Exercise prescription for the prevention and treatment of chronic diseases in primary care: Protocol of the RedExAP study.

BACKGROUND: Existing evidence supports the effectiveness of exercise in preventing and treating chronic diseases, yet its integration into clinical practice remains limited. This study protocol aims to address the evidence-practice gap by exploring barriers to exercise prescription in primary care and developing a clinical practice guideline (CPG). METHODS: Employing a qualitative approach, focus groups will be conducted to investigate primary care professionals' challenges in prescribing exercise and patients' adherence to recommendations. Phenomenological analysis will facilitate data interpretation. Data triangulation, expert analysis, and quality criteria will ensure study reliability. The CPG development process is outlined, emphasizing transdisciplinary collaboration and patient involvement. CONCLUSION: The RedExAP study responds to the imperative for evidence-based exercise integration in primary care. The study's combined qualitative exploration and CPG development present the potential to improve health outcomes and cost-effectiveness. By elucidating primary care professionals' and patients' perspectives, the study contributes to enhancing exercise prescription adoption. The innovative transdisciplinary approach aligns with the 2030 Agenda, promoting better population health and greater social well-being, showing promise in alleviating chronic disease burdens. This study's findings lay the groundwork for advancing evidence-based exercise interventions within primary care to transform chronic disease management.

EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial.

INTRODUCTION: Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates. MATERIALS AND METHODS: This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines. RESULTS: There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (p=0.0006, d=0.969), manic symptoms (p=0.027, d=0.513), and improving functioning (p=0.038, d=0.486). There was no significant difference in dropout between treatment arms. CONCLUSIONS: Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.

Media Exposure of Suicidal Behaviour: An Umbrella Review.

AIM: To analyse recommended interventions for the safe and responsible dissemination of suicidal behaviour in the media for preventive purposes. BACKGROUND: Suicide is a serious public health problem that leads to more than 700,000 deaths per year, which translates into one death every forty seconds. The media play a significant role in shaping public perceptions and reflecting societal issues. Because of its active role in the construction of reality, the way in which the media report and expose suicidal behaviour has the capacity to influence the population in either a preventive or harmful way. DESIGN: An umbrella review was carried out and a report was written according to the Preferred Reporting Items for Overviews of Reviews. METHODS: We systematically searched for reviews published from inception to February 2023 in MEDLINE (PubMed), CINAHL and PsycInfo (via EBSCOhost), Web of Science, Embase, Cochrane Library of Systematic Reviews, Scopus, and Google Scholar. A narrative synthesis of the results was conducted. RESULTS: Six systematic reviews with a moderate to high quality level were selected. Among the recommended interventions were the inclusion of positive messages of hope, resilience, or of overcoming the event, narratives with information on available resources or the promotion of support-seeking attitudes as an effective prevention mechanism, as well as the avoidance of repetitive reporting of the same suicide. The appropriate and responsible dissemination of information on suicidal behaviour in the media with complete and up-to-date information on available centres, organisations, institutions, and resources has proven to be effective, especially in vulnerable populations. CONCLUSION: Educating and training the media in an appropriate approach to disseminating suicidal behaviour helps to reduce the number of suicidal behaviours. Knowing what information is advisable to include in the news item as well as what information to avoid is a strong point. Guidelines to promote responsible media reporting are a key component of suicide prevention strategies. This study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 23 April 2022 with the registration number CRD42022320393.

Effects of a 4-Week After-School Physical Literacy Program on Health-Related Quality of Life and Symptomatology in Schoolchildren with ADHD: A Study Protocol.

Research has shown that physical activity programs led to improvements in children with Attention Deficit Hyperactivity Disorder (ADHD). However, no study evaluating the impact of a physical literacy (PL) program has been conducted. This study aims to examine PL and the effects of an after-school PL program on Health-related quality of life (HRQoL) and ADHD symptomatology including quality and sustained attention. A parallel-group randomised controlled trial will be conducted assessing PL, HRQoL and ADHD symptomatology, both at the beginning and the end of the PL after-school program implementation. The program will last 4 weeks, including two sessions per week lasting 55 min. Sessions will be divided into several parts: greeting (5 min), block I (20 min), block II (20 min) and relaxation and feedback (10 min). Block I will focus on the acquisition of content that contributes to the development of the domains of knowledge and understanding and daily activity; and block II, in addition to favouring physical competence, will seek to improve motivation. If this program proves its effectiveness, it could be an alternative to be included in educational systems, representing a scientific breakthrough regarding physical activity adherence and inactivity-related disease prevention, HRQoL and management of ADHD-associated symptomatology.

Effects of a Raisin Supplement on Cognitive Performance, Quality of Life, and Functional Activities in Healthy Older Adults-Randomized Clinical Trial.

The objective of this study was to evaluate the effects of consuming 50 g of raisins on cognitive performance, quality of life, and functional activities in healthy older adults. This is a parallel randomized controlled clinical trial, in which 80 subjects over 70 years of age participated. For 6 months, the intervention group (IG; n = 40) consumed 50 g of raisins per day added to their usual diet, whereas the control group (CG; n = 40) received no supplement. All variables were measured at baseline and at 6 months. Cognitive performance assessed with the Montreal Cognitive Assessment (MOCA) test shows a difference of 3.27 points (95% CI 1.59 to 4.96), p ≤ 0.001, favorable to the IG, after the intervention. Among the cognitive performances, an improvement is observed in the IG in orientation, assessed both with the MOCA test 0.49 (95% CI 0.10 to 0.87), p = 0.014, and with the Mini-Mental State Examination (MMSE) test, 0.36 (95% CI 0.02 to 0.70), p = 0.038. In visuospatial/executive capacity and in language, improvements were also observed in the IG, 1.36 (95% CI 0.77 to 1.95), p = 0.001, and 0.54 points (95% CI 0.12 to 0.96), p = 0.014, respectively. Immediate and delayed recall, assessed with the Rey Auditory Verbal Learning Test, improved in the IG. In addition, the IG showed a better quality of life and greater autonomy in instrumental activities of daily living after 6 months. No significant changes were observed in the rest of the variables analyzed. Therefore, the consumption of 50 g of raisins produces a slight improvement in cognitive performance, quality of life, and functional activities in the elderly.

High incidence of PTSD diagnosis and trauma-related symptoms in a trauma exposed bipolar I and II sample.

Background: Post-traumatic stress disorder (PTSD) is an established comorbidity in Bipolar Disorder (BD), but little is known about the characteristics of psychological trauma beyond a PTSD diagnosis and differences in trauma symptoms between BD-I and BD-II. Objective: (1) To present characteristics of a trauma-exposed BD sample; (2) to investigate prevalence and trauma symptom profile across BD-I and BD-II; (3) to assess the impact of a lifetime PTSD diagnosis vs. a history of trauma on BD course; and (4) to research the impacts of sexual and physical abuse. Methods: This multi-center study comprised 79 adult participants with BD with a history of psychological trauma and reports baseline data from a trial registered in Clinical Trials (https://clinicaltrials.gov; ref: NCT02634372). Clinical variables were gathered through clinical interview, validated scales and a review of case notes. Results: The majority (80.8%) of our sample had experienced a relevant stressful life event prior to onset of BD, over half of our sample 51.9% had a lifetime diagnosis of PTSD according to the Clinician Administered PTSD scale. The mean Impact of Event Scale-Revised scores indicated high levels of trauma-related distress across the sample, including clinical symptoms in the PTSD group and subsyndromal symptoms in the non-PTSD group. Levels of dissociation were not higher than normative values for BD. A PTSD diagnosis (vs. a history of trauma) was associated with psychotic symptoms [2(1) = 5.404, p = 0.02] but not with other indicators of BD clinical severity. There was no significant difference between BD-I and BD-II in terms of lifetime PTSD diagnosis or trauma symptom profile. Sexual abuse significantly predicted rapid cycling [2(1) = 4.15, p = 0.042], while physical abuse was not significantly associated with any clinical indicator of severity. Conclusion: Trauma load in BD is marked with a lack of difference in trauma profile between BD-I and BD-II. Although PTSD and sexual abuse may have a negative impact on BD course, in many indicators of BD severity there is no significant difference between PTSD and subsyndromal trauma symptoms. Our results support further research to clarify the role of subsyndromic PTSD symptoms, and highlight the importance of screening for trauma in BD patients.

Effect of Polyphenolic Complements on Cognitive Function in the Elderly: A Systematic Review.

Polyphenols have been shown to be effective against many chronic diseases. These compounds could have a beneficial effect at the cognitive level. The exact mechanism by which they provide positive effects at the cognitive level is not well known, but it is believed that they could counteract neuroinflammation. The objective of this study is to review nutritional interventions that include foods or supplements rich in flavanols, flavonols, or stilbenes to the usual diet on cognitive deterioration in people over 50 years of age. Clinical trials published in PubMed and Web of Science from 1 March 2010 to 1 March 2020 were explored, from which 14 studies were selected. All of them showed some improvement after the intervention. In interventions with flavanols and stilbenes, relevant improvements have been observed both in healthy patients and in patients with established cognitive impairment. Most studies agree that the greatest benefits are found with high doses and longer duration treatments. The changes were fundamentally assessed through cognitive tests, and in some of the studies, through magnetic resonance imaging (fMRI). The type of cognitive test used to assess the effect of the intervention was revealed to be critical. Several studies have also shown improvements in analytical parameters and blood pressure.

Design and Validation of a Questionnaire on Risk Perception, Coping Behaviors and Preventive Knowledge against COVID-19 among Nursing Students.

As shown in the previous literature, in view of the future responsibilities of nursing professionals and the consequences for healthcare, it is of great interest to examine their risk perceptions, coping behaviors, and sense of coherency during the COVID-19 pandemic. The purpose of this study is to design and to validate a specific questionnaire that evaluates the factors relating to perceived risk, coping behaviors, and preventive knowledge against COVID-19 infection among nursing students from Spain. This is a psychometric study of a questionnaire's design and its validation in 1562 nursing students at 16 undergraduate nursing institutions in Spain. An ad-hoc survey was designed by a panel of six experts drawing from the literature. After a trial test, the questionnaire was formed with four scales (perception, risk, coping, and knowledge of preventive practices for COVID-19), with a total of 69 items. The final questionnaire was composed of 52 items grouped into four scales, with good psychometric properties to measure risk perception (Cronbach's alpha 0.735), factors related to perceived risk (Cronbach's alpha 0.653), coping behaviors (Cronbach's alpha 0.80), and knowledge of preventive practices against COVID-19 (Cronbach's alpha 0.77). This questionnaire, specifically designed and validated for nursing students, is the first to address four important areas in the development of preventive measures against COVID-19.

Multimodal physical exercise and functional rehabilitation program in oncological patients with asthenia. study protocol.

BACKGROUND: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. METHODS: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04761289. (February 18, 2021).  https://clinicaltrials.gov/ct2/show/ NCT04761289.

The Relationship between Adherence to the Mediterranean Diet, Intake of Specific Foods and Depression in an Adult Population (45-75 Years) in Primary Health Care. A Cross-Sectional Descriptive Study.

BACKGROUND: The relationship between the quality of the diet and the adherence to the Mediterranean diet with the presence of persistent or recurrent depressive symptoms have been described. The objective of this study is to analyze the relationship between adherence to the Mediterranean diet and the intake of specific foods in primary care patients aged 45 to 75, having subclinical or major depression. The study also specifically analyzes this relationship in individuals suffering from chronic diseases. METHODS: A cross-sectional descriptive study was conducted. 3062 subjects met the inclusion criteria from the EIRA study. Sociodemographic variables, clinical morbidity, depression symptomatology (PHQ-9) and adherence to Mediterranean diet (MEDAS) were collected. RESULTS: Being female, younger, with a higher BMI, consuming more than 1 serving of red meat a day and drinking more than one carbonated or sugary drink daily, not consuming 3 servings of nuts a week and not eating 2 vegetables cooked in olive oil a week are predictors of having higher depressive symptomatology. CONCLUSIONS: Assessing the type of diet of patients presenting depressive symptoms and promoting adherence to a healthy diet is important, especially in patients with chronic diseases. However, depression is a very complex issue and the relationship between nutrition and depression must be further examined.

Knowledge about Fibromyalgia in Fibromyalgia Patients and Its Relation to HRQoL and Physical Activity.

Introduction: Fibromyalgia (FM) affects 2.40% of the Spanish population. The most widespread treatment has been the combination of patient education, pain coping strategies and exercise. With regard to patient education, there are few previous studies on the efficacy of relating FM education in isolation with an improvement in FM, although there are some studies that report that health education programs could modify the perception of quality of life and improve pain. Objectives: the aim was to find out the level of knowledge about FM among patients in Extremadura, to explore the relationship between knowledge of FM and Health-Related Quality of Life (HRQoL) and to analyze the relationship between knowledge of physical activity in FM and the practice of physical activity. Methods: A single-measure cross-sectional study was carried out with 121 women with a mean age of 55.06 (±9.93) years. The following questionnaires were used: Fibromyalgia Knowledge Questionnaire (FKQ); SF12v2 (Short-Form Health Survey); and EURO-QOL-5D-5L (EQ-5D-5L). Results: regarding the level of knowledge of the participants about FM, it was found that 10% had a low knowledge, 49% medium and 41% high. In relation to the associations between the level of knowledge and HRQoL, a weak correlation between EQ-5D-5L and the FKQ in the domain of physical activity (r = 0.243) were found. Conclusions: it can be concluded that the level of knowledge about FM of the patients from Extremadura was medium-high and that there is a direct weak relationship between knowledge about physical activity in FM and HRQoL. However, no association was found between knowledge of physical activity in FM and the practice of physical activity.

Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol.

BACKGROUND: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. METHODS: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).

Spanish Translation and Cultural Adaptation of the Fibromyalgia Knowledge Questionnaire.

INTRODUCTION: Fibromyalgia (FM) translates into a reduction in the quality of life of people who suffer from it, being a chronic disease of unknown etiology. One of the most widespread treatments includes the combination of patient education, along with other components. At the educational level, the Fibromyalgia Knowledge Questionnaire (FKQ) is a tool that assesses knowledge of fibromyalgia. OBJECTIVE: To obtain the translation and cultural adaptation of the FKQ questionnaire into Spanish, as well as its readability, in addition to knowing the relationship between knowledge of the disease and the level of disability. METHOD: In phase one, a translation-back translation and an evaluation of the readability of the questionnaire was carried out from INFLESZ, while in phase two, the questionnaire was passed to women with FM to detect their knowledge of the disease. A total of 49 women participated, with a mean age of 54.48 years. RESULTS: The Spanish version of the FKQ questionnaire was rated by the participants in all its items as "clear and understandable". The readability obtained by the questionnaire was similar to its original version, with both totals being in the "normal" range, following the INFLESZ ranges. Regarding the patients' knowledge about FM, the component in which the highest score was obtained was physical activity (80% correct), while the one that obtained the worst score was knowledge about medication (50% correct). In addition, an inverse correlation was obtained between the FKQ and the FIQ (Fibromyalgia Impact Questionnaire) (r = -0.438; p < 0.01). CONCLUSIONS: The FKQ has been translated and culturally adapted, obtaining a correct understanding by the participants, as well as a degree of readability similar to the original questionnaire. Furthermore, it was obtained that, the lower the level of knowledge of the sick person, the greater the disability.

Influencia de la regucalcina en la pérdida de masa ósea / Influence of regucalcin on bone loss

Objetivo: El propósito de este trabajo ha sido revisar la literatura científica con relación al papel de la regucalcina en la pérdida de masa ósea. Método: Se realizó una búsqueda bibliográfica en la base de datos PubMed. Se encontraron 31 artículos. Tras analizar su contenido y aplicar los criterios de inclusión y exclusión, un total de 13 artículos fueron incluidos. Resultados: La disminución en el contenido de calcio femoral observado en ratones transgénicos con regucalcina se observó con el aumento de la edad, lo que sugiere que la pérdida ósea no se restaura con el modelado óseo. De la misma manera, se encontró que la adición de regucalcina con 1 a 100 nM estimulaba significativamente la actividad basal de NF-kB (P<0.01). Se apreció una disminución significativa en el contenido de ADN en los tejidos metafisarios femorales, con una mayor disminución en hembras que en machos, siendo estos valores: 3.3 mg/g pasaron a ser 2.6 mg/g en las hembras (P<0.01). La reabsorción ósea osteoclástica aumentó en ratones transgénicos con regucalcina machos y hembras con edad creciente. La regucalcina exógena revela efectos supresores sobre la osteoblastogénesis y la mineralización in vitro y que no tuvo efectos sobre la proliferación celular y la apoptosis en las células osteoblásticas en cultivos a corto plazo. Conclusión: La regucalcina desempeña un papel fundamental en el mantenimiento del homeostasis celular y la función de la respuesta celular en relación a la masa ósea.(AU)

Purpose: The aim of this work has been to review the scientific literature regarding the role of regucalcin in bone loss.Method: A bibliographic search was performed in the PubMed database. A total of 31 articles were used. After analyzing its content and applying the inclusion and exclusion criteria, a total of 13 articles were included.Results: The decrease in femoral calcium content observed in regucalcin transgenic mice decreased with increasing age, suggesting that bone loss is not restored with bone modeling. In the same way, it was found that the addition of regucalcin with 1 to 100 nM significantly stimulated the baseline activity of NF-kB (P <0.01). Likewise, there was a significant decrease in the DNA content in femoral metaphyseal tissues, with a greater decrease in females than in males, these values ​​being: 3,3 mg / g became 2,6 mg / g (P <0.01). Osteoclastic bone resorption increased in male and female transgenic regucalcin mice with increasing age. Also, exogenous regucalcin reveals suppressive effects on osteoblastogenesis and mineralization in vitro and that it had no effects on cell proliferation and apoptosis in osteoblast cells in short-term cultures.Conclusion: Regucalcin plays a fundamental role in the maintenance of cell homeostasis and the function of the cellular response in relation to bone mass.(AU)

Efectos agudos y crónicos de la práctica de Bodypump / Acute and chronic effects of Bodypump practice

Objetivo: Analizar las intervenciones científicas existentes sobre la actividad de fitness colectiva Bodypump, en cuanto a composición corporal, condición física y aspectos psicológicos, para sintetizar los beneficios que reporta su práctica. Método: Configuración y Diseño: Búsqueda bibliográfica que incluyó todos los artículos publicados hasta el 15 de marzo de 2020, en la base de datos Pubmed. En el buscador se han utilizado las palabras clave “Bodypump” or “fitness clases”, apareciendo 78 artículos. Se han excluido aquellos que no estaban en el idioma de inglés (1) y los que no incluían la práctica de Bodypump en ninguno de sus grupos experimentales (64), quedando finalmente 13 artículos para analizar. Resultados: Entre los efectos agudos, una clase de 60 minutos de Bodypump se desarrolla a una frecuencia cardiaca media entre 60 y 74% de la frecuencia cardiaca máxima, existiendo un gasto calórico de entre 250 y 334 kcal. A nivel fisiológico y hormonal, se ha producido un aumento significativo de la concentración de lactato en sangre, así como de hormona de crecimiento e interleucina-6. En cuanto a los efectos crónicos, en lo que se refiere a cambios en antropometría y composición corporal, podemos decir que únicamente se producen cuando esta actividad se combina con ciclismo indoor. Por último, se ha observado un aumento de fuerza tanto en miembros superiores, como inferiores, así como también una mejora significativa en las variables psicológicas de motivación para el ejercicio y percepción de salud. Conclusiones: La práctica de Bodypump permite mejorar la condición física, aspectos psicológicos y composición corporal, en este último caso, para disminuir el peso y el % de grasa corporal, la práctica de Bodypump no resulta efectiva y es necesario combinarla con la práctica de ciclismo indoor.(AU)

Aim: To Analyse the scientific interventions on Bodypump collective fitness activity, in terms of body composition, physical condition and psychological aspects, to synthesize the benefits of Bodypump practice.Method: Bibliographic search that included all articles published until March 15, 2020, in the Pubmed database. The keywords "Bodypump" or "fitness classes" have been used in the search, showing 78 articles. Those were not in the English language (1) and those did not include Bodypump practice in any of the experimental groups (64) were excluded, finally a total of 13 articles were analysed.Results: Among the acute effects, a 60-minute Bodypump class is develop at an average heart rate between 60 and 74% of the maximum heart rate, with a caloric expenditure of between 250 and 334 kcal. At the physiological and hormonal level, there were a significant increase in the concentration of lactate in the blood, as well as growth hormone and interleukin-6. The chronic effects, in terms of changes in anthropometry and body composition, happen when Bodypump is combined with indoor cycling. Finally, an increase in strength has been observed in both upper and lower limbs, as well as a significant improvement in the psychological variables of motivation for exercise and perception of health. Conclusions: The practice of Bodypump allows to improve the physical condition, psychological aspects and body composition, in the last case, to decrease weight and % of body fat, the Bodypump practice is not effective but itself and it is necessary to combine Bodypump with the practice of indoor cycling.(AU)

Relationship between Health-Related Quality of Life and Physical Activity in Children with Hyperactivity.

The main purpose of this paper was to evaluate the relationship between health-related quality of life (HRQoL) and the frequency of physical activity in Spanish children aged 8 to 14 years with attention deficit hyperactivity disorder (ADHD). Sample selection was performed using the data obtained from the children's questionnaire of the National Health Survey of Spain 2017 that is carried out with the children's parents, and that had an initial size of 6106 participants. After the application of the inclusion and exclusion criteria, the sample size was reduced to 496 subjects. Results show significant differences between the different levels of physical activity frequency, as well as a positive correlation of the average between HRQoL and ADHD. In conclusion, the practice of physical activity may contribute to the improvement of HRQoL in children with ADHD, possibly achieving greater benefits at higher levels of physical activity practice.

Risk factors for open conversion of lateral transperitoneal laparoscopic adrenalectomy: retrospective cohort study of the Spanish Adrenal Surgery Group (SASG).

BACKGROUND: Laparoscopic adrenalectomy has become the standard of care for treating adrenal tumors. Conversion from laparoscopic adrenalectomy to an open approach during surgery may be necessary in some cases. This study aimed to identify the risk factors for open conversion of laparoscopic adrenalectomy. METHODS: Retrospective analysis of all consecutive patients undergoing lateral transperitoneal laparoscopic adrenalectomy in six endocrine surgery units of the Spanish Adrenal Surgery Group (SASG) between January 2005 and December 2017. Demographic, clinical, surgical, and histopathologic characteristics were recorded. Risk factors for conversion were assessed by logistic regression analysis. RESULTS: Of a total of 865 patients included in the study, 58 (6.7%) required conversion to open surgery. In the univariate analysis, factors associated with conversion from laparoscopic to open adrenalectomy were body mass index (BMI) ≥ 30 kg/m2 (P = 0.002), previous abdominal surgery (P = 0.015), tumor size > 5 cm (P = 0.001), and surgery for pheochromocytoma (P = 0.034). In the multivariate analysis, independent risk factors were BMI ≥ 30 kg/m2 [odds ratio (OR) 4.26, 95% confidence interval (CI) 2.81-8.75; P = 0.001], tumor size > 5 cm (OR 10.15, 95% CI 4.24-28.31; P < 0.001), and surgery for pheochromocytoma (OR 2.96, 95% CI 1.89-11.55; P = 0.015). CONCLUSIONS: Obesity, tumor size, and pheochromocytoma as the type of adrenal tumor were predictive factors for intraoperative conversion from laparoscopic to open adrenalectomy. Preoperative assessment of these characteristics should be valuable to clinicians in discussing conversion risk in patients and for surgical planning.

The human gallbladder microbiome is related to the physiological state and the biliary metabolic profile.

BACKGROUND: The microbial populations of the human intestinal tract and their relationship to specific diseases have been extensively studied during the last decade. However, the characterization of the human bile microbiota as a whole has been hampered by difficulties in accessing biological samples and the lack of adequate methodologies to assess molecular studies. Although a few reports have described the biliary microbiota in some hepatobiliary diseases, the bile microbiota of healthy individuals has not been described. With this in mind, the goal of the present study was to generate fundamental knowledge on the composition and activity of the human bile microbiota, as well as establishing its potential relationship with human bile-related disorders. RESULTS: Human bile samples from the gallbladder of individuals from a control group, without any record of hepatobiliary disorder, were obtained from liver donors during liver transplantation surgery. A bile DNA extraction method was optimized together with a quantitative PCR (qPCR) assay for determining the bacterial load. This allows the selection of samples to perform functional metagenomic analysis. Bile samples from the gallbladder of individuals suffering from lithiasis were collected during gallbladder resection and the microbial profiles assessed, using a 16S rRNA gene-based sequencing analysis, and compared with those of the control group. Additionally, the metabolic profile of the samples was analyzed by nuclear magnetic resonance (NMR). We detected, for the first time, bacterial communities in gallbladder samples of individuals without any hepatobiliary pathology. In the biliary microecosystem, the main bacterial phyla were represented by Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. Significant differences in the relative abundance of different taxa of both groups were found. Sequences belonging to the family Propionibacteriaceae were more abundant in bile samples from control subjects; meanwhile, in patients with cholelithiasis members of the families Bacteroidaceae, Prevotellaceae, Porphyromonadaceae, and Veillonellaceae were more frequently detected. Furthermore, the metabolomics analysis showed that the two study groups have different metabolic profiles. CONCLUSIONS: Our results indicate that the gallbladder of human individuals, without diagnosed hepatobiliary pathology, harbors a microbial ecosystem that is described for the first time in this study. Its bacterial representatives and metabolites are different from those detected in people suffering from cholelithiasis. In this regard, since liver donors have been subjected to the specific conditions of the hospital's intensive care unit, including an antibiotic treatment, we must be cautious in stating that their bile samples contain a physiologically normal biliary microbiome. In any case, our results open up new possibilities to discover bacterial functions in a microbial ecosystem that has not previously been explored.

Measurement equivalence of PROMIS depression in Spain and the United States.

In this study, we assessed the psychometric properties of the Spanish Patient-Reported Outcomes Measurement Information System (PROMIS) Depression in an adult population-representative sample from Spain (n = 1,503). We tested unidimensionality and local independence item response theory (IRT) assumptions with confirmatory factor and bifactor models under the exploratory structural equations modeling framework. We evaluated item monotonicity assumption with Mokken scaling analysis. We calibrated the items with an IRT-graded response model and assessed score reliability and test information, and evidence of validity with regard to scores on external measures. To examine differential item functioning by age, sex, education, and country (United States vs. Spain, N = 2,271), we used ordinal logistic regression. Results support compliance with IRT assumptions. We found few signs of differential item functioning: Only one item showed country differential functioning between the United States (n = 768) and Spain, with minimal impact on the overall score. Information values were equivalent to reliabilities over 0.90 from -1 (low depression) to +4 SD (high depression) around the population score mean. Evidence of validity in relation to concurrent measures was supported by the expected correlation pattern with external variables of depression, but higher than expected correlations with anxiety were found. Results indicate that the Spanish version of PROMIS Depression is adequate for assessing and monitoring depression levels in the general population and that PROMIS Depression is especially suitable for cross-national comparisons. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Limitaciones en los profesores de Ciencias Médicas de Sancti Spirítus en el desarrollo de investigaciones educativas / Limitations of Medical Sciences professors in Sancti Spirítus in the development of educational research

RESUMEN Fundamento: Las Ciencias Médicas se caracterizan por estudios profesionales en relación a la salud pública y al proceso de salud enfermedad, pero presentan debilidades en la formación del profesional de la Medicina, en el conocimiento y desarrollo de sus habilidades investigativas. Objetivo: Determinar las limitaciones del docente de las Ciencias Médicas en la investigación educativa en el colectivo de primer año de la carrera de Medicina. Metodología: Se realizó un estudio descriptivo de corte transversal; la población estuvo conformada por 30 docentes del colectivo de año, 3 directivos de la facultad el resto profesores principales de las asignaturas. Se realizó el análisis de documentos, la entrevista a directivos, docentes y estudiantes, la encuesta a docentes, y la triangulación de datos en la carrera de Medicina durante el curso 2017-2018 de la Universidad de Ciencias Médicas de Sancti Spíritus. Resultados: Reflejan la formación de un docente concentrado en el contenido de la enseñanza del saber disciplinar, en detrimento de su implicación hacia la investigación educativa, donde el colectivo del año académico no evidencia su potencial formativo. Conclusiones: La actuación del docente de las ciencias médicas se concibe desde lo individual y grupal en el ejercicio docente. Reconociendo que la investigación científica forma parte de sus funciones, pero se inclinan a la materia que imparten y el colectivo de año no los estimula hacia la investigación de los problemas educativos.

ABSTRACT Background: Medical Sciences are characterized by professional studies related to public health and the disease health process, but they present weaknesses in the training of the medical professional, also in the knowledge and development of their research skills. Objective: To determine the limitations of the Medical Sciences professors in the educational research in the first academic year group of the Medicine career. Methodology: A descriptive cross-sectional study was carried out; the population consisted of 30 teachers from the teachers´ academic year group, 3 faculty directors, and the rest, some of the main professors of the subjects. The analysis of documents, the interview with managers, teachers and students, the survey of teachers, and the triangulation of data in the Medicine career during the course 2017-2018 at the Sancti Spíritus University of Medical Sciences were used. Results: The performance of teacher of medical sciences is conceived from both, the individual and the group in the teaching practice. Recognizing that the scientific research is part of their functions, but they are mainly interested into the subject they teach and the teachers´ academic year group does not encourage them to research about educational problems.