Alcohol Consumption in Nursing Students after the COVID-19 Lockdown.

Excessive alcohol consumption is a major public health issue that can negatively affect behavior among university students. The objective of this study was to estimate the frequency of alcohol consumption in nursing students as well as to describe the pattern of alcohol consumption after COVID-19 lockdown. A descriptive, cross-sectional observational study was carried out, in which 1162 degree-level nursing students were evaluated. Sociodemographic characteristics, lifestyles and levels of physical activity were determined using the International Physical Activity Questionnaire: Short Form (IPAQ-SF), and alcohol consumption was determined using the ISCA (Systematized Alcohol Consumption Questionnaire) and AUDIT (Alcohol Use Disorders Inventory Test) questionnaires. According to the AUDIT questionnaire, 36.7% of the students met the criteria for excessive alcohol consumption (26.8% men vs. 39.9% women; p < 0.001). The prevalence of hazardous drinkers was found to be 10.2% (95% CI 5.6-11.7), with the difference between men and women being statistically significant. The IPAQ-SF questionnaire indicated that 26.1% of students were sedentary. No relationship was observed between alcohol consumption and the level of physical activity. The frequency of hazardous drinkers was significantly higher in women (OR: 2.2) and in smokers (OR: 4.2). In conclusion, approximately 10% of nursing students can be considered hazardous drinkers, with significant differences between the sexes. The percentage is higher in women and in smokers. Strategies should be created that encourage healthy lifestyles, emphasizing preventive activities against excessive alcohol consumption. Furthermore, given the differences in excessive alcohol consumption between men and women, it would be advisable to include the gender perspective in these activities.

Attitudes towards Tattoos among Spanish Health Science Students.

(1) Background: The aim is to ascertain health science students' attitudes towards tattoos and their association with healthy lifestyles and socio-demographic variables. (2) Methods: Descriptive study conducted on pharmacy, medical and nursing students (n = 423). To ascertain attitudes towards tattoos, we used the Attitudes Towards Tattoos Scale. Other variables were physical activity, healthy diet, harmful habits and socio-demographic variables. (3) Results: A total of 12.6% (95% CI 9.1−16.2) of students reported having a tattoo; 58.9% did not regard tattoos as a health risk. In terms of attitudes, the mean score in the range of 7−35 (7­most unfavourable to 35­most favourable) was 22.6 (SD 5.2; 95% CI: 22.0−23.2). Scores were higher (p < 0.05) among women (23.1; SD: 5.3), persons aged <20 years (23.6; SD: 5.0) and smokers (23.9; SD: 4.6). Attitudes were found to be more favourable (p < 0.05) in nursing students than in pharmacy or medical students. No relationship was observed with physical activity, healthy diet or drug use. (4) Conclusions: The attitude to tattoos is most favourable among women, persons aged under 20 years and nursing students. In terms of health habits, attitudes are more favourable among smokers, regardless of their level of physical activity, compliance with healthy eating guidelines or consumption of alcohol or other drugs.

Development and Validation of a Novel Ultra-Compact and Cost-Effective Device for Basic Hands-On CPR Training: A Randomized, Sham-Controlled, Blinded Trial.

To examine the performance of a novel low-cost, ultra-compact, and attractive auditory feedback device for training laypeople in external chest compressions (ECCs), we conducted a quasi-experimental cross-sectional study from September to November 2021 at the Faculty of Nursing of Albacete, University of Castille-La Mancha, Spain. The ECC sequence was performed in the laboratory with the new device for basic hands-on CPR training. Results: One hundred college students were included in this study. The compression rate/min with the new device was 97.6, and the adequate %ECC was 52.4. According to the status of body mass index (BMI) and muscle strength of the upper limbs in the bivariate analysis, it was observed that the new device discriminated between those who performed correct ECCs according to their BMI and muscle strength and those who did not, which led to significantly influenced results in terms of the percentage of ECCs with correct depth. Conclusions: The new ultra-compact auditory feedback device "Salvando a Llanetes®" demonstrated utility for teaching and learning ECCs in basic CPR. We can affirm that the analyzed device is an adequate, safe and economical method for teaching "CPR Hands-Only™" to the general population.

Evaluation of Intranasal Midazolam for Pediatric Sedation during the Suturing of Traumatic Lacerations: A Systematic Review.

OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of intranasal midazolam as part of a paediatric sedation and analgesic procedure during the suturing of traumatic lacerations in paediatric emergency departments. METHODOLOGY: A systematic review of clinical trials was completed in July 2021. The databases consulted were PUBMED, SCOPUS, WEB OF SCIENCE, NICE and Virtual Health Library. ELIGIBILITY CRITERIA: randomised and nonrandomised clinical trials. Two independent, blinded reviewers performed the selection and data extraction. The participants were 746 children, of whom, 377 received intranasal midazolam. All of the children were admitted to an emergency department for traumatic lacerations that required suturing. The quality of the articles was evaluated with the Jadad scale. This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS: Nine studies were included in the review. The intranasal administration of midazolam in healthy children produces anxiolysis and minimal/moderate sedation without serious side effects. Although there are combinations of parenteral drugs that produce deeper sedation, they also have greater adverse effects. No significant differences in the initiation of sedation and the suture procedure were found between the intranasal route and the parenteral route. CONCLUSIONS: The use of intranasal midazolam in healthy children produces sufficiently intense and long-lasting sedation to allow for the suturing of traumatic lacerations that do not present other complications; therefore, this drug can be used effectively in paediatric emergency departments.

Development and semantic validation of an instrument for the assessment of knowledge and attitudes towards cardiopulmonary resuscitation in adolescents.

OBJECTIVES: Develop and semantically validate an instrument to assess the knowledge and attitudes of adolescents towards cardiopulmonary resuscitation (CPR). METHODS: Validation study of an instrument to evaluate the knowledge and attitudes of adolescents towards CPR, developed in three phases: (i) development of the evaluation instruments by the authors; (ii) content validation performed by 14 expert judges in the area using the content validity index for analysis; and (iii) semantic validation carried out with the participation of 30 adolescents between 11 and 13 years old. RESULTS: In the content validation, the questions on CPR knowledge obtained a content validity index (CVI) between 0.92 and 1.00, with a general index of 0.98; and the questions about attitudes obtained an IVC between 0.85 and 1.00, with a general index also of 0.98. Regarding semantic validation, three questions were modified in the knowledge assessment instruments and five in the attitude assessment instrument. CONCLUSIONS: Semantic and content validation of the instruments studied showed that they are suitable for assessing the knowledge and attitudes of adolescents related to CPR, so their use is recommended in the evaluation of training actions in this population group.

Comparison of Nine Early Warning Scores for Identification of Short-Term Mortality in Acute Neurological Disease in Emergency Department.

(1) Background: The aim was screening the performance of nine Early Warning Scores (EWS), to identify patients at high-risk of premature impairment and to detect intensive care unit (ICU) admissions, as well as to track the 2-, 7-, 14-, and 28-day mortality in a cohort of patients diagnosed with an acute neurological condition. (2) Methods: We conducted a prospective, longitudinal, observational study, calculating the EWS [Modified Early Warning Score (MEWS), National Early Warning Score (NEWS), VitalPAC Early Warning Score (ViEWS), Modified Rapid Emergency Medicine Score (MREMS), Early Warning Score (EWS), Hamilton Early Warning Score (HEWS), Standardised Early Warning Score (SEWS), WHO Prognostic Scored System (WPSS), and Rapid Acute Physiology Score (RAPS)] upon the arrival of patients to the emergency department. (3) Results: In all, 1160 patients were included: 808 patients were hospitalized, 199 cases (17%) required ICU care, and 6% of patients died (64 cases) within 2 days, which rose to 16% (183 cases) within 28 days. The highest area under the curve for predicting the need for ICU admissions was obtained by RAPS and MEWS. For predicting mortality, MREMS obtained the best scores for 2- and 28-day mortality. (4) Conclusions: This is the first study to explore whether several EWS accurately identify the risk of ICU admissions and mortality, at different time points, in patients with acute neurological disorders. Every score analyzed obtained good results, but it is suggested that the use of RAPS, MEWS, and MREMS should be preferred in the acute setting, for patients with neurological impairment.

Impact of physical exercise in advanced-stage cancer patients: Systematic review and meta-analysis.

Health professionals predict that the number of people who will suffer and die from oncological diseases will continue to increase. It is vitally important to provide comprehensive care to these patients and prescribe physical exercise programs as adjuvant therapy. The objective of this systematic review was to determine the impact of physical exercise on advanced-stage cancer patients. A literature search was performed in eight different databases. This search focused on randomized controlled trials (RCTs) published during the last 10 years. To assess the methodological quality of the sample of 15 RCTs finally obtained, the PEDro scale was used. Aerobic and strength training methods were used. The combination of both aerobic and strength training methods was the most frequently reported. Likewise, different physical and psychological variables were recorded, from which improvements were seen in fatigue, independence, quality of life and sleep, among others. The participation in physical exercise programs by advanced-stage cancer patients has a positive impact on health. Providing these programs serves as adjuvant therapy, facilitating the comprehensive care of patients. Similarly, aerobic, strength or mixed training programs increase the muscle mass of patients and therefore reduce hypotonia, the main side effect during the advanced-stages of cancer.

Development and semantic validation of an instrument for the assessment of knowledge and attitudes towards cardiopulmonary resuscitation in adolescents / Desarrollo y validación semántica de un instrumento para la evaluación en adolescentes de los conocimientos y actitudes hacia la Resucitación cardiopulmonar / Desenvolvimento e validação semântica de um instrumento para a avaliação em adolescentes dos conhecimentos e atitudes para a Ressuscitação cardiopulmonar

Objective. Develop and semantically validate an instrument to assess the knowledge and attitudes of adolescents towards cardiopulmonary resuscitation (CPR)..Methods. Validation study of an instrument to evaluate the knowledge and attitudes of adolescents towards CPR, developed in three phases: (i) development of the evaluation instruments by the authors; (ii) content validation performed by 14 expert judges in the area using the content validity index for analysis; and (iii) semantic validation carried out with the participation of 30 adolescents between 11 and 13 years old. Results. In the content validation, the questions on CPR knowledge obtained a content validity index (CVI) between 0.92 and 1.00, with a general index of 0.98; and the questions about attitudes obtained an IVC between 0.85 and 1.00, with a general index also of 0.98. Regarding semantic validation, three questions were modified in the knowledge assessment instruments and five in the attitude assessment instrument. Conclusion. Semantic and content validation of the instruments studied showed that they are suitable for assessing the knowledge and attitudes of adolescents related to CPR, so their use is recommended in the evaluation of training actions in this population group.

Objetivo. Desarrollar y validar semánticamente un instrumento para evaluar los conocimientos y las actitudes de adolescentes hacia la resucitación cardiopulmonar (RCP). Métodos. Estudio de validación de un instrumento para evaluar los conocimientos y las actitudes de adolescentes hacia la RCP que se desarrolló en tres fases: (i) desarrollo de los instrumentos de evaluación por parte de los autores; (ii) validación de contenido realizada por 14 jueces expertos en el área utilizando el índice de validez de contenido para el análisis; y (iii) validación semántica realizada con la participación de 30 adolescentes, entre los 11 y 13 años. Resultados. En la validación de contenido, las preguntas sobre conocimientos de RCP obtuvieron un índice de validez de contenido (IVC) entre 0.92 y 1.00, con índice general de 0.98; y las preguntas sobre actitudes obtuvieron un IVC entre 0.85 a 1.00, con un índice general también de 0.98. En cuanto a la validación semántica, se modificaron tres preguntas en los instrumentos de evaluación de conocimientos y cinco en el instrumento de evaluación de actitudes. Conclusión. La validación semántica y de contenido de los instrumentos estudiados mostraron que son adecuados para la valoración de conocimientos y actitudes de los adolescentes relacionados con la RCP, por lo que se recomienda su uso en la evaluación de acciones formativas en este grupo poblacional.

Objetivo. Desenvolver e validar semanticamente um instrumento para avaliar os conhecimentos e as atitudes de adolescentes para a ressuscitação cardiopulmonar (RCP). Métodos. Estudo de validação de um instrumento para avaliar os conhecimentos e as atitudes de adolescentes para a RCP que se desenvolveu em três fases: (i) desenvolvimento dos instrumentos de avaliação por parte dos autores; (ii) validação de conteúdo realizada por 14 juízes especialistas na área utilizando o índice de validez de conteúdo para a análise; e (iii) validação semântica realizada com a participação de 30 adolescentes de entre 11 e 13 anos. Resultados. Na validação de conteúdo, as perguntas sobre conhecimentos de RCP obtiveram um índice de validez de conteúdo (IVC) entre 0.92 e 1.00, com índice geral de 0.98; e as perguntas sobre atitudes obtiveram um IVC entre 0.85 a 1.00, com um índice geral também de 0.98. Enquanto à validação semântica, se modificaram três perguntas nos instrumentos de avaliação de conhecimentos e cinco no instrumento de avaliação de atitudes. Conclusão. A validação semântica e de conteúdo dos instrumentos estudados mostraram que são adequados para a valoração de conhecimentos e atitudes dos adolescentes relacionados com a RCP, por isso se recomenda seu uso na avaliação de ações formativas neste grupo populacional.

Reliability and Validity of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) in Persons with Arterial Hypertension.

OBJECTIVE: To evaluate the reliability and validity of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) in persons with arterial hypertension undergoing pharmacological treatment, along with its convergent validity with degree of control of blood pressure levels, therapeutic adherence, and tolerability of antihypertensive drugs. METHODS: Observational cross-sectional study conducted on a sample of 484 persons. Treatment satisfaction was evaluated with the SATMED-Q, an instrument consisting of 17 items with six dimensions. Other variables were blood pressure, antihypertensive drugs, adverse effects, therapeutic adherence, and participants' characteristics. RESULTS: Cronbach's alpha was 0.916. Factor analysis revealed six factors that could account for 89.97% of total variance. The test-retest reliability analysis yielded an intraclass correlation coefficient of 0.910 (95% CI = 0.806-0.959). In a possible range of 0 through 100 points, participant satisfaction with treatment ranged from 38.2 to 100 (mean 79.9 (SD = 12.9; 95% CI = 78.8-81.0); median 80.9). SATMED-Q scores were higher among persons who reported experiencing no adverse effects (82.5 ± 11.6 SD vs. 68.7 ± 11.9 SD; p < 0.001). Satisfaction levels were significantly lower among subjects not complying with the treatment (73.2 ± 12.9 vs. 82.1 ± 12.1; p < 0.001), and significantly higher among those presenting with controlled blood pressure levels (82.1 ± 12.1 SD vs. 77.5 ± 13.3 SD; p < 0.001). CONCLUSIONS: The SATMED-Q showed high internal consistency and good stability in the reliability analysis. It is an appropriate instrument for evaluating satisfaction with antihypertensive treatment, both in routine clinical practice and in community pharmacy or clinical research settings.

Parental Perception of Weight and Feeding Practices in SchoolChildren: A Cross-Sectional Study.

Childhood obesity has become a public health problem. Parents play an important role in the transmission of feeding habits and the detection of their child's weight status. The aim was to analyse the prevalence of overweight/obesity and to determine the relationship between children's weight status, different feeding practices and weight misperception. A cross-sectional study was conducted in randomly selected schools. The children's weight status was measured, and a questionnaire was used to identify the feeding practices applied by parents and their perception of their children's weight. The sample comprised 127 children aged 4 and 5 years and 189 aged 10 and 11. Differences were observed between parental feeding practices and weight status, monitoring being the most used practice. Parents use less pressure to eat and more restriction if their children have overweight or obesity. Misperception of weight was 39.6%, being higher in overweight children, who were perceived as normal weight in 53.19%. Children classified as obese were perceived as overweight in 88.23%. The use of inappropriate eating practices shows a need for health education in parents according to weight status. In addition, the parents' perception should be improved to increase early detection of overweight and start actions or seek professional help.

Analysis of compliance of the criteria recommended by the European resucitation council in first aid books published in Spanish.

AIMS: Analyse the compliance of criteria recommended by the European Resuscitation Council (ERC) in the layperson First Aid (FA) and Cardiopulmonary resuscitation (CPR) books published in Spanish. METHODS: A review of FA literature published in Spain, carried out through a systematic literature search procedure. We drew up a checklist with clarifications, based on different responses to twenty categories published in November 2015 by the ERC. The validity of the questions was analysed using the Fleiss' Kappa measure of inter-rater reliability, with a value >0.7 being deemed valid and questions displaying the lowest level of agreement being excluded. RESULTS: Eight texts obtained from the limited search of materials published between 2016-2020 in the ISBN 13 database were analysed. Evaluation of eight texts ranging from 47 to 328 pages in length showed that only three included the upgraded 2015 CPR recommendations. Twenty categories/items were analysed, after exclusion of categories/items that displayed a low consistency. None of the handbooks was in total compliance with the new CPR recommendations, and only one included 70% of the recommendations. Seven categories were included in more than 50% of the texts, and nine categories were not included in any of them. CONCLUSIONS: There is a gap between the 2015 CPR recommendations and those published in Spanish FA handbooks. The ERC Guidelines should serve to standardise FA and CPR training materials. Systematic analysis of compliance with scientific societies' recommendations for FA handbooks enables detection of guidelines and patterns that need to be updated and adapted.

Eficacy of Cryotherapy in the Prevention of Oral Mucosistis in Adult Patients with Chemotherapy.

Oral mucositis (OM) is a common side effect of cancer therapies. It causes ulcerative, painful lesions in the oral cavity that can provoke malnutrition, increased risk of infection, longer hospital stays, and seriously affect the quality of life. Cooling the mucosa with oral cryotherapy (OC) during and/or after chemotherapy is the most accessible and tolerable intervention available. The aim of this study is to define the efficacy of OC for preventing OM induced by chemotherapy/radiotherapy in adult patients with cancer. Secondary endpoints include associated problems as pain. A systematic search was performed using the Pubmed, WOS (Web of Science), Cochrane Library, CINAHL, and BVS databases for articles published up to 2010. After inclusion and exclusion criteria were applied, a total of eight articles were analyzed in this review. In seven of the eight articles, the incidence of OM of all grades was significantly lower in the OC group compared with the no-OC group. Use of opioids and level of pain were also significantly reduced. OC is an effective intervention to reduce the incidence of OM induced by chemotherapy as well as the associated severity and pain. Based on these results, OC with only water or with chamomile, associated or not with other mouthwash therapies, is an effective intervention to reduce the incidence of OM induced by chemotherapy as well as the associated severity and pain.

Prevalence of Overweight and Obesity among Health Sciences Students in the Amazonia Region of Peru.

A cross-sectional study was conducted to evaluate 199 health sciences students in the city of Iquitos. Their socio-demographic characteristics, lifestyle, level of physical activity, type of food, substance abuse, and prevalence of overweight and obesity were ascertained using purpose-validated questionnaires, i.e., the Systematic Alcohol Consumption Interview (Interrogatorio Sistematizado de Consumos Alcohólicos/ISCA), a questionnaire on the frequency of dietary intake (CFCA), the International Physical Activity Questionnaire (IPAQ), and anthropometric measurements. The prevalence of overweight (body mass index (BMI) of 25.0-29.9 kg/m2) was 26.5% (95% CI = 19.9-33.0%) and that of obesity (BMI ≥ 30.0 kg/m2) was 7.9% (95% CI = 3.8-12.1%). A total of 34.4% of students (95% CI = 27.4-41.4%) presented with a BMI > 25 kg/m2. The frequency of overweight was significantly higher in persons aged over 20 years (OR = 2.5) and smokers (OR = 3.2), and the frequency of obesity was significantly higher in older students (OR = 4.1) and males (OR = 5.5). In conclusion, a considerable proportion of health sciences students in the Amazonia region presented with a high BMI. The proportion of students with overweight was higher among students aged over 20 years and smokers, while that of obesity was also higher among males. In the university setting, the development of more overweight- and obesity-preventive activities and educational interventions would therefore be desirable.

Physical Activity Programs during Pregnancy Are Effective for the Control of Gestational Diabetes Mellitus.

Gestational diabetes mellitus has an incidence of 14% worldwide and nursing is responsible for its monitoring during pregnancy. Excessive weight gain during pregnancy is directly related to gestational diabetes mellitus development. Gestational diabetes mellitus (GDM) has negative repercussions on the evolution of the pregnancy and the fetus. The objective of this systematic review is to establish how physical activity influences pregnant women with gestational diabetes mellitus and to analyze what benefits physical activity has in the control of gestational diabetes mellitus. A systematic search was carried out in different databases (Cochrane, Superior Council of Scientific Investigations (CSIC), EBSCOhost, Pubmed, Scopus, Web os Science, and Proquest) for papers published within the last 12 years, taking into account different inclusion and exclusion criteria. Six randomized controlled studies and one observational case-control study of a high quality were selected. Fasting, postprandial glucose and HbcA1 were assessed, as well as the requirement and amount of insulin used. Thus, there is a positive relationship between the performance of physical activity and the control of gestational diabetes mellitus. Resistance, aerobic exercise, or a combination of both are effective for the control of glucose, HbcA1, and insulin. Due to the variability of the exercises of the analyzed studies and the variability of the shape of the different pregnant women, it does not permit the recommendation of a particular type of exercise. However, any type of physical activity of sufficient intensity and duration can have benefits for pregnant women with GDM. Pregnant women with gestational diabetes mellitus should exercise for at least 20-50 min a minimum of 2 times a week with at a least moderate intensity.

Eficacia de una estrategia combinada para mejorar el control del colesterol unido a lipoproteínas de baja densidad en pacientes con hipercolesterolemia. Ensayo clínico aleatorizado / Efficacy of a combined strategy to improve low-density lipoprotein cholesterol control among patients with hypercholesterolemia: a randomized clinical trial

Introducción y objetivos: Intervenciones diferentes pueden mejorar el control del colesterol unido a lipoproteínas de baja densidad (cLDL). El objetivo principal era evaluar la eficacia de una intervención combinada para mejorar el control del cLDL de pacientes con hipercolesterolemia. También se evaluó su eficacia para mejorar el cumplimiento (farmacológico, dieta y ejercicio). Métodos: Ensayo clínico aleatorizado, de grupos paralelos y multicéntrico (atención primaria) que incluyó a 358 adultos diagnosticados de hipercolesterolemia con tratamiento previo farmacológico o no. Se comparó a 178 sujetos que recibieron intervención combinada (material escrito, tarjetas autocumplimentadas y mensajes al móvil) frente a 178 controles. La variable principal de resultado fue la proporción de sujetos con adecuado control del cLDL (valores recomendados en las guías europeas de dislipemias y riesgo cardiovascular) a los 24 meses. Resultados: El grupo de intervención mostró una reducción media del cLDL significativamente superior a los 24 meses respecto al control, 23,8 mg/dl (IC95%, 17,5-30,1) y 14,6 mg/dl (IC95%, 8,9-20,4), respectivamente (p = 0,034). El promedio de la reducción del cLDL fue del 13,1 ± 28,6%. La proporción de sujetos con adecuado control al año fue significativamente superior en el grupo de intervención (43,7 frente a 30,1%; p = 0,011; RR = 1,46). En el grupo de intervención, el cumplimiento farmacológico fue significativamente superior (77,2 frente a 64,1%; p = 0,029) y de la práctica de ejercicio (64,9 frente a 35,8%; p < 0,001), aunque no de la dieta. Conclusiones: La intervención combinada consigue una reducción significativa de las cifras de cLDL (superior al 13% al cabo de 2 años) y mejora el grado de control de pacientes con hipercolesterolemia al año (AU)

Introduction and objectives: Several interventions can improve low-density lipoprotein cholesterol (LDL-C) control. Our main objective was to evaluate the efficacy of a combined intervention to improve LDL-C control in patients with hypercholesterolemia. The study also assessed the efficacy of the intervention in improving adherence (pharmacological, diet, and exercise). Methods: A multicenter, parallel group, randomized clinical trial (primary care) was conducted in 358 adults diagnosed with hypercholesterolemia, whether receiving prior drug therapy or not. We compared 178 participants who received the combined intervention (written material, self-completed registration cards, and messages to mobile telephones) with 178 controls. The main outcome variable was the proportion of participants with adequate LDL-C control (target levels of the European guidelines on dyslipidemia and cardiovascular risk) at 24 months. Results: At 24 months, the mean reduction in LDL-C was significantly higher in the intervention group (23.8 mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6 mg/dL [95%CI, 8.9-20.4]; P = .034). The mean LDL-C decrease was 13.1% ± 28.6%. At 1 year, the proportion of participants with adequate control was significantly higher in the intervention group than in the control group (43.7% vs 30.1%; P = .011; RR, 1.46). Adherence was significantly higher in the intervention group, both to drug therapy (77.2% vs 64.1%; P = .029) and exercise (64.9% vs 35.8; P < .001), but not to diet. Conclusions: The combined intervention significantly reduced LDL-C (by more than 13% at 2 years) and improved the degree of LDL-C control in patients with hypercholesterolemia at 1 year (AU)

Efficacy of a Combined Strategy to Improve Low-density Lipoprotein Cholesterol Control Among Patients With Hypercholesterolemia: A Randomized Clinical Trial.

INTRODUCTION AND OBJECTIVES: Several interventions can improve low-density lipoprotein cholesterol (LDL-C) control. Our main objective was to evaluate the efficacy of a combined intervention to improve LDL-C control in patients with hypercholesterolemia. The study also assessed the efficacy of the intervention in improving adherence (pharmacological, diet, and exercise). METHODS: A multicenter, parallel group, randomized clinical trial (primary care) was conducted in 358 adults diagnosed with hypercholesterolemia, whether receiving prior drug therapy or not. We compared 178 participants who received the combined intervention (written material, self-completed registration cards, and messages to mobile telephones) with 178 controls. The main outcome variable was the proportion of participants with adequate LDL-C control (target levels of the European guidelines on dyslipidemia and cardiovascular risk) at 24 months. RESULTS: At 24 months, the mean reduction in LDL-C was significantly higher in the intervention group (23.8mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6mg/dL [95%CI, 8.9-20.4]; P=.034). The mean LDL-C decrease was 13.1%±28.6%. At 1 year, the proportion of participants with adequate control was significantly higher in the intervention group than in the control group (43.7% vs 30.1%; P=.011; RR, 1.46). Adherence was significantly higher in the intervention group, both to drug therapy (77.2% vs 64.1%; P=.029) and exercise (64.9% vs 35.8; P<.001), but not to diet. CONCLUSIONS: The combined intervention significantly reduced LDL-C (by more than 13% at 2 years) and improved the degree of LDL-C control in patients with hypercholesterolemia at 1 year.

Alimentación saludable y autopercepción de salud / Healthy eating and self-perception of health

OBJETIVO: Determinar si en mayores de 50 años existe asociación entre el estado de salud percibido, una alimentación saludable y otros estilos de vida. DISEÑO: Estudio observacional transversal. Emplazamiento: Ocho zonas básicas de salud del área sanitaria de Albacete. PARTICIPANTES: Un total de 781 sujetos, de 50 a 74 años, seleccionados mediante muestreo simple aleatorio. MEDICIONES PRINCIPALES: Variables: autopercepción de salud (cuestionario EuroQol-5D), hábitos alimentarios (cuestionario sobre frecuencia de consumo de alimentos), actividad física (cuestionario IPAQ), hábitos tóxicos, problemas de salud (clasificación internacional de atención primaria) y características sociodemográficas. RESULTADOS: La edad media fue de 61,4 años (DE: 6,6) y la proporción de mujeres, del 60,1%. En una escala de 0-100 la puntuación media en el estado de salud percibido fue de 74,0 (DE: 15,2). Dicha puntuación presentó una débil correlación con el número de criterios de alimentación saludable (r = 0,078; p = 0,03). Se observó una tendencia lineal (p = 0,001) entre intensidad de ejercicio físico y mejor autopercepción de salud. En fumadores la puntuación fue inferior (DE: 70,9 ± 15,6 vs. DE: 74,9 ± 15,1; p = 0,004). Mediante regresión múltiple el número de criterios de alimentación saludable mantuvo una asociación con la puntuación en el estado de salud percibido (p = 0,04), una vez ajustado el modelo por características sociodemográficas, número de problemas de salud y hábitos tóxicos. CONCLUSIONES: En mayores de 50 años el nivel de salud autopercibida se asocia al cumplimiento de los criterios de una alimentación saludable, lo cual es independiente de otros hábitos de salud y de las principales variables sociodemográficas

OBJECTIVES: The aim is to determine whether there is an association between perceived health status, healthy eating and other lifestyles in people over 50 years old. DESIGN: Cross-sectional study. SETTING: 8 Basic Health Zones from the Health Area of Albacete. PARTICIPANTS: A total of 781 subjects, randomly selected by simple random sampling. MAIN MEASUREMENTS: variables: self-rated quality of life (EuroQol 5D), dietary habits (questionnaire on frequency of food consumption), physical activity (IPAQ questionnaire), toxic habits, health problems (International Classification of Primary Care) and sociodemographic characteristics. RESULTS: The mean age was 61.4 years (SD: 6.6) and the proportion of women was 60.1%. On a scale of 0-100 the mean score in the perceived health status was 74.0 (SD: 15.2). This score had a weak correlation with the number of healthy eating criteria (r = 0.078; P = .03). A linear trend (P = .001) was observed between exercise intensity and better self-rated health. The score was lower in smokers (70.9 ± 15.6 vs 74.9 ± 15.1 SD; P = .004). In the multiple regression, the number of healthy eating criteria remained an association with the score on perceived health status (P = .04), after adjusting the model for sociodemographic characteristics, number of health problems, and toxic habits. CONCLUSIONS: In people over 50 years of age the level of self-rated health is associated with the fulfilment of the criteria of a healthy diet, which is independent of other health habits and main sociodemographic variables

Muscular fitness as a mediator of quality cardiopulmonary resuscitation.

BACKGROUND: It has been hypothesized that body mass index (BMI) and muscle strength (MS) of the rescuers are predictors of adequate external chest compressions (ECC). The aims of this study were: (a) to analyze, in college students, the relationship between BMI and MS with adequate ECC parameters; and (b) to examine whether the association between BMI and adequate ECC parameters is mediated by MS. METHODS: A cross-sectional analysis of the evaluation of a CPR performance test involving students (n=63). We determined BMI and MS. After previous training, participants performed cardiopulmonary resuscitation on a mannequin for 20 minutes. PROCESS macro developed by Preacher and Hayes was used to assess whether the association between BMI and ECC was mediated by MS. RESULTS: Underweight subjects achieved lower results than those with normal weight and overweight/obese in several dependent variables including: correct compression depth (P<.001) and adequate ECC (P<.001). This differences remained after adjusting for muscle strength except for the compression rate (P=.053). Moreover, participants in the low MS quartile were lower in both correct compression depth (P=.001) and adequate ECC (P<.001) than participants in the medium/high quartile after adjusting for confounding variables. The effect of BMI on adequate ECC was partially mediated by MS. Similar results were obtained in the analysis of the mediator role of MS in the relationship between BMI and correct compression depth. CONCLUSIONS: The ability to provide adequate ECC is influenced by the rescuer's MS. Rescuers should be advised to exercise arm strength to improve the quality of CPR.

Effectiveness of three interventions to improve participation in colorectal cancer screening

Background and objective: Participation in colorectal cancer (CRC) screening varies widely among different countries and different socio-demographic groups. Our objective was to assess the effectiveness of three primary-care interventions to increase CRC screening participation among persons over the age of 50 years and to identify the health and socio-demographic-related factors that determine greater participation. Methods: We conducted a randomized experimental study with only one post-test control group. A total of 1,690 subjects were randomly distributed into four groups: written briefing; telephone briefing; an invitation to attend a group meeting; and no briefing. Subjects were evaluated 2 years post-intervention, with the outcome variable being participation in CRC screening. Results: A total of 1,129 subjects were interviewed. Within the groups, homogeneity was tested in terms of socio-demographic characteristics and health-related variables. The proportion of subjects who participated in screening was: 15.4% in the written nformation group (95% confidence interval [CI]: 11.2-19.7); 28.8% in the telephone information group (95% CI: 23.6-33.9); 8.1% in the face-to-face information group (95% CI: 4.5-11.7); and 5.9% in the control group (95% CI: 2.9-9.0), with this difference proving statistically significant (p < 0.001). Logistic regression showed that only interventions based on written or telephone briefing were effective. Apart from type of intervention, number of reported health problems and place of residence remained in the regression model. Conclusions: Both written and telephone information can serve to improve participation in CRC screening. This preventive activity could be optimized by means of simple interventions coming within the scope of primary health-care professionals (AU)

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Effectiveness of three interventions to improve participation in colorectal cancer screening.

BACKGROUND AND OBJECTIVE: Participation in colorectal cancer (CRC) screening varies widely among different countries and different socio-demographic groups. Our objective was to assess the effectiveness of three primary-care interventions to increase CRC screening participation among persons over the age of 50 years and to identify the health and socio-demographic-related factors that determine greater participation. METHODS: We conducted a randomized experimental study with only one post-test control group. A total of 1,690 subjects were randomly distributed into four groups: written briefing; telephone briefing; an invitation to attend a group meeting; and no briefing. Subjects were evaluated 2 years post-intervention, with the outcome variable being participation in CRC screening. RESULTS: A total of 1,129 subjects were interviewed. Within the groups, homogeneity was tested in terms of socio-demographic characteristics and health-related variables. The proportion of subjects who participated in screening was: 15.4% in the written information group (95% confidence interval [CI]: 11.2-19.7); 28.8% in the telephone information group (95% CI: 23.6-33.9); 8.1% in the face-to-face information group (95% CI: 4.5-11.7); and 5.9% in the control group (95% CI: 2.9-9.0), with this difference proving statistically significant (p < 0.001). Logistic regression showed that only interventions based on written or telephone briefing were effective. Apart from type of intervention, number of reported health problems and place of residence remained in the regression model. CONCLUSIONS: Both written and telephone information can serve to improve participation in CRC screening. This preventive activity could be optimized by means of simple interventions coming within the scope of primary health-care professionals.