Factor protector de las estrategias de afrontamiento y la cohesión de grupo sobre el bienestar psicológico ante situaciones de ansiedad competitiva en futbolistas / Protective factor of coping strategies and group cohesion on psychological well-being when facing situations of competitive anxiety in football players / Fator protetor das estratégias de enfrentamento e coesão do grupo no bem-estar psicológico diante de situações de ansiedade competitiva em jogadores de futebol

El bienestar psicológico que experimenta un individuo puede verse afectado por diversas variables, como, por ejemplo, la ansiedad. En el caso concreto de los deportistas, la ansiedad derivada de la práctica deportiva es algo frecuente, pudiendo derivar en niveles bajos de bienestar. Sin embargo, podrían existir factores protectores que amortiguasen esta relación. En este sentido, el objetivo del presente estudio es analizar el posible efecto protector tanto de las estrategias de afrontamiento (evaluadas mediante el Cuestionario de Estrategias de Afrontamiento en Competición Deportiva), como de la cohesión de grupo (evaluada mediante el Cuestionario de Entorno de Grupo) sobre el bienestar psicológico (evaluado mediante la Escala de Bienestar Psicológico de Ryff), a pesar de experimentar ansiedad en la competición deportiva (evaluada mediante el Cuestionario de Causas, Manifestaciones y Estrategias de Afrontamiento de la Ansiedad en la Competición Deportiva). Para ello se contó con una muestra de 99 futbolistas amateurs. Los resultados mostraron relaciones bivariadas negativas entre ansiedad y bienestar (r = -.03 / -.37). Sin embargo, al analizar el efecto moderador tanto de la cohesión grupal (β = .82, p < .001) como de las estrategias de afrontamiento (β = .87, p < .001), se observó que ambas variables amortiguaban el efecto negativo de la ansiedad sobre el bienestar. Estos resultados pueden tener importantes implicaciones prácticas en el desarrollo de intervenciones con deportistas para mejorar el nivel de bienestar psicológico a través de la mejora tanto de la cohesión grupal como de las estrategias de afrontamiento

The psychological well-being experienced by an individual can be affected by several variables, such as anxiety. In the specific case of athletes, anxiety derived from practicing sports is common and can lead to low levels of well-being. However, there could be protective factors that would buffer this relationship. The aim of the present study is to analyse the possible protective effect of both coping strategies (assessed with the Cuestionario de Estrategias de Afrontamiento en Competición Deportiva) and group cohesion (assessed with the Cuestionario de Entorno de Grupo) on psychological well-being (assessed with the la Escala de Bienestar Psicológico de Ryff), despite experiencing anxiety in sports competition (assessed with the Cuestionario de Causas, Manifestaciones y Estrategias de Afrontamiento de la Ansiedad en la Competición Deportiva). A sample of 99 amateur football players was used. The results showed negative bivariate relationships between anxiety and well-being (r = -.03 / -.37). However, when analysing the moderating effect of both group cohesion (β = .82, p < .001) and coping strategies (β = .87, p < .001), it was observed that both variables dampened the negative effect of anxiety on well-being. These results may have important practical implications in the development of interventions with athletes to improve the level of psychological well-being through the improvement of both coping strategies and group cohesion

O bem-estar psicológico que um indivíduo experimenta pode ser afetado por diversas variáveis, como a ansiedade. No caso específico dos atletas, a ansiedade derivada do esporte O bem-estar psicológico que um indivíduo experimenta pode ser afetado por diversas variáveis, como a ansiedade. No caso específico dos atletas, a ansiedade derivada do esporte é comum e pode levar a baixos níveis de bem-estar. No entanto, pode haver fatores de proteção que amenizem tal associação. Nesse sentido, o objetivo deste estudo é analisar o possível efeito protetor das estratégias de enfrentamento (avaliadas pelo Questionário de Estratégias de Enfrentamento em Competições Esportivas ) e da coesão grupal (avaliada pelo Questionário Entorno Grupal) no bem-estar psicológico dos atletas (avaliado pela Escala de Bem-estar Psicológico de Ryff), apesar da ansiedade nas competições esportivas (avaliada pelo Questionário das Causas, Manifestações e Estratégias de Enfrentamento da Ansiedade na Competição Esportiva). Para isso, investigou-se uma amostra de 99 jogadores de futebol amador. Os resultados revelaram relações bivariadas negativas entre ansiedade e bem-estar (r = -.03 / -.37). No entanto, ao analisar o efeito moderador das estratégias de coesão (β = .82, p < .001) e de enfrentamento em grupo (β = .87, p < .001), observou-se que ambas as variáveis atenuaram o efeito negativo da ansiedade no bem-estar. Esses resultados podem ter implicações práticas importantes no desenvolvimento de intervenções com atletas para melhorar o nível de bem-estar psicológico através do aprimoramento das estratégias de coesão e de enfrentamento em grupo

Los médicos de urgencias deben implicarse en la organización de sus servicios / Emergency department doctors must get involved in organising the services

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Characterisation and modelling of brain tissue for surgical simulation.

Interactive surgical simulators capable of providing a realistic visual and haptic feedback to users are a promising technology for medical training and surgery planification. However, modelling the physical behaviour of human organs and tissues for surgery simulation remains a challenge. On the one hand, this is due to the difficulty to characterise the physical properties of biological soft tissues. On the other hand, the challenge still remains in the computation time requirements of real-time simulation required in interactive systems. Real-time surgical simulation and medical training must employ a sufficiently accurate and simple model of soft tissues in order to provide a realistic haptic and visual response. This study attempts to characterise the brain tissue at similar conditions to those that take place on surgical procedures. With this aim, porcine brain tissue is characterised, as a surrogate of human brain, on a rotational rheometer at low strain rates and large strains. In order to model the brain tissue with an adequate level of accuracy and simplicity, linear elastic, hyperelastic and quasi-linear viscoelastic models are defined. These models are simulated using the ABAQUS finite element platform and compared with the obtained experimental data.

Variación de las características y epidemiología de los pacientes con neumonía adquirida en la comunidad atendidos en los servicios de urgencias hospitalarios / Variation of the characteristics and epidemiology of patients with pneumonia acquired in the community treated in hospital A and E services

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[Job satisfaction and improvement factors in primary care professionals]. / Satisfacción laboral y factores de mejora en profesionales de atención primaria.

BACKGROUND: The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. METHODOLOGY: Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. RESULTS: We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. CONCLUSION: Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

Identificación de problemas y propuestas para mejorar la atención de las urgencias extrahospitalarias en Navarra: un estudio Delphi / Identification of problems and proposals for improving outpatient emergency care in Navarre: a Delphi study

Fundamento. Las urgencias extrahospitalarias de Navarra sufrieron modificaciones en la organización hace dos años, destacando la creación del servicio de urgencias rural (SUR) que coexiste geográficamente con el servicio normal de urgencias. El objetivo del estudio es conocer la opinión de expertos sobre los problemas y las recomendaciones de mejora que afectan a las urgencias extrahospitalarias. Metodología. Se realizó un estudio Delphi con la participación de 37 expertos (médicos y enfermeras). Por medio del correo electrónico se realizan 3 rondas de cuestionarios sucesivos. El último cuestionario identifica el grado de acuerdo con las ideas del grupo y se identifican los 15 problemas y recomendaciones más relevantes, seleccionando aquellas ideas que alcancen, al menos, el 50 % de acuerdo y una prioridad superior al percentil 25. Agrupamos las ideas mediante análisis de clúster jerárquico. Resultados. Se identifican 4 clúster de problemas, destacando entre ellos que “la población utiliza las urgencias para patología banal, como una consulta más” con una puntuación de 297 puntos. De las recomendaciones, con 3 clúster identificados, destaca la “necesidad de diseñar un plan estratégico de atención a las urgencias con unos recursos acorde a las necesidades” (310 puntos de prioridad) y “enviar mensajes claros a la población sobre uso correcto de urgencias” (192 puntos de prioridad). Conclusión. El método Delphi identifica problemas y áreas de mejora a través del consenso (AU)

Background. Two years ago there were alterations to outpatient A and E departments in Navarre; in particular, a rural A and E service (Servicio de Urgencias Rural, SUR) was set up, which coexists geographically with the normal A and E service. The aim of this study is to determine the opinion of experts on problems and recommendations for improvements that affect outpatient A and E services. Methodology. A Delphi study was carried out with the participation of 37 experts (doctors and nurses). Threes successive rounds of questionnaires were completed using email. The final questionnaire identified degree of agreement with the group’s ideas, and the 15 most relevant problems and recommendations were identified; those ideas that were selected achieved at least 50% agreement and their priority was above 25%. We grouped the ideas using a hierarchic cluster analysis. Results. Four cluster problems were identified; the most outstanding amongst them being “the population uses A and E for banal pathologies, just like any other consultation” with a score of 297 points. Outstanding amongst the recommendations, with 3 identified clusters, were the “need to design a strategic plan for A and E care with resources appropriate to the needs” (310 priority points) and “sending clear messages to the population on the correct use of A and E” (192 priority points). Conclusion. The Delphi method identifies problems and improvement areas through consensus (AU)

[Disparities in food consumption and nutrient intake among in relation to smoking]. / Diferencias en el consumo de alimentos y nutrientes según el hábito tabáquico.

BACKGROUND: Nutritional habits and smoking are well known to be two of the most important risk factors for the development of cardiovascular diseases and cancer. The aim of this study was to assess disparities in food consumption and nutrient intake in relation to smoking in the population of Pamplona, Spain. METHODS: A cross study by postal survey was carried out on a representative sample (n=875; 29.3% of the theoretical sample) of Pamplona's population aged between 18 and 65 years. Food consumption was evaluated by a food consumption frequency questionnaire. The survey also contained questionnaires about consumption of tobacco and alcohol, physical activity, as well as a sociodemographic record. A bivariant analysis was carried out (p<0.05) by Kruskal Wallis and chi2 Pearson tests. RESULTS: Male smokers consume less fruit, vegetables and chicken than other groups, while male ex-smokers seem to have healthier food consumption patterns. Female smokers have a less healthy diet as well, although differences are less marked. In both genders, smokers consume more alcohol. With respect to nutrients, smokers consume less folate, niacin and antioxidants (vitamin C). Female non-smokers consume more fibre than other groups. CONCLUSIONS: This study highlights the prevalence of a healthier diet among non-smokers and ex-smokers, who share similar diet patterns that are healthier than those of smokers. It would also be desirable for smokers to have healthier food consumption habits in order to reduce the effects of tobacco and to meet the additional demand for some nutrients required by this group.

Diferencias en el consumo de alimentos y nutrientes según el hábito tabáquico / Disparities in food consumption and nutrient intake among in relation to smoking

Fundamento. Los hábitos alimentarios y el consumo de tabaco suponen dos de los principales factores de riesgo para el desarrollo de enfermedades cardiovasculares y cáncer. El objetivo del presente estudio fue describir posibles diferencias en el consumo de alimentos y nutrientes en función del consumo de tabaco en la población de Pamplona.Métodos. Se llevó a cabo un estudio transversal mediante encuesta postal en una muestra significativa (n =874), correspondiente al 29,3% de personas de la muestra teórica que respondieron a la encuesta, de la población de Pamplona con edad comprendida entre 18 y 65 años. Se evaluó el consumo de alimentos mediante un cuestionario de frecuencia de consumo de alimentos. La encuesta incluía también un cuestionario sobre el consumo de tabaco, otro para evaluar el consumo de alcohol y distintas preguntas para evaluar la actividad física, además de una ficha sociodemográfica. Se llevó a cabo un análisis bivariado (p<0,05) mediante las pruebas de Kruskal Wallis, c2 de Pearson y residuos tipificados corregidos.Resultados. Los varones fumadores consumen menos fruta, vegetales y carne de pollo que las otras categorías, mientras que los varones exfumadores son los que presentan un patrón de consumo más saludable. Las mujeres fumadoras también presentan una dieta menos sana, aunque las diferencias son menores. En ambos sexos, los fumadores ingieren más alcohol. Respecto a los nutrientes, las personas fumadoras ingieren menor cantidad de folatos, ácido nicotínico y antioxidantes (vitamina C). En el caso de las mujeres, además, el consumo de fibra aparece incrementado entre las no fumadoras.Conclusiones. El presente estudio pone de manifiesto la existencia de una dieta más saludable en los no fumadores y exfumadores, que comparten una dieta parecida y más sana que los fumadores. Sería deseable además que los fumadores tuvieran hábitos alimentarios más saludables para atenuar el efecto del tabaco y para cubrir la demanda adicional de algunos nutrientes requerida por este grupo

Background. Nutritional habits and smoking are well known to be two of the most important risk factors for the development of cardiovascular diseases and cancer. The aim of this study was to assess disparities in food consumption and nutrient intake in relation to smoking in the population of Pamplona, Spain. Methods. A cross study by postal survey was carried out on a representative sample (n=875; 29.3% of the theoretical sample) of Pamplona´s population aged between 18 and 65 years. Food consumption was evaluated by a food consumption frequency questionnaire. The survey also contained questionnaires about consumption of tobacco and alcohol, physical activity, as well as a sociodemographic record. A bivariant analysis was carried out (p<0.05) by Kruskal Wallis and c2 Pearson tests. Results. Male smokers consume less fruit, vegetables and chicken than other groups, while male ex-smokers seem to have healthier food consumption patterns. Female smokers have a less healthy diet as well, although differences are less marked. In both genders, smokers consume more alcohol. With respect to nutrients, smokers consume less folate, niacin and antioxidants (vitamin C). Female non-smokers consume more fibre than other groups. Conclusions. This study highlights the prevalence of a healthier diet among non-smokers and ex-smokers, who share similar diet patterns that are healthier than those of smokers. It would also be desirable for smokers to have healthier food consumption habits in order to reduce the effects of tobacco and to meet the additional demand for some nutrients required by this group

International Study of Asthma and Allergies in Childhood. Results on rhinitis of first phase in Pamplona, Spain.

BACKGROUND: The ISAAC (International Study of Asthma and Allergies in Childhood) was thought in order to maximize the value of epidemiological research into asthma and allergic diseases in childhood, establishing a standardized methodology and facilitating collaboration and comparison between several countries. METHODS AND RESULTS: The written questionnaires in the group of children aged 6-7 years was answered by the parents and the group of children aged 13-14 years self-completed the written questionnaires. RESULTS: 3,040 children aged 13-14 years answered the questionnaire and 3,002 in the group aged 6-7 years. In the group of children aged 13-14, 49.7% referred rhinitis symptoms some time, and 15.6% in the 6-7 year old group. The prevalence of nasal symptoms in the last year was 35.5% in the 13-14 year group and 10.6% in the 6-7 year group. The presence of nasal symptoms was more frequent in winter. The prevalence of seasonal allergic rhinitis (hay fever) was 6.1% in the 13-14 year group and 4.8% in the group of children aged 6-7 years. CONCLUSIONS: These results can contribute to a better control of some factors and to future studies where the etiology and incidence of the disease could be investigated.

Neumomediastino espontáneo. Análisis de 16 casos / Spontaneus pneumomediastinum. Analysis of 16 cases

Objetivos: Conocer las características de los enfermos con neumomediastino espontáneo (NE) atendidos en nuestro servicio. Métodos: Estudio prospectivo de los enfermos con NE diagnosticados durante un período de dos años en un Servicio de Urgencias. Resultados: Se diagnosticaron 16 enfermos de NE. La proporción de varones y mujeres fue similar, con sintomatología de dolor torácico (87,5 por ciento), disfagia (53,6 por ciento) y enfisema subcutáneo (43,7 por ciento), principalmente. El 43,7 por ciento presentaron signo de Hamman. El 53,6 por ciento de los casos fueron vistos durante los meses estivales. Todos los casos se resolvieron en 2 a 5 días (media 3,56ñ0,96), con tratamiento sintomático. Conclusiones: Encontramos algunas diferencias entre nuestro estudio y otros similares, en cuanto presentación por sexos, sintomatología y época de presentación. (AU)

International study of asthma and allergies in childhood. Results on rhinitis of first phase in Pamplona, Spain

Background: the ISAAC (International Study of Asthma and Allergies in Childhood) was thought in order to maximize the value of epidemiological research into asthma and allergic diseases in childhood, establishing a standardized methodology and facilitating collaboration and comparison between several countries. Methods and Results: the written questionnaires in the group of children aged 6-7 years was answered by the parents and the group of children aged 13-14 years self-completed the written questionnaires. Results: 3,040 children aged 13-14 years answered the questionnaire and 3,002 in the group aged 6-7 years. In the group of children aged 13-14, 49.7% referred rhinitis symptoms some time, and 15.6% in the 6-7 year old group. The prevalence of nasal symptoms in the last year was 35.5% in the 13-14 year group and 10.6% in the 6-7 year group. The presence of nasal symptoms was more frequent in winter. The prevalence of seasonal allergic rhinitis (hay fever) was 6.1% in the 13-14 year group and 4.8% in the group of children aged 6-7 years. Conclusions: these results can contribute to a better control of some factors and to future studies where the etiology and incidence of the disease could be investigated (AU)

Introducción: la rinitis alérgica es una patología frecuente en la infancia y en las tres últimas décadas ha ido aumentando de manera significativa. Por otra parte, es una manifestación temprana de predisposición atópica que puede ser exacerbada por exposición a alergenos y puede preceder al asma bronquial. Los estudios epidemiológicos ponen de manifiesto el incremento en la prevalencia de las enfermedades alérgicas. El proyecto ISAAC ha sido ideado para maximizar el valor de los estudios epidemiológicos en el asma y enfermedades alérgicas en la infancia, estableciendo un método de cuestionario capaz de facilitar la colaboración entre países.Métodos y Resultados: fueron encuestados un total de 3.040 niños de entre 13-14 años y 3.002 niños de 6-7 años. En los niños de 6-7 años, los cuestionarios fueron contestados por los padres y en los de 13-14 años, por los propios niños.Síntomas de rinitis alguna vez, refirieron el 49,7 por ciento de los niños de 13-14 años frente al 15,6 por ciento de los niños de 6-7 años. La prevalencia de síntomas nasales en el último año es de 35,5 por ciento en los de 13-14 años y 10,6 por ciento en 6-7 años. Es más frecuente la presencia de síntomas nasales en invierno, y la prevalencia de rinitis estacional fue de 6,1 por ciento en los niños de 13-14 años frente a un 4,8 por ciento en los de 6-7 años.Conclusiones: el conocer la prevalencia de rinitis en nuestro medio contribuye a un mejor control de determinados factores, y a la realización de futuros estudios en los que podamos investigar etiología e incidencia que nos aclaren el curso natural de la enfermedad. (AU)

Estudio de la acumulación de plomo en dientes primarios / Study of the accumulation of lead in the primary teeth

El estudio tiene como objetivo determinar la concentración de plomo en un grupo de niños de la comarca de Pamplona, utilizando como indicador de acumulación de dicho metal en el organismo el diente primario. Asimismo se intenta relacionar la cantidad de plomo acumulado con ciertos factores de exposición recogidos a través de una encuesta realizada en el momento de entrega de la pieza dental. Se analizan 457 dientes mediante la aplicación de una técnica de digestión por microondas de la muestra, y posterior determinación del contenido en plomo con Espectrometría de Absorción Atómica. La concentración media de plomo obtenida en las muestras fue de 2'60 +/- 1'36 ug/g con rango entre 0'25 ug/g y 10'71 ug/g. La concentración media de plomo obtenida en nuestra muestra es inferior a la observada en otros estudios europeos. (AU)

[Study of the accumulation of lead in the primary teeth]. / Estudio de la acumulación de plomo en dientes primarios.

The purpose of the study was to determine the accumulation of lead in deciduous teeth in children living in the area of Pamplona (Spain). In this manner, we tried to make a relationship between the quantity of lead accumulated in the tooth against certain factors of exposure that were documented on a questionnaire carried out at the time that the tooth was presented. We analysed 457 deciduous teeth using a technique of microwave digestion follow by Atomic Absorption Spectrometry (AAS), to determine the concentration of lead in the sample. The mean lead concentration was 2.60+/-1.36 microg/g (range 0.25-10.71 microg/g). The lead concentration in our study is inferior to those observed in other European studies.

[Prevalence of smoking, awareness and evaluation of cessation methods amongst medical students]. / Prevalencia del tabaquismo, conocimiento y valoración de los métodos de cesación tabáquica en estudiantes de medicina.

This work describes and analyses the prevalence of smoking amongst medical students, their awareness of the methods of smoking cessation and the effectiveness they attribute to these methods and to medical advice. A questionnaire was distributed to students of medicine at the University of Navarra with open questions on the methods of smoking cessation of which they were aware, the effectiveness attributed to each of these and the effectiveness attributed to medical advice. Information was also gathered on: sex, year of study, smoking habit, average number of cigarettes smoked per day and the length of exposure to tobacco. Of 480 valid interviews, the prevalence of active smokers was 27.5% (CI 95%: 23.5-31.9); 4.2% ex-smokers and 68.3% who had never smoked. 42.7% named nicotine patches as a method of cessation and 25.2% nicotine chewing gum. With respect to the effectiveness attributed to each method, a median and interquartile range (IQR) of 20% (0-50) for the nicotine patches, 10% (0-40) for nicotine chewing gum and 20% (1-50) for medical advice. The more senior students and those that had been smoking for longer mentioned nicotine patches more frequently; more women than men knew about nicotine chewing gum. The senior students attributed greater effectiveness to nicotine patches. A future reduction is predicted in the number of active smokers in the medical sector. Amongst medical students the effectiveness of medical advice is overestimated. It is necessary to increase awareness of the methods for smoking cessation amongst medical students.

[Hepatitis A, B, and C in an occupational center for the mentally handicapped]. / Hepatitis A, B y C en un centro ocupacional para disminuidos psíquicos.

BACKGROUND: Estimation of prevalence of serologic markers of viral hepatitis A, B and C in students and staff of an occupational centre in Castellón (Spain). METHODS: Serologic markers of hepatitis A (IgG anti-HAV) and B (HBsAg, anti-HBe, anti-HBc, anti-HBs) were detected by radioimmunoassay (RIA) and serologic markers of hepatitis C (anti-HCV) by immunoradiometric assay (IRMA). Ninety per cent of students (54/60) and 80% of staff (8/10) participated. RESULTS: The prevalence of IgG anti-HVA was 55.6% in students and 75% in staff, increasing with age. Considering persons not vaccinated against hepatitis B, the prevalence of serologic markers hepatitis B was 18.5% in students, two HBsAg and anti-HBe positive, and nobody in staff. Serologic markers hepatitis B was associated with duration of stay institutions for mentally handicapped. None of the center was positive for anti-HCV. CONCLUSIONS: Viral hepatitis prevalences present notable differences. To maintain a serological surveillance of these diseases is important to control and prevention.