Relationship between physical activity levels of Portuguese physical therapists and mental health during a COVID-19 pandemic: Being active is the key.

Introduction: Physical activity is essential for a healthy life and quality of life, representing a fundamental role in individuals' physical and mental health. Concomitantly, the physical therapist, through the promotion of physical activity and exercise, can improve mental health, an essential factor in the current pandemic, triggering anxiety, fear, and depression crisis. Objective: To verify physical activity among Portuguese physical therapists and its association with mental health during pandemic times. Methods: An online questionnaire was applied through social media to all Portuguese physical therapists between October 21, 2021, and January 14, 2022. It contained general characterization questions of the sample, the IPAQ-SF questionnaire to assess physical activity levels, the Goldberg General Health Questionnaire (GHQ-28), which assesses the levels of mental health and the WHO Well-Being Index (WHO-5) to assess the subjective wellbeing. Results: The sample totaled 286 respondents (82% female), with a mean age of 33. Of the total answers, 82% practiced physical activity, 45% had moderate levels of physical activity, and 19% vigorous. Physical therapists in these categories had lower values in the GHQ-28 and higher in the WHO-5. Those with better mental health also showed better subjective wellbeing (r = -0.571, p = 0.000). Conclusion: The data obtained showed that physical therapists mostly have moderate and vigorous levels of physical activity and that physical activity positively influences individuals' mental health and wellbeing, which proved to be a key factor due to the pandemic situation.

Sustainable and Active Program-Development and Application of SAVING Methodology.

The SAVING project aimed to create a sustainable and active aging program to promote the transition to sustainable aging in residential structures for the elderly (RSEs), developing research activities to apply the best strategies and good practices regarding the promotion of an active, healthy, and sustainable aging regarding social, economic, environmental, and pedagogic aspects. All this innovative methodology was built on a living-lab approach applied in one RSE, that was used as a case study. The results showed that the creation of the SAVING Brigade allowed not only increased reflection and mutual learning, but also created better conditions to face uncertainties and obstacles. Moreover, the use of indicators supported the basic themes and enabled comparison with other studies, between institutions or programs. Finally, the Action Plan acted as a tool for the development of previously defined strategies. It is possible to conclude that the breadth of the concept of quality of life encompasses the physical health of the individual, their psychological state, their social relationships, their perceptions, and the relationship with the characteristics of the context in which they are inserted. Therefore, active, sustainable, and healthy aging should be the goal.

Consequences, Motives, and Expectancies of Consumption as Predictors of Binge Drinking in University Women.

The increasing presence of women, especially university women, in risky alcohol consumption such as Binge Drinking (BD), which is associated with gender-specific biopsychosocial problems, makes it necessary to analyze the variables underlying BD in order to adjust possible interventions more in line with their reality. The motives and expectancies of this pattern of consumption, as well as the consequences derived from it, are some of the variables that are shown to have the greatest weight in the prediction of BD. In the present study we analyze, on the one hand, the performance of these variables among college women with alcohol use, and on the other hand, which of these variables allow us to classify BD. A total of 501 female university consumers of alcohol (mean age 19.02 years) were assessed. Specifically, they completed a self-report of alcohol consumption (77.1% engage in BD), the Expectancy Questionnaire (EQ), the Drinking Motives Questionnaire (DMQ-R) and the Alcohol Consumption Consequences Evaluation (ACCE). BD female students scored significantly higher on these instruments, except for compliance motives. The logistic regression analysis carried out to estimate the probability of performing BD using the social and conformity motives, the ACCE and positive expectancies correctly estimated (χ2 8 = 9.149, p < 0.33) 88.6% of the cases and explained 26.2% of the BD. Thus, young women with a level of consequences classified as high risk (>25 in ACCE) have a 3.55-fold increase in the probability of having BD, compared to women classified as low risk by the ACCE. On the other hand, women classified as moderate risk by the ACCE have a 4.77-fold increase in the probability of having BD. In the case of social motives and positive expectancies, their increase multiplies by 1.165 and 1.024, respectively, the probability of having BD. The results of this study highlight the importance of adapting preventive measures to the consequences experienced by BD university students, especially in relation to the social motives and positive expectancies that modulate decision-making when engaging in this pattern of consumption.

Binge Drinking: The Top 100 Cited Papers.

We conducted a review to analyze the 100 most-cited studies on binge drinking (BD) in the Web of Science (WoS) database to determine their current status and the aspects that require further attention. We carried out a retrospective bibliometric analysis in January 2021. The year of publication, authors, design, subject, journal, institution and lead author's country, as well as the definition of BD, were extracted from the articles. The data on the country, year, thematic category of the journals and their rank were obtained from the Institute for Scientific Information (ISI) Journal Citation Reports 2020. The number of citations was collected from the WoS, and the h index was collected from the Scopus database. The citation density and Bradford's law were calculated. The majority of the articles were empirical quantitative studies with a cross-sectional design published between 1992 and 2013 in 49 journals. There were 306 authors, mostly English-speaking and from the USA. The definitions used to describe BD are not homogeneous. The most-cited topics were the analysis of consequences, determinants and epidemiology. There is a need to unify the definitions of BD and base them on scientific evidence. The multidisciplinary nature of BD is not well reflected in each of the thematic areas discussed in this work.

Psychometric Properties of the "Alcohol Consumption Consequences Evaluation" (ACCE) Scale for Young Spanish University Students.

Instruments that evaluate alcohol use consequences among young people do not consider the intensive alcohol consumption pattern that is so characteristic during these ages. Some of these instruments are even ineffective in the Spanish population. Hence the interest in developing an instrument more adapted to the reality of our young people. A total of 601 university students (35.9% male and 64.1% female) from 18 to 20 years old were recruited. All of them answered a total of 77 items obtained from the review of both the scientific literature and the different scales used to measure consequences derived from alcohol consumption. In addition, they completed the AUDIT and the Timeline Followback for self-reported consumption. The data were analyzed using factor analysis and a two-parameter logistic model. ROC curve analysis was used to establish cut-off points for different risk levels of alcohol consumption distinguishing between genders. The final 43-item scale Alcohol Consumption Consequences Evaluation (ACCE) (Evaluación de Consecuencias derivadas del Consumo de Alcohol [ECCA]) shows adequate psychometric properties: α = 0.94; unidimensionality through exploratory factor analysis (EFA) (26.25% of explained variance) and confirmatory factor analysis (CFA) (RMSEA = 0.39; TLI and CFI > 0.90). In addition, ROC analyses, both at a global scale and distinguishing between genders, were able to characterize consumers with different levels of risk, obtaining areas under the curve between 0.82 and 0.88. A scale has been obtained that enables the establishment of cut-off points to distinguish between the consequences of low, moderate and high risk alcohol consumption. The clinical utility of the ACCE is highlighted by using one single instrument to perform the screening of a possible alcohol risk consumption as well as identifying the consequences that need to be worked on in the evaluated person's or group's intervention.

Evaluation of AUDIT Consumption Items New Adaptation to Improve the Screening of College Students Binge Drinking. / Evaluación de la adaptación de los ítems de consumo del AUDIT para mejor el cribado de Binge Drinking en universitarios.

The strong presence of Binge Drinking (BD) amongst university students, as well as the consequences associated with the same and the changes taking place over recent years regarding its conceptualization make it necessary to examine the usefulness of screening instruments used to detect this drinking pattern. This study examines the usefulness of a briefer adaptation of the AUDIT proposed by Cortés, Giménez, Motos, and Sancerni (2017a).College students self-administered the AUDIT, the revised items 2 and 3 (A2r and A3r), and completed a weekly self-report of their alcohol intake. BD was classified according to the amount consumed and the frequency of that consumption over the past six months. The AUDIT, AUDIT-C and items A2r+A3r (AR2I) were examined. The results obtained from a sample of 605 college students (18-21 years old/55.2% female) indicate that 449 meet the BD criteria. Items A2r and A3r, adapted to the most consensual definition of BD, were found to identify 98% of BD college students when using a cut-off point of ≥ 3 in females and ≥ 4 in males with optimum levels of sensitivity and specificity. The new adaptation, which includes fewer items, identifies BD college students more accurately. This confirms the need to adjust both consumption items from the model according to the pattern of consumption in college students to detect BD more precisely and as soon as possible.

La importante presencia del Binge Drinking (BD) entre estudiantes universitarios, junto con las consecuencias asociadas al mismo y los cambios experimentados en los últimos años en su conceptualización, hacen necesario revisar la utilidad de los instrumentos de cribado para detectar este patrón de consumo. Este estudio examina la utilidad de una adaptación del AUDIT propuesta por Cortés, Giménez, Motos y Sancerni (2017a).Una muestra de estudiantes universitarios cumplimentó el AUDIT, los ítems 2 y 3 revisados (A2r y A3r), y un autoinforme semanal de su consumo de alcohol. A partir de la cantidad máxima de alcohol consumido en una ocasión y de la frecuencia de dicho consumo en los últimos seis meses se clasificaron los jóvenes como BD o no-BD. Se examinaron las puntuaciones del AUDIT, AUDIT-C y de los ítems A2r+A3r (AR2I).Los resultados obtenidos con 605 universitarios (18-21 años/55,2% mujeres) indican que 449 cumplen criterios de BD. Los ítems A2r y A3r, adaptados a una definición más consensuada de BD, identifican el 98% de los estudiantes BD cuando se usa un punto de corte ≥ 3 en mujeres y ≥ 4 en varones, con valores óptimos de sensibilidad y especificidad.Esta adaptación realizada, que incluye menor número de ítems, identifica a los universitarios BD de manera más precisa. Se confirma la necesidad de ajustar ambos ítems de consumo de acuerdo al patrón de ingesta BD que realizan los estudiantes universitarios mejorando notablemente su detección y facilitando un abordaje temprano.

Evaluación de la adaptación de los ítems de consumo del AUDIT para mejor el cribado de Binge Drinking en universitarios / Evaluation of AUDIT Consumption Items New Adaptation to Improve the Screening of College Students Binge Drinking

La importante presencia del Binge Drinking (BD) entre estudiantes universitarios, junto con las consecuencias asociadas al mismo y los cambios experimentados en los últimos años en su conceptualización, hacen necesario revisar la utilidad de los instrumentos de cribado para detectar este patrón de consumo. Este estudio examina la utilidad de una adaptación del AUDIT propuesta por Cortés, Giménez, Motos y Sancerni (2017a). Una muestra de estudiantes universitarios cumplimentó el AUDIT, los ítems 2 y 3 revisados (A2r y A3r), y un autoinforme semanal de su consumo de alcohol. A partir de la cantidad máxima de alcohol consumido en una ocasión y de la frecuencia de dicho consumo en los últimos seis meses se clasificaron los jóvenes como BD o no-BD. Se examinaron las puntuaciones del AUDIT, AUDIT-C y de los ítems A2r+A3r (AR2I). Los resultados obtenidos con 605 universitarios (18-21 años/55,2% mujeres) indican que 449 cumplen criterios de BD. Los ítems A2r y A3r, adaptados a una definición más consensuada de BD, identifican el 98% de los estudiantes BD cuando se usa un punto de corte ≥ 3 en mujeres y ≥ 4 en varones, con valores óptimos de sensibilidad y especificidad. Esta adaptación realizada, que incluye menor número de ítems, identifica a los universitarios BD de manera más precisa. Se confirma la necesidad de ajustar ambos ítems de consumo de acuerdo al patrón de ingesta BD que realizan los estudiantes universitarios mejorando notablemente su detección y facilitando un abordaje temprano

The strong presence of Binge Drinking (BD) amongst university students, as well as the consequences associated with the same and the changes taking place over recent years regarding its conceptualization make it necessary to examine the usefulness of screening instruments used to detect this drinking pattern. This study examines the usefulness of a briefer adaptation of the AUDIT proposed by Cortés, Giménez, Motos, and Sancerni (2017a). College students self-administered the AUDIT, the revised items 2 and 3 (A2r and A3r), and completed a weekly self-report of their alcohol intake. BD was classified according to the amount consumed and the frequency of that consumption over the past six months. The AUDIT, AUDIT-C and items A2r+A3r (AR2I) were examined. The results obtained from a sample of 605 college students (18- 21 years old/55.2% female) indicate that 449 meet the BD criteria. Items A2r and A3r, adapted to the most consensual definition of BD, were found to identify 98% of BD college students when using a cut-off point of ≥ 3 in females and ≥ 4 in males with optimum levels of sensitivity and specificity. The new adaptation, which includes fewer items, identifies BD college students more accurately. This confirms the need to adjust both consumption items from the model according to the pattern of consumption in college students to detect BD more precisely and as soon as possible

Creating a Culture of Health in Planning and Implementing Innovative Strategies Addressing Non-communicable Chronic Diseases.

Ongoing demographic changes are challenging health systems worldwide especially in relation to increasing longevity and the resultant rise of non-communicable diseases (NCDs). To meet these challenges, a paradigm shift to a more proactive approach to health promotion, and maintenance is needed. This new paradigm focuses on creating and implementing an ecological model of Culture of Health. The conceptualization of the Culture of Health is defined as one where good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities where citizens have the opportunity to make choices and be co-producers of healthy lifestyles. Based on Antonovsky's Salutogenesis model which asserts that the experience of health moves along a continuum across the lifespan, we will identify the key drivers for achieving a Culture of Health. These include mindset/expectations, sense of community, and civic engagement. The present article discusses these drivers and identifies areas where policy and research actions are needed to advance positive change on population health and well-being. We highlight empirical evidence of drivers within the EU guided by the activities within the thematic Action Groups of the European Innovation Partnership on Active and Healthy Aging (EIP on AHA), focusing on Lifespan Health Promotion and Prevention of Age-Related Frailty and Disease (A3 Action Group). We will specifically focus on the effect of Culture on Health, highlighting cross-cutting drivers across domains such as innovations at the individual and community level, and in synergies with business, policy, and research entities. We will present examples of drivers for creating a Culture of Health, the barriers, the remaining gaps, and areas of future research to achieve an inclusive and sustainable asset-based community.

Physical activity and physiotherapy: perception of women breast cancer survivors.

BACKGROUND: Physical activity levels seem to play an important role on musculoskeletal disorders in women diagnosed with breast cancer. However, the effects of physical activity after diagnosis are not fully understood. Our purpose was to understand the importance of physical activity and physiotherapy on musculoskeletal disorders as a sequela of treatment in breast cancer survivor women. METHODS: For this cross-sectional study, a sample of 94 breast cancer survivor women fulfilled a self-completed questionnaire with questions on clinical and functional variables, and levels of physical activity before and after breast cancer diagnosis. RESULTS: All 94 women, aged between 23 and 72 years, reported at least one or more post-cancer musculoskeletal disorders. More active women reported fewer changes than the less active women (p < 0.05). For the majority of women who underwent physiotherapy after breast cancer, this intervention was perceived as helpful in the treatment of post-cancer disorders. CONCLUSIONS: Physical activity habits and physiotherapy treatments contributed for the perception of lower number of musculoskeletal disorders. This practice should be advocated among women with breast cancer.

A 5-Year Follow-Up of The Benefits of an Exercise Training Program in Liver Recipients Transplanted Due to Familial Amyloidotic Polyneuropathy.

BACKGROUND: Supervised (SE) and home-based exercise (HBE) training regimes are effective on reconditioning patients with familial amyloidotic polyneuropathy (FAP) after liver transplantation, but research of the long-term retention of the benefits attained in patients with FAP has not yet been conducted. PURPOSE: In this 5-year follow-up study, we aimed to determine whether the exercise training gains in body composition, physical activity, and function promoted by a 24-week SE or HBE training regimes are retained in patients with FAP who resume normal activity. METHODOLOGY: Sixteen liver-transplanted patients with FAP were reassessed for body composition (dual X-ray absorptiometry), physical activity (questionnaire), and function (handgrip strength and 6-minute walk test). RESULTS: Total body fat increased with both exercise regimes during follow-up ( P < .05; η2 = 0.432-0.625) as well as femoral neck bone density ( P = .048; η2 = 0.119). However, gains in upper limbs muscle quality during follow-up ( P < .001; η2 = 0.597) were only found in the SE group ( P = .042; η2 = 0.245). Both exercise regimes showed retaining aptitudes in walking capacity ( P < .05; η2 = 0.329-0.460) and muscle mass ( P = .05; η2 = 0.245). Still, none could retain the physical activity levels. CONCLUSION: Long-term resumption of normal activity following a 24-week SE or HBE regime in patients with FAP resulted in loss of exercise induced increases in physical activity but counterweighted postoperative losses in bone mineral density and substantially retained the benefits in walking capacity, muscle mass, and quality, in particular, in the SE group.

Revision of AUDIT Consumption Items to Improve the Screening of Youth Binge Drinking.

This study analyzes the appropriateness of an improved version of one of the most frequently used instruments for the screening of high-risk alcohol consumption. This adaptation was created in accordance with certain limitations recognized by other researchers and in an attempt to adjust the content and scales of some items to a more consensual definition of binge drinking. After revising items 2 and 3, the areas under the ROC curves of the AUDIT and of different abbreviated versions were calculated. A total of 906 minors (468 females) between the ages of 15 and 17 were evaluated. Stratified sampling was conducted on a population of high school students in the city of Valencia (Spain). One school was randomly chosen from each of the city's 16 school districts. Information was collected on sociodemographic aspects, consumption patterns and the AUDIT containing the improved items. The percentage of underage BD reached 36%, regardless of gender or age. BD groups have been differentiated by different intensity levels, both in males and females. Upon comparing the effectiveness of the distinct versions of the AUDIT, it is recommended that researchers and clinics use the combination of the revised items 2 and 3 to ensure a more precise identification of underage BD. A cut-off point of 5 for this test would permit identification of 94% of the underage BD and would notably reduce false positives.

The utility of the alcohol use disorders identification test (Audit) for the analysis of binge drinking in university students / Utilidad del Alcohol Use Disorders Identification Test (AUDIT) en el análisis del binge drinking en estudiantes universitarios

BACKGROUND: The increasingly precise conceptualization of Binge Drinking (BD), along with the rising incidence of this pattern of intake amongst young people, make it necessary to review the usefulness of instruments used to detect it. Little evidence exists regarding effectiveness of the AUDIT, AUDIT-C and AUDIT-3 in the detection of BD. This study evaluates their utility in a sample of university students, revealing the most appropriate cut-off points for each sex. METHODS: All students self-administered the AUDIT and completed a self-report of their alcohol consumption. A Two-step cluster analysis differentiated 5 groups of BD in terms of: the quantity consumed, the frequency of BD over the past six months and gender. A ROC curve adjusted cut-off points for each case. RESULTS: 862 university students (18-19 years-old/59.5% female), 424 (49.2%) from Valencia and 438 (50.8%) from Madrid, had cut-off points of 4 in AUDIT and 3 in AUDIT-C as a better fit. In all cases, the best classifier was AUDIT-C. Neither version properly classifies students with varying degrees of BD. CONCLUSIONS: All versions differentiate BD from non-BD, but none are able to differentiate between types of BD

ANTECEDENTES: la operacionalización cada vez más precisa del Binge Drinking (BD), unido a su elevada prevalencia entre los jóvenes, hace necesario revisar la utilidad de los instrumentos utilizados para detectarlo. Existe poca evidencia de la eficacia del AU-DIT y AUDIT-C en la detección del BD. Este artículo evalúa su utilidad en una muestra de universitarios, identificando los puntos de corte más adecuados, en función del sexo. MÉTODO: se cumplimentó el AUDIT y un autoregistro de consumo de alcohol. Un análisis de conglomerados en dos fases diferenció 5 grupos de BD en función de: cantidad consumida, frecuencia de realización en los últimos seis meses y género. Con curvas ROC se ajustaron los puntos de corte para cada caso. RESULTADOS: 862 universitarios (18-19 años/59,5% mujeres), 424 (49,2%) de Valencia y 438 (50,8%) de Madrid obtuvieron puntos de corte de 4 en AUDIT y 3 en AUDIT-C como mejor ajuste. En todos los casos el mejor clasificador de BD fue el AUDIT-C. Ninguna versión clasifica adecuadamente a estudiantes con diferente intensidad de BD. CONCLUSIONES: ambas versiones diferencian BD de noBD, pero ninguna de ellas permite distinguir entre tipos de BD

The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System.

OBJECTIVES: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. METHODS: Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. RESULTS: There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. CONCLUSIONS: Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control in all positions. We think that the main factor influencing these results is that patients use more of their available cognitive processing to improve their postural control. The ABAR system allows us to make this assumption because the system requires the continuous attention of patients, promoting cognitive processing.

Functional Capacity and Levels of Physical Activity in Aging: A 3-Year Follow-up.

Over the last decades, the world elderly population has increased exponentially and this tendency will continue during the coming years; from 2000 to 2050, people over 60 will double and those over 80 will quadruple. Loss of independence occurs as people age due to mobility restrictions, frailty, and decreased functional fitness and cognitive abilities. Evidence has shown that appropriate programs and policies contribute to keep older adults healthy and independent over time. The purpose of this chapter is to report the results of our 3-year follow-up study designed to characterize functional physical fitness in a sample of Portuguese community-dwelling older adults to propose a set of functional parameters that decline the most. We studied a group of 43 elderly people, aged 60 and over. Variables assessed on the participants were anthropometric measurements, functional capacity with the Senior Fitness Test battery (muscle strength, aerobic endurance, flexibility, agility, and dynamic balance), handgrip strength, levels of physical activity, and balance. Three years after the first assessment, a second assessment of the same variables was conducted. We analyzed what were the variables that, for this group, were related with a healthier aging and the relation with different physical activity levels. Our study showed that the distance covered in 6-min walk test and handgrip strength seem to explain a great amount of variability on functional variables that have changed on this period (68% of balance, lower and upper functional strength, respectively) and the active participants showed less decrements with aging in anthropometric and functional variables than those inactive or insufficiently active (p < 0.05). Greater importance should be given to prescription of exercise targeting older adults and, specifically, walking and manual activities should be given more attention as components of a community exercise program.

Edad de inicio en el consumo, motivos y cantidad de alcohol en la determinación de consecuencias en consumidores intensivos universitarios / Age of Onset, Motives and Amount of Alcohol Consumed in the Determination of Consequences in College Binge Drinkers

Las implicaciones clínicas y sociales derivadas del consumo intensivo de alcohol (CIA) en universitarios motivan la necesidad de analizar los factores que favorecen su aparición. Este estudio evalúa cómo influye la cantidad de alcohol ingerido, la edad de inicio en el consumo de esta sustancia y los motivos asociados a esta conducta en la presencia de un mayor o menor número de consecuencias psicosociales. 312 estudiantes de primero de la Universidad de Valencia que realizan CIA cumplimentaron el instrumento IECI (Cortés et al., 2012): autoregistro de consumo, motivos asociados a esta ingesta y consecuencias psicosociales derivadas. Se confirman resultados de investigaciones precedentes. Ambos sexos duplican los gramos de alcohol que definen un CIA. Aparecen diferencias en los efectos esperados en función del sexo, así como en la edad de inicio en el consumo y en el número de consecuencias experimentadas. Los análisis de regresión de orden jerárquico muestran la importancia de la edad de inicio y los motivos, por encima de los gramos consumidos, para dar cuenta del deterioro psicosocial generado por la ingesta. Esto apoya la necesidad de atender a la combinación de variables en la explicación y posterior intervención para paliar las consecuencias derivadas del CIA.

Drinking onset, motives and alcohol use in the prediction of alcohol-related problems in undergraduate binge drinkers. The clinical and social implications derived from binge drinking (BD) in university students cause the need to analyze the factors which contribute to its appearance. This research assesses the influence of the amount of alcohol consumed, drinking onset and the motives associated with this behaviour in the presence of a greater or least number of psychological consequences. 312 first year university students at Valencia University performing BD completed the IECI instrument (Cortés et al., 2012): self report about consumption, associated motives to their consumption and the psychosocial consequences. Results are confirmed by previous research. Both sexes double the grams of alcohol which define a BD. Differences appear in the expected outcome depending on the sex as well as the age at which they drinking onset and the number of experienced consequences. The hierarchical regression analysis shows the importance of the drinking onset and the motives, above the quantity of consumed grams, in order to report the psychosocial impairment generated by the intake. This supports the need to comply with the combination of variables in the explanation and subsequent intervention to alleviate the consequences of the BD.

Different versions of the Alcohol Use Disorders Identification Test (AUDIT) as screening instruments for underage binge drinking.

BACKGROUND: The changes experienced in recent years in the conceptualization of binge drinking (BD) make it necessary to revise the usefulness of the existing instruments for its detection among minors. The AUDIT and its abbreviated versions have shown their utility in different populations and consumption ranges, but there has been little research into their use in the detection of BD among adolescents. This study tests the capacity of the AUDIT, AUDIT-C and AUDIT-3 to identify BD adolescents, indicating the optimal cut-off points for each sex. METHODS: High school students self-administered the AUDIT and completed a weekly self-report of their alcohol intake. BD is classified into different groups according to parameters like the quantity consumed and its frequency in the past six months, adjusting the cut-off points for each case. RESULTS: The results obtained with a sample of 634 adolescents (15-17 years old/52.2% female) indicate that cut-off points of 4 on the AUDIT and 3 on the AUDIT-C show the best fit. Dividing the sample by sexes, the AUDIT and the AUDIT-C would detect BD males with scores of 5 and 4, respectively (with the AUDIT-C being more sensitive), and BD females with a score of 3 on both (the more sensitive being the AUDIT). CONCLUSIONS: All three versions are adequate to classify BD adolescents but none of them made it possible to safely differentiate binge drinkers with different consumption intensities.

Evolución clínica de los enfermos renales crónicos en tratamiento sustitutivo con infección por VIH / Clinical evolution of chronic renal patients with HIV infection in replacement therapy

Los pacientes con infección por el virus de la inmunodeficiencia humana (VIH) y enfermedad renal que terminan en tratamiento sustitutivo renal constituyen un grupo especial con interés creciente para la nefrología. Con el objetivo de conocer datos epidemiológicos de los pacientes VHI+ en España, recogimos información individualizada durante los años 2004 a 2011 (periodo de uso de tratamiento antiviral de alta eficacia) en las comunidades autónomas (CCAA) de Andalucía, Aragón, Asturias, Cataluña, Comunidad Valenciana, Castilla-La Mancha, Castilla y León, Galicia, Madrid, La Rioja y País Vasco, que comprendían un 85% de la población española. Se analizó a un total de 271 pacientes incidentes y 209 prevalentes. Se compararon con el resto de pacientes en tratamiento sustitutivo durante el mismo periodo de tiempo. La incidencia anual fue de 0,8 pacientes por millón de habitantes, con un aumento significativo a lo largo del periodo de seguimiento. La proporción de pacientes prevalentes VIH+ fue de 5,1/1.000 pacientes en tratamiento sustitutivo, intervalo de confianza (IC) del 95%: 4,4-5,8. Las causas glomerulares constituyeron la mayoría (42%), aunque hubo un 14% de nefropatía diabética. En el total de España, esos porcentajes son 13 y 25%, respectivamente. Comparando frente al total de pacientes en tratamiento, el riesgo de muerte fue significativamente mayor en el grupo VIH+: hazard ratio (HR) ajustado por edad, sexo y presencia de diabetes: 2,26 (IC 95%: 1,74-2,91). La coinfección por hepatitis C aumentó el riesgo de muerte dentro del grupo VIH+: HR 1,77 (IC 95%: 1,10-2,85). La probabilidad de recibir trasplante renal en los VIH+ solo alcanzó el 17% a los 7 años, comparando con el total de pacientes en diálisis HR: 0,15 (IC 95%: 0,10-0,24). A pesar del uso de las nuevas combinaciones de antivirales, la incidencia de pacientes VIH+ en diálisis se ha incrementado, su mortalidad supera todavía al resto de pacientes, y tienen una tasa de trasplante muy baja. Se hace necesario profundizar en el conocimiento de esta enfermedad para mejorar los resultados (AU)

Patients on renal replacement therapy (RRT) infected with the human immunodeficiency virus (HIV) are a special group with growing interest. In order to study the epidemiological data of HIV+ patients on RRT in Spain, we collected individual information from 2004-2011 (period of use of highly active antiretroviral therapy [HAART] in the Autonomous Communities of Andalusia, Aragon, Asturias, Catalonia, Valencia, Castilla la Mancha, Castilla León, Galicia, Madrid, La Rioja and the Basque Country, comprising 85% of the Spanish population. A total of 271 incident and 209 prevalent patients were analysed. They were compared with the remaining patients on RRT during the same period. The annual incidence was 0.8 patients per one million inhabitants, with a significant increase during the follow-up period. The proportion of prevalent HIV+ patientswas 5.1 per 1,000 patients on RRT (95% confidence interval [CI] 4.4-5.8. Although glomerular diseases constituted the majority of cases (42%), diabetic nephropathy was the cause in 14% of patients. The nation-wide totals for these percentages were 13 and 25%, respectively. Compared to the total of patients in treatment, the risk of death was significantly higher in the HIV+ group: hazard ratio (HR) adjusted for age, sex and diabetes was 2.26 (95% CI 1.74 - 2.91). Hepatitis C coinfection increased the risk of death in the HIV+ group (HR 1.77; 95% CI 1.10 - 2.85). The probability of kidney transplantation in HIV+ was only 17% after 7 years, comparing with total RTT patients (HR 0.15; 95% CI: 0.10-0.24). Despite the use of HAART, the incidence of HIV+ patients on dialysis has increased; their mortality still exceeds non-HIV patients, and they have a very low rate of transplantation. It is necessary to further our knowledge of this disease in order to improve results (AU)