Dolores Escrivá

Background/Objectives: Adolescence is a critical period for the development of body-shape concerns and eating disorder-related traits. This study examined sex differences and associations among anthropometric and estimated body-composition indicators, body-shape concerns, and eating disorder-related traits in adolescents. Methods: This school-based cross-sectional study included a convenience sample of 723 adolescents aged 11–17 years (404 boys and 319 girls) from three secondary schools in Valencia, Spain. Anthropometric and skinfold measurements were obtained, and participants completed the Body Shape Questionnaire (BSQ) and the Drive for Thinness, Bulimia, and Body Dissatisfaction subscales of the Eating Disorder Inventory-3 Referral Form. Between-sex comparisons, sex-stratified Spearman correlations, and multivariable linear regression models were performed. Results: Girls had higher estimated body-fat percentages than boys (19.29% vs. 11.95%; p < 0.001), as well as higher BSQ (62.23 ± 26.71 vs. 56.62 ± 27.19; p < 0.001) and Drive for Thinness scores (11.43 ± 6.55 vs. 8.36 ± 6.26; p < 0.001). No significant sex differences were observed for Bulimia or Body Dissatisfaction. Sex-stratified correlations between anthropometric or estimated body-composition indicators and the psychological outcomes were weak. Although several associations reached nominal significance, none remained statistically significant after false-discovery-rate correction for multiple testing. Nevertheless, the adjusted multivariable analysis continued to show an independent association between body-fat percentage and Drive for Thinness. The sex-stratified correlations should therefore be regarded as exploratory findings requiring replication. Conclusions: Girls showed greater body-shape concerns and Drive for Thinness. Body-fat percentage was independently associated with EDI-DT scores after adjustment for age and sex; its association with BSQ scores was of borderline significance with robust standard errors. These cross-sectional findings do not support causal interpretations.

Background: Nursing research has evolved through different historical stages, from the initial development of theoretical models to today’s challenges involving advanced practice and emerging technologies. Within this context, Middle-Range Nursing Theories (MRNTs) play a crucial role as a bridge between abstract conceptual frameworks and clinical practice. However, their recent production appears limited. Aims: To identify MRNTs published in the last five years, determine the main thematic fields addressed, and analyze current trends in their development. Methods: A scoping review was conducted in accordance with PRISMA-ScR guidelines. Databases searched included MEDLINE, CINAHL, PsycINFO, EMBASE, and Education Research Complete (August 2025). Eligible studies were published within the last five years in journals indexed in the Journal Citation Reports and explicitly proposed an MRNT. Exclusion criteria encompassed non-nursing theories, secondary applications of existing models, and purely methodological studies. Results: From 1230 initial records, 18 articles met the inclusion criteria. The Revista Brasileira de Enfermagem accounted for the highest number of publications. The identified MRNTs predominantly addressed clinical diagnoses and phenomena such as heart failure self-care, overweight, occupational stress, peripheral tissue perfusion, and social support networks. Most theories were derived from established nursing models (Orem, Roy, Levine, Neuman, Watson). Despite thematic diversity, few MRNTs had undergone methodological validation. Conclusions: Recent MRNT development remains limited and geographically concentrated, with Brazil emerging as a leading contributor. Strengthening methodological validation, clinical integration, and international dissemination is essential, as MRNTs continue to be pivotal tools for advancing nursing science, reinforcing disciplinary identity, and reducing the persistent gap between theory and practice.

Background: Amyotrophic lateral sclerosis (ALS) is characterized by progressive motor neuron degeneration, with oxidative stress playing a key role. Paraoxonase 1 (PON1) is an antioxidant enzyme that may influence ALS progression. This study aimed to establish a predictive model for the influence of PON1 activity on functionality in ALS patients and explore its relationship with nutrition. Methods: In this observational cross-sectional study, 70 ALS patients underwent assessments of PON1 activity, lipid profile, functional capacity, respiratory function, and heart rate variability. A structural equation model was developed to determine the relationships between variables. Nutritional intake was analyzed in 65 patients. Results: The predictive model showed that PON1 activity and LDL levels positively influenced functionality, both directly and indirectly through respiratory capacity. Heart rate variability moderately predicted functionality independently. HDL levels were not significantly associated with functionality. Weak to moderate correlations were found between PON1 activity and intake of certain nutrients, with positive associations for monounsaturated fats and vitamin D, and negative associations for carbohydrates, proteins, and some micronutrients. Conclusions: PON1 activity appears to play an important role in ALS patient functionality, both directly and through effects on respiratory capacity. However, its relationship with nutritional intake was not strongly evident in this sample population.

Background: Early detection tools for eating disorders play an essential role in their prevention. The aim of this study was to analyze different variables associated with the risk of eating disorders and their relation to anthropometric parameters, nutritional status and body self-image. Methods: The Eating Disorder Invetory-3 Referral Form (EDI-3 RF) and the Body Shape Questionnaire (BSQ) were administered to 809 adolescents (413 boys and 396 girls), aged 11 to 17 years, from three randomly chosen schools in a big Mediterranean city. Anthropometric measurements were taken following standardized methods. Overweight and obesity were determined according to the International Obesity Task Force (IOTF). Results: Overweight (23%) prevailed over obesity (9.37%). Girls registered a higher score in the Obsession for Thinness EDI-3 RF subscale and in the body dissatisfaction section of the BSQ. The only statistically significant differences in the Obsession for Thinness and Body Dissatisfaction levels among the different ages were seen in boys. In this series, body dissatisfaction assessed by the EDI-3 RF was not correlated with BSQ body dissatisfaction. Sex and age in adolescence determine the relationship between eating disorder attitudes and body shape dissatisfaction. Conclusions: It is necessary to look for other parameters to investigate to determine body dissatisfaction.

Background: Patient safety is a public health problem worldwide. In situ simulation (ISS) arises as a learning strategy that allows health professionals to immerse themselves in a real environment without endangering the patients until they have learned the skills needed, thus increasing the quality of care. This systematic review aimed to verify the efficacy of the use of “in situ simulation” as a method that will allow health professionals to increase patient safety in Intensive Care Units after the situation experienced during the pandemic caused by the COVID-19 virus. Methods: Seven studies were reviewed using the PRISMA methodology for systematic reviews. The CASPe guide was used to assess the quality of the manuscripts. Results: The main topics that emerged from this review in relation to in situ simulation were as follows: looking at aspects such as patient self-perception of safety, adverse events, interprofessional communication and health system organization in relation to in situ simulation. Conclusions: The adequate implementation of in situ simulation after the COVID-19 pandemic in ICU services is shown to be an efficient and effective strategy to promote improvement in the attitudes on a culture of safety and teamwork of professionals.

(1) Background: Parkinson’s disease (PD) is a relatively common neurodegenerative disease in elderly individuals, with a high risk of falls. There is abundant literature on the relationship between PD and osteoporosis. The aim of this study is to describe the bone quality of a population with PD by calcaneal ultrasound and to compare it with a healthy control, assessing the influence of possible sex differences. (2) Methods: 21 patients diagnosed with PD were recruited. The control group was composed of 30 healthy individuals with similar sociodemographic characteristics. The bone quality of all participants was assessed using calcaneal quantitative ultrasound (QUS). The parameters recorded were broadband ultrasound attenuation (BUA, in decibels per megahertz), imaging speed of sound (SOS, in meters per second), stiffness index (SI) and T-score of each participant. Bone mineral density (BMD) was estimated using the equation BMD = 0.002592 × (BUA + SOS) − 3.687 (g/cm²). (3) Results: significant differences were observed between the healthy control and the PD group: the T-score was lower in the PD group (p < 0.05) and SOS was higher in Parkinson’s disease patients (p < 0.05), while 28.6% of the PD patients were osteoporotic with T-score values lower than −1.5 compared to 16.7% of osteoporotic individuals in the control group (p < 0.01). Regarding the sex, there were significant differences (p < 0.05) between the females of the PD group vs. control group, showing a significant difference in the SI (71.4 ± 14.7 vs. 87.8 ± 12), T-score (−2.19 ± 1.1 vs. −0.15 ± 0.8), BUA (104.5 ± 13 vs. 116 ± 10.6) and BMD (0.49 ± 0.09 vs. 0.60 ± 0.08), with no difference in the comparison between the male groups; and the comparison between both sexes in T-score only showed significant differences for the PD group (p < 0.05), with worse bone quality in women. (4) Conclusions: this study shows poorer bone quality in female patients with PD, who have a higher percentage of osteoporosis than healthy patients. The QUS technique of the calcaneus seems adequate for these determinations in patients with Parkinson’s disease.

The aim of this study was to analyze whether weight status has a relationship with the prevalence of body self-image dissatisfaction in Mediterranean urban teenagers. A series of 809 adolescents aged 11 to 17 years underwent anthropometric measurements according to ISAK protocols and completed the Body Shape Questionnaire (BSQ). The overall overweight prevalence according to International Obesity Task Force (IOTF) criteria was 11.5%, and 2.7% for obesity. Girls showed higher overweight prevalence than boys (18.4% vs. 12.9%; p < 0.05). At the late adolescence period (16–17 y), obesity was observed in the boys but not in the girls (8.7% vs. 0%; p < 0.01). There was a relative low prevalence of body image (BI) dissatisfaction among participants (boys 17.3%; girls 22.7%). In the late adolescence period, the girls were more often classified as being dissatisfied (31%). A weak correlation between the BSQ scores and all the anthropometric variables related to the adiposity profile was detected only in the boys. A logistic regression confirmed that female adolescents and the late pubertal period had a significant association with body dissatisfaction, regardless of their weight status. As BI are not related to weight status measured by body mass index (BMI) percentiles, other factors beyond anthropometry deserve further research to explain BI concerns specifically in girls.