Ángel Denche-Zamorano

Background/Objectives: Informal caregivers are at an increased risk of developing depressive symptoms; however, the combined role of sex, perceived social support (PSS), and physical activity (PA) in this population remains insufficiently characterized. This study aimed to describe the prevalence of depressive symptoms among informal caregivers in a national health survey sample and to identify the biopsychosocial factors independently associated with them. Methods: This cross-sectional study used data from the Spanish National Health Survey 2023 (ESdE 2023). Informal caregivers (n = 2072) were identified using the caregiving status item. Depressive symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8; score ≥5), a screening measure that does not establish a clinical diagnosis of depression. Backward Wald logistic regression identified the independently associated factors, and predicted probabilities were estimated using PA frequency (PAF) and PSS, stratified by sex. Survey weights and complex sample procedures were not applied. Results: Depressive symptoms were reported by 34.5% of caregivers, and were higher among women than men (37.2% vs. 30.7%). Being female (OR = 1.34) and never or occasionally engaging in PA (OR = 1.82 and 1.54, respectively; reference: very frequently) were associated with higher odds of depressive symptoms, whereas each one-point increase in PSS was associated with lower odds (OR = 0.79). The predicted probabilities were highest among caregivers with poor PSS and no PA and lowest among those with strong PSS and frequent PA. Conclusions: Female sex, lower PSS, and infrequent PA were independently associated with depressive symptoms in this sample of informal caregivers.

This descriptive cross-sectional study explores the levels and dimensions of University Social Responsibility (USR) as perceived by undergraduate students across different academic disciplines at the University of Extremadura. A total of 121 students from diverse fields participated by completing the University Student Social Responsibility questionnaire (RSEU), a validated multidimensional instrument. Descriptive and multivariate analyses were conducted to identify patterns based on gender and fields of study. The results indicate that most students perceived a medium to high level of social responsibility, with Health Sciences students scoring significantly higher in key dimensions such as personal exploration of values, responsibility development during university training, and professional commitment to the common good. No significant gender differences were observed in the overall RSEU score, although some variations were found in specific items. These findings offer relevant insights into the implementation of USR as a cross-cutting institutional strategy and suggest the value of providing opportunities to strengthen social responsibility across academic disciplines, particularly in non-Health disciplines.

This chapter analyzes the integration of health variables into contemporary Physical Education, with a focus on physical literacy and students’ holistic well-being. It examines the shift from subjective methods to objective measurement technologies, such as accelerometers, heart rate (HR) monitors, and positioning systems, which act as precise educational biomarkers. The text emphasizes the importance of physical health as a biological basis for cognitive development and academic performance and explores the link between aerobic capacity and brain plasticity. Furthermore, it provides an interpretative framework for key variables such as moderate-to-vigorous physical activity (MVPA), sedentary time, and HR, emphasizing their pedagogical value in workload management and fostering autonomy. The teacher’s role in bridging the gap between technological data and students’ health literacy is also discussed, as is the transformation of figures into practical knowledge. Finally, it discusses practical applications such as session monitoring, motivational feedback, and the ethical considerations necessary for the equitable use of wearables. This work guides researchers and teachers toward critically using technology to optimize health in school settings.

Background Autism spectrum disorder (ASD) is characterized by persistent difficulties in social communication and interaction, alongside restrictive and repetitive patterns of behavior. Virtual reality (VR) has emerged as a promising tool to enhance participation and engagement in individuals with ASD. Objective This bibliometric study aims to map the current research landscape on the intersection between ASD and VR, identifying trends in authorship, publication, geographic distribution, thematic focus, and keyword evolution. Methods A bibliometric analysis was conducted using the Web of Science Core Collection. Classic bibliometric laws and indicators (e.g., Bradford’s, Lotka’s, and Zipf’s laws) were applied to analyze publication volume, citation impact, author productivity, and thematic clustering. Results A total of 398 publications were identified between 2007 and 2024, showing an exponential growth trend (R2 = 0.97). The United States led in total output. Sarkar and Warren were among the most productive authors. The Journal of Autism and Developmental Disorders and IEEE Transactions on Neural Systems and Rehabilitation Engineering published the highest number of relevant articles. Fifty-six articles received 58 or more citations. Thematic clusters revealed emphasis on social skills training, immersive environments, and technological applications in ASD interventions. Conclusion Research on VR applications in ASD has increased exponentially, reflecting growing scientific and clinical interest. These findings provide a foundation for future interdisciplinary investigations and intervention development in developmental disabilities research.

Background: It is estimated that following acute SARS-CoV-2 infection, about 10% of people experience persistent symptoms lasting more than 3 to 4 weeks, a condition known as long COVID syndrome. Amongst its various sequelae is impairment of physical function or functional ability. Given the growing social impact of this condition, the dissemination of knowledge in this area is essential. Bibliometric analysis provides valuable information on research trends and hotspots, helping to guide future studies and inform evidence-based interventions. Aims: The aim of this study was to conduct a bibliometric analysis of research on long COVID syndrome and Physical Function. Method: A total of 213 single documents indexed in the Scopus (205) and WOS core collection (181) database were analysed using the traditional laws of bibliometrics. Results: It was found that annual publications have experienced exponential growth from 2020 to 2024, based on the data available at the time of the bibliographic search. Amongst the prolific authors, four production clusters were found, with Eleuterio A. Sánchez-Romero emerging as the most productive author. Spain and Brazil were the countries with the highest number of publications. The journals of the MDPI publishing house contributed the most papers to the object of study, especially the Journal of Clinical Medicine and the International Journal of Environmental Research and Public Health. Rehabilitation, fatigue, quality of life, and exercise were four of the main keywords used by the authors. Conclusions: The observed growth in publications suggests increasing research attention to long COVID syndrome and physical function; however, further research is still needed to establish physical function assessment protocols, patient profiles, and effective exercise-based rehabilitation programmes.

Understanding and addressing mental health in adolescents with sensory (vision and hearing), physical, health and participation difficulties/disabilities is particularly relevant in low- and middle-income countries, where structural and educational barriers may intensify vulnerability. This study examined the associations between functional difficulties/disabilities and self-perceived health (SPH), insomnia, fatigue, anxiety and depression in adolescents, and estimated the risk of presenting these conditions according to disability status. A cross-sectional study was conducted with data from 34,604 adolescents aged 15–16 years from seven participating countries in the PISA Development Survey (PISA-D). A descriptive analysis was performed to characterise the sample. Non-parametric statistical tests were used to examine dependence between variables (chi-square test) and differences in proportions between groups (z-test for independent proportions). Finally, odds ratios with 95% confidence intervals were estimated for negative SPH, insomnia, fatigue, anxiety and depression in adolescents with versus without difficulty/disability conditions. Adolescents with functional difficulties/disabilities showed the highest risks for negative self-perceived health (OR up to 3.19), followed by fatigue (up to 2.46) and insomnia (up to 2.41). Increased risks were also observed for anxiety (up to 2.12) and depression (up to 2.05). All associations were statistically significant ( p < 0.05). Targeted, school-based strategies are needed to identify and support these students early.

Aim: Back pain is one of the most prevalent and potentially disabling musculoskeletal conditions experienced by individuals, leading to reduced quality of life and long-term disability. The main objective of this study was to develop a simplified visual decision tree algorithm for the classification and prediction of severe or mild/moderate pain in the middle-aged and elderly European population with back pain, using as predictors sociodemographic variables and variables related to physical condition, pain symptom expansion, and mental health. Subject and methods: This was a cross-sectional study of 15,314 middle-aged and older European individuals with back pain. A predictive algorithm for the level of pain was developed using classification and regression tree (CRT) analysis. A cross-validation study was conducted to assess the performance of the model. In addition, a multivariate logistic binary regression model was developed to predict the level of pain and compare its performance with the CRT model. Results: The CRT found that physical inactivity, depression, and pain expansion were the combination of variables that predicted a high level of pain. The CRT model performed better than the logistic regression model in terms of accuracy (area under the curve [AUC] = 0.67 versus AUC = 0.66), and both identified physical inactivity, depression, and pain expansion as the main predictors of high pain levels. Conclusion: Our findings provide useful information for clinicians and those involved in physical activity, exercise and sport programs for assessing the level of pain in people with back pain, offering an easy-to-interpret visual model with similar accuracy to traditional models.

Introduction: Widespread or all over pain (AOP) can affect daily life by reducing functional capacity and fitness, and increases motor difficulties (MD), frailty and dependence more severely than localized pain. Physical activity (PA) may be related to hand grip strength (HGS), MD and frailty in people with AOP. Material and methods: This cross-sectional study, based on data from the SHARE Wave 9 survey 2021-22, in middle-aged and older European people with pain had as objectives: 1) To analyse the relationships between pain type (localized vs all over), HGS, MD and frailty; 2) To assess the associations between PA and HGS, MD and frailty in people with AOP; 3) To analyse risk factors for MD and frailty in people with AOP. Results: People with AOP presented the highest prevalence of weak HGS, MD and frailty. In people with AOP, PA was found to be related to HGS, MD and frailty. Physical inactivity was related to weak HGS and higher prevalences of MD and frailty. Physical inactivity was presented as a risk factor for MD and frailty. Conclusions: Type of pain affects HGS, MD and frailty. AOP is associated with lower HGS, greater MD and frailty. People with AOP who perform PA have higher HGS and lower MD and frailty. Physical inactivity is a significant risk factor for MD and frailty in people with AOP. These findings provide insight into the relationship between pain expansion, HGS, MD and frailty in people with pain. These findings could help new hypotheses and new care programs to address prevention and intervention in people with AOP.

Background: The increase in life expectancy has led to a higher prevalence of chronic conditions, including widespread pain (WP), which often compromises functional independence and quality of life in older adults. WP is strongly associated with limitations in Basic and Instrumental Activities of Daily Living (BADLs and IADLs). While physical activity (PA) and muscle strength (handgrip) are known to enhance general health, their specific role in preserving functional capacity in individuals with WP remains underexplored. Methods: This cross-sectional study analyzed data from 1154 adults aged 50–80 reporting WP, drawn from the Ninth Wave of The Survey of Health, Ageing and Retirement in Europe (SHARE). Associations between moderate and vigorous PA (MPA and VPA), handgrip strength (HGS), and limitations in BADLs and IADLs were examined using multivariate logistic regression, adjusting for demographic and health-related variables. Results: Lower MPA was significantly associated with greater odds of all BADL and most IADL limitations, while VPA had no significant associations. Higher relative HGS was significantly associated with lower odds of limitations in BADLs and IADLs. Conclusions: Among older adults with WP, MPA and muscular strength appear to reduce the risk of functional limitations. These findings highlight the relevance of promoting sustainable strategies to support independence in aging populations.