Assessing relational, emotional, and physical dimensions of young players during the tag game / Evaluación de las dimensiones relacional, emocional y física de jóvenes jugadores durante el juego de pillar / Avaliação das dimensões relacional, emocional e física de jovens jogadores durante o jogo de pega-pega

Many tag games present unstable motor communications between players, that is, the motor communication varies during the play due to role-changing. A holistic point of view provides a more complete assessment of the experience of the players during the traditional tag games. Thus, the aims of the study were to propose and use a specific guide to assess the relational, emotional, and physical dimensions during a traditional motor game in young players. Twenty-two young players took part in the study. The participants played a modification of the classic itmotor game for ten minutes. The relational dimension was assessed by observational methodology analysing counter-communications between the tagger and the runner who experienced the counter-communication. The emotional dimension was assessed by the BECS scale of perceived enjoyment and competence. Physical dimension was assessed by differentiating the tagger, the runner, and the target-player measuring the Total Distance covered per second. The relational analysis provided clues about the social relationship of the group. The high values of enjoyment (4.4 ± 0.6) and perceived competence (4.0 ± 0.6) declared by players (suggested the use of the traditional tag game during physical educationlessons and sport training. The tagger performed significantly greater total distance than the rest of the players (p< .001; Effect Size = 1.53 –2.76), suggesting that the assessment of the physical dimension during motor games should be carried out differentiating the motor roles. The assessment of the experience of the players during the motor games differentiating by roles and from a holistic point of view could help to optimise the pedagogical plan. (AU)

Gran parte de los juegos de pillarpresentan comunicaciones motrices inestables entre los jugadores, es decir, la comunicación motriz (i.e. interacciones de cooperación, oposición o neutras) varía durante el juego debido al cambio de rol. El punto de vista holístico posibilita una valoración más completa de la experiencia de los jugadores durante el juego tradicional de pillar. Por lo tanto, los objetivos del estudio fueron presentar y emplear una propuesta para valorar las dimensiones relacional, emocional y física de jóvenes jugadores durante un juego motor. Veintidós jóvenes jugadores participaron en el estudio. Los jugadores jugaron a una modificación del juego de pillardurante diezminutos. La dimensión relacional fue evaluada mediante la metodología observacional, analizando las contra-comunicaciones entre el pilladory el jugador contra-comunicado, la dimensión emocional mediante la escala BECS de disfrute y competencia percibida, y el análisis de la dimensión física(i.e. Distancia Total recorrida por segundo) diferenciando los roles motricesdurante el juego. El análisis relacional aportó pistas sobre las relaciones sociales del conjuntode participantes. Los altos niveles de disfrute (4.4 ± 0.6) y competencia percibida (4.0 ± 0.6) declarados por los jugadores sugieren el uso del juego tradicional de pillardurante las sesiones de educación física y de entrenamiento deportivo. El pilladorrecorrió una distancia significativamente mayor que el resto de los jugadores (p< .001; Tamaño del Efecto = 1.53 –2.76), sugiriendo que la valoración de la dimensión física debería ser llevada a cabo diferenciando los roles motrices. La evaluación de la experiencia de los jóvenes jugadores durante los juegos motores desde un punto de vista holístico y diferenciando por roles podría ayudara optimizar la intervención pedagógica. (AU)

Grande parte dos jogos de pega-pega apresenta comunicações motoras instáveis entre os jogadores, ou seja, a comunicação motora (i.e. interações cooperativas, opostas ou neutras) varia durante o jogo devido à câmbio de papel. O ponto de vista holístico permite uma avaliação mais completa da experiência dos jogadores durante o jogo tradicional de pega-pega. Portanto, os objetivos do estudo foram apresentar e utilizar uma proposta para avaliar as dimensões relacional, emocional e física de jovens jogadores durante um jogo motriz. Vinte e dois jovens jogadores participaram do estudo. Os jogadores jogaram um jogo de pega-pega modificado por 10 minutos. A dimensão relacional foi avaliada por meio da metodologia observacional, analisando as contracomunicações entre o apanhador e o jogador contracomunicado. A dimensão emocional foi avaliada por meio da escala BECS de prazer e competência percebida. A avaliação da dimensão física foi realizada diferenciando os papéis motrices através da medição da Distância Total percorrida por segundo. A análise relacional forneceu pistas sobre as relações sociais do grupo de participantes. Os altos níveis de prazer (4.4 ± 0.6)e competência percebida (4.0 ± 0.6)declarados pelos jogadores sugerem a utilização do tradicional jogo de pega-pega durante as sessões de educação física e treinamento esportivo. Aquele que o apanha percorreu uma distância significativamente maior (p < .001; Tamanho do Efeito = 1.53 –2.76) do que o restante dos jogadores, sugerindo que a avaliação da dimensão física deve ser realizada diferenciando os papéis motrices. A avaliação da experiênciade jovens jogadores durante os jogos motrices de um ponto de vista holístico e diferenciado por papéis pode ajudar a otimizar a intervenção pedagógica. (AU)

Role of primary care in the follow-up of patients with obstructive sleep apnoea undergoing CPAP treatment: a randomised controlled trial.

OBJECTIVE: To evaluate whether follow-up of patients with obstructive sleep apnoea (OSA) undergoing CPAP treatment could be performed in primary care (PC) settings. DESIGN: Non-inferiority, randomised, prospective controlled study. SETTINGS: Sleep unit (SU) at the University Hospital and in 8 PC units in Lleida, Spain. PARTICIPANTS: Patients with OSA were randomised to be followed up at the SU or PC units over a 6-month period. MAIN OUTCOMES MEASURED: The primary outcome was CPAP compliance at 6 months. The secondary outcomes were Epworth Sleep Scale (ESS) score, EuroQoL, patient satisfaction, body mass index (BMI), blood pressure and cost-effectiveness. RESULTS: We included 101 patients in PC ((mean±SD) apnoea-hypopnoea index (AHI) 50.8±22.9/h, age 56.2±11 years, 74% male) and 109 in the SU (AHI 51.4±24.4/h, age 55.8±11 years, 77% male)). The CPAP compliance was (mean (95% CI) 4.94 (4.47 to 5.5) vs 5.23 (4.79 to 5.66) h, p=0.18) in PC and SU groups, respectively. In the SU group, there were greater improvements in ESS scores (mean change 1.79, 95% CI +0.05 to +3.53, p=0.04) and patient satisfaction (-1.49, 95% CI -2.22 to -0.76); there was a significant mean difference in BMI between the groups (0.57, 95% CI +0.01 to +1.13, p=0.04). In the PC setting, there was a cost saving of 60%, with similar effectiveness, as well as a decrease in systolic blood pressure (-5.32; 95% CI -10.91 to +0.28, p=0.06). CONCLUSIONS: For patients with OSA, treatment provided in a PC setting did not result in worse CPAP compliance compared with a specialist model and was shown to be a cost-effective alternative. TRIAL REGISTRATION NUMBER: Clinical Trials NCT01918449.

El nivel de triaje en urgencias cambia según la escala de valoración del dolor utilizada / The choice of pain assessment scale influences emergency department triage grading

Objetivo: Valorar la concordancia entre la escala visual analógica (EVA) y la escala de valoración numérica (EVN) y comprobar si el utilizar una u otra puede modificar el nivel de triaje. Método: Estudio observacional, descriptivo y prospectivo, que incluyó a pacientes de edad superior a 14 años que consultaban por dolor en los que se utilizó tanto la escala EVA como la EVN. Los datos fueron insertados en una base de datos y se realizó una estadística descriptiva mediante análisis de frecuencias, una prueba de Levene y test ANOVA, el coeficiente de correlación de Lin, así como el método Passing y Bablok con un nivel de confianza del 95%.Resultados: La media de puntuación con la escala EVA fue 6,27 (desviación típica 2,02;IC 5,91-6,62), mientras que con la EVN fue 7,54 (desviación típica 1,94; IC 7,20-7,88(p < 0,001). El coeficiente de correlación de Lin es 0,652, e indica que el acuerdo es entre regular y bueno. El nivel de triaje al utilizar la escala EVA fue III en el 69,5%(N = 89) y II en el 19,5% (N =25), mientras que al utilizar la escala EVN el nivel detriaje fue III en el 41,4% (N = 53) y II en el 54,7% (N = 70) (p < 0,001).Conclusiones: Las escalas evaluadas no son intercambiables, pues la escala EVN muestra una tendencia a la sobrevaloración del dolor. Aconsejamos la utilización de la escala EVA en los servicios de urgencias desde el triaje hasta el alta del paciente (AU)

Objectives: To evaluate agreement between visual analog scale (VAS) and verbal numeric scale (VNS) pain assessments and explore whether using one scale or the other affects triage grading. Method: Prospective descriptive observational study that included patients over the age of 14 years who came to the emergency department with pain. The patients assessed pain on both a VAS and a VNS. Information was input to a database for descriptive statistics (frequencies) and analysis (Levene test, analysis of variance, and the Lin correlation coefficient). Passing-Bablock regression was used; 95% CIs were calculated. Results: The mean (SD) VAS rating was 6.27 (2.02) (95% CI, 5.91-6.62). The mean VNS rating was 7.54 (1.94) (95% CI,7.20-7.88) (P<0.001). The Lin correlation coefficient of 0.652 indicated a moderate-to-good level of agreement between scales. When the VAS pain rating was used as the basis for triage, a priority level 3 was assigned to 89 patients (69.5%)and a level 2 priority to 25 (19.5%). When the VNS pain rating was the basis for triage, 53 patients (41.4%) were assigned to level 3 priority and 70 (54.7%) to level 2 priority (P<0.001).Conclusions: The VAS and VNS pain rating instruments are not interchangeable. Pain assessments are higher when the VNSis used. We advise use of the VAS in the ED for triage and until the patient is discharged (AU)

Adaptive behaviour in Angelman syndrome: its profile and relationship to age.

BACKGROUND: Angelman syndrome (AS) is a neurodevelopmental disorder usually caused by an anomaly in the maternally inherited chromosome 15. The main features are severe intellectual disability, speech impairment, ataxia, epilepsy, sleep disorder and a behavioural phenotype that reportedly includes happy disposition, attraction to/fascination with water and hypermotoric behaviour. METHOD: We studied the level of adaptive behaviour and the adaptive behavioural profile in the areas of 'motor skills', 'language and communication', 'personal life skills' and 'community life skills' in a group of 25 individuals with genetically confirmed AS, to determine whether there is a specific adaptive behaviour profile. RESULTS AND CONCLUSIONS: None of the individuals, whatever their chronological age, had reached a developmental age of 3 years. A specific adaptive behaviour profile was found, with 'personal life skills' emerging as relative strengths and 'social and communication skills' as weaknesses.

Las tareas del psicólogo deurgencias / No disponible

Los estresores organizacionales, profesionales y ambientales,propios del ámbito físico de las urgencias hospitalariasgeneran elevado estrés, no sólo entre los profesionalessanitarios, sino también entre los usuarios de estos serviciosy sus familiares.Tradicionalmente esta situación ha sido asumida comoconsustancial al rol. El aumento de la frecuencia de las agresionesfísicas ha sido el detonante que nos conduce a la búsquedade soluciones al problema global.En este contexto aparecen una serie de propuestas ymedidas, de entre las cuales destaca la introducción de lafigura del psicólogo de urgencias. La caracterización de estafigura reviste gran importancia, ya que su idoneidad determinaráen gran medida su eficacia (AU)

What generates organizational stress, professional andenvironmental, own of physical environment in the hospitalemergency department generate high stress, not justbetween sanitary professionals, but also between the usersof these services and their relatives.Traditionally this situation has been assumed as consubstantialto the role.The increase of the sexual aggression’s frequency hasbeen the explosive that conducts us to the search of solutionsto the global problem.In this context it appears a series of proposals and measuresfromamong which emphasizes the figure of the emergencypsychologist. The characterization of this figure coversgreat importance, since its suitability will determine ingreat measure its efficacy (AU)

[Malama project in the Region of Murcia (Spain): environment and breastfeeding]. / Proyecto Malama en la Región de Murcia (España): medio ambiente y lactancia materna.

OBJECTIVES: To identify protective factors and risk factors for the initiation and length of breastfeeding and full breastfeeding, in the Region of Murcia (Spain). PATIENTS AND METHODS: The Malama study (Medio Ambiente y Lactancia Materna) is a follow up study from birth up to years of 1,000 mother-child pairs. A description of breastfeeding practices are presented here, the survival curve of breastfeeding and a Cox regression model of the pilot study that includes 101 mother-child pairs and 6 months of follow-up. RESULTS: After six months the prevalence of breastfeeding was 35 %. The mean duration of full breastfeeding was 63 days (median 45 days) with six months prevalence of 8 %. Hazard ratios (HR) for full breastfeeding were, to be a smoker (1.89; 95 % CI: 1.18-3.02), older than 35 years of age (2.04; 95 % CI: 1.22-3.42), caesarean birth (1.63; 95 % CI: 1.00-2.66). As well as those previously mentioned risks for breastfeeding, there were also hazard ratios for primary school education or less (1.63; 95 % CI: 0.98-2.82); to have breastfed an earlier child for at least 16 weeks (0.33; 95 % CI: 0.13-0.79), and to be the first birth (0.50; 95 % CI: 0.27-0.95). The length of both breastfeeding and full breastfeeding increased with the length of the maternal leave (0.96; 95 % CI: 0.94-0.99). Pregestational occupational exposure to endocrine disruptors did not seem to interfere with the duration of breastfeeding. CONCLUSIONS: In order to improve quality and duration of breastfeeding programmes, paediatric research and training on breastfeeding practice should be encouraged, to reduce unnecessary caesarean sections, promote tobacco cessation, focus human and economic resources to women with less education, and include legal mechanisms to ensure longer maternal leave.

Proyecto Malama en la Región de Murcia (España): medio ambiente y lactancia materna / Malama project in the Region of Murcia (Spain): environment and breastfeeding

Objetivo: Estudiar los factores protectores y de riesgo de la calidad y duración de la lactancia materna completa (LMC) y total (LMT) en la Región de Murcia. Pacientes y métodos: El estudio Malama (medio ambiente y lactancia materna) realiza un seguimiento de 1.000 parejas madre-hijo desde el nacimiento hasta los 2 años. Aquí presentamos la descripción, supervivencia de la lactancia y regresión de Cox del estudio piloto con 101 parejas y 6 meses de seguimiento. Resultados: La duración media de la LMC fue de 63 días (mediana de 45) y prevalencia a los 6 meses del 8 %. La prevalencia de LMT fue del 35 %. Riesgo relativo (RR) para LMC eran ser madre fumadora (1,89; intervalo de confianza del 95 % [IC 95 %]: 1,18-3,02), mayor de 35 años (2,04; IC 95 %: 1,22-3,42), con parto por cesárea (1,63; IC 95 %: 1,00-2,66); y para LMT, además de las anteriores el tener sólo estudios primarios (1,63; IC 95 %: 0,98-2,82); haber lactado antes al menos 16 semanas (0,33; IC 95 %: 0,13-0,79); primer hijo/a (0,50; IC 95 %: 0,27-0,95). La duración de LMC y LMT crecían con la mayor duración de la baja maternal (0,96; IC 95 %: 0,94-0,99). La exposición laboral pregestacional a disruptores endocrinos no parece interferir con la duración de la lactancia. Conclusiones: Los programas de protección-promoción de la LM deberían aumentar la investigación y formación pediátrica en LM, disminuir las cesáreas innecesarias, fomentar la deshabituación tabáquica, dedicar más recursos a las mujeres con menos estudios e incluir mecanismos legales que prolonguen la baja por maternidad para conseguir una lactancia más duradera y de mejor calidad (AU)

Objectives: To identify protective factors and risk factors for the initiation and length of breastfeeding and full breastfeeding, in the Region of Murcia (Spain). Patients and methods: The Malama study (Medio Ambiente y Lactancia Materna) is a follow up study from birth up to years of 1,000 mother-child pairs. A description of breastfeeding practices are presented here, the survival curve of breastfeeding and a Cox regression model of the pilot study that includes 101 mother-child pairs and 6 months of follow-up. Results: After six months the prevalence of breastfeeding was 35 %. The mean duration of full breastfeeding was 63 days (median 45 days) with six months prevalence of 8 %. Hazard ratios (HR) for full breastfeeding were, to be a smoker (1.89; 95 % CI: 1.18-3.02), older than 35 years of age (2.04; 95 % CI: 1.22-3.42), caesarean birth (1.63; 95 % CI: 1.00-2.66). As well as those previously mentioned risks for breastfeeding, there were also hazard ratios for primary school education or less (1.63; 95 % CI: 0.98-2.82); to have breastfed an earlier child for at least 16 weeks (0.33; 95 % CI: 0.13-0.79), and to be the first birth (0.50; 95 % CI: 0.27-0.95). The length of both breastfeeding and full breastfeeding increased with the length of the maternal leave (0.96; 95 % CI: 0.94-0.99). Pregestational occupational exposure to endocrine disruptors did not seem to interfere with the duration of breastfeeding. Conclusions: In order to improve quality and duration of breastfeeding programmes, paediatric research and training on breastfeeding practice should be encouraged, to reduce unnecessary caesarean sections, promote tobacco cessation, focus human and economic resources to women with less education, and include legal mechanisms to ensure longer maternal leave (AU)

Falta de aceptación de la diabetes: un enfoque diagnóstico y terapéutico / Lack of acceptance of diabetes: a diagnostic and therapeutic approach

En este trabajo se propone un modelo de intervención sobre la dificultad de aceptación de la enfermedad que presentan algunas personas con diabetes. Tras revisar el concepto de aceptación, se desarrolla un plan de diagnóstico y tratamiento, haciendo hincapié en el hecho de abordar tanto las ideas irracionales asociadas a la no aceptación como la modificación de algunos comportamientos inadecuados relacionados con el autocuidado de la diabetes fruto de dichas cogniciones

In this report, the authors propose an intervention model to overcome the lack of acceptance of diabetes experienced by some people with this disease. Following a review of the acceptance concept, a diagnostic and therapeutic strategy is described. This strategy highlights the need to deal with irrational ideas associated with nonacceptance of the disease, as well as to modify certain abnormal behaviors related to diabetes self-management practices that result from this illogical thinking

Genetic analysis of the first 4 patients with beta-ureidopropionase deficiency.

beta-Ureidopropionase is the third enzyme of the pyrimidine degradation pathway and it catalyses the irreversible hydrolysis of N-carbamyl-ss-aminoisobutyric acid or N-carbamyl-ss-alanine to beta-aminoisobutyric acid or ss-alanine, ammonia, and CO2. Analysis of the beta-ureidopropionase gene (UPB1) of the first 4 patients presenting with a complete enzyme deficiency, revealed the presence of 2 splice-site mutations (IVS1-2A>G and IVS8-1G>A) and one missense mutation (A85E). RT-PCR analysis of the complete beta-ureidopropionase cDNA suggested that both splice-site mutations lead to a variety of alternative splice variants, with deletions of a single or several exons. The alanine at position 85 was not conserved in other eukaryotic beta-ureidopropionase protein sequences.

Afasia primaria progresiva: detección de una demencia infrecuente en atención primaria / Progressive primary aphasia: primary care detection of an uncommon dementia

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Diagnosis of brucellosis by using blood cultures.

The performances of three blood culture systems, Hemoline performance diphasic medium (bioMérieux, Marcy l'Etoile, France), Bactec Plus Aerobic/F* (Becton Dickinson, Paramus, N.J.), and Vital Aer (bioMérieux), were compared for the diagnosis of 17 cases of brucellosis. By using a 5-day incubation protocol, positive results were 52.9, 82.4, and 11.8%, respectively. When the protocol was extended to 7 days, the results were 76.5, 94.1, and 47.1%, respectively. Bactec was the fastest system (P < 0.05).

[Mental deficiency preceded by transitory hypertonic cerebral motor disorder]. / Deficiencia mental precedida de trastorno motor cerebral hipertónico transitorio.

OBJECTIVE: To analyse clinical and outcome features of patients with mental retardation and transient hypertonia in early life which lead to the diagnosis of hypertonic cerebral palsy. MATERIAL AND METHODS: We study six patients that presented with the above features in our neuropediatric out patients clinic. Clinical data related with the hypertonic signs and its evolution were collected. All the patients were assessed to find their present cognitive and development state. RESULTS: Clinical and radiological signs of a possible prenatal neurological damage were found in all the patients. Structural anomalies were presented in neuroimaging in five cases. Agenesia or hypoplasia of corpus callosum was the most common finding. The pattern of progression of this cases were: 1. Improvement of hypertonia with almost normal tone by the age of two years. 2. Despite of the resolution of motor signs, persistence of different degrees of mental retardation. CONCLUSIONS: Our reported patients presented a peculiar pattern of progression within the wide variability of the cerebral palsy group.

Performance of six culture media for isolation of Salmonella species from stool samples.

The relative performance of five plating media [Rambach agar; salmonella-shigella (SS) agar, novobiocin-brilliant green-glycerol-lactose (NBGL), modified semisolid Rappaport-Vassiliadis medium (MSRV), and Salmonella Detection and Identification-2 (SM2)] and selenite broth (SB) subcultured in SS agar in the recovery of Salmonella spp. from 500 human stool specimens was evaluated. On Rambach agar and SS agar, the C8-esterase test was also used for selection of suspicious colonies. Eighty-one samples were positive for salmonellae on at least one of the six media. Sensitivities and specificities of MSRV, SB, NBGL, SS, Rambach agar, and SM2 were 95.1 and 98.1%, 87.6 and 99.8%, 79 and 91.9%, 69.1 and 99.3%, 56.8 and 96.9%, and 54.3 and 92.4%, respectively. There were statistically significant differences between MSRV and NBGL, Rambach agar, SS agar, and SM2 (p < 0.005), between SB and SS agar, Rambach agar, and SM2 (p < 0.05), and between NBGL and SM2 and Rambach agar (p < 0.005). The greatest number of isolates was recovered with MSRV, whose performance surpassed that of enrichment in selenite broth, probably because the subcultures were not repeated on MSRV. This hypothesis is now under investigation. The specificity of each of the five solid media was greater than 90%.

Comparison of five plating media for isolation of Salmonella species from human stools.

A comparative study was carried out to evaluate the performances of different culture media for the recovery of Salmonella spp. from 1,000 routine samples of human stools. By direct plating we tested Salmonella-Shigella agar (SS), Hektoen enteric agar (HE), bismuth sulfite agar (BS), novobiocin-brilliant green-glycerol-lactose agar (NBGL) and SM-ID medium (SM), and after selenite enrichment, we tested all of the media except HE. C8-esterase and oxidase tests were used for the screening of Salmonella spp. on SS and HE. The total number of Salmonella isolates from direct culture was 74, with respective sensitivities and positive predictive values (PPVs) of 78.4 and 61%, 64.9 and 18.7%, 36.5 and 34.2%, 55.4 and 20.7%, and 39.2 and 43.9% for NBGL, SS, HE, BS, and SMID, respectively. After enrichment, the total number of Salmonella isolates was 88. The respective sensitivities and PPVs obtained were 90.9 and 62.5%, 92 and 17%, 90.9 and 32% and 93.2 and 71.3% for NBGL, SS, BS, and SM, respectively. According to our results, NBGL in direct plating was the medium with the highest sensitivity with respect to the sensitivities of the other media, with significant statistical differences (P < 0.05). Likewise, the PPV for NBGL was also the highest (61%). After enrichment in selenite broth, the sensitivities of the four media tested were similar, with the best PPV obtained with SM (71.3%); this was followed by NBGL (62.5%). When C8-esterase was used on SS or HE, the PPVs improved from less than 40% to about 100%.

[Type I glutaric acidity with arachnoidal cysts]. / Aciduria glutárica tipo I con quistes aracnoideos.

Two sisters are shown who have been diagnosed as having glutaric acidity (GA) type I, in the neuroimage of which bilateral arachnoidal cysts were shown. There is a remarkable lack of correlation between the clinical status of the patients and the arachnoidal cysts. The younger sister developed the first symptoms of her illness at around 5 years of age, whereas the cysts had already been diagnosed at the age of one. It was considered convenient to doubt the diagnosis of type I GA, given the presence of bilateral or familiar arachnoidal cysts, despite the lack of symptoms.

Bioactivity of the essential oil of Bupleurum fruticosum.

The essential oil of Bupleurum fruticosum was investigated qualitatively and quantitatively together with the anti-inflammatory activity of the whole essential oil and its major components. In addition, antispasmodic activity was determined in rat uterus preparations using acetylcholine and oxytocin as agonists. The anti-inflammatory activity shown by the essential oil can be attributed in part to the two major components, alpha-pinene and beta-pinene, although the presence of thymol and carvacrol, minor components capable of potentiating the action of these hydrocarbons, was also confirmed.