Health and health inequalities impact assessment for non-clinical measures to control COVID-19 in the Basque Country and Navarre (Spain).

This article describes the results of a health and health inequalities impact assessment of the COVID-19 pandemic control measures in the regions of the Basque Country and Navarre in Spain. A literature review was conducted on Pubmed and Web of Science (WoS) databases, in addition to individual semi-structured interviews and focus groups with experts, key informants and different profiles of citizens. A wide variety of social determinants of health have been affected by the measures, which included individual health-related behaviors, service disruption in formal care, educational settings, and health care provision. These changes have particularly affected certain population groups including children and adolescents, older people, those with health conditions and disabilities together with caregivers, women, as well as people with low levels of education, income, and resources. In future scenarios it will be necessary to pay attention to the potential impacts of policy responses on health inequalities to avoid an increase in existing health gaps.

Anthocyanin Biosynthesis and DNA Methylation Dynamics in Sweet Orange Fruit [Citrus sinensis L. (Osbeck)] under Cold Stress.

The blood red color of pigmented orange fruit varieties [Citrus sinensis L. (Osbeck)] is due to the presence of anthocyanin pigments that largely contribute to determine the high organoleptic qualities and the nutritional properties of the fruits. The content of pigments in sweet orange depends primarily on genetic factors and on environmental conditions. In particular, it has been extensively shown that cold temperature induces an increase of anthocyanin content that is achieved by the induction of the related gene expression. The purpose of our work is to understand the mechanism underlying the color variegation occurring inside the blood oranges during the cold induction of anthocyanin biosynthesis, despite the fact that the entire fruit is genotypically programmed to produce pigments. Therefore, the amount of anthocyanin and the expression of both structural and regulatory genes have been monitored in either high-pigmented (HP) or not/low pigmented (NP) segments of the same fruit during the storage at 4 °C for a total experimental period of 25 days. Our results clearly indicate that the anthocyanin content is directly correlated with the levels of gene transcription, with higher pigmented areas showing higher enhancement of gene expression. Furthermore, we analyzed the reshaping of the DNA methylation status at the promoter regions of genes related to anthocyanin biosynthetic pathway, such as DFR and Ruby. Our results unequivocally demonstrate that in the promoter regions of both DFR and Ruby, the amount of cytosine methylation strongly decreases along the cold storage in the HP areas, whereas it increases in the NP areas of the same fruit, probably causing a partial block of the gene transcription. Finally, by measuring the changes in the expression levels of the Citrus DNA demethylases, we found that DML1 might play a crucial role in determining the observed demethylation of DFR and Ruby promoters, with its expression induced by cold in the HP areas of the fruits. This is the first report in which different levels of gene expression implicated in anthocyanin production in blood orange fruit is correlated with an epigenetic control mechanism such as promoter methylation.

Motivación educativa en la formación inicial del profesorado de educación física / Academic motivation in the initial training of physical education teachers

La regulación integrada se ha mostrado como la regulación motivacional con mayor poder predictivo sobre las conductas adaptativas en diferentes ámbitos de la vida, sin embargo, aún no ha sido estudiada en el contexto educativo. El objetivo de este estudio fue incorporar la medida de la regulación integrada a la Escala de Motivación Educativa y observar las propiedades psicométricas de este instrumento. Participaron en el estudio 333 universitarios del área de Educación Física de la Universidad Federal do Espirito Santo/ Brasil. El análisis factorial confirmatorio mostró índices de ajuste aceptables para el modelo de ocho factores correlacionados. Los resultados del análisis de regresión mostraron que la regulación integrada fue la variable que mejor predijo la intención de ser profesor. Este instrumento podría contribuir a una mayor comprensión de los procesos motivacionales involucrados en el ámbito de la formación inicial en Educación Física en Brasil

Integrated regulation has been showed as the motivational regulation with the highest predictive power on adaptive behaviours in different life domains; however, it has not been examined in the educational context yet. The purpose of this study was to incorporate the assessment of integrated regulation to the Academic Motivation Scale in the initial training of Physical Education teachers in Brazil and examine the psychometric properties of this instrument. There were 333 undergraduate participants from the bachelor degree of Physical Education, Federal University of Espirito Santo/ Brazil. Confirmatory factor analysis showed acceptable fit indices for the eight-factor correlated structure. The results of the regression analysis showed that the variable integrated regulation was the strongest predictor of the intention to become a teacher. This new instrument may contribute to a deeper understanding of the motivational processes involved in the initial training of Physical Education teacher

La necesidad de medir la motivación situacional en el contexto español de la educación física: Psicometría de la Situational Motivation Scale / The need to measure situational motivation in the Spanish Physical Education context: Psychometry of the Situational Motivation Scale / A neccesidade de medir a motivação situacional no contexto espanhol da educação física: Psicometria Situacional Motivacion Scale

El objetivo primario de este trabajo fue comparar la estructura factorial de las diversas versiones propuestas (SIMS-16, SIMS-15, SIMS-14 y SIMS-13), así como de explorar la posible sostenibilidad de una nueva estructura para la Situational Motivation Scale (SIMS) en el contexto español de la Educación Física. El objetivo secundario fue aportar evidencias que respalden la invariancia factorial, consistencia interna y validez externa de la mejor estructura factorial identificada. Participaron 644 estudiantes (344 hombres y 300 mujeres; Medad = 15,04, DT = 1,58) de educación secundaria obligatoria y bachillerato en clase de EF. El análisis factorial confirmatorio no respaldó psicométricamente las diferentes versiones (SIMS-16, SIMS-15, SIMS-14 y SIMS-13) identificadas por la investigación previa para la SIMS. No obstante, los hallazgos sustentaron psicométricamente un modelo factorial de cuatro factores correlacionados y 12 ítems, que permaneció invariante respecto al género y nivel educativo. El análisis correlacional apoyó la validez discriminante del instrumento y, a su vez, respaldó el continuum de auto-determinación. El análisis de consistencia interna reflejó adecuados valores para cada factor. Los resultados del modelo de ecuaciones estructurales respaldaron los asertos del Modelo Jerárquico de Motivación Intrínseca/ Extrínseca. Como conclusión, se recomienda la utilización de una nueva estructura factorial para la Situational Motivation Scale (modelo de cuatro factores correlacionados y 12 ítems) para el alumnado de EF de secundaria obligatoria y bachillerato en el contexto español

Based on Self-Determination Theory, the primary objective of this work was to compare the factor structure of the different versions proposed (SIMS-16, SIMS-15, SIMS-14 and SIMS-13), as well as to explore the possible sustainability of a new structure for the Situational Motivation Scale (SIMS) in the Spanish Physical Education context. The secondary objective was to provide evidences supporting measurement invariance, internal consistency and external validity for the best factor structure identified. A total of 644 Physical Education Post- Compulsory and Compulsory Secondary Education students (344 men y 300 women; Mage = 15.04, SDage = 1.58) participated. The confirmatory factor analyses did not support psychometrically the different versions (SIMS-16, SIMS-15, SIMS-14 y SIMS-13) found by the previous research for the SIMS. Nevertheless, the findings sustained psychometrically a 12-item 4-factor correlated model, which was invariant across gender and educational level. The correlational analysis supported the instrument’s discriminant validity and, in turn, underpinned the selfdetermination continuum. The internal consistency analysis reflected suitable values for each factor. The results of structural equation model supported the tenets of the hierarchical model of intrinsic/ extrinsic motivation. In conclusion, the use of a new factor structure for the Situational Motivation Scale (12-item 4-factor correlated model) was recommended in Physical Education Post-Compulsory and Compulsory Secondary students in the Spanish context

Baseado em Teoria da Autodeterminação, o objetivo primário desse trabalho foi comparar a estrutura fatorial das diversas versões propostas (SIMS-16, SIMS-15, SIMS-14 y SIMS-13), assim como, de explorar a possível sustentabilidade de uma nova estrutura para a Situational Motivation Scale (SIMS) no contexto espanhol da Educação Física. O objetivo secundário foi buscar evidências que respaldassem a invariância fatorial, consistência interna e validade externa da melhor estrutura fatorial identificada. Participaram 644 estudantes (344 homens e 300 mulheres; Midade = 15.04, DPidade = 1.58) de educação secundária obrigatória e bachillerato em aulas de EF. A análise fatorial confirmatória respaldou psicométricamente as diferentes versões (SIMS-16, SIMS-15, SIMS-14 y SIMS-13) identificadas pela investigação prévia para a SIMS. Não obstante, as descobertas sustentaram psicométricamente um modelo fatorial de quatro fatores correlacionados e 12 itens, que permaneceram invariantes com relação ao gênero e nível educativo. A análise correlacional apoiou a validade discriminante do instrumento que, por sua vez, respaldou o continuum de auto-determinação. A análise da consistência interna apresentou adequados valores para cada fator. Os resultados do modelo de equações estruturais respaldaram a assertiva do Modelo Hierárquico de Motivação Intrínseca/ Extrínseca. Como conclusão, se recomenda a utilização de uma nova estrutura fatorial para a Situational Motivation Scale (modelo de quatro fatores correlacionados e 12 itens) nos estudantes de EF de secundária obrigatória e bachillerato no contexto espanhol

Adaptación y Validación Española de la Escala Revisada del Locus Percibido de Causalidad (PLOC-R) en Educación Física / Adaptação e Validação espanhol do Locus Percebida revisada de causalidade Scale em Educação Física / Spanish Adaptation and Validation of the Revised Perceived Locus of Causality Scale in Physical Education

La investigación ha mostrado que los elementos motivacionales presentes en las clases de educación física (EF) podrían influir en la adquisición de hábitos saludables en población adolescente. Sin embargo, las herramientas disponibles para medir la motivación desde la perspectiva de la teoría de la autodeterminación (TAD) en este ámbito en el contexto español muestran limitaciones en cuanto a sus propiedades psicométricas y contenido. El objetivo de este trabajo fue validar al contexto español la ‘Escala del Locus Percibido de Causalidad Revisada’ (PLOC-R), incorporando la medición de la regulación integrada. Un total de 444 estudiantes de educación secundaria de entre 13 y 19 años (Medad = 15,63; DT= 1,17) participaron en el estudio. El análisis factorial confirmatorio reveló índices de ajuste adecuados para el modelo de seis factores correlacionados, mostrándose éste invariante en función del sexo. El instrumento ofreció evidencias de su validez discriminante y adecuados niveles de consistencia interna y estabilidad temporal. Las formas de motivación autodeterminadas (no autodeterminadas) correlacionaron de forma positiva (negativa) con la frecuencia de práctica de actividad físico-deportiva extraescolar. A su vez, la regulación integrada fue la única forma de motivación que predijo realizar actividad físico-deportiva extraescolar. El instrumento propuesto se muestra como una herramienta válida y fable para medir la totalidad del continuo motivacional propuesto por la TAD en el ámbito de la EF (AU)

Research has shown the influence of the motivational elements involved in physical education classes in the development of healthy behaviors by adolescents. However, the available instruments to assess the quality side of motivation postulated by the self-determination theory (SDT) in this field in the Spanish context show several psychometric and content-related limitations. the aim of this study was to validate the ‘Revised Perceived Locus of Causality Scale’ (PLOC-R) in the Spanish context, adding the measurement of integrated regulation. A sample of 444 secondary school students aged between 13 and 19 (Mage= 15,63; SD= 1,17) participated in the study. Confirmatory factor analysis indicated suitable fit for the correlated 6-factor model and invariance across sex. The instrument showed good discriminant validity, internal consistency and temporal stability. In addition, the self-determined (no self-determined) forms of motivation correlated positively (negatively) with students’ physical activity frequency. Integrated regulation was the only motivational form that predicted the practice of extracurricular physical and sporting activity. Conclusions: the obtained instrument seems to be a valid and reliable tool to measure the whole motivational continuum defined by SDT in physical education classes in the Spanish context (AU)

A investigação mostrou que os elementos motivacionais presentes nas aulas de Educação Física (EF) poderiam influenciar na aquisição de hábitos saudáveis no público adolescente. Entretanto, as ferramentas disponíveis para medir a motivação, a partir da perspectiva da teoria da autodeterminação (TAD) no contexto Espanhol, mostram numerosas limitações psicométricas y de conteúdo. O objetivo desse trabalho foi validar ao contexto espanhol a ‘Escala do Lócus Percebido de Causalidade Revisada’ (PLOC-R), incorporando a medição da regulação integrada. Um total de 444 estudantes de Educação Básica, do segundo ciclo, entre 13 e 19 anos (Medad= 15,63; DT= 1,17) participaram desse estudo. A análise fatorial confirmatória revelou índices de ajuste adequados para o modelo de seis fatores correlacionados, mostrando-seinvariante em função do sexo. O instrumento apresentou evidências de validez discriminante e níveis adequados de consistência interna e estabilidade temporal. As formas de motivação autodeterminadas (não autodeterminadas) correlacionaram de forma positiva (negativa) com a frequência de prática de atividade físico-esportiva extraescolar. Por sua vez, a regulação integrada foi a única que predisse a atividade físico-esportiva extraescolar. O instrumento obtido apresenta-se como uma ferramenta válida e fiável para medir a totalidade do contínuo motivacional proposto pela TAD no âmbito da EF (AU)

Predicting healthy and unhealthy behaviors through physical education: A self-determination theory-based longitudinal approach.

The aim of this study was to evaluate the relations between three dimensions of the structured teaching environment (promotion of theoretical knowledge, physical learning, and health improvement) in physical education (PE) and the adoption of health-related behaviors by students. The study adopted a two-occasion longitudinal design based on self-determination theory (SDT). PE students (N = 654, mean age = 16.13, SD = .77) completed measures of perceived structured teaching environment, satisfaction of basic psychological needs and motivation for PE, and healthy (physical activity, sport participation, and healthy eating) and unhealthy (consumption of tobacco, alcohol, and drugs) behaviors at the beginning and end of the first year of post-compulsory secondary education. Path analysis of the proposed relations among variables supported SDT tenets and showed positive relations between the three dimensions of the structured teaching environment, the satisfaction of basic psychological needs, and autonomous motivation in PE. Autonomous motivation contributed to an explanation of variance in two healthy behaviors, physical activity and sport participation. However, no relation was found among motivation in PE, healthy eating, and consumption of tobacco, alcohol, and drugs. These results show negligible trans-contextual influence of SDT motivational factors in PE on other healthy behaviors beyond physical activity.

Analisis de la prescripción farmacológica en pacientes institucionalizados / Analysis of the medical prescription in institutionalised patients

Objetivos. Valorar la concordancia terapéutica de fármacos prescritos con sus diagnósticos en pacientes institucionalizados en 2 periodos de tiempo, así como las características de esta prescripción. Material y métodos. Estudio observacional, descriptivo y cuasiexperimental. Se analiza la prescripción y diagnósticos clínicos de pacientes institucionalizados y al cuidado de un mismo profesional médico en 2 periodos de tiempo y con un intervalo de un año (2010-2011), ofreciendo en ese intervalo información sobre la prescripción. Resultados. Se estudió a 81 pacientes (78% mujeres), con edad media de 84 ± 7 años y con 5 ± 2 diagnósticos por paciente. El número de fármacos distintos por paciente fue más de 8 en los 2 periodos, siendo superior en el 2011 frente al 2010. De todos los fármacos prescritos, nos encontramos que en el año 2010 el 8,88% y en el 2011 el 9,38% están incluidos en el grupo de fármacos de utilidad terapéutica baja. En el año 2010 se aprecia una concordancia del 86,71 ± 13,75 frente a 87,17 ± 14,58 en el año 2011, es decir, el 87% de los pacientes tienen fármacos acordes a sus diagnósticos, lo que supone una mejora del 0,47 de un periodo con respecto al otro. No existen diferencias estadísticamente significativas entre ambos años. Conclusiones. La prescripción en pacientes institucionalizados es muy elevada y el número de fármacos por paciente aumentó tras la información. Cuando analizamos los fármacos prescritos destaca un alto porcentaje de medicamentos incluidos en el grupo de utilidad terapéutica baja (citicolina). Un porcentaje significativo de prescripciones no se corresponden con los diagnósticos presentes en su historia clínica (AU)

Objectives. To evaluate/assess the therapeutic concordance/agreement with prescribed medication in patients institutionalized diagnoses in two periods of time as well as the characteristics of this prescription. Material and methods. Observational and descriptive study. Prescribing and clinical diagnoses of institutionalized patients were analyzed. These patients were treated by the same physicians during the period of time with a one-year interval (2010-2011), offering prescribing information in this period. Results. A total of 81 patients (78% women), mean age 84 ± 7 years, and 5 ± 2 diagnoses per patient. The number of drugs per patient was more than 8 in the 2 periods, being higher in 2011 compared to 2010. From all the prescription, we found that 8.88% in 2010 and 9.3% in 2011 are included as “limited clinical value” drugs. In 2010, it sees a concordance of 86.71 ± 13.75 against 87.17 ± 14.58 in 2011, it means, 87% of patients are treated with drugs in agreement with their diagnoses, representing an increase of 0.47 in 2011 regarding 2010. No statistically significant differences between the 2 years. Conclusions. The prescriptions in institutionalized patients are very high and the number of drugs per patient increased after information. When we analyzed prescriptions we underline a high percentage of drugs included in the group of limited clinical value (citicoline). A significant percentage of prescriptions don’t correspond with diagnoses avaiable in their clinical history (AU)

[Analysis of the medical prescription in institutionalised patients]. / Analisis de la prescripción farmacológica en pacientes institucionalizados.

OBJECTIVES: To evaluate/assess the therapeutic concordance/agreement with prescribed medication in patients institutionalized diagnoses in two periods of time as well as the characteristics of this prescription. MATERIAL AND METHODS: Observational and descriptive study. Prescribing and clinical diagnoses of institutionalized patients were analyzed. These patients were treated by the same physicians during the period of time with a one-year interval (2010-2011), offering prescribing information in this period. RESULTS: A total of 81 patients (78% women), mean age 84±7 years, and 5±2 diagnoses per patient. The number of drugs per patient was more than 8 in the 2 periods, being higher in 2011 compared to 2010. From all the prescription, we found that 8.88% in 2010 and 9.3% in 2011 are included as "limited clinical value" drugs. In 2010, it sees a concordance of 86.71±13.75 against 87.17±14.58 in 2011, it means, 87% of patients are treated with drugs in agreement with their diagnoses, representing an increase of 0.47 in 2011 regarding 2010. No statistically significant differences between the 2 years. CONCLUSIONS: The prescriptions in institutionalized patients are very high and the number of drugs per patient increased after information. When we analyzed prescriptions we underline a high percentage of drugs included in the group of limited clinical value (citicoline). A significant percentage of prescriptions don't correspond with diagnoses avaiable in their clinical history.

Evaluation of recovery and quality of sexual activity in women during postpartum in relation to the different mode of delivery: a retrospective analysis.

AIM: Aim of the study was to assess the recovery and quality of sexual activity of women during postpartum, in relation to delivery. METHODS: We recruited 200 women at 8 weeks after delivery. For each patient we recorded mode of delivery, age, body mass index (BMI), parity and test Female Sexual Function Index (FSFI) score. RESULTS: Sixty-four women (32%) had spontaneous deliveries without episiotomy, 48 (24%) had it with episiotomy, 88 (44%) had caesarean sections. The analysis of variance (ANOVA) test showed no significant differences among the 3 groups for age, BMI, parity. The test FSFI evidenced 68 cases (34%) of Regular Female Sexual Function (RFSF) and 132 (66%) of Female Sexual Dysfunction (FSD). The ANOVA test showed significant differences among the 3 groups in RFSF (F [2, 14]=8.075, P=0.005), but not in FSD (F [2, 30]=2.646, P=0.087). In RFSF, FSFI score was higher in women who had vaginal delivery with episiotomy compared with the other two groups. Conversely, in FSD (both with or without resumed sexual activity at 8 weeks postpartum) we evidenced that patients who had vaginal delivery with episiotomy showed lower FSFI score than the other two groups, with a decrease in lubrication, orgasm and satisfaction scores. Furthermore, we observed that most of the RFSF patients had a job and breastfed. CONCLUSION: Our results did not evidence a direct and significant correlation between mode of delivery and onset of female postpartum sexual dysfunction, even if FSD patients who underwent episiotomy during delivery markedly showed low FSFI scores.

Broadening the trans-contextual model of motivation: A study with Spanish adolescents.

The original trans-contextual model of motivation proposed that autonomy support from teachers develops students' autonomous motivation in physical education (PE), and that autonomous motivation is transferred from PE contexts to physical activity leisure-time contexts, and predicts attitudes, perceived behavioral control and subjective norms, and forming intentions to participate in future physical activity behavior. The purpose of this study was to test an extended trans-contextual model of motivation including autonomy support from peers and parents and basic psychological needs in a Spanish sample. School students (n = 400) aged between 12 and 18 years completed measures of perceived autonomy support from three sources, autonomous motivation and constructs from the theory of planned behavior at three different points in time and in two contexts, PE and leisure-time. A path analysis controlling for past physical activity behavior supported the main postulates of the model. Autonomous motivation in a PE context predicted autonomous motivation in a leisure-time physical activity context, perceived autonomy support from teachers predicted satisfaction of basic psychological needs in PE, and perceived autonomy support from peers and parents predicted need satisfaction in leisure-time. This study provides a cross-cultural replication of the trans-contextual model of motivation and broadens it to encompass basic psychological needs.

Estudio cualitativo de la conducta alimentaria en una población de mujeres embarazadas inmigrantes del municipio de Fuenlabrada / Qualitative trial about the nourishing habits of a population of pregnant

Introducción: Los hábitos alimentarios de la población deben seguir las pautas de alimentación saludable recomendadas por la Organización Mundial de la Salud (OMS) u otros organismos oficiales, especialmente durante el embarazo ya que estos pueden repercutir en la salud de la madre y del futuro recién nacido. Hay estudios que reflejan como el mapa alimentario de la población inmigrante puede no seguir un patrón de alimentación saludable. Objetivos: Estudiar los hábitos alimentarios de una población de mujeres embarazadas inmigrantes, para conocer sus costumbres alimentarías y su grado de adaptación a la DM en España. Material y Método: Estudio cualitativo empleando la técnica de los grupos focales o grupos de debate. Se evaluaron los hábitos alimentarios de una muestra de mujeres inmigrantes embarazadas del área de Fuen - labrada, clasificadas en grupos según la zona geográ- fica, las características culturales afines y el idioma. Se siguió un guión de debate para obtener la información sobre los hábitos alimentarios, midiendo afinidades entre los grupos y el nivel de adaptación a la dieta en España. Resultados: El comportamiento alimentario de los grupos de mujeres marroquíes y latinoamericanas es el que más se acerca al patrón de DM en España, siendo los colectivos africano y chino los más dispares. El uso del aceite de oliva es el aspecto de la DM más adoptado por los colectivos de inmigrantes en nuestro país. A su vez, las mujeres marroquíes y las de Europa del este aumentan el consumo de frutas, mientras que prácticamente todos los grupos, citando a europeas, africanas y latinas, aumentan el consumo de carne. El colectivo chino y el africano señalan la poca variedad y frescura de los alimentos españoles, en comparación con sus países de origen. Todos los grupos dan importancia a unas adecuadas pautas dietéticas durante el embarazo, tales como un mayor consumo de frutas, verduras y lácteos. En general, los platos destacados considerados españoles son la paella, lentejas y tortilla de patata, entre otros. Discusión: El proceso de adaptación cultural de la embarazada inmigrante a la alimentación en España está influenciado por varios factores, entre los que 51 Nutr. clín. diet. hosp. 2013; 33(1):51-60 Correspondencia: Ana Alfonso Sánchez-Sicilia Hospital Universitario de Fuenlabrada, Servicio de Obstetricia y Ginecología Camino del Molino nº 2, Fuenlabrada 28942, Madrid Teléfono de contacto 639839107 ana. alfonso@salud. madrid. org. destacan el contacto con la población española en la hostelería, servicio doméstico y en el comedor escolar, siendo también importante el tiempo de permanencia en el país. La adaptación a la dieta española puede ocasionar en unos colectivos un enriquecimiento en su alimentación al adoptar costumbres alimentarias beneficiosas, o bien un empobrecimiento de la dieta en otros, al no disponer de aquellos alimentos indispensables para ellos y que consumían en su país de origen. Conclusiones: Globalmente todos los colectivos tienen una buena adaptación a la dieta española, destacando mayoritariamente la inclusión del aceite de oliva en su alimentación. La adaptación mejora con el tiempo de residencia en nuestro país y se ve facilitada por el nivel de interacción con la población española (comedores escolares, hostelería, etc…). Existen diferencias en el consumo de fruta y verduras en los diferentes colectivos, en base a la disponibilidad y diversidad. Comprobamos como todos los colectivos realizan un cambio en su dieta por el hecho de estar embarazadas (AU)

Introduction: Dietary patterns of the population should comply with the healthy eating guidelines recommended by WHO, and/or other official organisms, and more strictly during pregnancy, as deficiencies before and during this stage can influence the health of the mother and the future newborn. Several studies show an immigrant dietary pattern not in accordance with healthy eating pattern. Objectives: To study the dietary habits of pregnant immigrant women in Fuenlabrada comparing them to Mediterranean diet in Spain to find out differences and the level of adaptation. Methods: Qualitative trial using the technique of focus groups or discussion groups. Dietary patterns of immigrant pregnant women population of Fuenlabrada were studied. Women were classified in groups according to similar geographic area, culture and language. A discussion script was used to obtain information about their food, finding out affinities between groups and evaluating how they have adapted to Spanish diet. Results: The most similar groups to the Spanish population in terms of food and habits are the Moroccan and Latin American, being African and Chinese groups the most disparate. The aspect of the Mediterranean Diet most adopted by all immigrant groups is the incorporation of the olive oil to their diet. Moreover, Moro - ccan and Eastern Europe women increased fruit comsuption, while virtually groups increased intake of meat, including women from Europe, África and América. China and African collectives indicates the lack of variety and freshness of Spanish food compared with their own countries. All of them highlight healthy dietary patterns during pregnancy, such as an increased consumption of fruit, vegetables and dairy products. In general, they point out as “Spanish food´´ the paella, lentils and potatoes omelet, among others. Discussion: The cultural adaptation to our country and our diet by the immigrant pregnants is influenced by several factors, highlighting the contact with the Spanish population in catering jobs, domestic service and dining facilities, being also important the staying time in Spain. The adaptation to Spanish diet may cause in one hand a diet enrichement in some collectives by incorporating beneficial dietary habits or in the other hand can cause diet depletion in other groups, because of the lack of essential foods that they consumed in their origin countries. Conclusions: In general, all collectives have a good adaptation to Spanish diet, highlighting mainly the inclusion of olive oil. The adaptation process improves with the time living in Spain and it is favoured by the level of relationship with Spanish people (school meals, catering work, etc. ) The immigrant groups have some differences in the consumption pattern of fruit and vegetables, according to the availability and diversity of these foods. We found that all the collectives change their diet as a consecuence of their preganancy situation (AU)

CB1 receptor antagonism/inverse agonism increases motor system excitability in humans.

CB1 receptor is highly expressed in cerebral structures related to motor control, such as motor cortex, basal ganglia and cerebellum. In the spinal cord, the expression of CB1 receptors has also been observed in ventral motor neurons, interneurons and primary afferents, i.e., in the cells that may be part of the circuits involved in motor control. It is known that the antagonist/inverse agonist of CB1 receptors Rimonabant penetrates the blood-brain barrier and produces a broad range of central psychoactive effects in humans. Based on the occurrence of central effects in humans treated with Rimonabant and on the location of CB1 receptors, we hypothesized that the application of Rimonabant can also affect the motor system. We tested the effects of a single dose of 20mg of Rimonabant on the excitability of motor cortex and of spinal motor neurons in order to detect a possible drug action on motor system at cortical and spinal levels. For this purpose we use classical protocols of transcranial magnetic and electrical stimulation (TMS and TES). Single and paired pulse TMS and TES were used to assess a number of parameters of cortical inhibition and cortical excitability as well as of the excitability of spinal motor neurons. We demonstrated that a single oral dose of 20mg of Rimonabant can increase motor system excitability at cortical and spinal levels. This opens new avenues to test the CB1R antagonists/inverse agonists for the treatment of a number of neurological dysfunctions in which can be useful to increase the excitability levels of motor system. Virtually all the disorders characterized by a reduced output of the motor cortex can be included in the list of the disorders that can be treated using CB1 antagonists/reverse agonists (e.g. stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, fatigue syndromes, parkinsonisms, etc.).

Los programas de tratamiento con metadona: situación real e ideal, definida por profesionales de Andalucía / The methadone maintenance programs: real and ideal situation, definition by Andalucia´s professionals

Objetivos. Se explora la situación actual de los programas de tratamiento con metadona (PTM) en Andalucía, definida por los profesionales implicados y cómo ellos valoran que dicho programa debiera ser en términos de excelencia. Para ello se ofrecen propuestas y medidas de mejora con las que acercar las situaciones descritas. Material y métodos. Reunión de expertos articulada con una variante del grupo nominal. Participaron 9 profesionales. Resultados. La situación ideal y en términos de excelencia de los PTM no concuerda en buena parte de sus cláusulas con la realidad actual de estas intervenciones. Los aspectos más destacados sobre cómo debieran ser los PTM son la dispensación, la agilidad y rapidez de los programas, junto a la existencia de una buena coordinación entre los recursos. La descripción y valoración de la situación actual de los PTM es menos favorable con rela ción a la situación ideal definida por los asistentes. Se recogen y puntúan propuestas y medidas de mejora con las que acercar ambas situaciones. Conclusiones. Aunque los PTM sean intervenciones de eficacia comprobada por la evidencia científica, son susceptibles de mejora. Para ello recoger la voz de los protagonistas directos en estas prácticas es importante para asegurar su continuidad y dotarlos de mayor calidad

Objectives. This study explores the methadone maintenance programs (MMPs) currently offered in Andalucia based on the opinions of providers involved, as well as their views on how these programs should be organised to achieve excelence. In order to advance towards this goal, proposals and measures for improvement are also provided. Material and methods. Experts' consensus meeting (9 providers) based on an adaptation of the nominal group technique. Results. there is a lack of concordance between the ideal situation of the MMPs in terms of excelence and the real situation of current service provision. The most relevant components of an ideal MMP were dispensing procedures, steadiness and rapidity in program provision, and good coordination across available resources. Description and assessment of the actual situation was less favourable when compared with the ideal situation as defined by participants. Proposals and measures for program improvement to approach both situations were also gathered. Conclusions. Although available scientific evidence has proved the efficiency of MMT programs, there is still room for improvement. Therefore, it is important to gather the views of the main actors in order to ensure the continuity of existing programs and to improve their quality

A systematic review of powered vs manual toothbrushes in periodontal cause-related therapy.

BACKGROUND: Power-driven toothbrushes (PDT) have been designed to improve the efficacy of oral hygiene. It is not clear how they compare in efficacy with manual toothbrushes in cause-related periodontal therapy. OBJECTIVES: To evaluate the effectiveness of the use of a PDT as compared with a manual toothbrush (MT), in terms of gingival bleeding or inflammation resolution, in cause-related periodontal therapy. MATERIAL AND METHODS: An electronic (MEDLINE and Cochrane Oral Health Group Specialised Trials Register) and a manual search were made to detect studies which permitted the evaluation of the efficacy of PDT in the reduction of gingival bleeding or inflammation, and their effect on other secondary variables. Only randomized studies in adults, published in English up to June 2001, which compared a PDT with an MT, and evaluated the evolution of gingival bleeding or inflammation were included. The selection of articles, extraction of data and assessment of validity were made independently by several reviewers. RESULTS: Twenty-one studies were finally selected. The heterogeneity of the data prevented a quantitative analysis. A higher efficacy in the reduction of gingival bleeding or inflammation in the PDT patients was detected in 10 studies. This effect appears to be related to the capacity to reduce plaque, and is more evident in counter-rotational and oscillating-rotating brushes. No solid evidence was found for a higher efficacy of sonic brushes. In short-term studies with prophylaxis after initial examination, independently of the type of PDT tested, no significant differences were found. CONCLUSION: The use of PDT, especially counter-rotational and oscillating-rotating brushes, can be beneficial in reducing the levels of gingival bleeding or inflammation. There is a need for methodological homogeneity in future studies in this field to enable quantitative analysis of their results.

[Spiral computerized tomography in the diagnosis of acute occlusion of the abdominal aorta. A case report]. / La Tomografia Computerizzata spirale nella diagnosi dell'occlusione acuta dell'aorta addominale. Descrizione di un caso.

Aim of this report is to present a case of acute occlusion of the abdominal aorta recognized by spiral-CT. After a brief description of the etiology and pathology of abdominal aorta acute occlusion, stress is laid on diagnostic role of spiral-CT, based on personal and literature data. The advantage of spiral respect to non-spiral CT is the quicker examination time which is very important, mostly in emergencies. On the contrary, the diagnosis of acute abdominal aorta occlusion is not modified by volumetric CT respect to non-spiral and it is based on the absence of aorta contrast enhancement above the occlusion level.

Evaluation of the precision obtained with a fixed surgical template in the placement of implants for rehabilitation of the completely edentulous maxilla: a clinical report.

The fabrication of a complete maxillary implant-supported prosthesis in a patient with slight resorption of the alveolar ridge and a high lip line presents a professional challenge. The implants must be placed with high precision to achieve good esthetics, phonetics, and function. A fixed surgical template using microimplants has been developed for this purpose. The objective of this investigation was to compare a fixed surgical template (FST) to a conventional movable surgical template (MST) for the precise placement of implants in the slightly resorbed edentulous maxilla. Three patients (28 implants), edentulous in the maxilla, with slight ridge resorption, in whom the implants were placed with an FST, were compared with 5 controls having the same characteristics and implants placed with an MST (35 implants). After completion of the prosthesis, occlusal photographs (1:1) were taken, and these images were scanned and transferred to a drawing program in which the contours of the teeth, the ideal emergence position of the occlusal hole of the abutment screw, and its real position were drawn. A blind evaluation was made using the following variables: frequency of location of the abutment screw hole outside of the tooth contour, and the relative measurements of the area of coincidence between the circle that represents the ideal position and real position. A significantly smaller frequency of implants outside the tooth contour was seen with the FST (7%) than with the MST (46%) (P < .0008). Also, a significantly higher relative area of coincidence was observed between ideal position and real position in the FST (0.61) than in the MST (0.38) (P < .003). This study revealed that considerably higher precision was associated with the use of an FST.

Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report.

This article describes a surgical periodontal plastic procedure for the coverage of multiple adjacent gingival recessions. This surgical technique is based on the construction of a tunnel under the gingival tissue by means of a sulcular incision beyond the mucogingival line without raising the papillae. A large connective tissue graft obtained from the palatal mucosa is introduced through this tunnel, covering the adjacent gingival recessions. A suturing technique to allow this graft to slip through the tunnel under the gingival tissues and to secure and stabilize the graft covering the recessions is described. Twelve-month postoperative results are presented from 21 teeth that were treated with this technique: 100% root coverage was achieved in 66.7% of the recessions treated, with a mean root surface coverage of 91.6%. This study suggests that the use of this surgical procedure allows the treatment of multiple adjacent recessions in a single procedure with adequate early healing and highly predictable root coverage results.

Profile surgical template: a systematic approach to precise implant placement. A technical note.

The precise placement of dental implants is essential to designing a prosthesis that fulfills the esthetic and functional requirements of the patient, and simultaneously allows clear phonetics and facilitates oral hygiene. To achieve this, an effective surgical template is essential: it must provide good orientation, be comfortable, have adequate intraoral fixation, allow freedom of choice to the surgeon, and be capable of use during image-diagnostic procedures. In accordance with this criteria, the profile surgical template, based on utilization of the buccal contour of missing teeth, has been designed.

Erythropoietin treatment decreases cardiovascular morbidity and mortality in CAPD patients.

OBJECTIVE: To analyze the effects of recombinant human erythropoietin (rHuEPO) therapy on cardiovascular (CV) morbidity and mortality among continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN: Retrospective comparative study. SETTING: CAPD unit in a university hospital. PATIENTS: Forty-two patients on rHuEPO treatment for at least one year were compared with an rHuEPO nonuser group of 113 patients. Subcutaneous rHuEPO doses were adjusted to a hemoglobin objective level of 10.5-13.5 g/dL. Fifty-seven patients were considered as high cardiovascular risk (HCVR), 17 in the rHuEPO group and 40 in the rHuEPO nonuser group. Ninety-eight patients were classified as low cardiovascular risk (LCVR), 25 of whom were in the rHuEPO group. RESULTS: The incidence of cardiovascular morbidity was more frequent in the rHuEPO nonuser than in the rHuEPO user group (40% vs 22%) and in HCVR than in LCVR patients (59.6% vs 20.4%). By multiple logistic regression analysis, the best model to explain the development of cardiovascular morbidity comprises rHuEPO treatment, CV risk, and age. In the rHuEPO user group, HCVR and LCVR patients did not show significant differences in survival, while in the rHuEPO nonuser group, HCVR patients had a lower survival rate than LCVR patients (p = 0.0003). Cox proportional hazards model revealed that LCVR patients had an excellent prognosis compared with HCVR patients in the rHuEPO nonuser group, but this difference disappeared in the rHuEPO user group. CONCLUSION: These data show a beneficial effect of rHuEPO treatment on cardiovascular morbidity and mortality in CAPD patients, evidenced by the elimination of the correlation between prior cardiovascular risk and subsequent mortality.

Guided tissue regeneration in human Class II furcations and interproximal infrabony defects after using a bioabsorbable membrane barrier.

This study clinically evaluated a bioabsorbable barrier membrane designed for periodontal regeneration. Ten Class II furcations and 12 interproximal infrabony defects were treated by flap debridement and placement of a bioabsorbable barrier membrane using the principles of guided tissue regeneration. Treatment was evaluated in terms of changes in vertical probing depth, horizontal attachment level, clinical attachment level, and recession. Baseline data were collected on the day of surgery, and outcome measurements were performed at the 1-year appointment. The mean initial probing depth for Class II furcations was 6.5 mm. At 1 year, the mean probing depth was reduced to 2.9 mm, a 3.6 mm change. These differences were clinically and statistically significant (P < 0.01). There was a mean gain of 2.4 mm in clinical attachment level (P < 0.01) and a mean 3.4-mm change in horizontal attachment level (P < 0.01). Recession increased 1.2 mm. For interproximal infrabony defects, there was a mean probing depth reduction of 5.0 mm (P < 0.01), a mean gain of clinical attachment level of 3.8 mm (P < 0.02), and a mean increase of 1.2 mm in recession (P < 0.04). The results indicate that significant improvements occurred after treatment of Class II furcations and interproximal infrabony defects with the use of a bioabsorbable barrier membrane and guided tissue regeneration.