César Jiménez-Vaquero

Objective: We aimed to examine the association between adherence to the Mediterranean diet (MD) and sleep quality assessed using both subjective and objective methods in a general adult population. Design: This is a cross-sectional study. Adherence to the MD was evaluated using the Mediterranean Diet Adherence Screener, while sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index and objectively using wrist actigraphy over five consecutive days. Multivariable linear and logistic regression models were applied, adjusting for key sociodemographic and clinical confounders. Settings: We investigated a general adult population from Spain with a total of 500 Spanish adults aged 25–65 years. Results: Higher MEDAS scores were significantly associated with better subjective sleep quality. Each one-point increase in MD adherence was associated with lower PSQI scores, and participants with higher adherence had lower odds of poor sleep quality, although this association did not reach statistical significance. Cluster analysis identified a dietary pattern characterized by higher consumption of fruits, vegetables, fish and olive oil that was associated with better perceived sleep quality. No significant associations were observed between MD adherence and objective sleep parameters, including sleep efficiency, sleep fragmentation or wake after sleep onset. Conclusions: Greater adherence to the MD was associated with better perceived sleep quality but not with objectively measured sleep parameters. These findings suggest that dietary patterns may influence sleep perception rather than objective sleep characteristics and highlight the potential role of the MD as a modifiable factor related to sleep-related well-being.

Introduction: Alcohol is one of the most widely consumed psychoactive substances worldwide. Frequent and excessive consumption can lead to negative health and quality‐of‐life effects, including impaired sleep quality. This study aimed to analyse the relationship between alcohol consumption and sleep quality indices in a stratified random sample of adults aged 25–65 years residing in Salamanca and Ávila, central‐western Spain. Methods: A cross‐sectional descriptive study was conducted in the cities of Salamanca and Ávila, central‐western Spain. The study population included a sample of 500 individuals aged 25–65, selected via stratified random sampling by age and sex from the health card database of the regional health service. Sleep quality was assessed via actigraphy and the Pittsburgh Sleep Quality Index (PSQI). Results: Our results showed an association between alcohol consumption (measured in grams/week) and PSQI score, as well as with certain sleep parameters measured by actigraphy. Participants in the high‐risk alcohol consumption group (> 180 g/week) had higher PSQI scores, more awakenings, and a higher sleep fragmentation index compared with those reporting no alcohol consumption. Significant differences were also found between all alcohol consumption categories in sleep efficiency and Wake After Sleep Onset. Discussion and Conclusions: High‐risk alcohol consumption (> 180 g/week) was associated with poorer self‐reported sleep quality in a community‐based adult sample from central‐western Spain, as well as with worse values in actigraphy‐derived sleep parameters, including sleep efficiency, Wake After Sleep Onset, number of awakenings, and sleep fragmentation index.

This study aimed to examine plasma melatonin levels, seasonal variation, and their association with sleep quality in adults aged 25–65 years using both the Pittsburgh Sleep Quality Index and actigraphy. A cross-sectional study was conducted in a stratified random sample of 500 adults from Salamanca and Ávila (Spain). Plasma melatonin was quantified by HPLC-DAD-MS/MS, and sleep quality was assessed using the Pittsburgh Sleep Quality Index and a 5-day wrist actigraphy protocol (ActiGraph GT3X+). Participants were stratified by age and sex, and seasonal variation was evaluated. Multivariable analyses were adjusted for relevant confounders. A total of 334 participants with valid melatonin measurements were included (mean age 43 years). Mean plasma melatonin concentration was 14.5 ± 15.9 pg/mL, with higher levels observed in men than women and a decreasing trend with age. A trend toward higher melatonin levels during winter was observed, although the differences were not statistically significant. No significant association was found between plasma melatonin levels and Pittsburgh Sleep Quality Index scores. However, higher melatonin levels were associated with slightly greater sleep efficiency measured by actigraphy. Participants reporting melatonin supplement use showed higher Pittsburgh Sleep Quality Index scores and lower total sleep time compared with non-users. Overall, plasma melatonin levels varied by sex, age, and season but showed no association with subjective sleep quality, while a modest relationship was observed with objective sleep efficiency, suggesting that melatonin alone is not a strong determinant of perceived sleep quality and highlighting the multifactorial nature of sleep regulation in adults.

Introducción: La adicción al juego con dinero y a los videojuegos puede afectar negativamente el ámbito académico, psicológico y social de los universitarios. Objetivo: Evaluar la prevalencia y características de estas adicciones en estudiantes de Enfermería. Métodos: Estudio descriptivo transversal con 161 estudiantes mediante cuestionarios ESTUDES y EDADES. Resultados: El 49,7% jugó con dinero, predominando hombres (online) sobre mujeres (presencial). El riesgo de juego problemático fue del 5,5%. En videojuegos, participó el 42,2%, con mayor prevalencia femenina, pero mayor riesgo en hombres. No se observó un impacto negativo del uso de videojuegos sobre el rendimiento académico; no obstante, se identificaron asociaciones estadísticamente significativas con la nota media, que deben interpretarse con cautela. Conclusión: La alta prevalencia y diferencias por sexo requieren intervenciones preventivas específicas.

Poor sleep quality is associated with obesity, cardiovascular disease, cognitive impairment, increased hospitalization and mortality. Combining actigraphy with questionnaires effectively evaluates sleep. Age and sex shape both subjective sleep quality and objective actigraphic metrics; however, stratified estimates combining both approaches in Spanish adults are scarce. The aim of this study was to analyse the role of age and sex on sleep quality, in an age-sex stratified random sample of the general Spanish population. For this, it was carried out a cross-sectional descriptive study carried out in Salamanca and Ávila (Spain). The study population included a sample of 500 people aged 25-65 years selected by stratified random sampling by age and sex. Sleep quality was analysed using actigraphy and the Pittsburgh Sleep Quality Index-PSQI. Sociodemographic and clinical variables were also studied. The results were that men obtained a lower mean PSQI score than women. By age group, the poorer subjective sleep quality corresponded to the 25-years group, whereas the 45-year group had the lowest PSQI scores. Actigraphy showed higher efficiency in women. Men had more WASO, more awakenings and higher fragmentation. Midlife groups (35-45 years) showed lower efficiency and higher WASO. Trial registration number: NCT05324267.

Objective To identify sex-specific patterns based on determinants related to sleep quality, using a representative sample of the Spanish adult population. Design Cross-sectional, age-stratified and sex-stratified study. Setting Community-based assessments in two Spanish provinces (Salamanca and Ávila). Participants Adults aged 25–65 years (n=500), equally distributed by sex and five age strata, selected from the regional health-card database. Primary and secondary outcome measures Objective sleep metrics from wrist actigraphy (time in bed, total sleep time (TST), sleep efficiency, wake after sleep onset, number/duration of awakenings, fragmentation/movement indices) and self-reported sleep quality (Pittsburgh Sleep Quality Index). Methods Standardised baseline assessments collected sociodemographic, clinical, mental-health and lifestyle variables using validated instruments. Actigraphy (ActiGraph GT3X+) recorded triaxial acceleration at 30 Hz over 5 days; data were aggregated in 60 s epochs (ActiLife). Sleep/wake was classified with Cole-Kripke and nocturnal episodes identified with Tudor-Locke before deriving sleep indices. Two-step cluster analysis was applied separately by sex. Results Three clusters were identified for each sex, with age and educational level being the most influential factors. In men, the 65-year-old cluster with university education and lower anxious–depressive load showed the highest sleep efficiency (91.8±3.8%) and the lowest TST (351.7±74.8 min). In contrast, the 35-year-old cluster with middle or high school presented the lowest efficiency (88.3±10.0%) and higher TST (368.1±83.8 min). In women, the 55-year-old cluster with middle or high school and low emotional load showed the highest efficiency (93.6±2.8%), despite a reduced TST (352.0±79.7 min), while the 35-year-old cluster, with middle or high school and high levels of anxiety and depression, showed the worst efficiency metrics (89.5±3.9%) and a higher TST (394.8±67.3 min). Conclusion Sleep quality in Spanish adults is heterogeneous across sex-specific clusters shaped by age, education and mental-health burden. Cluster-based characterisation may support tailored public-health interventions. Trial registration number NCT05324267.

"Durante una estancia en Doga (Benín), profesionales de distintos ámbitos sanitarios se unieron para abordar un desafío silencioso pero devastador: las úlceras de Buruli. A través de un enfoque multidisciplinar, se trabajó no solo en el tratamiento médico de las lesiones, sino también en la promoción de hábitos higiénicos, la educación para la salud y el fortalecimiento del entorno social. El equipo intervino de manera integral, combinando la limpieza cuidadosa de heridas con acciones que fomentaran el acceso a agua segura, la concienciación sobre prácticas saludables y el empoderamiento local. Esta experiencia permitió observar de cerca cómo la coordinación entre distintos saberes puede transformar la evolución de una enfermedad que, aunque desatendida a nivel internacional, tiene profundas raíces en las condiciones socioeconómicas y ambientales. Más que un estudio, fue un ejercicio de humanidad compartida. Se aprendió que mejorar la higiene y el entorno cotidiano puede marcar la diferencia en la progresión de enfermedades como ésta. Y que, con compromiso y colaboración, se puede plantar una semilla de cambio duradero donde más se necesita."

La simulación clínica es una forma de enseñanza que se está implantando en muchas facultades cmo método de formación que permite llevar a la práctica actuaciones clínicas en un entorno realista y sib riesgo para los pacientes. Permite también, mejorar las habilidades de comunicación de los estudiantes, la autoeficacia, la competencia clínica y las habiliadades de resolución de problemas. El Grado de Enfermería de la Escuela Universitaria de Ávila, centro adscrito a la Universidad de Salamanca, implementa en el curso 2021-22, la simulación con metodología MAES cmo nuevo sistema de aprendizaje.El objetivo de este estudio es evaluar la satisfacción de los estudiantes del Grado de Enfermería con la Simulación Clínica de Alta Fidelidad. La muestra está formada por los estudiantes de 2º, 3º y 4º curso (n=150) a los que se les administró el cuestionario de 15 items “Calidad y Satisfacción en el método de enseñanza-aprendizaje de Simulación Clínica". Los resultados obtenidos muestran que la simulación con metodología MAES es un método útil de enseñanza que motiva al aprendizaje y mejora las habilidades técnicas. Se observa también que los casos en escenarios simulados ayudan a priorizar las actuaciones de enfermería, al mismo tiempo que aumentan su seguridad y confianza, y que la metodología MAES fomenta el trabajo en equipo. Es necesaria una continua formación para poder darle a los casos simulados la duración y el contenido adecuados, integrando la teoría impartida en las aulas con la práctica en un entorno seguro, que complemente y capacite al alumnado de enfermería para la vida profesional.

Introduction Sleep problems are a growing public health concern being related, among others, to an increased risk of cardiovascular diseases or worse cognitive functioning. In addition, they can affect aspects related to personal motivation and quality of life. However, very few studies have analysed the possible determinants of sleep quality in the adult population as a whole, establishing patterns based on these determinants. The objectives are to evaluate the determinants of sleep quality in a representative sample of the general adult population between 25 and 65 years old, and to establish patterns of sleep quality based on lifestyles, psychological factors, morbidities, sociodemographic variables, biological markers and other possible determinants. Methods and analysis Descriptive observational cross-sectional study. The study population will include a representative sample of 500 people between 25 and 65 years old from the cities of Salamanca and Ávila (Spain) selected by random sampling stratified by age groups and sex. A 90-minute visit will be performed, during which sleep quality will be assessed. The variables collected will be: morbidity, lifestyles (physical activity, diet, toxic habits), psychological factors (depression, stress, occupational stress and anxiety), socioeconomic and work-related variables, habitability conditions of the habitual residence and rest area, screen time, relaxation techniques and melatonin as a biological marker related to sleep quality. Discussion With the results of this work, improved interventions for behaviour modification could be designed, as well as intervention and education programmes or other research aimed at improving sleep quality. Ethics and dissemination This study has a favourable opinion from the Ethics Committee for Drug Research of the Health Areas of Salamanca and Ávila (CEim Code: PI 2021 07 815). The results of this study will be published in international impact journals of different specialties. Trial registration number NCT05324267.