Consumers' willingness to pay for health claims during the COVID-19 pandemic: A moderated mediation analysis.

The COVID-19 pandemic has posed a substantial threat to people's lives and raised health concerns. This research explores the mediating role of consumers' attitudes towards health claims in the relationship between consumers' interest in health claims and their willingness to pay (WTP) for health claims in extra virgin olive oil (EVOO). Additionally, we examine the moderation effect of COVID-19 risk perception in the relationship between consumers' interest in and attitudes towards health claims. Data were collected through an online survey in three countries: Spain, the UK and Chile. Findings confirm the mediating role of consumers' attitudes towards health claims. Furthermore, the relationship between consumers' interest and their attitudes towards health claims was stronger when COVID-19 risk perception was higher.

Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology.

Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.

¿Es más cara la alimentación saludable? / Is healthy food more expensive?

INTRODUCCIÓN: En ocasiones se ha relacionado el precio de los alimentos con su calidad nutritiva, de forma que los alimentos de menor valor nutritivo resultan los más baratos. Así, la alta disponibilidad de alimentos de bajo coste, podría ser un factor a considerar entre los responsables del aumento de la frecuencia de la obesidad que se observa. OBJETIVO: Realizar una comparativa económica entre el coste de una dieta saludable y otra no saludable. MÉTODO: Estudio descriptivo, transversal. Muestra constituida por 15 sujetos entre 18 y 57 años. Se recogieron los hábitos alimentarios de 3 días, mediante recordatorio de 24 horas y diario dietético. El criterio de dietas saludables o no, se estableció en función de la Guía Alimentaria SENC de diciembre de 2016. Se realizó un cálculo económico del coste diario de la cesta de la compra, un análisis de la media de 3 días del coste de la cesta de la compra y el coste de las comidas realizadas fuera del hogar. Se compararon los costes de la cesta de la compra de quienes tenían una Dieta Saludable y No Saludable. También se tuvo en cuenta en el estudio el IMC de los sujetos. RESULTADOS: Los resultados obtenidos confirman que es más económica una dieta saludable que una no saludable, y que el IMC no tiene una correlación directa y exclusiva con el hecho de seguir una dieta de mayor o menor calidad nutricional. CONCLUSIONES: Si consideramos que el factor económico no es uno de los factores más importante en el hecho de llevar unas pautas nutricionales saludables, sería interesante un estudio posterior con una muestra más amplia y una actuación educativo-nutricional para dar herramientas a la población que les posibilite unas elecciones más adecuadas de alimentos y mayor implicación personal en tiempo, conocimiento de técnicas, etc., más allá del aspecto puramente económico

INTRODUCTION: Occasionally, the price of food has been linked to its nutritional quality so that foods with lower nutritional value are the cheapest. Thus, the high availability of low-priced food could be a factor to consider among the ones responsible for the increased frequency of obesity that is now been observed. OBJECTIVE: The main objective of this study was to make an economic comparison between the cost of healthy eating vs unhealthy eating. METHODS: A cross-sectional descriptive study. The sample was made up of 15 individuals aged 18-57. Eating habits were collected for 3 days via 24- hour dietary recall and diet diary. The criteria for a healthy or unhealthy diet was stablished according to the SENC Food Guidance- December 2016. Daily cost of shopping basket, analysis of the average shopping basket for three days and the cost of food eating outside were made. The cost of shopping basket was compared between healthy and unhealthy eaters. The BMI was also considered in this study. RESULTS: The results obtained confirm that a healthy diet is cheaper than an unhealthy one and that there is not direct and exclusive correlation between the BMI and healthy or unhealthy eating. CONCLUSIONS: If we consider that the economic factor is the most important one regarding healthy eating patterns, further study based on a wider simple and an educational-nutritional intervention would be interesting in order to provide individuals with tools to make possible the most adequate election of the food and a greater personal involvement in time, technical knowledge, etc. beyond the economic aspect

Alimentación familiar: influencia en el desarrollo y mantenimiento de los trastornos de la conducta alimentaria / Family food habits: influence on development and maintenance of eating disorders

Los trastornos de la conducta alimentaria, en adelante TCA, son alteraciones de la conducta relacionada con la alimentación que normalmente se ven influenciados en gran medida por la alimentación del entorno y de la familia. Abordar los factores de riesgo que pueden estar relacionados con la alimentación familiar y que podrían ser desencadenantes de un TCA es clave como prevención. De las diferentes investigaciones de relevantes autores que estudiaron la correlación entre el ámbito familiar y los TCA, con centro en la alimentación familiar, surge el foco de esta revisión, tratando de dar una explicación a los motivos que apuntan a la relación entre alimentación familiar y TCA, destacando los factores de riesgo que se han considerado más influyentes tanto en el desarrollo como en el mantenimiento de los mismos. El objetivo es entender de qué manera el núcleo familiar puede influir sobre estos trastornos dependiendo de sus valores y creencias, la personalidad y relación de cada miembro con la persona afectada o las patologías previas, así como la herencia genética. Los resultados obtenidos fueron mayoritariamente correlacionales, es decir, una familia desestructurada, con altos niveles de ansiedad o estrés, o con presencia de sobrepeso, implicará más riesgo de que algún miembro sufra un TCA en contraposición a aquellas familias con buena comunicación y roles establecidos donde el peso no es importante. Sin embargo, y como se desarrolla a lo largo del trabajo, esto no parece ser un factor que se cumpla en todos los casos. El mantenimiento de estos desórdenes puede variar en función de la implicación que muestre la familia por la recuperación del paciente, la disposición de dicha familia a cambiar sus hábitos y la mejora del ambiente de convivencia

Eating disorders (mainly anorexia nervosa, bulimia nervosa, and binge eating disorder) are eating-related behavioral disturbances that are normally largely influenced by eating environment and family. Thus, addressing risk factors that may be related to family eating and that could be triggers for an eating disorder is key as prevention. From the different investigations in books and publications by great authors that studied the correlation between the family environment and eating disorders, Family Eating has been the focus of this review, trying to give an explanation to the reasons that point to the relationship between family nutrition and the appearance of these disorders, highlighting the risk factors that have been considered most influential both in the development and maintenance of eating disorders. The objective is to understand how the family nucleus can influence these disorders depending on the values and beliefs they have, the personality and relationship of each member with the affected person or previous pathologies, as well as genetic inheritance. The results obtained were mostly correlational, that is, an unstructured family concerned excessively with the figure, with high levels of anxiety or stress and previous overweight pathologies will tend to be more predisposed to a member suffering from an eating disorder than those families with good communication and established roles where weight is not important. However, and as it develops throughout the work, this does not seem to be a factor that is met in all cases. The maintenance of these disorders may vary depending on the family's involvement in the recovery of the patient, the family's willingness to change their habits and the improvement of the coexistence environment

Storytelling as instrument of communication in healthcontexts / Storytelling como instrumento de comunicación en contextosde salud

Storytelling (ST) has emerged as an instrument that helps us in the learning and management of the disease, by taking advantage of the teachings transmitted by other patients who have gone through the same illness: sharing experiences. It requires an interaction between the one who relates (implicit emotional and corporal language: visual, auditory and gestural) and the listener, allowing the listener to conceptualize and create more valuable ideas. The use of ST can serve as a means, establishing a network of trust and equality among participants, allowing a way of expression that would eliminate the stigmatization of suffering from a disease. In addition, telling stories can be a vehicle that breaks resistance to the messages promoting a healthy lifestyle, or that dilutes them to face behavioral changes facilitating the incorporation of new behaviors that improve health or overcome the disease. ST facilitates support for the disease by allowing the patient to examine their emotions and problem-solving strategies, set objectives and exchange social support. With this article we intended to conduct a review of empirical studies on ST and health education, considering contexts, purposes, learning, attitudes and behaviors improvements related to the use of this tool of communication

Lo que podríamos denominar "contar historias", Storytelling (ST), se ha convertido en un instrumento que nos ayuda en el aprendizaje y el manejo de la enfermedad, aprovechando las enseñanzas transmitidas por otros pacientes que han pasado por la misma enfermedad: compartiendo experiencias. Requiere una interacción entre el relator (lenguaje emocional y corporal implícito: visual, auditivo y gestual) y el oyente, lo que le permite conceptualizar y crear ideas más valiosas. El uso de ST puede servir como un medio, estableciendo una red de confianza e igualdad entre los participantes, permitiendo una forma de expresión que eliminaría la estigmatización del sufrimiento de una enfermedad. Además, contar historias puede ser un vehículo que rompa la resistencia a los mensajes que promueven un estilo de vida saludable, o que los diluya para enfrentar cambios conductuales que faciliten la incorporación de nuevos comportamientos que mejoren la salud o superen la enfermedad. ST facilita el apoyo a la enfermedad al permitir al paciente examinar sus emociones y estrategias de resolución de problemas, establecer objetivos e intercambiar apoyo social. Con este artículo intentamos realizar una revisión de estudios empíricos sobre ST y educación para la salud, considerando contextos, propósitos, aprendizaje, actitudes y mejoras de comportamiento relacionadas con el uso de esta herramienta de comunicación

Can treatment with statins have a negative influence on the tolerance of mandibular advancement devices?

BACKGROUND: Statins are considered the most effective drugs used in the treatment of dyslipidemias. Some of their adverse effects are related to muscle problems. Myalgias produced by statins appear more often during exercise. Mandibular advancement devices (MAD) force the propulsory and elevatory musculature of the mandible to exercise by making the jaw move forward. The aim of this study is to evaluate the incidence of muscular side effects (referred, spontaneous, or under palpation pain, myofascial pain, mandibular rigidity and fatigue, tension and sensitivity of the masticatory muscles) in a group of patients with a diagnosis of obstructive sleep apnea being treated with MAD. METHODS: This was a prospective study, involving consecutively 104 patients with a diagnosis of OSAS, and who had begun treatment with a custom made oral device. Muscular side effects were collected by anamnesis (verbal request and questionnaires), psychological status and clinical assessment (manual muscle palpation in the masticatory and cervical muscle groups), before and during MAD treatment. RESULTS: Of the total sample, 22.1 % presented muscular side effects with the oral device. However, in patients taking statins, this percentage was 57.1 %, as opposed to 16.7 % of the non-statins patients (p < 0.001). The risk of suffering muscular alterations during oral device treatment is higher in statin patients (odds ratio 6.67, p = 0.002). CONCLUSION: Treatment with statins can give rise to the appearance of undesirable side effects among patients being treated with oral devices.

Effectiveness of home single-channel nasal pressure for sleep apnea diagnosis.

INTRODUCTION: Home single-channel nasal pressure (HNP) may be an alternative to polysomnography (PSG) for obstructive sleep apnea (OSA) diagnosis, but no cost studies have yet been carried out. Automatic scoring is simpler but generally less effective than manual scoring. OBJECTIVES: To determine the diagnostic efficacy and cost of both scorings (automatic and manual) compared with PSG, taking as a polysomnographic OSA diagnosis several apnea-hypopnea index (AHI) cutoff points. METHODS: We included suspected OSA patients in a multicenter study. They were randomized to home and hospital protocols. We constructed receiver operating characteristic (ROC) curves for both scorings. Diagnostic efficacy was explored for several HNP AHI cutoff points, and costs were calculated for equally effective alternatives. RESULTS: Of 787 randomized patients, 752 underwent HNP. Manual scoring produced better ROC curves than automatic for AHI < 15; similar curves were obtained for AHI ≥ 15. A valid HNP with manual scoring would determine the presence of OSA (or otherwise) in 90% of patients with a polysomnographic AHI ≥ 5 cutoff point, in 74% of patients with a polysomnographic AHI ≥ 10 cutoff point, and in 61% of patients with a polysomnographic AHI ≥ 15 cutoff point. In the same way, a valid HNP with automatic scoring would determine the presence of OSA (or otherwise) in 73% of patients with a polysomnographic AHI ≥ 5 cutoff point, in 64% of patients with a polysomnographic AHI ≥ 10 cutoff point, and in 57% of patients with a polysomnographic AHI ≥ 15 cutoff point. The costs of either HNP approaches were 40% to 70% lower than those of PSG at the same level of diagnostic efficacy. Manual HNP had the lowest cost for low polysomnographic AHI levels (≥ 5 and ≥ 10), and manual and automatic scorings had similar costs for higher polysomnographic cutoff points (AHI ≥ 15) of diagnosis. CONCLUSION: Home single-channel nasal pressure (HNP) is a cheaper alternative than polysomnography for obstructive sleep apnea diagnosis. HNP with manual scoring seems to have better diagnostic accuracy and a lower cost than automatic scoring for patients with low apnea-hypopnea index (AHI) levels, although automatic scoring has similar diagnostic accuracy and cost as manual scoring for intermediate and high AHI levels. Therefore, automatic scoring can be appropriately used, although diagnostic efficacy could improve if we carried out manual scoring on patients with AHI < 15. CLINICAL TRIALS INFORMATION: Clinicaltrials.gov identifier: NCT01347398.

Multi-class determination of personal care products and pharmaceuticals in environmental and wastewater samples by ultra-high performance liquid-chromatography-tandem mass spectrometry.

In this work, a multi-class method for the simultaneous determination of 17 emerging contaminants, including pharmaceuticals and personal care products, has been developed. Target analytes were two anti-inflammatories, a lipid regulator agent, two angiotensin II antagonists, two antiepileptic drugs and a diuretic. Among personal care products, four preservatives and five UV filters were included. The method is based on solid-phase extraction (SPE) using Oasis HLB cartridges followed by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Up to three simultaneous transitions per compound were acquired to assure a reliable identification. A detailed study of the extraction process efficiency and matrix effects was carried out in surface water and effluent wastewater. The use of isotope-labeled internal standards (ILIS) was tested to compensate both potential SPE losses during sample extraction and signal suppression/enhancement observed, especially in EWW. Satisfactory correction in all water samples was only ensured when the own analyte ILIS was used. The use of analogues ILIS was a rather useful approach for correction in the majority of the samples tested when analyte ILIS was unavailable. The method was successfully validated in five different surface water (SW) samples and five effluent wastewater (EWW) samples spiked at two concentration levels (0.05 and 0.5 µg/L in SW; 0.1 and 0.5 µg/L in EWW). The developed method was applied to the analysis of 22 samples (SW and EWW) from the Spanish Mediterranean area and 51 reservoir water samples from Colombia. Personal care products were frequently detected, with the highest concentrations corresponding to benzophenone and benzophenone-4 (samples from Spain), and methylparaben (samples from Colombia). Several pharmaceuticals were detected in the Spanish samples, where irbesartan and valsartan - two Angiotensin II antagonists that are not commonly monitored in the aquatic environment - were the compounds most frequently detected.

[Controversy in the management of WHO grade II gliomas in eloquent brain areas: recent literature review]. / Controversias en el tratamiento de los gliomas OMS grado II localizados en áreas elocuentes: revisión de la bibliografía reciente.

Recent studies have shown that diffuse grade II gliomas (GGII) located in eloquent brain areas represent over 80% of all GGII. The optimal management of these tumours is still controversial. It has long been considered that surgery is not an option for GGII within eloquent areas, due to the high risk of inducing postoperative sequelae in patients with normal neurological explorations. However, the safety of these surgeries has significantly improved in recent years due to the rapid development of techniques enabling a precise mapping of brain functions. Noninvasive functional neuroimaging techniques have been recently developed, enabling cortical mapping of the entire brain prior to surgical procedures. Such precise data provide a preoperative estimation of the location of eloquent areas in relation to the tumour, which is essential for surgical planning and preoperative assessment of morbidity for various surgical approaches. The intraoperative electrical stimulation (IES) mapping technique consists in the application of a bipolar electrode on the brain tissue, enabling an accurate location of brain functions. This provides unique assistance in GGII resection, as it generates a discrete and transient "virtual" lesion within the eloquent tissue. Tumour removal is then tailored according to functional boundaries in order to optimise the quality of resection and to minimise the risk of postoperative sequelae, preserving quality of life. For patients with a GGII in an eloquent area, the possibility of an early resection should be evaluated by a multidisciplinary neuro-oncology team specialising in the management of such tumours.

Controversias en el tratamiento de los gliomas OMS grado II localizados en áreas elocuentes: revisión de la bibliografía reciente / Controversy in the management of WHO grade II gliomas in eloquent brain areas: recent literature review

Estudios recientes han demostrado que los gliomas difusos de grado II (GGII), localizados en áreas elocuentes del cerebro, representan más del 80% del total de los GGII. El tratamiento de los GGII en áreas elocuentes es todavía hoy controvertido. El abordaje clásico de un GGII en un área elocuente considera que no es posible plantear una cirugía, porque hay un riesgo alto de secuelas neurológicas en un paciente con una exploración neurológica normal. Sin embargo, en los últimos años ha aumentado de forma significativa la seguridad de las cirugías de estos tumores, gracias al desarrollo de técnicas para mapear con precisión la función cerebral. Mediante las técnicas no invasivas de neuroimagen funcional, se obtiene un mapa de la función cortical de todo el cerebro, lo que es de gran ayuda para anticipar los hallazgos durante la cirugía y para planificar el abordaje. La técnica de mapeo por estimulación eléctrica intraoperatoria consiste en la aplicación, durante la intervención quirúrgica, de un electrodo bipolar sobre el tejido cerebral, lo que permite localizar las funciones con gran precisión. Esta técnica se considera hoy día como el procedimiento de elección para realizar una cirugía de un GGII en un área elocuente con seguridad, ya que ha demostrado ser capaz de aumentar el grado de resección y reducir de forma importante el riesgo de secuelas. En todo paciente con la sospecha de un GGII en un área elocuente, debe valorarse la posibilidad de una extirpación tumoral temprana por parte de un equipo multidisciplinario de profesionales especializados en el manejo de estos tumores (AU)

Recent studies have shown that diffuse grade II gliomas (GGII) located in eloquent brain areas represent over 80% of all GGII. The optimal management of these tumours is still controversial. It has long been considered that surgery is not an option for GGII within eloquent areas, due to the high risk of inducing postoperative sequelae in patients with normal neurological explorations. However, the safety of these surgeries has significantly improved in recent years due to the rapid development of techniques enabling a precise mapping of brain functions. Noninvasive functional neuroimaging techniques have been recently developed, enabling cortical mapping of the entire brain prior to surgical procedures. Such precise data provide a preoperative estimation of the location of eloquent areas in relation to the tumour, which is essential for surgical planning and preoperative assessment of morbidity for various surgical approaches. The intraoperative electrical stimulation (IES) mapping technique consists in the application of a bipolar electrode on the brain tissue, enabling an accurate location of brain functions. This provides unique assistance in GGII resection, as it generates a discrete and transient "virtual" lesion within the eloquent tissue. Tumour removal is then tailored according to functional boundaries in order to optimise the quality of resection and to minimise the risk of postoperative sequelae, preserving quality of life. For patients with a GGII in an eloquent area, the possibility of an early resection should be evaluated by a multidisciplinary neuro-oncology team specialising in the management of such tumours (AU)

El riesgo de reincidencia en agresores sexuales: in vestigación básica y valoración mediante el SVR_20 / Eviolence and sexual offender recidivism: basic research and risk assessment with SVR-2

El estudio de la violencia y de la reincidencia de los agresores sexuales constituye en la actualidad un ámbito de especial interés dela Psicología Criminal. En este trabajo se revisan tanto las teorías y conocimientos existentes sobre etiología y factores de riesgo deagresión sexual, como algunas investigaciones internacionales y españolas que sustentan estos conocimientos. Su principal objetivoes la presentación de un nuevo instrumento de predicción en este campo denominado SVR-20: Manual de valoración del riesgo deviolencia sexual. Dicho instrumento ha sido traducido y adaptado para el contexto español y latino por el Grupo de Estudios Avanzadosen Violencia (GEAV) de la Universidad de Barcelona. Para su validación se ha efectuado un primer estudio piloto sobre la capacidadpredictiva del SVR-20 con una muestra de agresores sexuales que cumplieron condena en una prisión española. La conclusión principal de este estudio es que el SVR-20 es un buen instrumento para predecir el riesgo de reincidencia sexual

Violence and sexual offenders’ recidivism are nowadays two fields of interest for Criminal Psychology. In this article, there is a reviewof theories and knowledge about the etiology and risk factors of sex aggression, and also of international and Spanish research thatsupports this theoretical foundation. The main goal of this study is to introduce an instrument for risk assessment called SVR-20:Guide for sexual violence risk assessment. This instrument has been translated and adapted for the Spanish context by the Group inAdvanced Studies on Violence (GEAV) of the University of Barcelona. In order to validate this instrument, a pilot study about the predictiveaccuracy of the SVR-20 has been carried out, using a sample of incarcerated sex offenders from a Spanish prison. The mainconclusion of this study is that SVR-20 is a good instrument to predict the risk of sexual recidivism (AU)

Subacute encephalopathy with seizures in alcoholics (SESA syndrome): report of an unusual case.

Subacute encephalopathy with seizures in alcoholics (SESA syndrome) is a rare neurologic disorder complicating the chronic abuse of alcohol. This acute or subacute condition is characterized by transient neurologic deficits, seizures and severe lateralized abnormalities on the electroencephalogram (EEG). Our case demonstrates that in SESA syndrome, convulsive (generalized tonic-clonic) and nonconvulsive (complex partial) seizures may coexist.

Permanent dysphasia after status epilepticus: long-term follow-up in an elderly patient.

We report the long-term follow-up of an elderly patient who developed a permanent sensorimotor dysphasia after status epilepticus. Magnetic resonance imaging of the brain and magnetic resonance angiography failed to demonstrate structural cerebral damage; however, a fluorodeoxyglucose positron emission tomography scan revealed marked hypometabolism involving a large area in the left hemisphere and contralateral cerebellar cortex. Our case illustrates that permanent language dysfunction may occur after recurrent complex partial and secondarily generalized seizures.

Early-onset absence epilepsy: clinical and electroencephalographic features in three children.

To describe the clinical and electroencephalographic features of three infants diagnosed as having early-onset absence seizures. Two males and one female, aged 21-29 months were seen in our neuropaediatric outpatient clinic because of daily episodes of motor arrest and loss of contact. Neurological examination and mental development was considered normal in all of them. Two out three had first-degree relatives with seizures with onset in the childhood and favourable evolution in the adulthood. A video-electroencephalogram was requested. Ictal EEG revealed a normal background and generalised spike-and-wave complexes at 3-3.5 Hz accompanied by disruption of ongoing activity in keeping with absence seizures. The duration of seizures ranged from 2 to 10s. One child (patient 2) experienced rhythmic myoclonic jerks in upper limbs and head as those described in myoclonic absences. Clinical and electroencephalographic follow-up ranged from 8 months to 4 years. Two children were on treatment with valproate and in the case of the patient 3, the combination of valproate and ethosuximide was necessary. Control of absence seizures was achieved in all our cases. Absence seizures should be considered as a possible cause of transient impairment of consciousness even among infants minor than 3 years of age. A video-electroencephalogram is the method of choice in the diagnostic evaluation and syndromic classification of these paroxysmal events.