Effect of preparation design and endodontic access on fracture resistance of zirconia overlays in mandibular molars: An in vitro study.

PURPOSE: To evaluate the fracture resistance of zirconia overlays, considering various preparation designs and the presence of endodontic access. MATERIALS AND METHODS: Ninety translucent zirconia (5Y-PSZ) overlay restorations were divided into six groups (n = 15/group) based on different preparation designs, with and without endodontic access: chamfer margin 4 mm above the gingival level without (group 1) and with endodontic access (group 2); margin 2 mm above the gingival level without (group 3) and with endodontic access (group 4); overlay with no chamfer margin without (group 5) and with endodontic access (group 6). Restorations were bonded to mandibular first molar resin dies, and the groups with endodontic access were sealed with flowable resin composite. All restorations underwent 100,000 cycles of thermal cycling between 5°C and 55°C, followed by loading until fracture. Maximum load and fracture resistance were recorded. ANOVA with Tukey post-hoc tests were used for statistical comparison (α < 0.05). RESULTS: Fracture resistance significantly varied among overlay designs with and without endodontic access (p < 0.001), except for the no-margin overlays (groups 5 and 6). Overlays with a 2 mm margin above the gingival margin with endodontic access (group 4) exhibited significantly higher fracture resistance compared to both the 4-mm supragingival (group 2) and no-margin (group 6) designs, even when compared to their respective intact groups (groups 1 and 5). There were no significant differences between the no-margin and 4-mm supragingival overlays. CONCLUSION: The more extensive zirconia overlay for mandibular molars is the first choice since the 2 mm margin above the gingival level design withstood considerable loads even after undergoing endodontic access. A no-margin overlay is preferred over the 4-mm supragingival design as it preserves more tooth structure and there was no outcome difference, irrespective of endodontic access. Caution is warranted in interpreting these findings due to the in vitro nature of the study.

[Effectiveness of strategies to increase adherence to colorectal cancer screening: a systematic review]. / Efectividad de estrategias para incrementar la adherencia al tamizaje de cáncer colorrectal: una revisión sistemática.

INTRODUCTION: Coverage for colorectal cancer screening in Argentina is very low. The objective of this review is to assess and synthesize the evidence on the effectiveness of strategies aimed at increasing adherence to colorectal cancer screening among healthcare personnel and the general population at average risk. METHODS: A review of systematic reviews (SRs) that evaluated the effectiveness of these strategies was conducted. Searches were performed in electronic databases, meta-search engines, the Cochrane Library, and through manual searching. Eligibility and inclusion criteria were applied, with assessment of the quality of the SRs using AMSTAR II and the certainty of evidence using the GRADE approach. Thematic synthesis was conducted based on the taxonomy of strategies proposed by Dougherty (patient/community-targeted, professionaltargeted, and other types of strategies). RESULTS: A total of 635 studies were identified, with 36 deemed eligible and 11 excluded due to insufficient quality, resulting in the inclusion of 10 SRs. A multiplicity of strategies with varying effectiveness were identified, with the majority targeting the population. Among these, education, self-testing with specimen collection at specific locations, and reminders stood out. For professionals, only education and reminders showed effectiveness. Combined strategies demonstrated greater effectiveness than isolated strategies. CONCLUSIONS: There is more evidence on strategies targeting the population than professionals. Combined strategies showed greater effectiveness, highlighting the need to explore barriers in both the population and professionals in each specific context in order to prioritize and combine those that have proven effective and would have a greater impact.

Introducción: En Argentina la cobertura al tamizaje de cáncer colorrectal (CCR) es muy baja. El objetivo de esta revisión fue relevar y sintetizar la evidencia sobre la efectividad de estrategias dirigidas a incrementar la adherencia al tamizaje de CCR del personal de salud y población con riesgo promedio. Métodos: Revisión de revisiones sistemáticas (RS) que evaluaron la efectividad de dichas estrategias. Búsqueda en bases de datos electrónicas, meta-buscadores, biblioteca Cochrane y búsqueda manual. Aplicación de criterios de elegibilidad e inclusión; con evaluación de la calidad de las RS a través del AMSTAR-II y la certeza de la evidencia por el método GRADE. Síntesis temática sobre la base de la taxonomía de estrategias propuesta por Dougherty (dirigidas al paciente/comunidad; a profesionales; otro tipo de estrategias). Resultados: Se identificaron 635 estudios; 36 fueron elegibles y 11 se descartaron por no contar con calidad suficiente, incluyéndose 10 RS. Se identificó una multiplicidad de estrategias de efectividad variada, la mayoría dirigida a la población. Entre estas, destacan la educación, el auto-test con recolección en lugares específicos y recordatorios. En el caso de profesionales, solo educación y recordatorios mostraron ser efectivas. La combinación de estrategias mostró tener mayor efectividad que las estrategias aisladas. Conclusiones: Es mayor la evidencia sobre estrategias dirigidas a la población que a profesionales. Las estrategias combinadas demostraron tener mayor efectividad, lo que destaca la necesidad de explorar, en cada contexto, las barreras en la población y en los profesionales para priorizar y combinar aquellas que demostraron ser efectivas y tendrían mayor impacto.

[Barriers and facilitators of colorectal cancer screening access]. / Barreras y facilitadores del acceso al tamizaje de cáncer colorrectal.

INTRODUCTION: Colorectal cancer (CRC) is a global health problem. In the public sector of Bahía Blanca, CRC screening is opportunistic, through the request of fecal occult blood test (FOBT). The objective of this study is to describe access to CRC screening for the population with exclusive public coverage residing in the programmatic area 2 of the city between 2019 and 2021, and to identify the barriers and facilitators that determine it. METHODS: The annual and cumulative usage rate was estimated based on the number of patients who requested FOBT. The barriers and facilitators were studied through 41 semi-structured individual interviews to healthcare staff from the area, the Municipal Hospital, Health Secretariat and users/non-users of the system. RESULTS: The cumulative usage rate of FOBT during the period was less than 5%. Among the perceived barriers to screening, we found: the difficulties in accessing more complex studies for patients with positive FOBT, the lack of population awareness and perception of CRC as a health problem, the low adherence of professionals to guidelines. The territoriality and link of health centers with the population, as well as the willingness of users and professionals to incorporate screening, emerge as facilitators. CONCLUSION: The identification of barriers and facilitators will allow the design of context-adapted strategies that will strengthen screening in the future.

Introducción: El cáncer colorrectal (CCR) es un problema de salud a nivel global. En el sector público de Bahía Blanca, el tamizaje de CCR es oportunista, por solicitud de sangre oculta en materia fecal (SOMF). El objetivo de este trabajo es describir el acceso al tamizaje de CCR de la población con cobertura pública exclusiva que reside en el área programática 2 de la ciudad entre 2019 y 2021, y relevar las barreras y facilitadores que lo determinan. Métodos: Se estimó la tasa de uso anual y acumulada de SOMF. Las barreras y facilitadores se relevaron a través de 41 entrevistas individuales semi-estructuradas al personal de salud del área programática, el Hospital Municipal, Secretaría de Salud y usuarios/no usuarios del sistema. Resultados: La tasa acumulada de uso de SOMF en el período fue 4.8%. Entre las barreras al tamizaje percibidas se destacan: la dificultad en el acceso a estudios de mayor complejidad para pacientes con SOMF+, el desconocimiento y falta de percepción del CCR como un problema de salud por parte de la población y la baja adherencia de los profesionales a los lineamientos. La territorialidad y el vínculo de los centros de salud con la población, y la predisposición de usuarios y profesionales a incorporar el tamizaje surgen como facilitadores del mismo. Conclusiones: El relevamiento de las barreras orientará el diseño de estrategias adaptadas al contexto que permitan en el futuro reforzar el tamizaje.

Acquisition of educational values at the Real Madrid Foundation's social-sports schools.

The objective of this study was to analyse the impact of the educational programme of the Real Madrid Foundation (RMF) on the acquisition of educational values at social-sports football and basketball schools among children aged between 12 and 16 years in Italy, Romania, Spain and the United Kingdom. The most significant results showed that: (a) between the 20-21 and 21-22 seasons, there were statistically significant increases in personal and team success, self-fulfilment, personal and group superiority, health and physical fitness, and peaceful behaviour; and (b) the increase in variables being studied was different according to the country analysed in such a way that: in the per-sonal and team success dimension there was a rise in the United Kingdom and Italy; in self-fulfilment there was an increase in the United Kingdom; in the personal and group superiority dimension there was a rise in Italy and Romania; in the health and physical fitness dimension there was an increase in social-sports schools in the United Kingdom and Italy; in the peaceful behaviour dimension there was a rise in social-sports schools in the United Kingdom and a drop in social-sports schools in Romania. There were very significant improvements in the majority of dimensions and countries, although the development of the various dimensions is different and specific to every one of the distinct countries, meaning that it is necessary to keep adapting the educational programme of the Real Madrid Foundation in line with the sociocultural characteristics of each of the countries in which it is implemented.

CRAFTing Delivery of Membrane Proteins into Protocells using Nanodiscs.

For the successful generative engineering of functional artificial cells, a convenient and controllable means of delivering membrane proteins into membrane lipid bilayers is necessary. Here we report a delivery system that achieves this by employing membrane protein-carrying nanodiscs and the calcium-dependent fusion of phosphatidylserine lipid membranes. We show that lipid nanodiscs can fuse a transported lipid bilayer with the lipid bilayers of small unilamellar vesicles (SUVs) or giant unilamellar vesicles (GUVs) while avoiding recipient vesicles aggregation. This is triggered by a simple, transient increase in calcium concentration, which results in efficient and rapid fusion in a one-pot reaction. Furthermore, nanodiscs can be loaded with membrane proteins that can be delivered into target SUV or GUV membranes in a detergent-independent fashion while retaining their functionality. Nanodiscs have a proven ability to carry a wide range of membrane proteins, control their oligomeric state, and are highly adaptable. Given this, our approach may be the basis for the development of useful tools that will allow bespoke delivery of membrane proteins to protocells, equipping them with the cell-like ability to exchange material across outer/subcellular membranes.

Tooth-reduction 3D-printed guides for facilitating the provision of ultrathin laminate veneers.

Tooth-reduction guides offer a more controlled and conservative tooth preparation. Many types of tooth-reduction guides are available such as those with horizontal or vertical reduction grooves. A transparent cross-shaped tooth-reduction guide allows the clinician to make vertical and horizontal depth grooves to evaluate tooth reduction in all directions. The reference grooves on the guide enable the clinician to use a periodontal probe to measure the reduction accurately, and the transparent material provides a clear view of the entire tooth. Controlled tooth reduction offers a more conservative approach that is key for long-term bonded ceramic restorations. The multiaxial rigid transparent tooth-reduction guide could facilitate the provision of ultrathin handcrafted porcelain veneers to predictably fulfill patients' esthetic demands while preserving more tooth structure. The use of technically sound and artistically documented photographic evidence further underscores the effectiveness of this approach, particularly when intra-enamel preparations and adhesive luting under rubber dam isolation are employed. The present article describes a novel 3D-printed guide design that allows the clinician to perform the reduction grooves and evaluate the preparation in the horizontal and vertical directions within the same guide.

An Innovative 3D Printed Tooth Reduction Guide for Precise Dental Ceramic Veneers.

Tooth reduction guides allow clinicians to obtain the ideal space required for ceramic restorations. This case report describes a novel design (CAD) for an additive computer-aided manufactured (a-CAM) tooth reduction guide with channels that permitted access for the preparation and evaluation of the reduction with the same guide. The guide features innovative vertical and horizontal channels that permit comprehensive access for preparation and evaluation of the reduction with a periodontal probe, ensuring uniform tooth reduction and avoiding overpreparation. This approach was successfully applied to a female patient with non-carious lesions and white spot lesions, resulting in minimally invasive tooth preparations and hand-crafted laminate veneer restorations that met the patient's aesthetic demands while preserving tooth structure. Compared to traditional silicone reduction guides, this novel design offers greater flexibility, enabling clinicians to evaluate tooth reduction in all directions and providing a more comprehensive assessment. Overall, this 3D printed tooth reduction guide represents a significant advancement in dental restoration technology, offering clinicians a useful tool for achieving optimal outcomes with minimal tooth reduction. Future work is warranted to compare tooth reductions and preparation time for this guide to other 3D printed guides.

Factors Influencing the Training Process of Paralympic Women Athletes.

(1) Background: Paralympic women athletes in their training process go through a series of interrelated stages which are parallel to their evolutionary development, during which a wide variety of psychological, social, and biological factors will have an impact. The purpose of this study was to analyze the factors influencing the sports training process of Spanish Paralympic women athletes (social, sporting, psychological, technical-tactical factors, physical condition, as well as barriers and facilitators) who had won at least one medal (gold, silver, or bronze) in the 21st century Paralympic Games (from Sydney 2000 to Tokyo 2020). (2) Methods: The research involved 28 Spanish Paralympic women athletes who had won at least one medal at a Paralympic Games in the 21st century. An interview of 54 questions grouped into 6 dimensions (sport context, social context, psychological, technical-tactical, physical fitness, and barriers and facilitators) was used. (3) Results: Coaches, as well as families, were essential in the sport development of Paralympic athletes. In addition, most women athletes recognized that psychological aspects were of vital importance, as well as working on technical-tactical aspects and physical fitness in an integrated way. Finally, the Paralympic women athletes highlighted that they had to face numerous barriers, mainly financial challenges and issues with visibility in the media. (4) Conclusions: Athletes consider it necessary to work with specialists to control emotions, increase motivation and self-confidence, as well as to reduce stress and anxiety and manage pressure. Finally, the training process and sporting performance of Paralympic women athletes are conditioned by several barriers, including economic, social, architectural, and disability barriers. These considerations can be taken into account by the technical teams working with Paralympic women athletes, as well as by the competent bodies, to improve the sports training process of these athletes.

The Perception of Grassroots Coaches of Spanish Professional Clubs on the Process of Training Young Players.

(1) The aims of this study were to find out the perception of the coaches of male and female football players in the initiation stage of Spanish professional clubs about different factors of the training process (context, talent development, and methodology), and to identify possible differences according to age/category (U10s: 8-10 years old, and U12s: 10-12 years old) and gender (male and female). (2) For this purpose, a questionnaire of 57 questions grouped into seven dimensions was applied, selecting for this work those related to talent development, training methodology, and social context. A total of 153 coaches from top-level Spanish professional clubs participated in the study: the first and second male division and the first female division. (3) The coaches consider that genetic inheritance is more important than contextual variables in the development of sporting talent. On the other hand, they do not show a clear consensus on whether players who perform better in the initiation stage have a greater chance of reaching the elite. (4) In addition, they value decision-making and technical qualities as fundamental factors in the development of talent rather than physical preparation.

The Sport Training Process of Para-Athletes: A Systematic Review.

The aim of this systematic review was to identify the main factors affecting the training process of para-athletes, as well as the barriers they encounter. For this purpose, a systematic review was carried out in accordance with the PRISMA declaration guidelines, in which six databases were analysed (Web of Science, Scopus, SportDiscus, Pubmed, Eric, and PsycInfo). A total of 19 articles were selected for analysis after applying the inclusion criteria. The results show that the figures of the coach and families in the sporting and social contexts, respectively, had a relevant influence on the training process of para-athletes. Furthermore, in terms of psychological aspects, stress reduction, the importance of self-esteem, and motivation were highlighted. On the other hand, there are some barriers hindering the training and performance of athletes, which are related to the lack of financial support, lack of visibility in the media, and dependence on other people. These considerations can be of great help to coaches and competent institutions in the field (Paralympic committees, federations, etc.) in order to improve the training process and performance of para-athletes and to eliminate the barriers encountered by this group, promoting policies which facilitate access to sports for people with disabilities.

New PCR-Based Assay for the Identification of Pectobacterium carotovorum Causing Potato Soft Rot.

Soft rot on potato tuber is a destructive disease caused by pathogenic bacterial species of the genera Pectobacterium and Dickeya. Accurate identification of the causal agent is necessary to ensure adequate disease management because different species may have distinct levels of aggressiveness and host range. One of the most important potato pathogens is Pectobacterium carotovorum, a highly heterogeneous species capable of infecting multiple hosts. The complexity of this species, until recently divided into several subspecies, has made it difficult to develop precise diagnostic tests. This study proposes a PCR assay based on the new pair of primers Pcar1F/R to facilitate the identification of potato isolates of P. carotovorum according to the most recent taxonomic description of this species. The new primers were designed on a variable segment of the 16S rRNA gene and the intergenic spacer region of available DNA sequences from classical and recently established species in the genus Pectobacterium. The results of the PCR analysis of genomic DNA from 32 Pectobacterium and Dickeya strains confirmed that the Pcar1F/R primers have sufficient nucleotide differences to discriminate between P. carotovorum and other Pectobacterium species associated with damage to potato crops, with the exception of Pectobacterium versatile, which improves the specificity of the currently available primers. The proposed assay was originally developed as a conventional PCR but was later adapted to the real-time PCR format for application in combination with the existing real-time PCR test for the potato-specific pathogen Pectobacterium parmentieri. This should be useful for the routine diagnosis of potato soft rot.

Effects of Sport Teaching on Students' Enjoyment and Fun: A Systematic Review and Meta-Analysis.

The methodology used in sport teaching influences not only the students' technical and tactical learning, but also psychological and social dimensions such as enjoyment. We aimed to analyze the effects of interventions using conventional and non-conventional sport teaching methodology on students' enjoyment/fun, through a systematic review and meta-analysis. The search was carried out following the PRISMA Statement in the databases of Web of Science, PubMed, Scopus, SportDiscus, Eric and PsycInfo. A total of 1,481 documents were obtained, with the addition of 5 more which were identified in the reference lists of the articles found in the databases. Eleven articles were considered to meet the inclusion criteria. The meta-analysis yielded a moderate effect size of 0.72, and a 95% CI from 0.48 to 0.96 in favor of non-conventional teaching methods, highlighting the model of sports education. Nevertheless, the heterogeneity of the interventions was large and the quality of the evidence, according to GRADE, was very low. In conclusion, the use of non-conventional models in sport teaching with the aim of increasing the enjoyment/fun of boys and girls is advised. These suggestions could be useful for teachers and sport coaches to increase the enjoyment/fun of their trainees during sport practice.

The development of respect in young athletes: A systematic review and meta-analysis.

BACKGROUND: The practice of sports can lead to the development of values such as respect, self-control, effort, autonomy and leadership. However, sport can only foster educational habits and values if it is properly timed and specifically focused towards that end. The aim of this study was to carry out a systematic review and meta-analysis of the effect of interventions on the development and promotion of respect in the practice of sport among young people. METHODS: A systematic search was conducted, according to the guidelines of the PRISMA declaration, in the Web of Science (WOS), PubMed (Medline), Scopus, Google Scholar and SportDiscus databases. A total of 6 articles were considered to meet the inclusion criteria for the promotion of respect. Criteria for inclusion included: the full text needed to be available; it should be written in one of the selected languages: English, Spanish and Portuguese; it should be an intervention, an experimental or quasi-experimental study or a randomized controlled trial. Each manuscript was independently reviewed by three authors of this work. RESULTS: The results of the meta-analyses showed that the Siedentop sports education model, and Hellison's personal and social responsibility model (TPRS), had significant improvements regarding respect for opponents (total effect size = 0.39, small effect, with 95% Confidence Interval of 0.07 to 0.72). In addition, these models, along with another programme called Fair Play, also achieved significant increases as regards respect for the social conventions of sport (total effect size = 0.67, moderate effect, with 95% IC from 0.25 to 1.10). CONCLUSIONS: In conclusion, the use of interventions related to the above-mentioned models is recommended when it is intended to encourage respect for opponents and social conventions. These considerations could be useful to both teachers and coaches in order to further cultivate these important attitudes.

El desarrollo del respeto en la formación deportiva: una revisión sistemática / Developing respect in sports training: a systematic review

La práctica deportiva bien orientada puede fomentar al desarrollo valores tales como el respeto, el autocontrol, el esfuerzo, la autonomía y el liderazgo. En este sentido, el objetivo de este estudio fue doble: 1) realizar una revisión sistemática relativa a las investigaciones que examinaban los efectos de alguna intervención sobre el desarrollo del respeto en la formación de jóvenes deportistas; y 2) describir y analizar dichas intervenciones. Para tales fines, se llevó a cabo una revisión sistemática en la que se estudiaron y analizaron diferentes investigaciones sobre el respeto en el ámbito deportivo y de la Educación Física. Para realizar esta revisión sistemática se empleó la Declaración PRISMA. Los resultados más destacados hacen referencia a la aplicación exitosa del Modelo de Responsabilidad Personal y Social de Hellison (TPRS) y de la Educación Deportiva de Siedentop. De esta manera, tanto en el contexto escolar como en el de clubes deportivos, la utilización de intervenciones relacionadas con los Modelos mencionados es aconsejada cuando se pretende fomentar el respeto

The practice of sport can promote the development of values such as respect, self-control, effort, autonomy and leadership. In this sense, the aim of this study was twofold: 1) to carry out a systematic review of research analyzing the effects of any intervention on the development of respect in the training of young athletes; 2) to describe and examine such interventions. To this end, a systematic review was carried out in which different research on respect in the field of sport and physical education was studied and analysed. The PRISMA Statement was used to conduct this systematic review. The most outstanding results refer to the successful application of Hellison's Personal and Social Responsibility Model (TPRS) and Siedentop's Sports Education. Thus, both in the school context and in the sports club context, the use of interventions related to the above-mentioned models is recommended when respect is to be encouraged

Effects of Cooperative-Learning Interventions on Physical Education Students' Intrinsic Motivation: A Systematic Review and Meta-Analysis.

The aim was to review the effects of cooperative learning interventions on intrinsic motivation in physical education students, as well as to conduct a meta-analysis to determinate the overall effect size of these interventions. The PRISMA guidelines were followed to conduct this systematic review and meta-analysis. The PEDro Scale was used to assess the risk of bias and the GRADE approach was used to evaluate the quality of the evidence. A total of five studies fulfilled the inclusion criteria and they were included in the meta-analysis. Effect size for intrinsic motivation of each study was calculated using the means and standard deviations of the Perceived Locus of Causality Scale (PLOC) before and after the intervention. The overall effect size for intrinsic motivation was 0.38 (95% CI from 0.17 to 0.60) while the heterogeneity was large. Although four of the five studies reported significant within-group improvements in intrinsic motivation, only three studies showed significant between-group differences in favor of the experimental group. The findings showed that program duration and participant age may be relevant factors that must be considered by educators and researchers to conduct future effective interventions. Cooperative learning interventions could be a useful teaching strategy to improve physical education students' intrinsic motivation. However, given the large heterogeneity and the low quality of the evidence, these findings must be taken with caution.

Analysis of a Sports-Educational Program in Prisons.

The aim of this study was to analyze the implementation of a sports-educational program in prisons where the Real Madrid Foundation's Social-Sports Program is carried out. For that purpose, a survey of 468 inmates was conducted at 21 prisons in Spain where the Real Madrid Foundation implements its program (441 men (94.23%) and 27 women (5.77%)). Inmates stated that the program had had a favorable influence on their life in prison and considered that their participation in the program might have a significant influence on the likelihood of them continuing to play sports when they are released. In addition, inmates felt that they had learned a great deal about the contents relating to football and the values they had worked on, and that the program had had a very positive effect on their overall development as a person.

Small-Sided Games as a Methodological Resource for Team Sports Teaching: A Systematic Review.

New models for teaching sports have arisen in the last years, characterised by the use of more contextualised situations, modified games, tactical awareness, transference of technical-tactical learning and different teaching progression, among other aspects. In this regard, small-sided games must be highlighted, due to their ability to integrate physical fitness, technique and tactical behaviour stimuli in similar conditions to the real game. Therefore, the aim of this systematic review was to analyse and describe the methodological possibilities that SSGs can provide regarding the teaching of technical-tactical aspects in team sports at young ages. The guidelines of the PRISMA declaration were followed with the purpose of conducting a systematic search. The search was performed in the databases Pubmed, Web of Science, Scopus and SportDiscus. From the 451 identified in an early phase, plus the 20 found in the references of other studies, only 47 met the inclusion criteria and were selected. The results yielded scientific evidence that justifies the use of small-sided games as a methodological resource for sports teaching at young ages. Among the main reasons, it can be highlighted that a reduction in the number of players and in the size of the pitch area increases the total ball contact per player and, therefore, the number of technical actions. Moreover, the intentional modification of certain rules helps to develop some sport training fundamentals.

Functional Ability, Frailty and Risk of Falls in the Elderly: Relations with Autonomy in Daily Living.

The objective of this research was to determine the differences in autonomy in both basic activities of daily life in instrumental activities of daily life, as well as functional capacity, fragility and risk of falls between an active group and a sedentary group. The individual associations of functional capacity, fragility and risk of falls were also analyzed, with autonomy in basic activities of daily living and in instrumental activities of daily living in the active group. In this cross-sectional investigation, 139 people from Huelva between 65 and 87 years of age were evaluated (Mean (M) = 73.1; standard deviation (SD) = 5.86); 100 were women and 39 men. The active and sedentary group were composed of 69 and 70 elderly people, respectively. The active group carried out a physical activity program. Among the results, a significant effect was seen in the multivariate contrast of the study variables, V = 0.24, F (5, 137) = 8.58, and p < 0.001; while in the linear regressions in the active group, the Vivifrail with the Barthel Index (Δ Adj. R2 = 0.15) and with the Lawton and Brody Scale (Δ Adj. R2 = 0.22) were used. In conclusion, the active group presented better values in all the variables evaluated in comparison to the sedentary group, establishing statistically significant differences. In addition, in the active group, it has been found that functional capacity is a significant predictive variable of autonomy in instrumental activities of daily living (22%), while fragility and the risk of falls are significant predictors of autonomy in activities of basic daily life (15%).

Effects of Teaching Games on Decision Making and Skill Execution: A Systematic Review and Meta-Analysis.

The question of how games should be taught is still a controversial subject. There has been a growing number of studies on teaching games and coaching sports since the first publication of Bunker and Thorpe on Teaching Games for Understanding (TGfU). In this sense, the present systematic review and meta-analysis aimed to systematically review the scientific literature about the effects of technical and tactical approach interventions on skill execution and decision making, and to examine the influence of the teacher/coach management style. A systematic literature search was carried out in accordance with PRISMA guidelines in Web of Science (WOS), PubMed (Medline), Scopus, and SportDiscus electronic databases. A total of seven and six studies were deemed to meet the inclusion criteria for decision making and skill execution, respectively. Meta-analysis results showed that tactical interventions achieved significant improvements in decision making (effect size = 0.89 with 95% confidence interval (CI) from 0.12 to 1.65), but they did not show significant improvements in skill execution (effect size = 0.89 with 95% CI from -0.45 to 2.23) compared to technical approaches. However, the heterogeneity of interventions was large and the quality of evidence was low according to GRADE. In conclusion, tactical approaches are recommended to teach games and sports in order to develop technique, understanding, tactical knowledge, and decision making, which are demanded in game play. These findings could be useful for teachers and coaches to improve these aspects of their players and students.

Recomendaciones de expertos en la mejora de la prevención efectiva del ictus isquémico en la fibrilación auricular no valvular: papel del rivaroxabán / Expert recommendations on improving effective ischemic stroke prevention in nonvalvular atrial fibrillation: the role of rivaroxaban

La fibrilación auricular aumenta de manera marcada el riesgo de ictus isquémico. A pesar de que los antagonistas de la vitamina K (AVK) reducen ese riesgo, tienen una eficacia limitada y numerosos inconvenientes que han hecho que durante años hubiese una proporción importante de pacientes con fibrilación auricular no anticoagulados. En cambio, no solo los ensayos clínicos, sino también los estudios en práctica clínica real y últimamente los estudios poblacionales, han demostrado que los anticoagulantes orales de acción directa (ACOD) tienen más eficacia y seguridad y un mejor beneficio clínico neto que los AVK. De hecho, en las regiones donde la prescripción de ACOD es mayor, está disminuyendo la incidencia de ictus isquémico, además de los costes generales asociados con la fibrilación auricular. A pesar de que en los últimos años ha aumentado la prescripción de ACOD, España es de los países con menores tasas de prescripción de toda Europa, lo que podría asociarse con mayores tasas de ictus isquémico. A pesar de que todas las guías posicionan los ACOD como de primera elección frente a los AVK para los pacientes con fibrilación auricular no valvular, en España, debido a las restricciones impuestas por el informe de posicionamiento terapéutico, con necesidad de visado, y también por la inercia terapéutica, es mayor la prescripción de AVK. Son necesarias medidas inmediatas para corregir esta situación, y así mejorar el pronóstico de nuestros pacientes

Atrial fibrillation markedly increases the risk of ischemic stroke. Although vitamin K antagonists (VKAs) reduce this risk, they have limited efficacy and several disadvantages, which has meant that over the years a substantial proportion of patients with atrial fibrillation have remained without anticoagulation. In contrast, clinical trials, studies in routine clinical practice and, more recently, population-based studies have all demonstrated that direct oral anticoagulants (DOACs) are more effective and safer than VKAs and also have a greater net clinical benefit. In fact, in regions where the DOAC prescription rate is high, the incidence of ischemic stroke has decreased, as have the overall costs associated with atrial fibrillation. Although the prescription of DOACs in Spain has increased in recent years, the country has one of the lowest prescription rates in Europe, which may be associated with a higher incidence of ischemic stroke. Despite clinical guidelines all recommending that DOACs should be used in preference to VKAs in patients with nonvalvular atrial fibrillation, more prescriptions are issued for VKAs in Spain, largely due to restrictions imposed by national statements on appropriate medicine use (including the need for approval), but also because of therapeutic inertia. Immediate action should be taken to correct this situation and to improve patients' prognoses