[Maintenance of chest compressions skill in cardiopulmonary resuscitation in primary health care professionals: Quasi-experimental study]. / Mantenimiento de la habilidad de las compresiones torácicas en reanimación cardiopulmonar en profesionales de la atención primaria de salud: estudio cuasiexperimental.

OBJECTIVE: To validate the efficacy of brief CPR training with dual feedback to maintain the ability to perform quality chest compressions. MATERIALS AND METHODS: Quasi-experimental study with two groups to evaluate a brief theoretical training followed by a practice with manikin with feedback; Participants: 155 health and non-health professionals from 5 primary care health centers of urban area (43 losses); Main measurements: Characteristics of compressions that were measured before and after the brief training and their maintenance at 3 and 6 months according to the study group. The effect of training and maintenance of skills were analyzed using multiple linear regression models. RESULTS: 155 participants were included, mean age 39.7 years (SD=12.0) with 82.7% female. The training effect had an improvement in mean compression depth (pre-post difference: 3.5, P<.001), total compressions with adequate depth (pre-post difference: 0.2, P<.001) and Total Compressions with Adequate Rhythm (pre-post difference: 0.4, P<.001). The second phase was completed by 112 participants (72.2%). Compression skills declined at 3 months and were lower at 6 months, although the loss of skills was not statistically significant between the two groups. CONCLUSIONS: An individualized, brief training action with feedback immediately improves the quality of compressions. The progressive loss of skills from 3 to 6 months is not relevant.

Healthy dietary pattern and their corresponding gut microbiota profile are linked to a lower risk of type 2 diabetes, independent of the presence of obesity.

BACKGROUND: Prediabetes and old age are both high risk factors for developing Type 2 Diabetes (T2D), while obesity is one of the most important factors triggering the disease. Nutritional interventions are the most effective tool for preventing T2D, as they improve different biochemical and anthropometric outcomes and growth-promoting/inhibiting gut microbiota populations. However, to date there are no specific dietary recommendations to stop the development of T2D in elderly groups, for whom hypocaloric diets and other commonly used weight-loss programs could be considered dangerous. The objective of our study, thus, was to understand the impact of dietary patterns on T2D risk as related to gut microbiota profile in obese and non-obese elderly prediabetic subjects. METHODS: A cross-sectional study was performed in 182 subjects ≥65 years old with prediabetes, divided into obese (OB) or non-obese (NOB) subgroups, and their risk of developing T2D was measured according to FINDRISK score and biochemical parameters. Also, clusters into different dietary patterns in each group by PCA analysis was related with gut microbiota, which was analyzed from stool samples by qPCR. The creation of clusters was used to re-evaluate T2D risk. RESULTS: OB was at higher risk of developing T2D and showed worse metabolic outcomes. Unhealthier and healthier dietary pattern clusters were observed for both OB (OB-6 and OB-5 respectively) and NOB (NOB-2 and NOB-3 respectively) groups. Results obtained from the gut microbiota showed that only Prevotella was higher in NOB, but when comparisons were made between clusters, a clear relation with dietary pattern was observed; showing in healthier dietary clusters a decrease in Prevotella, an increase of Faecalibacterium prausnitzii and an increase in lactic acid bacteria. T2D risk was greater in the obese group between unhealthier dietary clusters. No difference between healthier dietary clusters was observed. CONCLUSION: A healthy dietary pattern and the growth-promoting beneficial and growth-inhibiting disadvantageous gut microbiota populations linked to it provide protection against the development of T2D in an obese population with advanced age and preDM.

Función y respaldo a la asociación de pacientes con psoriasis en España según sus miembros: estudio descriptivo transversal / The Spanish psoriasis patients’ association according to its members: cross-sectional descriptive study of members’ opinions of the association’s functions

INTRODUCCIÓN: Las asociaciones de pacientes son un elemento más del sistema sanitario, sin embargo en España se desconoce la funcionalidad y el respaldo que tienen según sus propios asociados. OBJETIVO: Estudiar la funcionalidad de la principal asociación española de pacientes y familiares afectados por la psoriasis según sus propios socios. MATERIAL Y MÉTODOS: Estudio mediante un cuestionario autoadministrado a una muestra de socios y/o simpatizantes (población total = 26.349 personas). Se estudió la credibilidad, confianza y satisfacción y se comparó con otros agentes sanitarios. El cuestionario de funcionalidad se analizó con un modelo de Rasch, y se examinó si había diferencias entre grupos de participantes con la prueba de ANOVA. RESULTADOS: Participaron 746 socios y/o simpatizantes (tasa de respuesta 2,83%). La credibilidad de la asociación se situó tras la de los especialistas que tratan la psoriasis. El respaldo medio a la función de la asociación fue notable (7,53 en una escala de 0 a 10). Según los socios las funciones mejor puntuadas se relacionaban con acciones colectivas para sensibilizar a la sociedad sobre el problema de la psoriasis, en cambio, tuvieron una menor valoración las acciones relacionadas con los servicios de atención personalizada. Solo hubo diferencias significativas (p < 0,05) en el respaldo a la asociación en función del nivel académico de los participantes. CONCLUSIONES: Las asociaciones son unas instituciones que contribuyen a la difusión de información de la enfermedad, que cuidan y representan a los pacientes. Los profesionales de salud e instituciones deberían tenerlas en cuenta para afrontar la psoriasis y diseñar políticas de salud efectivas

INTRODUCTION: Patient associations form part of health care systems, but little is known about how their members' view the functionality of these associations and whether they endorse their goals and activities. OBJECTIVE: To study how the members of the leading Spanish association of patients with psoriasis and their relatives view the group's functioning. MATERIAL AND METHODS: Survey study using a self-administered questionnaire answered by members of the association (total membership, 26 349 persons). The credibility of the association and respondents' confidence in and satisfaction with it were studied and compared with their attitudes toward other agents in the health care system. A Rasch model was used to analyze respondents' ranking of functions. Analysis of variance was used to study between-group differences. RESULTS: A total of 746 members participated (response rate 2.83%). The association's credibility was rated in second place, after that of specialists who treat psoriasis. Support for the association functions was good (7.53 on a scale of 0 to 10). The function the members rated highest was the raising of societal awareness of psoriasis and its problems. Rated lowest were functions related to personal services for members. Educational level was the only participant factor associated with significant differences in evaluations (P < .05). CONCLUSIONS: The psoriasis association contributes by disseminating information about the disease and patient care, and it serves to represent patients. Health professionals and institutions should take the association into account in their efforts to deal with the disease and in designing effective policies

The Spanish Psoriasis Patients' Association According to Its Members: Cross-Sectional Descriptive Study of Members' Opinions of the Association's Functions. / Función y respaldo a la asociación de pacientes con psoriasis en España según sus miembros: estudio descriptivo transversal.

INTRODUCTION: Patient associations form part of health care systems, but little is known about how their members' view the functionality of these associations and whether they endorse their goals and activities. OBJECTIVE: To study how the members of the leading Spanish association of patients with psoriasis and their relatives view the group's functioning. MATERIAL AND METHODS: Survey study using a self-administered questionnaire answered by members of the association (total membership, 26 349 persons). The credibility of the association and respondents' confidence in and satisfaction with it were studied and compared with their attitudes toward other agents in the health care system. A Rasch model was used to analyze respondents' ranking of functions. Analysis of variance was used to study between-group differences. RESULTS: A total of 746 members participated (response rate 2.83%). The association's credibility was rated in second place, after that of specialists who treat psoriasis. Support for the association functions was good (7.53 on a scale of 0 to 10). The function the members rated highest was the raising of societal awareness of psoriasis and its problems. Rated lowest were functions related to personal services for members. Educational level was the only participant factor associated with significant differences in evaluations (P<.05). CONCLUSIONS: The psoriasis association contributes by disseminating information about the disease and patient care, and it serves to represent patients. Health professionals and institutions should take the association into account in their efforts to deal with the disease and in designing effective policies.

Conflictos de intereses en investigación clínica en el área de atención primaria de salud / Conflicts of interests in clinical research in primary health care

En investigación biomédica los conflictos de intereses entre profesionales y pacientes pueden ser un problema ético. Ninguna de las normas legales vigentes en España menciona si el investigador debe clarificar a los participantes de un estudio clínico todos los motivos por los que le es propuesto participar. En este artículo, los conflictos de intereses en investigación se analizan en el contexto de atención primaria y se clarifica la importancia de tenerlos en cuenta. En esta área clínica los conflictos de intereses pueden afectar a la confianza terapéutica y alterar la función social que tiene. Finalmente, se sugieren algunas estrategias de carácter práctico que pueden facilitar a los participantes tomar la decisión de participar en un estudio clínico con mayor voluntariedad y autonomía (AU)

Conflicts of interests between professionals and patients in biomedical research, is an ethical problem. None of the laws in Spain mention whether the clinical researcher has to clarify to participants the reasons why it proposes them to participate in a clinical trial. In this article, conflicts of interests in research are discussed in the context of primary healthcare. In this area conflicts of interests might alter the confidence between patients and healthcare professionals. Finally, we suggest some practical strategies that can help participants make the decision to participate in a clinical trial more willingly and freely (AU)

[Conflicts of interests in clinical research in primary health care]. / Conflictos de intereses en investigación clínica en el área de atención primaria de salud.

Conflicts of interests between professionals and patients in biomedical research, is an ethical problem. None of the laws in Spain mention whether the clinical researcher has to clarify to participants the reasons why it proposes them to participate in a clinical trial. In this article, conflicts of interests in research are discussed in the context of primary healthcare. In this area conflicts of interests might alter the confidence between patients and healthcare professionals. Finally, we suggest some practical strategies that can help participants make the decision to participate in a clinical trial more willingly and freely.

Una bioética clínica para la atención primaria de salud / Clinical bioethics for primary health care

El modelo de toma de decisiones éticas en el área de atención primaria difiere de otras áreas asistenciales. Desde la perspectiva ética es relevante incorporar estas particularidades al método de deliberación. El presente artículo justifica la necesidad de un procedimiento de deliberación ética propio para la atención primaria y realiza una propuesta metodológica. Este proceso de decisión es flexible y requiere un sistema de salud participativo. Esta propuesta tiene la finalidad de facilitar la adquisición de responsabilidad sobre la salud personal y colectiva, e implica a profesionales y ciudadanos de igual manera (AU)

The clinical decision making process with ethical implications in the area of primary healthcare differs from other healthcare areas. From the ethical perspective it is important to include these issues in the decision making model. This dissertation explains the need for a process of bioethical deliberation for Primary Healthcare, as well as proposing a method for doing so. The decision process method, adapted to this healthcare area, is flexible and requires a more participative Healthcare System. This proposal involves professionals and the patient population equally, is intended to facilitate the acquisition of responsibility for personal and community health (AU)

[Clinical bioethics for primary health care]. / Una bioética clínica para la atención primaria de salud.

The clinical decision making process with ethical implications in the area of primary healthcare differs from other healthcare areas. From the ethical perspective it is important to include these issues in the decision making model. This dissertation explains the need for a process of bioethical deliberation for Primary Healthcare, as well as proposing a method for doing so. The decision process method, adapted to this healthcare area, is flexible and requires a more participative Healthcare System. This proposal involves professionals and the patient population equally, is intended to facilitate the acquisition of responsibility for personal and community health.