa propone que el alumnado sea protagonista en la elaboración de un argumento o de una videocápsula que ponga el foco en aquello que caracteriza las relaciones de pareja saludables y equitativas entre jóvenes. El programa está diseñado como una herramienta de apoyo para profesionales del ámbito educativo, que pueden fácilmente integrar los conceptos y actividades que se proponen en el currículo educativo. Esperamos que este manual sea una guía útil para educadoras, educadores y otros/as profesionales que trabajan en el ámbito de la promoción de las relaciones equitativas y, en concreto, la prevención de la violencia de género, especialmente en el entorno escolar. Proyecto multicéntrico de «Promoción de activos protectores de la violencia de género en la adolescencia y pre-adolescencia» (PI18/00590; PI18/00544) FINANCIADO POR Instituto de Salud Carlos III, como organismo intermedio del Fondo Europeo de Desarrollo Regional (FEDER) y del Fondo Social Europeo (FSE). Adicionalmente, se cuenta con la ayuda del CIBER de Epidemiología y Salud Pública a través del Subprograma sobre Prevención de la Violencia de Género del Programa de Determinantes Sociales de la Salud.

Objetivos: revisar las recomendaciones de prácticas clínicas sobre el cribado del cáncer de próstata disponibles en España, valorando su adecuación en las indicaciones de la U.S Preventive Services Task Force. Métodos: revisión de las recomendaciones de prácticas clínicas en el cribado del cáncer de próstata, de las principales sociedades científicas y las autoridades sanitarias de las comunidades autónomas. Comparativa posterior con la U.S Preventive Services Task Force. Resultados: tanto las Consejerías de Salud de las comunidades autónomas como las sociedades científicas, a excepción de dos de ellas que muestran ambigüedad, descartan su uso rutinario y su implantación como programa de detección precoz. Conclusión: existen aún recomendaciones de realización del indicador PSA en hombres asintomáticos. Objective: to review the clinical practice recommendations available in Spain regarding prostate cancer screening, assessing their suitability according to the indications by the U.S Preventive Services Task Force. Methods: a review of the clinical practice recommendations for prostate cancer screening by the main scientific societies and the health authorities of the autonomous communities. A subsequent comparison with the U.S Preventive Services Task Force. Results: both the Regional Ministries of Health of the autonomous communities and the scientific societies, except for two who showed ambiguity, have ruled out its routine use and implementation as a program for early detection. Conclusion: there are still recommendations for PSA testing in asymptomatic men.

El programa “Filmémonos para vernos en un nuevo presente”, se plantea con la finalidad de promover relaciones interpersonales equitativas y saludables entre el alumnado de 5º y 6º de primaria, que sirvan de base para la prevención de posibles situaciones de conflicto en sus futuras relaciones afectivas. Se enmarca en el marco teórico del “Desarrollo positivo de la juventud” centrado en el potencial que existe tanto en los propios individuos (activos internos) como en su entorno (familia, centro educativo y comunidad) para un desarrollo saludable hacia la etapa adulta. En este caso, se propone la aplicación de este modelo teórico al fomento de competencias personales (actitudes, habilidades y reconocimiento de factores de apoyo en su entorno) para el desarrollo de relaciones interpersonales saludables y basadas en la igualdad de género. Se parte de la premisa de que la infancia y preadolescencia constituyen periodos clave para el desarrollo de actitudes, conductas y construcciones sociales en torno a las relaciones interpersonales de diferente índole. Consideramos que la intervención temprana puede ser clave en la calidad, la igualdad y el respeto mutuo en las relaciones interpersonales afectivas futuras. En el programa, se adopta una metodología participativa, proporcionando al alumnado un espacio para hablar sobre las relaciones interpersonales, en el que puedan compartir situaciones que puedan considerar fuente de conflicto, y construyan con el apoyo del profesorado algunas alternativas de solución basadas en los principios de equidad de género y el respeto. Además, se propone que el alumnado sea artífice y protagonista de una breve historia que ponga el foco en las actitudes, habilidades y contenidos trabajados en el programa que consideran útiles para dar respuesta a conflictos que pueden darse en sus relaciones interpersonales. Adicionalmente, se les proporciona las herramientas para que puedan trasladar dicha historia al formato audiovisual que más se adapte o les llame la atención (una representación teatral, una video-cápsula, un cómic). El programa está concebido como una herramienta de apoyo para que profesionales del ámbito educativo puedan integrar fácilmente los conceptos y actividades que se proponen en el currículo educativo. Esperamos que este manual sea una guía útil para profesionales de la educación y de otras disciplinas que trabajan en el ámbito de la promoción de la salud y los factores que influyen en las relaciones interpersonales, especialmente en el entorno escolar. Proyecto multicéntrico de "Promoción de activos protectores de la violencia de género en la adolescencia y pre-adolescencia” (PI18/00590; PI18/00544) FINANCIADO POR Instituto de Salud Carlos III, como organismo intermedio del Fondo Europeo de Desarrollo Regional (FEDER) y del Fondo Social Europeo (FSE). Adicionalmente, se cuenta con la ayuda del CIBER de Epidemiología y Salud Pública a través del Subprograma sobre Prevención de la Violencia de Género del Programa de Determinantes Sociales de la Salud.

El objetivo de este estudio ha sido analizar el impacto en jóvenes de una experiencia de violencia de género en el hogar. En concreto se trata de conocer su estado actual y las necesidades y apoyos que tuvieron, contados desde su propia experiencia. Se realizó un estudio cualitativo con 9 jóvenes (4 mujeres y 5 hombres) mayores de edad y que hacía más de 3 años que habían vivido una experiencia de violencia de género de su padre a su madre. Los resultados muestran que los apoyos sociales, tanto informales (familiares o amistades), como formales (apoyo psicológico), fueron fundamentales en su recuperación. Por otro lado, el rechazo social y la ausencia del padre es lo que afectó más negativamente a su bienestar. Estos datos pueden ayudar a la hora de evaluar o de diseñar programas de intervención en esta población., The objective of this study has been to analyze the impact on young people of an experience of gender violence in the home. Specifically, participants were inquired about their current state and the needs and support they had, told from their own experience. A qualitative study was carried out with 9 young people (4 women and 5 men) who were over 18 years old and who had experienced gender violence from their father to their mother more than three years ago. The results showed that social support, both informal (family or friends) and formal (psychological support), were essential in their recovery. On the other hand, social rejection and the absence of the father is what most negatively affected their well-being. These results can help in assessing or designing future intervention programs.

Background: Machismo and acceptance of violence (AV) against women are part of the social construction of hegemonic masculinity and are related to the risk of dating violence. This study aims to analyze the effectiveness of the Lights4Violence program in reducing machismo and AV in secondary school students from different European cities. Methods: Quasi-experimental longitudinal study using a convenience sample of 1,146 high school students from different European cities (12–17 years old) including 575 intervention group students (59.1% girls) and 571 control group students (62.7% girls). We performed linear regression models to identify the effect of the intervention, modelling the difference in means in machismo and AV (dependent variables) between wave-2 and wave-1. Results: An interaction was identified between the group variable and the empathy variable. In wave-2, girls with high empathy at baseline in the intervention group obtained lower mean AV scores (β: -0.131; p = 0.004). However, the boys in the intervention group (reference: control group) with low empathy at baseline registered a significant increase in the mean values of machismo (β: 0.247; p

Background: In the last years, overviews of systematic reviews, or umbrella reviews, have seen a dramatic increase in their use. An overview aims to provide a summary of the included reviews and will often examine research questions beyond those addressed in the systematic reviews being synthesised. The purpose of this article is to provide some recommendations on how overviews should be conducted and reported. Method: A literature review was performed to identify relevant papers on both methodological and applied overviews. Results: The current literature recommends carrying out overviews by following similar steps to those of systematic reviews: (a) Defining the overview research question; (b) inclusion and exclusion criteria; (c) literature search; (d) data extraction; (e) assessment of risk of bias and reporting quality; (f) overview results; and (g) reporting the overview. Of special interest is how to address dependencies between the systematic reviews. Conclusions: Overviews allow evidence to be efficiently combined from multiple systematic reviews. This offers the possibility of translating and summarizing large amounts of information. As in primary studies and systematic reviews, conducting and reporting of overviews must meet appropriate quality standards. Antecedentes: en los últimos años, las meta-revisiones, o revisiones paraguas, han incrementado exponencialmente su uso. Una meta-revisión proporciona un resumen de las revisiones incluidas y, a menudo, aborda preguntas más allá de las planteadas en las revisiones sistemáticas sintetizadas. El propósito de este artículo fue proporcionar recomendaciones sobre cómo deben hacerse y reportarse las meta-revisiones. Método: se llevó a cabo una revisión de la literatura para identificar artículos relevantes sobre meta-revisiones, tanto metodológicos como aplicados. Resultados: a día de hoy la literatura sobre meta-revisiones recomienda seguir los mismos pasos que en las revisiones sistemáticas: (a) definición de la pregunta de investigación; (b) criterios de inclusión y exclusión; (c) búsqueda de la literatura; (d) extracción de datos; (e) valoración del riesgo de sesgo y de la calidad del reporte; (f) presentación de resultados; y (g) reporte de la meta-revisión. De especial interés es cómo abordar los problemas de dependencia entre las revisiones sistemáticas sintetizadas. Conclusiones: las meta-revisiones permiten combinar evidencia de múltiples revisiones sistemáticas de una forma eficiente. Esto permite transformar y resumir grandes cantidades de información. Al igual que en los estudios primarios y las revisiones sistemáticas, las meta-revisiones deben realizarse y reportarse cumpliendo con estándares mínimos de calidad. This study was funded by Agencia Estatal de Investigación (Government of Spain) and by FEDER Funds, AEI/10.13039/501100011033, grants no. PID2019-104033GA-I00 and PID2019-104080GB-I00.

El programa “Filmémonos para vernos en un nuevo presente”, se plantea con la finalidad de promover relaciones interpersonales equitativas y saludables entre el alumnado de 5º y 6º de primaria, que sirvan de base para la prevención de posibles situaciones de conflicto en sus futuras relaciones afectivas. Se enmarca en el marco teórico del “Desarrollo positivo de la juventud” centrado en el potencial que existe tanto en los propios individuos (activos internos) como en su entorno (familia, centro educativo y comunidad) para un desarrollo saludable hacia la etapa adulta. En este caso, se propone la aplicación de este modelo teórico al fomento de competencias personales (actitudes, habilidades y reconocimiento de factores de apoyo en su entorno) para el desarrollo de relaciones interpersonales saludables y basadas en la igualdad de género. Se parte de la premisa de que la infancia y preadolescencia constituyen periodos clave para el desarrollo de actitudes, conductas y construcciones sociales en torno a las relaciones interpersonales de diferente índole. Consideramos que la intervención temprana puede ser clave en la calidad, la igualdad y el respeto mutuo en las relaciones interpersonales afectivas futuras. En el programa, se adopta una metodología participativa, proporcionando al alumnado un espacio para hablar sobre las relaciones interpersonales, en el que puedan compartir situaciones que puedan considerar fuente de conflicto, y construyan con el apoyo del profesorado algunas alternativas de solución basadas en los principios de equidad de género y el respeto. Además, se propone que el alumnado sea artífice y protagonista de una breve historia que ponga el foco en las actitudes, habilidades y contenidos trabajados en el programa que consideran útiles para dar respuesta a conflictos que pueden darse en sus relaciones interpersonales. Adicionalmente, se les proporciona las herramientas para que puedan trasladar dicha historia al formato audiovisual que más se adapte o les llame la atención (una representación teatral, una video-cápsula, un cómic). El programa está concebido como una herramienta de apoyo para que profesionales del ámbito educativo puedan integrar fácilmente los conceptos y actividades que se proponen en el currículo educativo. Esperamos que este manual sea una guía útil para profesionales de la educación y de otras disciplinas que trabajan en el ámbito de la promoción de la salud y los factores que influyen en las relaciones interpersonales, especialmente en el entorno escolar. Proyecto multicéntrico de "Promoción de activos protectores de la violencia de género en la adolescencia y pre-adolescencia” (PI18/00590; PI18/00544) FINANCIADO POR Instituto de Salud Carlos III, como organismo intermedio del Fondo Europeo de Desarrollo Regional (FEDER) y del Fondo Social Europeo (FSE). Adicionalmente, se cuenta con la ayuda del CIBER de Epidemiología y Salud Pública a través del Subprograma sobre Prevención de la Violencia de Género del Programa de Determinantes Sociales de la Salud.

Health care personnel constitutes the most vulnerable group of professionals, as they are employed in a work context with higher exposure to SARS-CoV-2 infection. This study aims to estimate the prevalence of SARS-CoV-2 infection in health personnel (n = 2858) of two health departments in the Valencian community between March 2020 and April 2021, as well as the sociodemographic and work variables predicting higher infection prevalence in this group. A cross-sectional descriptive study was performed on health workers from the health departments of Torrevieja and Elche-Crevillente of the Valencian Community (Spain). After obtaining the samples, the cases were identified through an active infection diagnostic test (AIDT). The analyzed variables were: sex, age (18–34/35–49/>50 years), professional category, health care, risk service, and AIDT. A total of 2858 staff members were studied. Of them, 55.4% (1582) underwent an AIDT, with 9.7% (277) of positive cases. Infection predominated in the age group of 18 to 34 years, 12.6% (OR = 1.98, 95% CI [1.26, 3.11]); nurses, 12.1% (OR = 1.5, 95% CI [1.00, 2.23]); and at-risk services, 11.4% (OR = 1.3, 95% CI [1.06, 1.81]). A very low positivity rate was identified in the health personnel linked to the health departments analyzed during the 14 months of the study period. Based on our results, prevention strategies could focus more intensively on the most at-risk groups, specifically young nurses who work in at-risk services, mainly in emergency and internal medicine.

Nicolás Ruiz-Robledillo,1 Violeta Clement-Carbonell,1 Rosario Ferrer-Cascales,1 Irene Portilla-Tamarit,1 Cristian Alcocer-Bruno,1 Eva Gabaldón-Bravo2 1Department of Health Psychology, Faculty of Health Science, University of Alicante, Alicante, Spain; 2Department of Nursing, Faculty of Health Science, University of Alicante, Alicante, SpainCorrespondence: Violeta Clement-CarbonellDepartment of Health Psychology, Faculty of Health Science, University of Alicante, Ctra. San Vicente, s/n. San Vicente Del Raspeig, Alicante, 03690, SpainTel +34 96 590 39 90Fax +34 96 590 98 35Email violeta.clement@ua.esIntroduction: The human immunodeficiency virus (HIV) stills remains a serious public health problem. HIV acquisition has several negative health consequences, such as a cognitive deterioration or health-related quality of life (HRQoL) impairment. Although these negative consequences could be directly related to a significant increase in self-stigma in this population, few previous studies have analysed the possible associations between these variables. This is especially the case in specific groups of people living with HIV, such as men who have sex with men who could be at a greater risk of stigmatisation. The main aim of the present study was to evaluate the association between cognitive functioning, HRQoL and self-stigma in a group of men with HIV who have sex with men.Methods: The present study was conducted in the Infectious Diseases Unit of the General University Hospital of Alicante (Spain). The final sample was composed of 70 participants who passed the inclusion and exclusion criteria. All were men with HIV who had sex with men and the sample’s mean age was 45 years. Each participant completed questionnaires on HRQoL and HIV self-stigma. Moreover, they completed an online cognitive assessment through the previously validated platform for cognitive evaluation CogniFit, Inc.Results: The obtained results showed a significant association between memory functioning impairment, lower levels of HRQoL and higher HIV self-stigma scores. Hence, HRQoL, in the mental summary domain, was shown to be a significant mediator in the relationship between low memory performance and higher HIV self-stigma.Discussion: Neurocognitive impairment could decrease HRQoL in men with HIV who have sex with men, and hence, reinforce the idea widespread in society that having HIV holds serious consequences. This fact, together with the reduced cognitive abilities to fight against their own self-stigma could represent plausible explanations of the obtained results. In this sense, intervention strategies, oriented towards reducing cognitive impairment, such as those based on cognitive training, and other psychological interventions to promote HRQoL could be effective approaches to prevent the negative effects of HIV self-stigma in this population.Keywords: HIV, men who have sex with men, memory, health-related quality of life

Tobacco, alcohol and cannabis use are important health problems that contribute greatly to causes of death in worldwide. Early onset of substance use increases rapidly during adolescence and it has been associated with a wide range of adverse events. Because substance use is associated with dramatic consequences, delaying the initiation of substance use among adolescents remains a major public priority. This study examined the effectiveness of a school-based intervention program based on the application of the Reasoning and Rehabilitation V2 (R&amp, R2) program for preventing substance use among adolescents at risk of academic failure. A sample of 142 participants (aged 13–17 years old) who were studying alternative education provision in Spain were randomly allocated to two conditions (68 experimental group, 74 control group). A pre-test survey assessing past and current substance use was conducted prior the implementation of the program, while a post-test survey was conducted about 12 months after the pre-test. The results showed a significant effect of the R&amp, R program in the reduction of cigarette smoking, episodes of drunkenness, alcohol consumption and cannabis use. However, for daily smoking and episodes of drunkenness such benefits showed a reduction over time. These findings offer additional evidence of the effectiveness of the Reasoning and Rehabilitation V2 program in Spanish adolescent students who are exposed to substance use and suggest areas of future research.

Background: Standardised patient simulations seem to be useful for improving the communication skills of health sciences students. However, it is important to define the effectiveness of these types of interventions in complex scenarios linked to disease chronicity and end-of-life contexts. Methods: A quasi-experimental study with pre- and post-intervention measures was carried out in a single group. A total of 161 nursing students completed different assessment instruments to measure their attitudes towards communication (Attitude Toward Communication Scale), self-efficacy (Self-Efficacy of Communication Skills, SE-12), and communication skills (Health Professionals Communication Skills Scale, EHC-PS) before and after simulation training with standardised patients. The objective of the program was to train students in non-technical skills for complex situations involving chronicity and end-of-life care. It comprised eight sessions lasting 2.5 h each. Results: The results showed notable baseline gender differences in attitudes towards communication and in the informative communication dimension, with women obtaining higher scores. The participants’ self-efficacy and communication skills significantly improved after completing the intervention, with no significant differences being found for the attitudes towards communication variable. Conclusion: The standardised patient simulation programme for complex scenarios related to chronicity and end-of-life contexts improved communication self-efficacy and communication skills in these nursing students. In future work it will be important to analyse the influence of gender and attitudes towards communication as variables in the learning of communication skills in nursing students., Program Redes-I 3CE for Research in University Teaching of the Institute of Education Science (Vice-Chancellorship of Quality and Educational Innovation) of the University of Alicante, edition 2018-19 (No. XARXES-I3CE-20184344).

The aim of the present study was to describe and compare the specific profiles of Attention Deficit Hyperactivity Disorder (ADHD) and Sluggish Cognitive Tempo (SCT) through the Hybrid Model of Executive Functioning (HMEF). The total sample of 1049 subjects, aged 6 to 18 years (M = 10.75, SD = 3.20), were classified into a non-pathologic group, an ADHD group and an SCT group, and assessed using the short version of the Barkley Deficit in Executive Functions Scale for Children and Adolescents (BDEFS-CA). The results revealed significant differences between the three groups in all executive domains (non-pathologic &lt, SCT &lt, ADHD). While the ADHD group demonstrated a consistently high profile of difficulties in each subscale, the SCT group showed an irregular profile of difficulties, with middle and low scores, depending on the executive function. Although the SCT group’s score was far away from the ADHD group’s score for Self-Motivation, Emotions Self-Regulation and Self-Restraint and Inhibition, the two groups’ scores were very close for Time Self-Management and Self-Organization and Problem Solving. Accordingly, through logistic regression analyses, the SCT group was exclusively related to these last two executive domains, however, the ADHD group was strongly associated with almost every executive function. The findings suggest that the short version of the BDEFS-CA discriminates between both disorders, supporting psycho-pedagogical assessment and differential diagnosis.

Background: Sensory processing has been described as the ability to register, modulate, and organize sensory information to respond to environmental demands. Different theoretical approaches have studied the differential characteristics of sensory processing, such as Dunn’s model. From this framework, high sensitivity in sensory processing has been described as responses to stimuli from environment quite often due to a rapid activation of the central nervous system. It should be noted that the association between high sensitivity in sensory processing and health outcomes obtained in different studies are not homogeneous, so it is necessary to develop a review of this research in order to clarify the relationship between sensory processing and quality of life. Methods: We conducted a systematic review of the relevant studies using the PubMed, ScienceDirect, Scopus, and ProQuest databases to assess how sensory processing patterns are related to quality of life. Results: Fourteen studies concerning sensory processing and quality of life were included in the review. Some studies indicate negative, moderate, and significant correlations between these variables in which high sensitivity is related to a poor quality of life in the population studied. Conclusions: High sensitivity in sensory processing could have a negative impact on quality of life, thereby facilitating a fluctuation in well-being, daily functioning, and health. This research was funded by the European Union, 2018‐1‐PL01‐KA201‐501033.

Background: Hegemonic masculinity has been recognized as contributing to the perpetration of different forms of gender-based violence (GBV). Abandoning hegemonic masculinities and promoting positive masculinities are both strategies used by interventions that foreground a “gender-transformative approach.” Preventing GBV among young people could be strengthened by engaging young men. In this article, we aim to systematically review the primary characteristics, methodological quality, and results of published evaluation studies of educational interventions that aim to prevent different forms of GBV through addressing hegemonic masculinities among young people. Main body: We conducted a systematic review of available literature (2008–2019) using Medline (PubMed), Scopus, Web of Science, PsycInfo, the CINAHL Complete Database, and ERIC as well as Google scholar. The Template for Intervention Description and Replication was used for data extraction, and the quality of the selected studies was analyzed using the Mixed Method Appraisal Tool. More than half of the studies were conducted in Africa (n = 10/15) and many were randomized controlled trials (n = 8/15). Most of the studies with quantitative and qualitative methodologies (n = 12/15) reported a decrease in physical GBV and/or sexual violence perpetration/victimization (n = 6/15). Longitudinal studies reported consistent results over time. Conclusions: Our results highlight the importance of using a gender-transformative approach in educational interventions to engage young people in critical thinking about hegemonic masculinity and to prevent GBV. This work was part of a multi-site study supported by GENDER NET Plus Co-Fund (reference number 2018-00968). It was funded by the Ministry of Science and Innovation of Spain (Ref. PCI2019-103580); the Swedish Research Council (Grant number: 2018-00968); the Irish Research Council; and the Ministry of Science & Technology of Israel (3-15662). This study has also been conducted within the grant received from Instituto de Salud Carlos III & FEDER, and V. Pérez-Martínez is recipient of PFIS grant from FSE (FI19/00201).

Meta-analysis is a powerful and important tool to synthesize the literature about a research topic. Like other kinds of research, meta-analyses must be reproducible to be compliant with the principles of the scientific method. Furthermore, reproducible meta-analyses can be easily updated with new data and reanalysed applying new and more refined analysis techniques. We attempted to empirically assess the prevalence of transparency and reproducibility-related reporting practices in published meta-analyses from clinical psychology by examining a random sample of 100 meta-analyses. Our purpose was to identify the key points that could be improved, with the aim of providing some recommendations for carrying out reproducible meta-analyses. We conducted a meta-review of meta-analyses of psychological interventions published between 2000 and 2020. We searched PubMed, PsycInfo and Web of Science databases. A structured coding form to assess transparency indicators was created based on previous studies and existing meta-analysis guidelines. We found major issues concerning: completely reproducible search procedures report, specification of the exact method to compute effect sizes, choice of weighting factors and estimators, lack of availability of the raw statistics used to compute the effect size and of interoperability of available data, and practically total absence of analysis script code sharing. Based on our findings, we conclude with recommendations intended to improve the transparency, openness, and reproducibility-related reporting practices of meta-analyses in clinical psychology and related areas. This research has been funded with a grant from the Ministerio de Ciencia e Innovación and by FEDER funds (Project n° PID2019-104080GB-I00).

Neste estudo buscamos identificar as formas e estratégias de mobilização coletiva de contestação e protesto no enfrentamento das medidas neoliberais e de austeridade no Sistema Nacional de Saúde na Espanha, tomando como referência o Real Decreto-ley 16/2012 e o Real Decreto-ley 7/2018. O estudo se sustenta no uso de método qualitativo com instrumentos múltiplos de coleta, baseado em revisão narrativa da literatura, análise documental e aplicação de questionário com perguntas abertas a pessoas de referência na área, profissionais e líderes de associações, com posicionamentos contrários às restrições ao direito universal à saúde. Os resultados sugerem que as mobilizações e ações de protesto conseguiram deter as propostas do Real Decreto-ley 16/2012. Os êxitos são considerados inspiradores, mas não suficientes. A saúde passa a ser vinculada novamente à condição de cidadania, no entanto, há reminiscências do modelo anterior e permanecem as disputas com o setor privado. In this study we sought to identify the forms and strategies of collective mobilization of contestation and protest against neoliberal and austerity measures in National Health System in Spain, as referred in the Royal Decree-Law 16/2012 and the Royal Decree-Law 7/2018. This study is founded on qualitative method with multiple instruments of collection, based on bibliographical reviews, on documental analysis and the application of open-ended questionnaires with selected people in the area, and with professionals and association leaders contrary to the restrictions against universal health rights. The results suggest that the mobilizations and protest acts managed to detain the Royal Decree-Law 16/2012 and the Royal Decree-Law 7/2018. The successes are considered inspiring, but not enough. Health becomes once more linked to the condition of citizenship, however, there are reminiscences of the previous model, and the disputes with the private sector remain. O estudo foi financiado pela Fundação de Apoio à Pesquisa do Distrito Federal -FAPDF, no âmbito do Programa de Bolsas de Pós – Doutoramento no Exterior, Edital DPG/UnB Nº 05/2018.

We aim to assess the beneficial effects of the Mediterranean style-diet before and after the period of confinement due to COVID-19 in a sample of 51 older patients who were part of a clinical trial of the Instituto de Investigación sanitaria y Biomédica de Alicante (ISABIAL, CEIM). Participants were randomly assigned to two conditions: experimental vs. a control group. A pre-test survey assessment was conducted before confinement, while a post-test survey was conducted after the confinement period. Adherence to Mediterranean Diet and nutritional status were evaluated through self-reported questionnaires. Individuals who initiated the Mediterranean Diet intervention program before confinement increased 3.5% their level of adherence to the Mediterranean Diet and maintained their nutritional status after the confinement. In the case of BMI, there no were statistically significant differences between groups before and after confinement. These results suggest that adherence to the Mediterranean Diet may play an important role in the establishment of appropriate dietary guidelines in confinement situations such as the COVID-19. This research was funded by the Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) (CEIm: PI2019/057).

Evidence accumulated to date suggests that excess weight in the adult population is associated with a wide range of impairments in executive function. However, most studies have only examined the influence of body mass index (BMI) on the cognitive function of individuals with overweight and obesity. This study examined the potential associations of markers of adiposity (BMI, body fat, and visceral fat) with five domains of executive function including cognitive flexibility, inhibition, monitoring, planning, and working memory in a sample of 87 adult with overweight (n = 34) and obesity (n = 53). The results show that obese people had poorer working memory than those with overweight. After controlling for educational levels and physical activity, the results suggest that neither the waist-hip index not visceral fat were associated with cognitive function. In overweight, body fat was negatively associated with executive components of inhibition (p = 0.05) and monitoring (p = 0.02). In the obesity subgroup, body fat was negatively associated with inhibition (0.02) and working memory (0.04). The results provide evidence of the importance of adiposity for cognitive function. The implications for understanding the influence of markers of adiposity in adults with overweight and obesity are discussed.

Health Promoting Universities (HPUs) are more likely to perform actions intended to change habits and increase personal empowerment, than they are to develop community actions. The objective of this research is to create an asset map to visualize collective actions in a Chilean HPU. A qualitative study, based on the ABCD model was conducted. There were 149 people, distributed into 48 semistructured interviews and 14 focus groups, who participated in this study (students, employees, ex-students and retirees). An asset map was elaborated, identifying the contributions of residents, associations and organizations, local institutions, physical resources, economic assets and local culture and with a new category, ‘connecting assets’. These categories show the range of resources in a university. According to the participants, the questions on asset identification were a tool for reflection, and by giving their opinions and discovering or drawing attention to new resources, they gained a better understanding of the assets in the university. Several participants stated that these talks could generate a positive emotional environment, which boosted their wellbeing. There were gender- and group-based differences in how the assets were valued. Students stressed assets related to services and benefits from the institution, green areas, and collective spaces. Employees, retirees and ex-students emphasized assets related to belonging, identity and traditions. Men appreciated openness and privacy in physical spaces. Women highlighted assets related to the institution. The resulting map, displays a range of resources that can help the university develop new possibilities for comprehensive and collective actions that would revitalize the HPU strategy. This study is part of the project VRID 217.089.007-1.0IN, funded by the Vice-rectorate for Research and Development of the University of Concepción, Chile.

Background and aimsResearch shows inconsistent findings about the link between muscle dysmorphia (MD) and eating disorder (ED) symptomatology. The aim of this study is to synthesize the scientific evidence available on this topic, the researchers conducted a systematic review and meta-analysis.MethodsThe literature search enabled us to identify 39 published articles, which provided 36 independent estimations of the correlation between the two variables.ResultsOur analysis found a positive association between MD and ED symptoms (r+ = .36; 95% CI = 0.30, 0.41). Moderator analyses showed that the type of sample and the tools for assessing MD and ED were statistically associated with the MD–ED effect sizes. The methodological quality of the studies exhibited a positive, statistically significant association with the MD–ED effect sizes.ConclusionsHigher levels of MD were related to greater ED symptomatology, but several study characteristics may moderate the association between the two variables. In this study, we discuss limitations and implications for clinical practice and future research.

Background Changes in the demographic epidemiology of multiple sclerosis (MS) may challenge the view of a latitudinal gradient in the distribution of MS. The objective of this study was to assess the incidence and prevalence of MS in addition to information on MS phenotypes and the use of disease modifying therapies (DMTs) in San Vicente del Raspeig in south eastern Spain. Methods This was a prospective epidemiological study of MS in San Vicente del Raspeig (population of 57,175 inhabitants based on the 2017 census) from 2005 to 2018. Multiple sources were used to identify MS cases. We considered as prevalent and incident cases all patients who satisfied either the criteria of Poser for clinically or laboratory-supported definite MS, or McDonald criteria. MS phenotypes were defined according to the 2013 revisions. Results For the prevalence data, 64 patients were identified. The non-adjusted prevalence was 111.9 (95% CI: 87.7–142.9) cases per 100,000 inhabitants; the prevalence was 159.3 cases per 100,000 inhabitants for women and 63.6 cases per 100,000 inhabitants for men. The female-to-male ratio was 2.6:1. The age-adjusted prevalence for the European standard population was 107 cases per 100,000 inhabitants. During the study period, the incidence was 5 cases per 100,000 inhabitants per year. Most patients were being treated with DMTs (81.3%). MS was active in at least 12.5% of patients. Conclusions The results are consistent with the increased risk of MS in Spain observed over the last three decades, with growing prevalence rates that place the country in the high-risk prevalence zone.

BACKGROUND: Preventing intimate partner violence or dating violence (DV) among adolescents is a public health priority due to its magnitude and damaging short and long-term consequences for adolescent and adult health. In our study protocol, we complement prior experiences in DV prevention by promoting protective factors (or assets) against gender violence such as communication skills, empathy and problem-solving capability through "Cinema Voice", a participatory educational intervention based on adolescents' strengths to tackle DV. METHODS/DESIGN: A longitudinal quasi-experimental educational intervention addressed to boys and girls ages 13-17 years, enrolled in secondary education schools in Alicante (Spain), Rome (Italy), Cardiff (UK), Iasi (Romania), Poznan (Poland) and Matosinhos (Portugal). Both process and results evaluations will be carried out with 100-120 intervention and 120-150 control group students per city at three time periods: before, after and 6 months after the implementation of the following interventions: 1) Training seminar with teachers to promote knowledge and skills on the core issues of intervention; 2) Workshops with intervention groups, where participants produce their own digital content presenting their perspective on DV; and 3) Short film exhibitions with participants, their families, authorities and other stakeholders with the objective of share the results and engage the community. Outcome measures are self-perceived social support, machismo, sexism, tolerance towards gender violence, social problem-solving and assertiveness as well as involvement in bullying/cyberbullying. Other socio-demographic, attitudes and violence-related co-variables were also included. DISCUSSION: This study may provide relevant information about the effectiveness of educational interventions that combine a positive youth development framework with educational awareness about the importance of achieving gender equality and preventing and combating gender violence. To our knowledge, this is the first study that involves six European countries in an educational intervention to promote violence protective assets among enrolled adolescents in secondary schools. This study may provide the needed tools to replicate the experience in other contexts and other countries. TRIAL REGISTRATION: Clinicaltrials.gov: NCT03411564 . Unique Protocol ID: 776905. Date registered: 18-01-2018. This paper was funded by the European Union’s Rights, Equality and Citizenship Programme (2014–2020), under grant agreement No. 776905. Sí

The socioeconomic status (SES) of parents has a crucial influence on the cognitive development of children, but it is not clear whether this effect varies as a function of the children’s age. The objective of this study was to investigate the development of children aged 7, 9, and 11 years of parents with extremely low SES in a developing country (Ecuador). Participating children were divided between a medium-SES group and a low-SES group. Statistically significant differences were observed as a function of SES group and age in verbal memory, language, and executive function, observing wider between-group differences among the 11-year-olds. This work was supported by the Spanish Agency for International Development Cooperation (AECID) [A3/042954/11] (PI: Francisco Cruz-Quintana) and Conselleria d'Educació, Investigació, Cultura i Esport de la Generalitat Valenciana (Proyectos I+D+i desarrollados por grupos de investigación emergentes) [GV/2017/166] (PI: Manuel Fernández-Alcántara).

Background The diagnosis of intellectual disability in children can produce complex grief-related feelings in their parents. Previous studies have focused on the moment of the diagnosis or the early life of the children, and little research has been conducted on their feelings of grief in adulthood. The objective was to analyse the process of grief/loss in parents of adult offspring with intellectual disability. Method The intentional sampling included sixteen parents who responded to semi-structured interviews. A qualitative study was conducted based on grounded theory. Results Five categories were identified: "Reception of the diagnosis", "Emotional bonds with the child", "Experience of loss and feelings in response to intellectual disability diagnosis", "Recurrent grief" and "Coping strategies". Conclusions Recurring feelings of loss experienced by parents in relation to their child's diagnosis persist over time. Specialized emotional interventions are needed to help parents to reduce the intensity of their feelings of grief.

Chemsex, a new risky sexual behavior involving participation in sexual relations under the influence of drugs, has shown a significantly increased prevalence in recent years. This fact entails a serious public health issue, especially when Chemsex is practiced by individuals with an HIV (Human Immunodeficiency Virus) diagnosis. Hence, analyzing the characteristics of Chemsex practices, associated sexual practices and the health outcomes of individuals who participate in Chemsex, is extremely important. The main aim of the present study is to analyze the prevalence and characteristics of the practice of Chemsex in a sample of 101 men with HIV who have sex with men who attended the Department of Infectious Diseases of the General University Hospital of Alicante (Spain). Furthermore, the association between Chemsex and Health-Related Quality of Life (HRQoL) was also assessed. Chemsex and sexual practices were evaluated by employing a questionnaire applied on an ad hoc basis. HRQoL was assessed by employing the Medical Outcomes Study HIV Health Survey (MOS-HIV). In total, 40.6% of the participants had practiced Chemsex during the last year. When sexual practices were compared between those individuals who practiced Chemsex and those who did not, the former presented a higher level of risky sexual behaviors, especially with occasional and multiple sexual partners. Regarding HRQoL, those individuals who practiced Chemsex exhibited a poorer HRQoL in the majority of domains, especially those participants who practiced it with a higher intensity. The present study points out the high prevalence of Chemsex practice between men with HIV who have sex with men in Spain. Moreover, this study highlights the negative effects of Chemsex on HRQoL, probably due to the mixed effects of higher levels of risky sexual practices and the consequences of drug consumption. This research was funded by the Office of the Vice President of Research and Knowledge Transfer of the University of Alicante, Grant Number: GRE-18-17B.

Presented at the 3rd International Electronic Conference on Environmental Research and Public Health—Public Health Issues in the Context of the COVID-19 Pandemic, 11–25 January 2021; Available online: https://ecerph-3.sciforum.net/. Sensory processing sensitivity, characterized by deeper cognitive, sensory and emotional information processing, has been previously related to several mental health problems. However, the studies are rare, and an integration of the obtained findings needs to be addressed. We conducted a systematic review of studies using scientific databases in order to integrate the available information about sensory processing sensitivity and its consequences in mental health. Thirteen studies were included and analyzed in the review. According to these studies, high levels of sensory processing sensitivity might be related to the appearance of several mental health disturbances, such as anxiety or depression. This research was funded by the European Commission (project no: 2018-1-PL01-KA201-051033).

Given the seriousness of the existing situation regarding the mental health of children and adolescents relating to the confinement period imposed due to COVID-19, we conducted this study to describe the effects of the confinement on state anxiety and executive functioning dimensions in a period of online educational modality. A sample of 953 children and adolescents was assessed. A sociodemographic questionnaire, the State Anxiety Inventory for Children (STAIC), and the Behavioral Evaluation of Executive Function (BRIEF-2) scale were applied. The analysis of the results indicates that 68.8% of children and adolescents presented medium–high levels of anxiety. Regarding sex, females showed higher levels of anxiety and worse levels of executive functioning. Although the group aged 11 to 18 years showed methodologically higher state anxiety (p = 0.041) than the group aged 6 to 10 years, the difference was not clinically relevant (δ = −0.113). The state anxiety variable was also correlated positively and significantly to the three executive functioning dimensions explored. In conclusion, it seems evident that COVID-19 lockdowns could have psychological and emotional effects on children and adolescents.