Radial extracorporeal shock wave therapy for the management of spasticity in cerebral palsy: study protocol for a randomized controlled trial.

Background: Spasticity is the most common motor disorder in cerebral palsy (CP), and its management is complex, posing a significant challenge for the rehabilitation team. Radial extracorporeal shock wave therapy (rESWT) has emerged in recent years as an effective, non-invasive, and low-risk alternative for the management of spasticity in CP patients, with only minor side effects such as small bruises or discomfort during application. There is great variability in rESWT administration protocols, ranging from a single session up to the 12 sessions. The most extensively studied protocol involves 3 rESWT sessions with a one-week interval between session. According to current literature, the effect of rESWT has not been investigated by extending the time interval between sessions beyond 1 week to determine if therapeutic effects on spasticity can be prolonged over time. Methods: Following a power calculation using the minimal clinical important difference of our primary outcome (R2 of Modified Tardieu Scale), 72 patients will be included in the study. Enrolment is based upon inclusion/exclusion criteria outlined in the Methods section. Participants will be randomized in 3 groups. Each patient will receive 2000 impulses in the Triceps Sural muscle (distributed by all the plantar flexor muscles: soleus and gastrocnemius), at a 2.2 Bars pressure and a frequency of 8 Hz. The Control Group will receive 3 rESWT sessions with a time interval of 1 week between each session. The Experimental Group A will receive 3 rESTW sessions with a time interval of 2 weeks between each session and the Experimental Group B will receive 3 rESTW sessions with a time interval of 4 weeks between each session. Discussion: This study will provide further information regarding the effect of rESWT on spasticity in patients with CP. If an increase in the time interval between rESWT sessions allows for the prolongation of therapeutic benefits on spasticity, it will be clinically relevant fact. With the same treatment dosage, patients will be able to benefit from its effects for a longer period of time. Clinical trial registration: ClinicalTrials.gov, identifier NCT05702606.

Effects of low-load blood flow restriction training in healthy adult tendons: A systematic review and meta-analysis.

OBJECTIVE: To systematically review the effects of low-load blood flow restriction training (LL-BFR) on healthy adult tendons. DESIGN: A systematic review with meta-analysis. LITERATURE SEARCH: Six electronic databases were searched by two researchers. STUDY SELECTION CRITERIA: Clinical trials comparing the effects of LL-BFR to high-load resistance training (HL-RT) or low-load resistance training (LL-RT) in healthy adult tendons. DATA SYNTHESIS: Two reviewers selected the eligible clinical trials, and one reviewer exported the data. Two reviewers evaluated the study quality and risk of bias using the PEDro scale and the ROB2 scale. We performed meta-analysis where appropriate using a random-effects model. We rated the quality of evidence using GRADE. RESULTS: Six studies were eligible. We analyzed tendon cross-sectional area (CSA) and tendon stiffness as the outcomes. Across all comparisons, there was low-to moderate-quality evidence of a difference between LL-BFR and LL-RT immediately after exercise. There was high-quality evidence of no difference between LL-BFR and HL-RT in the long term. CONCLUSION: The effects of LL-BFR on the tendons depends on the time and dose of the intervention. LL-BFR could be useful to increase the CSA of the tendons in a similar or superior way to HL-RT after 8 weeks of intervention.

Validación al español del cuestionario PEDI-EAT-10 para el cribado de disfagia / Translation and validation of the spanish version of the Pedi-EAT-10 questionnaire for screening of dysphagia

Introducción: El Pedi-EAT-10 es un instrumento validado, sencillo y rápido para el despistaje de disfagia en la edad pediátrica. El estudio tiene como objetivo traducir y adaptar al español la escala y comprobar sus propiedades psicométricas, dificultad y rapidez de cumplimentación. Pacientes y métodos: Tras la traducción, retrotraducción y aprobación por los investigadores de la versión en español del Pedi-EAT-10, se realizó un estudio prospectivo con un grupo de pacientes con disfagia y otro grupo de niños sanos o con patología menor. Sus tutores legales cumplimentaron el test y valoraron la duración y dificultad del mismo. Resultados: El estudio incluyó 87 casos con disfagia y 91 controles. El coeficiente de consistencia interna alfa de Cronbach fue 0,87. La mayoría de las correlaciones entre las puntuaciones de cada ítem y el total de la escala fueron>0,65 (p<0,001). Las puntuaciones del Pedi-EAT-10 fueron significativamente más altas en los pacientes con disfagia en todos los grupos de edad (p<0,001), mostrando así una alta sensibilidad y especificidad para el cribado de disfagia. En el grupo control, el tiempo medio de administración fue de 2,18±1,98 minutos y todos consideraron fácil su cumplimentación. Conclusiones: Se ha comprobado la validez, fiabilidad y consistencia interna de la versión en español del Pedi-EAT-10. Es un instrumento fácil y rápido, útil para el despistaje de la disfagia en la práctica clínica en pediatría. (AU)

Introduction: The Pedi-EAT-10 is a quick and simple validated tool for screening for dysphagia in the paediatric age group. The objective of our study was to translate and adapt the scale to Spanish and assess its psychometric properties, level of difficulty and speed of completion. Patients and methods: Following the forward and back translation and the approval by the research team of the Spanish version of the Pedi-EAT-10, we carried out a prospective study in a group of patients with dysphagia and a group of children who were healthy or had minor disease. Their legal guardians completed the questionnaire and reported the duration and difficulty of the test. Results: The study included 87 cases of dysphagia and 91 controls. The Cronbach alpha for internal consistency was 0.87. Most correlations between single item scores and the total scale score were greater than 0.65 (P<.001). The Pedi-EAT-10 scores were significantly higher in patients with dysphagia in every age group (P<.001), evincing a high sensibility and specificity for the screening of dysphagia. In the control group, the mean time taken to complete the questionnaire was 2.18±1.98 minutes, and all participants found it easy. Conclusions: We verified the validity, reliability and internal consistency of the Spanish version of the Pedi-EAT-10. It is an easy and quick instrument that can be used for screening of dysphagia in paediatric clinical practice. (AU)

Translation and validation of the Spanish version of the Pedi-EAT-10 questionnaire for screening of dysphagia.

INTRODUCTION: The Pedi-EAT-10 is a quick and simple validated tool for screening for dysphagia in the paediatric age group. The objective of our study was to translate and adapt the scale to Spanish and assess its psychometric properties, level of difficulty and speed of completion. PATIENTS AND METHODS: Following the forward and back translation and the approval by the research team of the Spanish version of the Pedi-EAT-10, we carried out a prospective study in a group of patients with dysphagia and a group of children who were healthy or had minor disease. Their legal guardians completed the questionnaire and reported the duration and difficulty of the test. RESULTS: The study included 87 cases of dysphagia and 91 controls. The Cronbach alpha for internal consistency was 0.87. Most correlations between single item scores and the total scale score were greater than 0.65 (P < .001). The Pedi-EAT-10 scores were significantly higher in patients with dysphagia in every age group (P < .001), evincing a high sensibility and specificity for the screening of dysphagia. In the control group, the mean time taken to complete the questionnaire was 2.18 ± 1.98 min, and all participants found it easy. CONCLUSIONS: We verified the validity, reliability and internal consistency of the Spanish version of the Pedi-EAT-10. It is an easy and quick instrument that can be used for screening of dysphagia in paediatric clinical practice.

A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial.

BACKGROUND: Physical activity (PA) is a key behaviour for patients with type 2 diabetes (T2DM). However, healthcare professionals' (HCP) recommendations (walking advice), which are short-term and individually focused, did not reduce the PA drop-out ratio in the long run. Using a socio-ecological model approach may contribute to reducing patient dropout and improving adherence to PA. The aim of this study is threefold: first, to evaluate the effectiveness of a theory-driven Nordic walking intervention using a socio-ecological approach with T2DM patients in Spain; second, to explore the feasibility on the PA adherence process in T2DM patients while participating in the SENWI programme; and third, to understand the HCPs' opinion regarding its applicability within the Spanish healthcare system. METHODS: A three-arm randomized control trial (n = 48 each group) will assess the efficacy of two primary care-based PA interventions (Nordic walking vs. Nordic walking plus socio-ecological approach; two sessions per week for twelve weeks) compared to a control group (usual HCPs' walking advice on PA). Inclusion criteria will include physically inactive patients with T2DM, older than 40 years and without health contraindications to do PA. PA levels and drop-out ratio, quality of life and metabolic and health outcomes will be assessed at baseline, post-intervention and at 9- and 21-month follow-ups. The effect of the different interventions will be assessed by a two-factor analysis of variance: treatment group vs time. Also, a two-factor ANOVA test will be performed with linear mixed models for repeated measures. A qualitative analysis using focus groups will explore the reasons for the (in)effectiveness of the new PA interventions. Qualitative outcomes will be assessed at post-intervention using thematic analysis. DISCUSSION: Compared with the general PA walking advice and Nordic walking prescriptions, integrating a socio-ecological approach into Spanish primary care visits could be an effective way to reduce the PA drop-out ratio and increase PA levels in patients with T2DM. Such interventions are necessary to understand the role that multiple socio-complex process in day-to-day PA behaviour has in patients with T2DM in the Spanish context. TRIAL REGISTRATION: ClinicalTrials.gov NCT05159089. Physical Activity Drop-out Ratio in Patients' Living with Type 2 Diabetes. Prospectively registered on 15 December 2021.

Higher Vertical Jumping Asymmetries and Lower Physical Performance are Indicators of Increased Injury Incidence in Youth Team-Sport Athletes.

ABSTRACT: Fort-Vanmeerhaeghe, A, Milà-Villarroel, R, Pujol-Marzo, M, Arboix-Alió, J, and Bishop, C. Higher vertical jumping asymmetries and lower physical performance are indicators of increased injury incidence in youth team-sport athletes. J Strength Cond Res 36(8): 2204-2211, 2022-To date, the literature about the association between injury-risk factors and actual injury incidence in young elite team-sports athletes is scarce. The main objective of this study was to examine how modifiable factors may affect injury incidence. Eighty-one young elite team-sports athletes (age: under-14 to under-18) performed the countermovement jump (CMJ), a single leg CMJ (SLCMJ), the one-legged hop test (OLHT), a 30-m sprint test, the V-cut test, a repeated sprint ability, and the 30-15 intermittent fitness test (IFT) during the pre-season period. Interlimb asymmetries were calculated for SLCMJ and OLHT. Injuries were recorded prospectively for the entirety of the 2017-2018 season. Comparison of injury and noninjury data was performed using a two-way analysis of variance (ANOVA). Results of the ANOVA according to injury showed significant differences in CMJ ( p = 0.01), SLCMJ on the lowest performing limb ( p = 0.03), and SLCMJ asymmetry (<0.001). Sex × injury interaction was significant from CMJ ( p = 0.018) and 30-15 IFT ( p = <0.001). In conclusion, this study indicated that athletes with greater interlimb asymmetries, less vertical jump capacity, and lower intermittent aerobic fitness had a greater predisposition to injury. Therefore, monitoring CMJ, aerobic performance, and interlimb asymmetries is recommended given their sensitivity to detect significant differences between injured and healthy youth athletes.

Clinical and Nutritional Impact of a Semi-Elemental Hydrolyzed Whey Protein Diet in Patients with Active Crohn's Disease: A Prospective Observational Study.

BACKGROUND: Malnourishment is a common complication in patients with Crohn's disease. METHODS: An observational, prospective study was conducted to assess the nutritional status, disease activity, and stool frequency at baseline and after 12 weeks of treatment with a semi-elemental diet in patients with active Crohn's disease. RESULTS: A total of 144 patients with Crohn's disease were included. The nutritional status improved after treatment, resulting in 76.1% of patients at low risk of malnourishment, 20.4% moderately malnourished, and 8.5% severely malnourished after 12 weeks of treatment. Nutritional status improvement was associated with the number of nutritional supplements. Mean albumin levels and body mass index (BMI) improved after 12 weeks of nutritional treatment (from 3.0 g/dL to 3.7 g/dL and from 20.2 kg/m2 to 21.1 kg/m2, respectively). A significant decrease in HBI was found after 12 weeks of nutritional treatment (from 10.2 to 3.7). The mean number of stools per day decreased with the 12 week semi-elemental diet (from 4.6 stools/day to 1.7 stools/day). CONCLUSION: In this observational study, the semi-elemental diet seemed effective in improving the nutritional status, disease activity, and stool frequency in patients with active Crohn's disease.

The Measurement of Food Insecurity in High-Income Countries: A Scoping Review.

The measurement of food insecurity is essential to monitor the prevalence, risk factors, consequences and effects of food insecurity and the interventions and policies implemented to tackle it. Yet, how best to apply it remains an unsettled issue due to the multifaceted and context-dependent nature of food insecurity. We report a scoping review of measures of food insecurity at the individual and household level in high-income countries with the final purpose of facilitating a catalogue of instruments to be used by both researchers and practitioners. The scoping review was conducted following the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute guidelines. We included all types of documents published between 2000-2020 using instruments that estimate food insecurity at both individual and household level in high-income countries, and with respondents including adolescents, adults, and elderly. We identified a total of 23 measurement strategies being used in 33 peer-reviewed publications and 114 documents from the grey literature. Our results show that most measures focus on the access dimension of food insecurity and that further research is required to develop measures that incorporate aspects of quality of dietary intake and relevant individual, household and social conditions related to food insecurity.

Oxytocin Administration in Low-Risk Women, a Retrospective Analysis of Birth and Neonatal Outcomes.

BACKGROUND: In recent years, higher than the recommended rate of oxytocin use has been observed among low-risk women. This study examines the relationship between oxytocin administration and birth outcomes in women and neonates. METHODS: A retrospective analysis of birth and neonatal outcomes for women who received oxytocin versus those who did not. The sample included 322 women with a low-risk pregnancy. RESULTS: Oxytocin administration was associated with cesarean section (aOR 4.81, 95% CI: 1.80-12.81), instrumental birth (aOR 3.34, 95% CI: 1.45-7.67), episiotomy (aOR 3.79, 95% CI: 2.20-6.52) and length of the second stage (aOR 00:18, 95% CI: 00:04-00:31). In neonatal outcomes, oxytocin in labor was associated with umbilical artery pH ≤ 7.20 (OR 3.29, 95% CI: 1.33-8.14). Admission to neonatal intensive care unit (OR 0.56, 95% CI: 0.22-1.42), neonatal resuscitation (OR 1.04, 95% CI: 0.22-1.42), and Apgar score <7 (OR 0.48, 95% CI: 0.17-1.33) were not associated with oxytocin administration during labor. CONCLUSIONS: Oxytocin administration during labor for low-risk women may lead to worse birth outcomes with an increased risk of instrumental birth and cesarean, episiotomy and the use of epidural analgesia for pain relief. Neonatal results may be also worse with an increased proportion of neonates displaying an umbilical arterial pH ≤ 7.20.

Clinical and Nutritional Effectiveness of a Nutritional Protocol with Oligomeric Enteral Nutrition in Patients with Oncology Treatment-Related Diarrhea.

(1) Background: Poor nutritional status and diarrhea are common complications in cancer patients. (2) Methods: This multicenter, observational, prospective study evaluated the effectiveness of an oligomeric enteral nutrition (OEN) protocol in the improvement of nutritional status and reduction of diarrhea symptoms. Nutritional status was assessed with the Subjective Global Assessment (SGA), Body Mass Index (BMI) and albumin levels. Diarrhea was evaluated by the frequency and consistency of stools (Bristol Stool form scale). (3) Results: After 8 weeks of OEN protocol, the nutritional status improved in 48.3% of patients, with an increased proportion of patients at risk of malnourishment (+27.3%) at the expense of a decrease of moderately (-19.9%) and severely (-7.3%) malnourished patients (p < 0.001). Serum albumin and BMI significantly increased after 8 weeks of OEN treatment (p < 0.005). OEN showed a 71.1% effectiveness in the improvement of stool consistency. The mean number of stools per day significantly decreased from baseline (4.17 stools/day) to week 8 (1.42 stools/day; p = 0.0041). The nutritional status significantly improved even in those patients with persistent diarrhea. (4) Conclusion: The proposed OEN protocol seemed to be effective in improving the nutritional status, frequency and consistency of stools in patients with oncology treatment-related diarrhea even in persistent cases.

Efectos de la actividad física de intensidad suave sobre las condiciones físicas de los adultos mayores: revisión sistemática / Effects of mild intensity physical activity on the physical condition of older adults: A systematic review

La actividad física (AF) puede mejorar la funcionalidad en las personas mayores de 65 años. El objetivo del estudio fue evaluar la eficacia de intervenciones de ejercicio de intensidad suave en la salud funcional y la calidad vida de estas personas. Se realizó una revisión sistemática en las bases de datos WOS (n=20), Scopus (n=235), PubMed (n=15) y PEDro (n=20). Ocho estudios cumplieron los criterios de inclusión. Se evaluaron 619 sujetos con un rango de edad entre 60-103 años. Las intervenciones incluyeron ejercicios de resistencia, aeróbicos y de vibración. Aquellos que usaron podómetros, llamadas telefónicas y controles de seguimiento mostraron efectos positivos en el aumento de la actividad física. Cinco estudios evaluaron la fuerza y mostraron que al aumentar la fuerza se mejoraba también el equilibrio y la velocidad de la marcha. Los resultados indican que aplicar intervenciones de actividad física de intensidad suave es una garantía de mejora en la salud funcional y la calidad de vida en la gente mayor

Physical activity can improve function in people over 65. The aim of the study was to evaluate the efficacy of mild intensity exercise interventions on the functional health and quality of life of this population. A systematic review was conducted using WOS (n=20), Scopus (n=235), PubMed (n=15), and PEDro (n=20) databases. Eight studies met the inclusion criteria. Six hundred and nineteen subjects with an age range of 60-103 years were evaluated. Interventions included endurance, aerobic, and vibration exercises. Those who used pedometers, telephone calls and follow-up controls showed positive effects in increasing physical activity. Five studies evaluated strength and showed that increasing strength also improved balance and walking speed. The results indicate that applying mild intensity physical activity interventions is a way of ensuring improved functional health and quality of life in older people

Impact of an Oral Nutritional Protocol with Oligomeric Enteral Nutrition on the Quality of Life of Patients with Oncology Treatment-Related Diarrhea.

(1) Background: Nutritional status can influence the quality of life (QoL) of cancer patients. (2) Methods: This subanalysis evaluated the impact of an oral oligomeric enteral nutrition (OEN) protocol on the QoL of patients with oncology treatment-related diarrhea (OTRD) in a multicenter, observational, prospective study (DIAPOENO study). QoL was assessed with the Nottingham Health Profile (NHP) at baseline and after eight weeks of OEN treatment. (3) In the overall population, all the NHP categories significantly improved after eight weeks of OEN treatment: energy levels (p < 0.001), pain (p < 0.001), emotional reactions (p < 0.001), sleep (p < 0.001), social isolation (p = 0.023), and physical abilities (p = 0.001). QoL improvement was higher in patients with improved or maintained nutritional status and in those with improved consistency of stools with the OEN protocol. However, QoL did not significantly improve in patients with worse nutritional status and with worse or maintained stool consistency with the OEN protocol. QoL improved regardless of disease severity. Multivariate logistic regression analysis showed that weight change was significantly associated with improved QoL (OR 2.90-5.3), except for social isolation, in models unadjusted and adjusted to age, sex, oncology treatment, and stool consistency. (4) Conclusion: In this subanalysis, the OEN protocol was associated with improved QoL.

Drop-out ratio between moderate to high-intensity physical exercise treatment by patients with, or at risk of, type 2 diabetes mellitus: A systematic review and meta-analysis.

AIMS: Physical exercise represents the cornerstone in the treatment for patients with type 2 diabetes mellitus (T2DM). However, it is not clear how different physical exercise intensities might affect the drop-out ratio. The aim of this review is to examine the extent to which exercise interventions impact dropout risk in patients with, or at risk of, T2DM. METHODS: A Systematic review and meta-analysis of dropouts to aerobic exercise training interventions of varying intensity were conducted. Randomized controlled trials with exercise interventions on patients with, or at risk of, T2DM were included. The intervention had to last a minimum of three months and the studies had to include at least two groups (moderate- vs high-intensity exercise). RESULTS: Twenty-three studies were selected for both systematic revision and meta-analysis. Although no difference between intensities groups have been seen (OR 1,12 [CI95% 0,85-1,47] p = 0,41), high intensity exercise training has a higher dropout risk than moderate exercise when both are conducted over a similar time period (OR 1,81 [CI95% 1,12-2,91] p=0,01). CONCLUSION: It seems that high-intensity protocols did not decrease drop-out ratio. Although high-intensities are more time efficient than moderate intensities, the difficult to carry on the exercise might also become a barrier to take into consideration. Further research is needed to explore barriers and enablers to better understand patients' participation.

[Effects of mild intensity physical activity on the physical condition of older adults: A systematic review]. / Efectos de la actividad física de intensidad suave sobre las condiciones físicas de los adultos mayores: revisión sistemática.

Physical activity can improve function in people over 65. The aim of the study was to evaluate the efficacy of mild intensity exercise interventions on the functional health and quality of life of this population. A systematic review was conducted using WOS (n=20), Scopus (n=235), PubMed (n=15), and PEDro (n=20) databases. Eight studies met the inclusion criteria. Six hundred and nineteen subjects with an age range of 60-103 years were evaluated. Interventions included endurance, aerobic, and vibration exercises. Those who used pedometers, telephone calls and follow-up controls showed positive effects in increasing physical activity. Five studies evaluated strength and showed that increasing strength also improved balance and walking speed. The results indicate that applying mild intensity physical activity interventions is a way of ensuring improved functional health and quality of life in older people.

Estudio y promoción de hábitos alimentarios saludables y de actividad física entre los adolescentes españoles: programa TAS (tú y Alicia por la salud) / Study and promotion of healthy eating habits and physical activity among Spanish adolescents: TAS program (you and Alicia for health)

La obesidad, el sobrepeso y, en general, los malos hábitos han aumentado en todo el mundo de manera alarmante en las últimas cuatro décadas. Y lo más preocupante es el aumento del número de niños y adolescentes con sobrepeso y obesidad. La obesidad infantil es un problema de salud pública mundial, y su asociación con otras enfermedades, tanto en la niñez como en la vida adulta, así como su elevada prevalencia, hacen que sea imprescindible una intervención precisa y a temprana edad desde diferentes ámbitos. El programa TAS (Tú y Alícia por la Salud) tiene como objetivo promover una alimentación saludable y una actividad física suficiente a través de la cocina y del ocio activo. Se realizó una intervención educativa en el aula, que se midió mediante encuestas alimentarias y el cuestionario Physical Activity Questionnaire for Adolescents PAQ-A (antes y después) a 2.516 estudiantes de 13-14 años de 79 escuelas distribuidas en las 17 comunidades autónomas de España. En general, los adolescentes no cumplen con las recomendaciones alimentarias y de actividad física de la Sociedad Española de Nutrición Comunitaria (SENC) y de la Organización Mundial de la Salud (OMS), respectivamente. En la gran mayoría de los participantes, la ingesta de frutas y verduras fue menor de lo recomendado, mientras que el consumo de carne, bollería, pastelería, snacks y alimentos fritos fue excesivo. En cuanto a la actividad física, se observó una falta generalizada y una escasa dedicación a actividades no sedentarias. En conclusión, los adolescentes españoles presentan baja adherencia a las recomendaciones dadas por la SENC y por la OMS

Obesity, overweight and overall inadequate habits have alarmingly increased across the world over the past four decades. More worrisome is the increase in the number of obese children and adolescents. Obesity in childhood in a Public Health problem worldwide, and its association with other diseases, both in childhood and in adult life, as well as its high prevalence, makes it essential to develop early and precise intervention from different areas. The TAS program, (Tú y Alicia por la Salud-Alice and you for Health), aims to promote healthy eating and physical activity through cooking and active leisure. An educational intervention was carried out in the classroom, measured by food surveys and the Physical Activity Questionnaire for Adolescents PAQ-A questionnaire (before and after) in 2,516 students aged 13 and 14 yrs. from 79 schools distributed in the 17 Autonomous Regions in Spain. Overall, adolescents do not comply with the dietary guidelines and recommendations for physical activity by the Spanish Society of Community Nutrition (SENC) and the World Health Organization (WHO), respectively. In the vast majority of the participants, intake of fruit and vegetables was less than recommended, while the consumption of meat, pastries, snacks and fried foods exceeded recommendations. As for physical activity, there was a generalized lack of attention and little dedication to non-sedentary activities. In conclusion, Spanish adolescents show low adherence to recommendations given by SENC and WHO

[Study and promotion of healthy eating habits and physical activity among Spanish adolescents: TAS program (you and Alicia for health)]. / Estudio y promoción de hábitos alimentarios saludables y de actividad física entre los adolescentes españoles: programa TAS (tú y Alicia por la salud).

Obesity, overweight and overall inadequate habits have alarmingly increased across the world over the past four decades. More worrisome is the increase in the number of obese children and adolescents. Obesity in childhood in a Public Health problem worldwide, and its association with other diseases, both in childhood and in adult life, as well as its high prevalence, makes it essential to develop early and precise intervention from different areas. The TAS program, (Tú y Alicia por la Salud-Alice and you for Health), aims to promote healthy eating and physical activity through cooking and active leisure. An educational intervention was carried out in the classroom, measured by food surveys and the Physical Activity Questionnaire for Adolescents PAQ-A questionnaire (before and after) in 2,516 students aged 13 and 14 yrs. from 79 schools distributed in the 17 Autonomous Regions in Spain. Overall, adolescents do not comply with the dietary guidelines and recommendations for physical activity by the Spanish Society of Community Nutrition (SENC) and the World Health Organization (WHO), respectively. In the vast majority of the participants, intake of fruit and vegetables was less than recommended, while the consumption of meat, pastries, snacks and fried foods exceeded recommendations. As for physical activity, there was a generalized lack of attention and little dedication to non-sedentary activities. In conclusion, Spanish adolescents show low adherence to recommendations given by SENC and WHO.

La obesidad, el sobrepeso y, en general, los malos hábitos han aumentado en todo el mundo de manera alarmante en las últimas cuatro décadas. Y lo más preocupante es el aumento del número de niños y adolescentes con sobrepeso y obesidad. La obesidad infantil es un problema de salud pública mundial, y su asociación con otras enfermedades, tanto en la niñez como en la vida adulta, así como su elevada prevalencia, hacen que sea imprescindible una intervención precisa y a temprana edad desde diferentes ámbitos.El programa TAS (Tú y Alícia por la Salud) tiene como objetivo promover una alimentación saludable y una actividad física suficiente a través de la cocina y del ocio activo. Se realizó una intervención educativa en el aula, que se midió mediante encuestas alimentarias y el cuestionario Physical Activity Questionnaire for Adolescents PAQ-A (antes y después) a 2.516 estudiantes de 13-14 años de 79 escuelas distribuidas en las 17 comunidades autónomas de España.En general, los adolescentes no cumplen con las recomendaciones alimentarias y de actividad física de la Sociedad Española de Nutrición Comunitaria (SENC) y de la Organización Mundial de la Salud (OMS), respectivamente. En la gran mayoría de los participantes, la ingesta de frutas y verduras fue menor de lo recomendado, mientras que el consumo de carne, bollería, pastelería, snacks y alimentos fritos fue excesivo. En cuanto a la actividad física, se observó una falta generalizada y una escasa dedicación a actividades no sedentarias. En conclusión, los adolescentes españoles presentan baja adherencia a las recomendaciones dadas por la SENC y por la OMS.

The PlantLIBRA consumer survey: Findings on the use of plant food supplements in Italy.

BACKGROUND: Food supplements, and in particular those containing botanicals (plant food supplements, PFS), have in recent decades been of great interest both to consumers and to food/pharmaceutical industries. OBJECTIVES: The aim of this paper is to examine replies by Italian consumers to the PlantLIBRA consumers' survey in order to: 1) assess the behaviour of an Italian population with respect to the use of PFS, and to compare it with that of other 5 countries involved in the whole survey; 2) identify different habits in the 4 Italian cities selected according to their geographical distribution; 3) collect independent information on the actual intake of PFS and consumers' behaviour. SUBJECTS/SETTING: 397 Italian consumers enrolled, 187 males (49.5%) and 191 female (50.5%). The distribution of subjects among the 4 cities included was: Milan 99; Venice 90; Rome 96 and Catania 96. RESULTS: The interest in PFS in Italy is high, the prevalence of "regular" consumers being 22.7%. Some differences were observed between the 4 cities involved: the pattern of use during the year was specific to each city; consumers in Milan reported reasons to use PFS significantly different from those in the whole Italian sample and did not indicate supermarkets as an important place of purchase; respondents from Rome and Catania more frequently used family doctors and pharmacists as a source of recommendation. Some significant difference among cities, sex and age groups were observed when the most frequently used botanicals were ranked. CONCLUSIONS: The results provide new insights on the socio-economic characteristics and lifestyle of Italian PFS consumers, on their reasons for and pattern of use, and on their behaviour and expectations. The value of this information is not restricted to the specific country (Italy) but allows for a more general evaluation of the pattern of use, according to habits and geographical area.

Critical care nursing interventions and the time required for their completion in Intensive Care Units: A Delphi study.

OBJECTIVE: To determine which interventions within the Nursing Interventions Classification are most often applied in intensive care units and to validate the time required for each. METHODOLOGY: A three-stage e-Delphi was conducted; 21 panelists were recruited, seven manager nurses and 14 clinical nurses with higher degrees and more than five years experience in intensive care nursing. The first round explored the most common interventions applied. Additionally, panelists were asked to propose others. In the second round, participants reflected on the interventions where no consensus was reached as well as to estimate the time required for each intervention. In the third, panelists were queried about the time required for the interventions for which consensus regarding the time was not reached. RESULTS: A total of 183 interventions were included; 50% of the "Physiological: Complex" domain. The list included 52 (90%) of the 58 "core interventions for critical care nursing" identified in the Nursing Interventions Classification. The time required for 89.1% of the interventions was the same as in the Nursing Interventions Classification seminal work recommendations. CONCLUSION: Results provide a clear picture of nursing activity in general intensive care units, allows to tailor the Nursing Intervetions Classification in Catalonia context and to confirm findings of previous studies.

Diseño y validación de un cuestionario para evaluar el nivel de conocimientos generales en trastornos del comportamiento alimentario en estudiantes de ciencias de la salud / Design and validation of a questionnaire to assess the level of general knowledge on eating disorders in students of Health Sciences

OBJETIVO: Diseñar y validar un cuestionario, para evaluar el nivel de conocimientos sobre los trastornos del comportamiento alimentario en estudiantes universitarios. DISEÑO: Estudio observacional longitudinal y prospectivo. Diseño del instrumento basado en una revisión conceptual y validación mediante un pretest cognitivo y una prueba piloto test-retest, con análisis de las propiedades psicométricas en cada aplicación. Emplazamiento: Fundación Universitaria del Bages, Barcelona. Marco de atención comunitaria. PARTICIPANTES: Fueron 140 estudiantes de ciencias de la salud; 53 mujeres y 87 hombres, con edad media de 21,87 años; participaron 28 en el pretest y 112 en el test-retest, completando el estudio 110 estudiantes. MEDICIONES PRINCIPALES: Validez y estabilidad con los estadísticos α de Cronbach y coeficiente de correlación de Pearson; relación de las calificaciones con el sexo y tipo de estudios, con estadísticos no paramétricos prueba U de Mann-Whitney y prueba de Kruskal-Wallis; para las variables demográficas se calcularon las frecuencias absolutas o porcentuales y la desviación estándar o la media como medidas de dispersión o tendencia central. El nivel de significación estadística fue del 95% de confianza. RESULTADOS: Se obtuvo un instrumento de 10 preguntas distribuidas en cuatro dimensiones: clasificación, características demográficas de los participantes, factores de riesgo y manifestaciones clínicas de los trastornos del comportamiento alimentario. La escala mostró una buena consistencia interna en su versión final (α de Cronbach=0,724) y una adecuada estabilidad (correlación de Pearson 0,749). CONCLUSIONES: El instrumento diseñado permite evaluar con garantía, el nivel de conocimientos sobre los trastornos del comportamiento alimentario de los estudiantes de ciencias de la salud

OBJETIVO: Diseñar y validar un cuestionario, para evaluar el nivel de conocimientos sobre los trastornos del comportamiento alimentario en estudiantes universitarios. DISEÑO: Estudio observacional longitudinal y prospectivo. Diseño del instrumento basado en una revisión conceptual y validación mediante un pretest cognitivo y una prueba piloto test-retest, con análisis de las propiedades psicométricas en cada aplicación. Emplazamiento: Fundación Universitaria del Bages, Barcelona. Marco de atención comunitaria. PARTICIPANTES: Fueron 140 estudiantes de ciencias de la salud; 53 mujeres y 87 hombres, con edad media de 21,87 años; participaron 28 en el pretest y 112 en el test-retest, completando el estudio 110 estudiantes. MEDICIONES PRINCIPALES: Validez y estabilidad con los estadísticos α de Cronbach y coeficiente de correlación de Pearson; relación de las calificaciones con el sexo y tipo de estudios, con estadísticos no paramétricos prueba U de Mann-Whitney y prueba de Kruskal-Wallis; para las variables demográficas se calcularon las frecuencias absolutas o porcentuales y la desviación estándar o la media como medidas de dispersión o tendencia central. El nivel de significación estadística fue del 95% de confianza. RESULTADOS: Se obtuvo un instrumento de 10 preguntas distribuidas en cuatro dimensiones: clasificación, características demográficas de los participantes, factores de riesgo y manifestaciones clínicas de los trastornos del comportamiento alimentario. La escala mostró una buena consistencia interna en su versión final (α de Cronbach=0,724) y una adecuada estabilidad (correlación de Pearson 0,749). CONCLUSIONES: El instrumento diseñado permite evaluar con garantía, el nivel de conocimientos sobre los trastornos del comportamiento alimentario de los estudiantes de ciencias de la salud

Assessment of Eating Habits and Physical Activity among Spanish Adolescents. The "Cooking and Active Leisure" TAS Program.

Worldwide obesity has more than doubled in the last forty years. Even more worrying is the fact that the number of overweight and obese children and adolescents has considerably increased. Socioeconomic development, as well as educational, agricultural and marketing policies have significantly changed dietary and physical activity habits among the youngest, who are thus susceptible to develop chronic and disabling diseases such as diabetes, some cancers and cardiovascular disorders. Adolescence is a critical age, in which the adoption of healthy habits may have dramatic effects on the health state in adulthood. For this reason, prompt interventions are urgently required to prevent the onset of obesity in this time of life. In this regard, the CAL-TAS program from Alicia Foundation was born to combat obesity and promote healthy lifestyles in Spanish adolescents. A total of 2519 students, aged 13-14 years, from 79 schools distributed all over the 17 autonomous communities in Spain were asked to report through the CAL-TAS platform their food intake and physical activity over one week. The body mass index, the consumption of food and beverages, the intake of macronutrients and micronutrients, and the values obtained from the PAQ-A questionnaire, which evaluated physical activity, were analyzed. Twenty percent of the participants were overweight or obese. In general, adolescents did not or poorly respected the recommendations provided by the Spanish Society of Community Nutrition. For example, in more than half of the subjects, the ingestion of fruits and beverages was less than recommended, whereas the consumption of meat, baked goods and fried foods was excessive. Moreover, adolescents with higher body mass index also presented worse eating habits and more inactivity. In conclusion, Spanish adolescents present low adherence to recommendations provided by the Spanish Society of Community Nutrition (SENC) and by the World Health Organization. In order to prevent obesity-related disorders, effective educational programmes have to be designed. Indeed, adolescents and their families should be aware that the early adoption of healthy dietary habits and of a correct physical activity may strongly improve their future quality of life.