Susceptibility to Electronic Cigarette and Consumption Patterns in Adolescents.

The use of electronic cigarettes (ECs) is a major problem globally. Susceptibility and curiosity are important factors that develop prior to the onset of substance use, such as ECs, and are therefore considered as predictors. Both factors are used to obtain an extended index of susceptibility (ESIe-c), which allows the identification of adolescents who are at risk of starting to use these devices. The aim of this study was to determine the prevalence of EC consumption and to assess the association of possible predictors with susceptibility to use and experimentation with ECs among adolescents. A cross-sectional study was carried out in 377 adolescents (53.0% female). Participants were compared according to their experimentation with ECs. A total of 45.9% had already used electronic cigarettes, and 20.8% were current users. Among those who had not tried electronic cigarettes, 43.3% had a medium-high susceptibility to EC initiation. Consumption among close friends, receiving offers of consumption and alcohol consumption were associated with initiation. There was an inverse association between a medium susceptibility index electronic cigarette score and the consumption of cigarettes and positive affect; on the other hand, the lack of premeditation was associated with a higher susceptibility index score. Intrapersonal factors and social factors seem to influence the ESIe-c and onset of EC use, respectively. The main conclusion in this study is that susceptibility is influenced by intrapersonal factors such as affectivity and impulsivity through the lack of premeditation, and by social factors such as EC consumption by best friends.

Gender differences in susceptibility to smoking among high school students.

AIMS: To analyse the degree of susceptibility to smoking according to gender in students between 12 and 16 years of age and study the role of factors associated with gender and the extended index of susceptibility to smoking. DESIGN: Cross-sectional study. METHODS: Between November 2019 and March 2020, 12- to 16-year-old students were recruited from three educational centres in western Spain. Sociodemographic, environmental, social and personal variables were analysed. The value of the extended index of susceptibility to smoking was calculated, and the associations between the students' genders and smoking susceptibility were studied. Multinomial logistic regression was used to study associations between the independent variables and Expanded Susceptibility Index (ESSI) results. The roles of factors in this association were explored through mediation analysis. RESULTS: A total of 364 students participated in the study (53% females). A total of 79.3% of females and 61.4% of males presented a medium-high level of the extended index of susceptibility. Females reported greater cigarette use (28% vs. 12.3%), hookah (19.9% vs 9.9%) and alcohol consumption (20.7% risk alcohol consumption). They obtained higher scores on the impulsivity scale in the urgency domain and the negative affect scale. Regardless of other factors, females showed more than double the smoking susceptibility (aOR: 2.05, 95% CI: 1.03-4.07, p = .041). Mediation analysis showed that gender had a total effect on the extended susceptibility index ß = .023 (95% CI: 0.07-0.38, p = .01). The effect appeared to be mediated only by having smoking friends (0.08; 95% CI: 0.03-0.15, p = .001). CONCLUSIONS: The greater susceptibility to smoking found in females may be related to a greater influence of smoking among friends. IMPACT: These results show that smoking friends have a strong influence among adolescent females; therefore, developing preventive programmes with gender approaches aimed at reducing the influence of these environmental factors would be of interest.

Childbirth Satisfaction during the COVID-19 Pandemic in a Hospital in Southwestern Spain.

Satisfaction, in relation to care received, is a good indicator of quality of care. The objective of this study was to analyze the degree of satisfaction with childbirth and postpartum care as reported by women from one hospital in southwestern Spain during the COVID-19 pandemic. Factors that influenced care were also examined. A cross-sectional study was carried out between the months of October 2020 and February 2021. Satisfaction was measured through the COMFORTS scale, validated in Spanish. A final sample of 116 women was included in the study. The mean age was 32.08 (±4.68) years. A total of 111 (95.69%) women were satisfied or very satisfied with the care received. The median satisfaction score was higher among multiparous women (187 (199-173)) than among primiparous women (174 (193-155.50)) (p = 0.003). Differences in satisfaction were found as a function of the use of epidural analgesia, being higher among women who had planned its use but ultimately did not use it (188 (172.50-199.75)) or who planned its use and did (186 (169.50-198)) than among those who had not planned to use epidural analgesia but ultimately received it (173.50 (187.50-146.25)) or those who did not use it, as planned, before childbirth (172 (157-185)) (p = 0.020). Overall satisfaction rate between SARS-CoV-2-negative women assisted was high. Parity and use of epidural analgesia were two factors influencing satisfaction scores in our sample.

Factors Associated with the Acceptance of New Technologies for Ageing in Place by People over 64 Years of Age.

BACKGROUND: In the context of growing population ageing, technologies aimed at helping people age in place play a fundamental role. Acceptance of the implementation of technological solutions can be defined as the intention to use a technology or the effective use of it. Approaches based on the technology acceptance model (TAM) have been shown to have good predictive power for pre-implementation attitudes towards new technologies. OBJECTIVE: To analyze the degree of acceptability of the use of new technologies for ageing in place and the factors associated with greater acceptance in people older than 64 years. METHODOLOGY: A descriptive cross-sectional study was carried out. Sociodemographic, clinical and environmental variables, architectural barriers, social risk and quality of life, degree of autonomy, morbidity, and risk of falls were collected in a population sample over 64 years of age in a large region of western Spain. The degree of acceptance of the use of technologies was measured through a scale based on the TAM. RESULTS: Of the 293 people included in the study, 36.2% exhibited a high acceptability of new technologies, 28.3% exhibited a medium acceptability, and 35.5% exhibited a low acceptability. Of all the factors, age, education level, and living alone were significantly associated with high acceptance in the adjusted analyses. CONCLUSIONS: Younger age, a higher education level, and living alone are factors associated with a greater degree of acceptance of the use of technologies for ageing in place.

Effect of a brief motivational intervention in the immediate postpartum period on breastfeeding self-efficacy: Randomized controlled trial.

Brief motivational intervention (bMI) is a therapeutic approach that encourages self-efficacy and may have a positive effect on breastfeeding self-efficacy (BSE). The purpose of this study was to analyze the effectiveness of a bMI in increasing BSE in women who started breastfeeding in the immediate postpartum period and to explore the roles of general self-efficacy and other baseline variables in this relationship. A randomized, parallel-group clinical trial was carried out. A bMI was compared with an educational session on breastfeeding. Changes in BSE and its dimensions and the interaction and mediation/moderation of general self-efficacy and other variables were analyzed. BSE increased in the bMI group from a mean baseline score of 59.14 (±9.35) to 64.62 (±7.91) at 1st month (p < 0.001). An interaction was found in that only women with higher education had an improvement in BSE during the follow-up period that was attributable to the bMI (mean difference between the bMI and the attention control group: 18.25 (95% confidence interval: 5.86-30.19; p = 0.006). This interaction was not found for the changes produced in the intrapersonal thoughts dimension of BSE, whose scores were higher in the bMI group at 3 and 6 months. General self-efficacy exerted a moderating effect on the association of bMI with BSE change. The effect of bMI was no longer significant when the general self-efficacy score was above 84. Thus, bMI is effective in increasing BSE. This effectiveness was limited by the mother's educational level and moderated by baseline general self-efficacy.

Influence of Breastfeeding in the Adaptation of and Absenteeism of Infants in Early Childhood Centers: A Preliminary Study.

Schooling of children between 0 and 3 years old involves a process of adaptation and increases their exposure to infectious diseases, which leads to school absenteeism. Breastfeeding facilitates the development of secure attachment and protects the infant against infections. This study aimed to determine whether breastfeeding facilitates the adaptation of infants between 0 and 3 years old to early childhood center and decreases school absenteeism. A cross-sectional study was carried out by collecting data through a questionnaire, which was filled out by the parents and the childcare professionals. 160 infants participated. 40% of the infants who received infant formula from birth showed dependency behaviors (inconsolable crying or do not leave the caregiver for a long time) at the time of pick-up from the center, compared with 10%, 2.7%, and 2.6% of children breastfed between 0 and 6 months, and more than 6 and 12 months, respectively (p = 0.001). The interquartile range of absenteeism days per episode was 2-3 days for infants fed infant formula versus 1-2 days for those who were breastfed for more than 12 months (p = 0.041). Breastfeeding seems to be associated with fewer dependency behaviors at the time of collection and with fewer days of absence.

Economic Analysis of Brief Motivational Intervention Following Trauma Related to Drugs and Alcohol.

BACKGROUND: Very few studies have conducted an economic assessment of brief motivational intervention (BMI) in patients experiencing traumatic injuries related to alcohol and/or substance use. Furthermore, findings concerning the potential long-term economic benefits of BMI applied in nursing are promising but very scarce. OBJECTIVE: The purpose of this study was to analyze the costs and benefits associated with the application of a BMI program by nursing staff to patients hospitalized for trauma related to substance use. METHODS: An analysis of costs and benefits was conducted in a nonrandomized study of a retrospective cohort of patients. An intervention and follow-up (of 10-52 months) of patients between 16 and 70 years of age admitted for traumatic injuries in University Hospital of Granada were carried out with a cohort of 294 patients (intervention = 162 vs. no intervention = 132) between 2011 and 2016. The National Health Service's perspective on the use of medical resources and the costs associated with intervention and recidivism was considered. A cost analysis with a 5-year time frame and a subsequent analysis of sensitivity were conducted. RESULTS: Direct medical costs associated with trauma recidivism were significantly lower in patients who received BMI, as compared to patients who did not receive it, &OV0556;751.82 per patient (95% CI &OV0556;13.15 to &OV0556;1,490.48) in the first year. The cost-benefit ratio of &OV0556;74.92 at 4 years reflects National Health Service savings for each euro invested in BMI. DISCUSSION: The implementation of BMI programs in nursing care may be profitable from an economic standpoint, justifying the inclusion of these programs in hospitals both because of their efficacy and the potential savings incurred by the health system. This study addresses the lack of evidence regarding the economic implications linked to the effectiveness of the intervention to reduce substance use and trauma recidivism. Results identify BMI delivered in hospitals by nurses as a technique that offers the potential for reducing costs linked to trauma recidivism. The research has important practical implications for hospital nurses and doctors.

Association of benzodiazepines, opioids and tricyclic antidepressants use and falls in trauma patients: Conditional effect of age.

INTRODUCTION: The relationship between benzodiazepines, opioids and tricyclic antidepressants and trauma is of great importance because of increased consumption and the growing evidence of a positive association among older adults. The objective of this study was to determine the effect size of the association between the consumption of psychotropic medications /opioids and falls in patients who have suffered trauma by studying the role of other variables in this relationship. METHOD: From 2011 to 2016, the presence of benzodiazepines, opioids and tricyclic antidepressants and other drugs in 1060 patients admitted for trauma at a level I trauma hospital was analysed. Multivariate models were used to measure the adjusted effect size of the association between consumption of benzodiazepines, opioids and tricyclic antidepressants and falls, and the effect of age on this association was studied. RESULTS: A total of 192 patients tested positive for benzodiazepines, opioids and tricyclic antidepressants, with same-level falls being the most frequent mechanism of injury in this group (40.1%), with an odds ratio of 1.96 (1.40-2.75), p < 0.001. Once other covariates were introduced, this association was not observed, leaving only age, gender (woman) and, to a lesser extent, sensory conditions as variables associated with falls. Age acted as an effect modifier between benzodiazepines, opioids and tricyclic antidepressants and falls, with significant effect sizes starting at 51.9 years of age. CONCLUSIONS: The association between the consumption of benzodiazepines, opioids and tricyclic antidepressants and falls in patients admitted for trauma is conditioned by other confounding variables, with age being the most influential confounding variable.

Effectiveness of a brief motivational intervention to increase the breastfeeding duration in the first 6 months postpartum: Randomized controlled trial.

AIMS: To evaluate the effectiveness of a brief motivational intervention to increase the breastfeeding duration in the first 6 months postpartum in mothers who began breastfeeding in the first hour after birth and to explore the role of general and breastfeeding self-efficacy in this relationship. DESIGN: A multi-centre randomized controlled clinical trial. METHODS: Data were collected from February 2018 - March 2019. Women were randomly assigned to an intervention group that received a brief motivational intervention (N = 44) or a control group that was offered standard education on breastfeeding (N = 44). Survival analysis techniques were carried out with a follow-up of 6 months. In addition, the roles of breastfeeding and general self-efficacy in the association between BMI and breastfeeding duration were explored through mediation/moderation analysis. RESULTS: Among 88 randomized patients (mean age, 32.82 years), 81 (92.04%) completed the trial. The survival analyses of exclusive breastfeeding and breastfeeding (exclusive and non-exclusive) showed reductions in the risk of abandonment in the intervention group of 63% (aHR: 0.37 [0.22-0.60] p < .001) and 61% (aHR: 0.39 [0.20-0.78] p = .008), respectively. We found that self-efficacy acted as a moderator of the effect of brief motivational intervention on breastfeeding self-efficacy. A discrete indirect effect of brief motivational intervention through increased breastfeeding self-efficacy was found on breastfeeding duration, with an index of moderated mediation of 0.08 (95% CI: 0.02-0.19). Greater positive variations in the breastfeeding self-efficacy scores during follow-up predicted exclusive and non-exclusive breastfeeding duration. CONCLUSION: A brief motivational intervention conducted in the immediate postpartum period increases breastfeeding and exclusive breastfeeding duration in the first 6 months. Although breastfeeding self-efficacy seems to moderate the effect of brief motivational intervention on the increase in breastfeeding duration, other factors may influence its effectiveness. Further studies could focus on exploring how brief motivational intervention works and whether it also works for pregnant mothers who have not yet decided whether to breastfeed. IMPACT: Brief motivational intervention could be introduced as part of routine care of women who begin breastfeeding to improve the low rates of exclusive breastfeeding at 6 months postpartum. TRIAL REGISTRATION: Unique Protocol ID: Moti003; https://ClinicalTrials.gov ID: NCT03357549.

Brief group-delivered motivational interviewing is equally effective as brief group-delivered cognitive-behavioral therapy at reducing alcohol use in risky college drinkers.

College students are particularly vulnerable to risky alcohol use, which increases their likelihood of developing an alcohol use disorder in the future. As such, preventing and reducing alcohol use among college students should be a priority for health and social policies. This work was aimed to show that brief group-delivered MI is as effective as brief-group CBT at reducing alcohol use in college students. Eighty-nine college students (69 females; mean age = 21.01, SD = 2.85) with risky alcohol use, as measured by the AUDIT-C, were assigned to two groups, receiving three sessions of either brief group-delivered MI or CBT (bMI/bCBT). Alcohol use was assessed 3 and 6 months after the interventions, and analyzed according to an Intention-to-treat design. Changes in alcohol use at both points (relative to baseline) as well as post-intervention scores of intention to continue treatment and satisfaction with the psychologist were compared across groups, using one-sided Bayesian t-tests. Alcohol use decreased in both groups at the 3- and 6-months measurement points (relative to baseline). However, using bCBT superiority as an alternative hypothesis and the absence of such superiority as a point-null hypothesis, the Bayes factors supported the null at both the 3- and the 6-months follow-up (BF01 = 7.13, and BF01 = 5.22 respectively). Furthermore, the intention to continue treatment was substantially higher in the bMI group (BF10 = 9.77). These results are considerably robust to changes in analyses' priors. This study suggests that bCBT is not more effective than bMI at reducing alcohol use in our college student group (in which females are overrepresented). Additionally, bMI showed higher intention to continue treatment scores. The comparable results of brief and group-delivered CBT and MI interventions in alcohol use reduction allows clinicians to select treatments based on their own skills or preferences without any detriment to efficacy.

Effects of Smoking and Physical Activity on the Pulmonary Function of Young University Nursing Students in Cáceres (Spain).

BACKGROUND: The simultaneous effect of physical activity (PA) and smoking on pulmonary function in young people remains unclear. PROPOSE: The aim of this study was to determine the influence of smoking and PA on pulmonary function in young university students in Cáceres, Spain. METHODS: A sample of 120 young nursing students was studied (60 smokers and 60 nonsmokers). All subjects underwent spirometry with a COPD-6 portable device, and their level of PA was quantified using the International Physical Activity Questionnaire. The influence of PA and smoking on pulmonary function was determined by comparing hypotheses. RESULTS: Significant differences were observed between smokers and nonsmokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and the difference between lung age and chronological age (LA-CA) in those who practiced mild PA. In the subjects who performed moderate and vigorous PA, these differences were not noted. In the intragroup analysis, significant differences were observed in smokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and LA-CA; however, in the control group, differences were only observed in terms of lung age and LA-CA. These findings were confirmed in the multivariate analysis. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Our findings confirmed a deterioration in pulmonary function in smokers who did not perform moderate or vigorous PA. The level of PA performed was positively related to pulmonary function in smokers, whereas in nonsmokers, improvements were only significant in LA-CA.

The effect of central nervous system depressant, stimulant and hallucinogenic drugs on injury severity in patients admitted for trauma / Efecto de las drogas alucinógenas, estimulantes y depresoras del sistema nervioso central sobre la gravedad de la lesión en pacientes ingresados por traumatismos

Objective: The effect of drugs other than alcohol on severity of trauma remains unclear. Pooled data analyses in previous studies that grouped substances with opposite effects on the central nervous system (CNS) may have masked the influence of substances on injury severity. The aim was to analyze the effect of stimulant, hallucinogenic and depressant drugs other than alcohol on injury severity in trauma patients. Methods: The presence of alcohol, stimulant drugs (cocaine, amphetamines and methamphetamines), depressant drugs (benzodiazepines, opiates, methadone and barbiturates) and hallucinogenic drugs (THC and PCP) was analyzed in 1187 patients between 16 and 70 years old admitted to a trauma hospital between November 2012 and June 2015. Injury severity was determined prospectively as the Injury Severity Score. A multivariate analysis was used to quantify the strength of association between exposure to substances and trauma severity, using the presence of alcohol as a stratification variable. Results: Drugs other than alcohol were found in 371 patients (31.3%): 32 (2.7%) stimulants, 186 (15.3%) depressants, 78 (6.6%) hallucinogenics and 75 (5.6%) polydrug use. The presence of CNS depressant substances was associated with increased injury severity only in patients also exposed to alcohol, with an adjusted odds ratio of 4.63 (1.37-15.60) for moderate injuries and 7.83 (2.53-24.21) for severe. Conclusion: CNS depressant drugs had a strong influence on injury severity in patients who screened positive for alcohol consumption

Objetivo: No está claro qué efecto tienen las drogas distintas del alcohol sobre la gravedad de los traumatismos. Los análisis incluidos en estudios previos, que agrupan sustancias con efectos opuestos sobre el sistema nervioso central (SNC), pueden haber enmascarado la influencia de estas sobre la gravedad. El objetivo fue analizar el efecto de las drogas alucinógenas, estimulantes y depresoras del SNC, diferentes del alcohol, sobre la gravedad de las lesiones en pacientes ingresados por traumatismos. Métodos: Se analizó la presencia de alcohol, drogas estimulantes (cocaína, anfetaminas y metanfetaminas), depresoras (benzodiacepinas, opiáceos, metadona y barbitúricos) y alucinógenas (THC y PCP) en 1187 pacientes de entre 16 y 70 años de edad ingresados por traumatismo de noviembre de 2012 a junio de 2015. La gravedad del traumatismo se determinó prospectivamente mediante la Injury Severity Score. Se cuantificó la fuerza de la asociación entre la exposición a sustancias y la gravedad del traumatismo mediante un análisis multivariante, utilizando la presencia de alcohol como variable de estratificación. Resultados: Se encontraron drogas diferentes del alcohol en 371 pacientes (31,3%): 186 (15,3%) depresoras, 78 (6,6%) alucinógenas, 32 (2,7%) estimulantes y 75 (5,6%) combinadas. La presencia de sustancias depresoras del SNC se asoció con un aumento de la gravedad del traumatismo solo en pacientes también expuestos al alcohol, con una odds ratio ajustada de 4,63 (1,37-15,6) para lesiones moderadas y de 7,83 (2,53-24,21) para lesiones graves. Conclusión: Las drogas depresoras del SNC tuvieron una fuerte influencia en la gravedad del traumatismo en los pacientes que además presentaban resultados positivos para consumo de alcohol

Sex differences in the association between impulsivity and driving under the influence of alcohol in young adults: The specific role of sensation seeking.

INTRODUCTION: There is an outstanding need to identify predictors of driving under the influence of alcohol (DUI) among young adults, particularly women. Impulsivity, or the tendency to act without thinking, is a predictor of DUI, but the specific facets of impulsivity that predict DUI and their interaction with sex differences remain unclear. We aimed to investigate sex differences in the link between impulsivity facets and DUI. Moreover, we sought to replicate previous findings regarding sex differences on impulsivity, and associations between impulsivity facets and DUI. METHOD: A total of 506 university students participated in the study (males, n = 128; females, n = 378). Participants completed measures of impulsivity (UPPS-P short version), alcohol use (AUDIT-C), frequency of DUI episodes and related perception of risk. The UPPS-P assesses five facets of impulsivity: sensation seeking, (lack of) premeditation and perseverance and positive and negative urgency. RESULTS: Men showed higher sensation seeking and lack of perseverance, alcohol use and DUI frequency and lower risk perception than women. DUI frequency was negatively associated with perception of risk and positively associated with alcohol use and the five impulsivity facets. After controlling for alcohol use and risk perception, only lack of premeditation was associated with DUI frequency in the whole sample. Sensation seeking was positively associated with DUI frequency only in women. DISCUSSION: The link between lack of premeditation and DUI suggest that pre-drinking planning strategies can contribute to prevent risky driving. In women, specific links between sensation seeking and DUI suggest the need for personality-tailored prevention strategies.

The effect of central nervous system depressant, stimulant and hallucinogenic drugs on injury severity in patients admitted for trauma.

OBJECTIVE: The effect of drugs other than alcohol on severity of trauma remains unclear. Pooled data analyses in previous studies that grouped substances with opposite effects on the central nervous system (CNS) may have masked the influence of substances on injury severity. The aim was to analyze the effect of stimulant, hallucinogenic and depressant drugs other than alcohol on injury severity in trauma patients. METHODS: The presence of alcohol, stimulant drugs (cocaine, amphetamines and methamphetamines), depressant drugs (benzodiazepines, opiates, methadone and barbiturates) and hallucinogenic drugs (THC and PCP) was analyzed in 1187 patients between 16 and 70 years old admitted to a trauma hospital between November 2012 and June 2015. Injury severity was determined prospectively as the Injury Severity Score. A multivariate analysis was used to quantify the strength of association between exposure to substances and trauma severity, using the presence of alcohol as a stratification variable. RESULTS: Drugs other than alcohol were found in 371 patients (31.3%): 32 (2.7%) stimulants, 186 (15.3%) depressants, 78 (6.6%) hallucinogenics and 75 (5.6%) polydrug use. The presence of CNS depressant substances was associated with increased injury severity only in patients also exposed to alcohol, with an adjusted odds ratio of 4.63 (1.37-15.60) for moderate injuries and 7.83 (2.53-24.21) for severe. CONCLUSION: CNS depressant drugs had a strong influence on injury severity in patients who screened positive for alcohol consumption.

A randomized controlled trial to evaluate the effectiveness of a brief motivational intervention to improve exclusive breastfeeding rates: Study protocol.

AIMS: To estimate the effectiveness of a brief motivational intervention (BMI) in increasing the duration of exclusive breastfeeding in the first 6 months postpartum. A complementary aim was to examine a potential mediating role of breastfeeding self-efficacy in the effectiveness of the BMI. BACKGROUND: Breastfeeding is associated with benefits for babies and mothers' health. Among the pool of techniques used to encourage healthy behaviours, BMI is highlighted based on the principles of motivational interviewing. One of the main components of these interventions is the promotion of self-efficacy, which, in fact, is a key factor for breastfeeding success. DESIGN: A multi-centre randomized controlled clinical trial of parallel groups. METHODS: Women who begin to breastfeed in the first hour after birth will be randomly assigned to the intervention group (receiving a BMI at immediate postpartum plus a telephone booster at the 1st and 3rd month postpartum) or the control group (receiving standard breastfeeding education at the same time). Outcome measures include the following: breastfeeding, breastfeeding self-efficacy, general self-efficacy, and postnatal depression. Data will be collected before the intervention and at the 1st, 3rd, and 6th month after birth. The study protocol has been approved by Badajoz Ethics Committee of Clinical Research in October 2017. DISCUSSION: This study will identify the effectiveness of BMI in improving exclusive breastfeeding rates. The findings will give useful evidence to health professionals about how to support breastfeeding. IMPACT: This study will address the low-exclusive breastfeeding rates, that in our country are far lower than World Health Organization's recommendation.

Automatic or manual arterial path for the ankle-brachial differences pulse wave velocity.

An automated method for measuring arterial path length with devices that determine pulse wave velocity (PWV) in peripheral arteries is frequently applied. We aimed to compare arterial path length measurements based on mathematical height-based formulas with those measured manually and to assess whether the ankle-brachial difference (abD-PWV) measured with the VOPITB device is comparable to that obtained by manual measurements. In 245 patients, a metric measuring tape was used to determine the arterial path length from the suprasternal notch to the midpoint of the VOPITB cuffs wrapped around the extremities, and the results were compared with those obtained with height-based formulas. We examined the relationship between the abD-PWV measured with both methods. The arterial path length measured manually was shorter than that calculated automatically by 5 ± 2 and 30 ± 4 cm-of 13% and 21% for the arms and legs, respectively (difference of 13% and 21%). As a result, the abD-PWV calculated with the automatic method was greater (automatic abD-PWV vs. manual: 462 ± 90 vs. 346 ± 79 cm/s). The Blant Altman plot showed a percentage error of: 15,2%, 7,5% and 17,3% for heart-brachial, heart-ankle length and abD-PWV respectively. In conclusion there were significant differences between manual and automated arterial length measurements and it translates into difference abD-PWV calculate from both methods. However, the Bland-Alman plot showed that abD-PWV was comparable for both techniques. The advantages of height-based formulas for the calculation of arterial path lengths suggest that they may be the recommended method for measuring the abD-PWV.

Association between the detection of alcohol, illicit drugs and/or psychotropic medications/opioids in patients admitted due to trauma and trauma recidivism: A cohort study.

OBJECTIVE: To quantify the association between the presence and type of drug detected and trauma recidivism in a cohort of patients admitted due to trauma. METHOD: A cohort study was conducted based on data from a project where the presence of alcohol and other drugs (cannabis, cocaine, amphetamines, methamphetamines, tricyclic antidepressants, barbiturates, opiates and benzodiazepines) was analysed in 1,187 patients aged 16 to 70 years admitted due to trauma. The patients were followed for a period of between 10 to 52 months until June 2016. For this study, the recurrence of injuries from a sample of 929 patients from this cohort was analysed according to their consumption profile. Survival curves were estimated and adjusted Hazard Rate Ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated. RESULTS: The incidence rate of TR was 10.94 cases per 100 patient-years in the group of patients negative for substances and 27.99 per 100 patient-years in positive patients. The survival curves show very significant differences in cumulative recurrence-free survival between the groups (Log Rank: p<0.001). Both the aHRR and the aIRR estimates show an increased risk of re-injury due to alcohol consumption (aIRR: 2.33 (1.72-3.15), p<0.001), cannabis use (aIRR: 1.87 (1.09-3.20), p = 0.022) and polydrug use (aIRR: 2.34 (1.80-3.04), p<0.001). CONCLUSIONS: The presence of alcohol and/or illicit drugs in these patients doubles the risk of trauma recidivism.

Critical points in the experience of spouse caregivers of patients who have suffered a stroke. A phenomenological interpretive study.

AIMS: To explore and document the experiences and values of spouse caregivers of stroke survivors. To gain more in-depth knowledge of how the act of caring and the adaption process affects caregiving spouses. MATERIALS AND METHODS: Phenomenological, qualitative study. This study included spouses of stroke survivors who also served as primary caregivers. Individual, semi-structured, in-depth interviews were conducted, transcribed, and analysed using a thematic content analysis as proposed by Giorgi. Data was analysed and managed using Atlas-ti (version 7.0). This study was approved by our institution´s Complejo Hospitalario de Caceres Ethics and Research Committee. RESULTS: Spouse caregivers of stroke survivors undergo a process of disruption in their private lives and relationships, marked by their caregiving duties. The experiences of spouses caring for stroke survivors is condensed into topics and subtopics: "Caregiving and that´s all" summarizes the sense of having no life horizons and also caregiver impossibility of moving away from caring role. Otherwise, "Breaking the couple´s life together" enlightens the further consequences of stroke in couples shared live biography, which needs to be understood and rebuilt. Finally, "Going through the (non) loss alone" alludes to how spouses reinterpret meaning of loss, which is not appreciated by others and that refers to the balance between stroke survival and any acquired global disability. CONCLUSIONS: A comprehensive approach to the couple (family), from a psycho-socio-emotional and relational perspective, is essential for ensuring adequate quality of life for people who suffered a stroke as well as their caregivers. Spouses-caregivers must be considered as individuals living a transition process due to their unexpected disrupting change, which nurses should address through a comprehensive and integrated approach focused on transition care. Care resources must be adapted to the interpretation that the spouses have of their caregiving role and their relationship with the different components of the caregiving process.