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Background This study identifies correlates of the lockdown’s psychological distress in frail older community-dwellers (Catalonia, Spain). Methods Participants from a community frailty intervention program, with a comprehensive geriatric assessment within the 12-months pre-lockdown and COVID-19 free during the first pandemic wave (March–May 2020), underwent a phone assessment past the lockdown to assess COVID-19-related emotional distress (DME) as well as other sociodemograhic, clinical and psychosocial factors. Results Of the 94 frail older adults (age = 82,34 ± 6,12 years; 68,1% women; 38,3% living alone), 84,9% were at risk of experiencing moderate-to-high psychological distress, according to the backward stepwise logistic regression model obtained (χ2 = 47,007, p 2 = 0,528), based on the following factors: absence of depressive symptoms before lockdown (OR = 0,12, p = 0,014, 95%CI[0,023–0,647]), not carrying out leisure activities during lockdown (OR = 0,257, p = 0,023, 95%CI[0,079–0,832]) and currently experiencing high malaise due to COVID-19 situation (OR = 1,504, p Discussion These findings suggest that it is necessary to favour a prior overall health status and to empower frail older community-dwellers in the use of a broad repertoire of coping strategies in the face of adversity to foster mental health and keep at bay the potential emotional impact of the situation generated by the COVID pandemic.

Rehabilitació cardíaca; Síndrome coronària aguda; Telemedicina Cardiac rehabilitation; Acute coronary syndrome; Telemedicine Rehabilitación cardíaca; Síndrome coronario agudo; Telemedicina La rehabilitación cardíaca tiene el máximo nivel de evidencia en las guías médicas de referencia. Estudiamos los efectos de un programa interdisciplinar dirigido mediante telemedicina tras síndrome coronario agudo en prevención secundaria fase II en periodo de confinamiento por COVID-19.Entre el 2 y 11 de marzo de 2020 se incluyeron 37 pacientes predominantemente con cardiopatía isquémica estable (76,4%) y función sistólica preservada sometidos a tratamiento 12 semanas. Se aplicó un programa de entrenamiento de tonificación muscular dinámico con sobrecarga domiciliario, además de asesoramiento nutricional y terapia psicológica y educativa mediante telemedicina.De la cohorte inicial, finalizaron 30 pacientes. La capacidad funcional aumentó en la prueba de marcha de seis minutos (47,13m; IC95% 32,82 a 61,45; p

El objetivo de este trabajo fue comparar y cuantificar las asimetrías neuromusculares entre las extremidades inferiores que presentan los jugadores de hockey sobre patines. Un objetivo secundario fue correlacionar el índice de asimetrías (ASI) entre las diferentes pruebas neuromusculares testadas. Un total de 27 jugadores de sexo masculino de hockey sobre patines (edad = 20,59 ± 3,81 años) realizaron diferentes pruebas neuromusculares de forma unilateral: 1) Test de salto vertical con contra-movimiento (SLCJ), 2) Batería de saltos horizontales (Hop test: single, triple y crossover hop test) y 3) Prueba de velocidad con cambio de dirección (COD test). Se observaron diferencias significativas (p 10% en el test de SLCJ, situación considerada como posible factor de riesgo de lesión. Solamente se obtuvo una correlación significativa entre el SLCJ y el COD test. En consecuencia, y con el objetivo de identificar las asimetrías entre miembros inferiores, es importante considerar la valoración de las diferencias capacidades neuromusculares. The aim of the current study was to compare and quantify the neuromuscular lower limb asymmetries present in roller hockey players and its link to high risk of injury. A secondary purpose was to correlate the index of asymmetries (ASI) between the different neuromuscular tests performed. 27 male roller hockey players (age = 20.59 ± 3.81 years) performed the single leg countermovement jump (SLCJ), the Hop Test battery (single hop test, triple hop test and crossover hop test) and the change of direction test (COD test). Significant differences were observed (p 10% in the SLCJ, a situation considered as an injury risk factor. Only a significant correlation was obtained between the SLCJ and the COD test. Consequently, it is suggested that the complete neuromuscular profile between lower limbs be evaluated with the different tests, for both in the conditioning programs and in the injury prevention and return-to- play.

To analyze the relationship between the level of knowledge about food, the degree of adherence to the Mediterranean Diet (MeDi) and nutritional status; an intervention study was performed with pre- and post-intervention evaluation after three educational sessions, designed according to the learning preferences of health science university students. Sixty-five physiotherapy and podology students participated. The mean age was 22.0 years and participants were mostly male 58.5%. The majority were normal weight (63.1%), but many (69.2%)needed to improve their eating habits in order to comply with DiMe recommendations. The statistical relationship found between the level of previous knowledge in nutrition and nutritional status (Pearson’s Correlation Coefficient= 0.7; p= 0.049) suggests that nutritional education actions in this group could contribute to improving the quality of the diet, nutritional status and future health of university students. Educational sessions were able to improve the level of knowledge regarding nutrition and food in the majority of students, thus it is possible to consider the intervention as an efficient tool for the transmission of nutritional knowledge in this group. Key words: Food habits; Nutritional education; Mediterranean diet; Learning strategies.

Introducción: La popularidad de que gozan las bebidas energéticas entre los adolescentes y jóvenes, ha aumentado en los últimos años. El aumento del consumo entre los estudiantes motivó el diseño de un taller educativo en un grupo de adolescentes, con el objetivo de aumentar el nivel de conocimientos sobre las características de estos refrescos y sobre sus posibles efectos para la salud; así como de evaluar el impacto del taller respecto a estos conocimientos. Material y Métodos: Se realizó un estudio de intervención con evaluación pre- y post- intervención en un instituto de Manresa, Barcelona. Se aplicó un cuestionario de conocimientos sobre las Bebidas Energéticas antes y después de realizar un taller educativo, en el que se emplearon técnicas de enseñanza afines a los Estilos de Aprendizaje preferentes de los participantes. Resultados: Las técnicas de enseñanza, correspondieron a las estrategias preferentes para los estilos auditivo (32,3%) y quinestésico (23,7%) predominantes en el colectivo. En la evaluación previa: el 76,3% de los adolescentes definen las Bebidas Energéticas como isotónicas para deportistas, la mayoría reconocen su elevado contenido en cafeína (95%), el 61,3% considera que aportan energía para el deporte, el 76,3% que pueden provocar nerviosismo y el 28% creen que no han de ser consumidas por adolescentes. En la evaluación posintervención aumentó el número de estudiantes que respondió correctamente en todas las preguntas del cuestionario. Conclusiones: Un gran número de adolescentes tiene poco o nulo conocimiento sobre las características de las bebidas energéticas y las consecuencias de su consumo para la salud, que mejora significativamente tras la realización de un taller a través de técnicas de enseñanza participativas y cooperativas afines a las estrategias de aprendizaje preferente de los participantes, Introduction: Recently there has been an increase in energy drink consumption in young and adolescents, leading to caffeine abuse. This increased consumption served as motivation for creating an educational workshop in a collective of adolescents. The aim of this work was improving the level of knowledge about energy drinks and to assess the impact on the knowledge of the workshop. Material and Methods: It was performed an intervention study with pre- and post- intervention assessment in a high school in Manresa, Barcelona. A questionnaire about energy drinks was applied before and after performing an educational workshop designed with teaching techniques, according to the preferred Learning Styles. Results: The learning techniques used in the workshop, corresponded to the preferred strategies for aural style (32.3%) and kinesthetic style (23.7%). In the previous assessment: 76.3% of adolescents define Energy Drinks as isotonic drinks, the most recognize their high caffeine content (95%); 61.3% consider that provide energy for the sport, 76.3% that can cause nervousness and 28% believe that they must not be consumed by adolescents. In the post-intervention assessment increased the number of correct answers to all questions in the questionnaire. Conclusions: Most of the adolescents have little or no knowledge about energy drinks and about health consequences of their consumption. This knowledge increased significantly after an educational workshop with participatory and cooperatives techniques which were selected according to the preferred learning strategies of the participants.

Introduction:\ud \ud Regular moderate‐to‐vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behaviour (SB) or increasing light PA (LPA) in older adults, is lacking. Using isotemporal substitution (IS) models, the aim of this paper is to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults.\ud \ud Methods:\ud \ud Data from 1,360 older adults (mean age 75.18 years) in four countries were utilised. PA and SB was measured using ActiGraph wGT3X‐BT+ accelerometers worn for 7 days. Self‐rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross‐sectional associations when 30 minutes of one behaviour was substituted with another. Models were adjusted for age, sex, marital status, educational attainment.\ud \ud Results:\ud \ud Substituting 30 minutes of SB with LPA (β ‐0.37; 95%CI ‐0.42, ‐0.32) or MVPA (β ‐0.14; 95%CI ‐0.21, ‐0.07) and substituting LPA with MVPA (β ‐0.11; 95%CI ‐0.18, ‐0.04) was associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (β 0.55; 95%CI 0.49, 0.62) was associated with increased depression.\ud \ud Conclusion:\ud \ud Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA.

Background This is the second part of a large spectrum systematic review which aims to identify and assess the evidence for the efficacy of non-pharmacological acupuncture techniques in the treatment of chronic obstructive pulmonary disease (COPD). The results of all techniques except for filiform needle are described in this publication. Methods Eleven different databases were screened for randomised controlled trials up to June 2019. Authors in pairs extracted the data and assessed the risk of bias independently. RevMan 5.3 software was used for the meta-analysis. Results Thirty-three trials met the inclusion criteria, which involved the follow techniques: AcuTENS (7 trials), moxibustion (11 trials), acupressure (7 trials), ear acupuncture (6 trials), acupressure and ear acupuncture combined (1 trial) and cupping (1 trial). Due to the great heterogeneity, only 7 meta-analysis could be performed (AcuTENS vs sham on quality of life and exercise capacity, acupressure vs no acupressure on quality of life and anxiety and ear acupuncture vs sham on FEV1 and FEV1/FVC) with only acupressure showing statistical differences for quality of life (SMD: -0.63 95%CI: − 0.88, − 0.39 I2 = 0%) and anxiety (HAM-A scale MD:-4.83 95%CI: − 5.71, − 3.94 I2 = 0%). Conclusions Overall, strong evidence in favour of any technique was not found. Acupressure could be beneficial for dyspnoea, quality of life and anxiety, but this is based on low quality trials. Further large well-designed randomised control trials are needed to elucidate the possible role of acupuncture techniques in the treatment of COPD. Trial registration PROSPERO (identifier: CRD42014015074).

Programa de doctorat: Cures Integrals i Serveis de Salut Introducción: La neurodinámica se considera una técnica de terapia manual donde las fuerzas aplicadas van orientadas a la acción sobre las estructuras nerviosas a partir de la movilización y posicionamiento de las articulaciones, integrando las funciones biomecánicas y fisiológicas del sistema nervioso. Objetivos: Analizar y cuantificar el desplazamiento del nervio ciático en la región isquiosural mediante ecografía mediante la técnica del “Frame-by-frame cross correlation system” en función de la rama terminal seleccionada así como observar si hay una restricción del desplazamiento en persones con lesión isquiosural. Resultados La rama terminal que genera un mayor desplazamiento del nervio ciático en la región isquiosural es la tibial con 1’89mm (SD±0,11). Hay diferencias significativas en el desplazamiento del nervio ciático en función de si hay lesión muscular a nivel isquiosural o no (p=0’0035), 1,26 mm (SD± 0,52) en personas sanas y 0,803 mm (SD± 0,57) en personas con lesión. Introduction: Neurodynamics is considered a manual therapy technique where the applied forces are oriented to the action on the nerve structures from the mobilization and positioning of the joints, integrating the biomechanical and physiological functions of the nervous system. Objectives: To analyze and quantify the displacement of the sciatic nerve in the hamstring region by ultrasound using the "Frame-by-frame cross correlation system" technique depending on the selected terminal branch, as well as to observe if there is a restriction of displacement in people with hamstring injury. Results The terminal branch that generates a greater displacement of the sciatic nerve in the hamstring region is the tibial nerve with 1.89mm (SD±0.11). There are significant differences in the displacement of the sciatic nerve depending on whether there is muscle injury at the hamstring level or not (p=0.0035), 1.26 mm (SD± 0.52) in healthy people and 0.803 mm (SD± 0.57) in people with injury.

Trabajos ganadores de la “V Edición Premios Cátedra Poncemar de Gerontología". Primer Premio Fin de Grado en Nutrición Humana y Dietética Introducción: En Barcelona, 104.922 personas de más de 60 años viven solas en su domicilio. En este colectivo es muy común que haya una ingesta reducida a causa de factores físicos y cognitivos o por problemas socioeconómicos y esto provoca problemas más graves en la salud de las personas grandes. Objetivos: Prevenir o revertir la desnutrición en adultos mayores de 65 años con pocos recursos económicos, mejorando su calidad de vida a través de la aplicación de una dieta adaptada a cada paciente y con el servicio de comida a domicilio. Metodología: El proyecto de investigación se llevará a cabo en los Centros de Atención Primaria (CAP) de Barcelona de los barrios más desfavorecidos, en los cuales se pasarán test a los pacientes para valorar el estado nutricional, físico y mental del paciente, para poder hacer una intervención a nivel nutricional que consistirá en el ofrecimiento de comer a domicilio. In Barcelona, 104,922 people over the age of 60 live alone in their homes. In this group it is very common that there is a reduced intake due to physical and cognitive factors or socioeconomic problems and this causes greater problems in the health of the elderly. Prevent or reverse malnutrition in adults over 65 with few financial resources by improving their quality of life through the application of a diet adapted to each patient and with the food service at home. The research project will be carried out in the Centers of Primary Atention of Barcelona of the most disadvantaged neighborhoods in which tests will be passed to pacients to assess the nutritional, physical and mental state of the patient and to make an intervention at the nutritional level that will consist on the food service at home.

Introducción. El presente proyecto pretende simplificar circuitos complejos que encarecen el coste del proceso asistencial debido a los numerosos trámites administrativos asociados, aplicando la metodología Lean y la reingeniería de proceso. Este estudio se enmarca en el área ambulatoria de la Fundación Hospital Sant Joan de Déu de Martorell, Barcelona. Métodos. Estudio cuantitativo preexperimental analítico retrospectivo, basado en la conceptualización del modelo de proceso asistencial de estructura, proceso y resultado, propuesta por Avedis Donabedian, en que se revisaron los principales circuitos de actividad asistencial y procedimientos administrativos que realizaba el usuario. Se establecieron líneas de acción, como la revisión de circuitos asistenciales, el rediseño de circuitos aplicando la reducción de los ciclos de tiempo y la optimización de recursos. Resultados. Los procesos que obtuvieron mayor beneficio tras esta revisión fueron: el ingreso hospitalario con una reducción del 53% del tiempo total de realización, el acto único preoperatorio con el 75% de reducción de los tiempos para la programación de las diferentes pruebas y desplazamientos del paciente, y la programación quirúrgica, del área ambulatoria y pruebas diagnósticas, con una reducción del 100% del tiempo invertido por el paciente ya que, al salir de la consulta, se marchaba a casa, sin tener que volver a pasar por el mostrador de programación. Conclusiones. Es posible, aplicando la metodología Lean, simplificar los circuitos administrativos, la reducción de colas y tiempos de espera, así como implementar procesos de atención no presencial y mejorar de forma importante la atención al usuario. Introduction. The aim of the present project was to simplify complex circuits that increase the cost of healthcare processes due to the large number of associated administrative procedures by applying Lean methodology and process reengineering. This study was conducted in the outpatient area of Fundación Hospital Sant Joan de Déu de Martorell, in Barcelona. Methods. This quantitative, pre-experimental, analytical, retrospective study was based on the conceptual model of structure, process and outcomes proposed by Avedis Donabedian and reviewed the main healthcare circuits and administrative procedures affecting users. Lines of action were established, such as a review of healthcare circuits and circuit redesign by applying reduction of time cycles and resource optimization. Results. The review revealed that the processes showing the greatest benefit were hospital admissions, with a 53% reduction in admitting time, preoperative assessment, which, by creating a single assessment, reduced the time for scheduling distinct tests and patient travel by 75%, and planning of surgery, outpatient visits and diagnostic tests, which reduced the time incurred by patients by 100% since, on leaving the consultation, they returned home without having to return to the appointments desk. Conclusions. Lean methodology can be successfully used to streamline administrative circuits, reduce queues and waiting times and to implement non-face-to-face care, thus significantly enhancing patient care. Programa de Doctorat: Cures Integrals i Serveis de Salut

Grip; Vigilància sindròmica; Farmàcies sentinella Influenza; Syndromic surveillance; Sentinel pharmacies Gripe; Vigilancia sindrómica; Farmacias centinela RESUM Objectius. Analitzar les dades sobre la mediació dispensada i prescrita als pacients amb síndrome gripal en l’àmbit de la Xarxa de farmàcies sentinella de Catalunya durant la temporada de grip 2019-2020. Mètodes. Es van analitzar les dades recollides per 35 farmàcies sentinella de Catalunya en el període del 31 de setembre de 2019 al 17 de maig de 2020. Es va utilitzar el programa IBMSPSS per analitzar les característiques dels casos de síndrome gripal declarats per les farmàcies sentinella i per determinar els percentatges de medicació dispensada i medicació prescrita en diferents grups de població. Resultats. Es van declarar 587 casos de síndrome gripal en el període d’estudi. El 48,2% dels casos declarats van ser homes i el 51,8% van ser dones. El 61,8% dels casos declarats es van detectar a la farmàcia comunitària, i el 14,8% dels casos es van derivar a equips d’atenció primària. Les oficines de farmàcia van dispensar medicaments que contenien, únicament, paracetamol, ibuprofè àcid acetilsalicílic, antihistamínics o antitussígens al 80,3% dels pacients, i van dispensar alguna medicació al 98% dels pacients. Conclusions. El sistema d’informació sindròmica de grip basat en la Xarxa de farmàcies sentinella ha permès obtenir informació sobre la morbiditat per grip no assistida en centres de salut i sobre la medicació dispensada als pacients amb síndrome gripal a Catalunya. Objetivos. Analizar los datos sobre la mediación dispensada y prescrita a los pacientes con síndrome gripal en el ámbito de la Red de farmacias centinela de Cataluña durante la temporada de gripe 2019-2020. Métodos. Se analizaron los datos recogidos por 35 farmacias centinela de Cataluña en el periodo del 31 de septiembre de 2019 al 17 de mayo de 2020. Se utilizó el programa IBM-SPSS para analizar las características de los casos de síndrome gripal declarados por las farmacias centinela, y para determinar los porcentajes de medicación dispensada y medicación prescrita en diferentes grupos de población. Resultados. Se declararon 587 casos de síndrome gripal en el periodo de estudio. El 48,2% de los casos declarados fueron hombres y el 51,8% fueron mujeres. El 61,8% de los casos declarados se detectaron en la farmacia comunitaria, y el 14,8% de los casos se derivaron a equipos de atención primaria. Las oficinas de farmacia dispensaron medicamentos que contenían, únicamente, paracetamol, ibuprofeno, ácido acetilsalicílico, antihistamínicos o antitusígenos al 80,3% de los pacientes, y dispensaron alguna medicación al 98% de los pacientes. Conclusiones. El sistema de información sindrómica de gripe basado en la Red de farmacias centinela ha permitido obtener información sobre la morbilidad por gripe no asistida en centros de salud, y sobre la medicación dispensada a los pacientes con síndrome gripal en Cataluña. ABSTRACT Objectives. To analyse data on medication dispensed and prescribed to patients with influenza-like syndrome obtained from the Catalan sentinel pharmacy network during the 2019−2020 influenza season. Methods. Data collected from cases of influenza-like syndrome reported by 35 sentinel pharmacies of Catalonia during the period from September 31, 2019 to May 17, 2020 were analysed. The IBM-SPSS software was used to analyse the characteristics of cases reported and to determine the percentages of medication dispensed and prescribed in different population groups. Results. A total of 587 cases of influenza-like syndrome were reported during the period of study. A total of 48.2% of the cases reported were men and 51.8% were women. A total of 61.8% of the cases reported were detected in the community pharmacy, and 14.8% of the cases were referred to primary care teams. The pharmacies dispensed medications including only paracetamol, ibuprofen, acetyl salicylic acid, antihistaminic or antitussives to 80.3% of the patients, and dispensed a medication to 98% of the patients. Conclusions. The influenza syndromic surveillance system based on the sentinel pharmacy network has made it possible to obtain information on influenza morbidity not assisted in health centres, and on the medications dispensed to patients with influenza-like syndrome.

Objectives: To investigate whether botulinum toxin type A (BTX-A) injection is more effective than radial extracorporeal shock wave therapy in reducing plantar flexor muscle spasticity in subjects with cerebral palsy. Methods: A total of 68 subjects with cerebral palsy were randomly allocated to BTX-A injection (Group 1) or radial extracorporeal shock wave therapy (Group 2) (first experiment; E1). Outcome was evaluated using the Tardieu V1 and V3 stretches, at 3 weeks, 2 months (M2) and M3 after baseline. At M6 subjects in Group 1 received radial extracorporeal shock wave therapy and subjects in Group 2 received BTX-A injection (second experiment; E2); outcome was evaluated as in E1. Treatment success was defined as improvement in foot dorsiflexion ≥10° when performing the V3 stretch at M2 in both experiments. Results: In both experiments mean V1 and V3 significantly improved over time. In E1 both treatments resulted in similar treatment success. In E2 fewer subjects treated with BTX-A injection reached the criteria of treatment success than did subjects treated with radial extracorporeal shock wave therapy, which was due to a carry-over effect from E1. No significant complications were observed. Conclusion: BTX-A injection is not superior to radial extracorporeal shock wave therapy in the treatment of plantar flexor muscle spasticity in subjects with cerebral palsy.

Introduction: Volleyball is one of the most popular sports in the world yet thereis limited knowledge about the risk factors for iinjury, especially for high level female youth volleyball. The purpose of this study is to investigate the injury incidence and the correlation between demography, screening tools and risk of injury. Methods: An observational study with high level female youth volleyball players aged 16-19 and uninjured at the time of participation from one club Barça Femení CVB Júvenil A with the main variable being if the players were injured in the 2019/20 season. Injury data were collected retrospectively through a questionnaire, whereas demography and test scores were collected prospectively with guidance of a written explanation and graphic illustration of the correct procedure to each participant to be performed from home during COVID19 isolation. The tests include: Weight-Bearing Lunge Test, Single Leg Hop for Distance, Counter Movement Jump with and without arm swing, Apley Scratch Test. Results: Two injuries occurred in the 2019/20 season and were found to be significantly correlated with age and Single Leg Hop Test for Distance, whereas previous injuries were found to be significantly correlated with Counter Movement Jumps with and without arm swing. Conclusion: A larger sample size over a prospective period is needed to validate the findings in this study.However, the descriptive data as well as the methodology in this study may be valuable to future studies for comparison and incentive to initiate further research on the topic.

Introducció: Durant l’última dècada s’ha evidenciat l’existència d’una comunicació bidireccional anomenada eix intestí-cervell, que pot alterar l’estat d’ànim a través de vies neurals, endocrines i immunològiques. El coneixement del paper de la dieta en la modulació de la composició i activitat metabòlica de la microbiota intestinal, ha donat lloc a pensar que l’addició de determinats probiòtics i prebiòtics podria alterar els bacteris intestinals i els metabòlits generats per fermentació. Les propietats funcionals dels aliments fermentats podrien modular la depressió i l'ansietat a través de la seva acció sobre algunes de les vies vinculades a aquests trastorns mentals. Objectius: Revisar l’evidència disponible sobre el rol dels aliments fermentats en la composició i activitat de la microbiota intestinal i la seva relació amb la depressió i l’ansietat. Metodologia: S’ha realitzat una cerca exhaustiva a través dels portals Medline i Cochrane Library. S’han inclòs (i) estudis observacionals o d’intervenció en humans adults, (ii) amb depressió i/o ansietat i sense cap altra condició mental, (iii) que estudiïn la relació entre els probiòtics de la dieta i la depressió i l’ansietat. Els articles, que van des de l’any 2000 fins el 2020, inclouen una intervenció probiòtica o una observació retrospectiva a través d’un (o més) aliment fermentat en voluntaris sans i estudis validats que provin la funció del SNC. Resultats: En total s’han inclòs 9 estudis en la revisió, dels quals 6 van trobar una millora significativa en les mesures de les respostes psicològiques. Els probiòtics L. casei, L. acidophilus, B. lactis, B. animalis, S. thermophilus, L. bulgaricus i L. lactis, administrats a través de productes lactis fermentats, han estat capaços de millorar la funció del SNC disminuint l’ansietat i la depressió en adults sans. Discussió: Algunes soques bacterianes del gènere Lactobacillus, Bifidobacterium i Streptococcus semblen tenir una implicació en l’eix cervell-intestí. Les principals vies d’actuació es relacionen amb la inflamació associada amb un augment de la permeabilitat intestinal, la disbiosis microbiana, la disfunció de l’eix HHA, substàncies neuroactives i deficiències en la dieta. Les intervencions amb aliments fermentats per al tractament de trastorns psicològics tenen limitacions i es posa de manifest la necessitat d’una major inversió en assaigs clínics. Conclusions: La influència dels aliments fermentats en la depressió i l’ansietat a través de l’eix intestí-cervell està cada vegada més demostrada gràcies a les seves propietats funcionals. No obstant això, l’evidència clínica encara és limitada i presenta algunes limitacions significatives. Es requereixen futures investigacions de qualitat que avaluïn la seva eficàcia. Introduction: Over the last decade, there has been evidence of a two-way communication called the bowel-brain axis, which can alter mood through neural, endocrine and immunological pathways. Knowledge of the role of diet in modulating the composition and metabolic activity of the intestinal microbiota has led to the idea that the addition of certain probiotics and prebiòtics could alter intestinal bacteria and metabolites generated by fermentation. The funcional properties of fermented foods could modulate depression and anxiety through their action on some of the pathways linked to these mental disorders. Objectives: Review the available evidence on the role of fermented foods in the composition and activity of the intestinal microbiota and their relationship to depression and anxiety. Methodology: A thorough search was conducted through the Medline and Cochrane Library portals. Included are (i) observational or intervention studies in adult humans, (ii) with depression and / or anxiety and no other mental condition, (iii) studying the relationship between dietary probiotics and depression; and anxiety. The articles, which run from 2000 to 2020, include a probiotic intervention or retrospective observation through one (or more) fermented foods in healthy volunteers and validated studies proving CNS function. Results: A total of 9 studies were included in the review, of which 6 found a significant improvement in the measures of psychological responses. The probiotics L. casei, L. acidophilus, B. lactis, B. animalis, S. thermophilus, L. bulgaricus and L. lactis, administered through fermented dairy products, have been able to improve CNS function by decreasing the anxiety and depression in healthy adults. Discussion: Some bacterial strains of the genus Lactobacillus, Bifidobacterium, and Streptococcus appear to have an involvement in the brain-gut axis. The main courses of action are related to inflammation associated with increased intestinal permeability, microbial dysbiosis, HHA axis dysfunction, neuroactive substances, and dietary deficiencies. Interventions with fermented foods for the treatment of psychologic disorders have limitations and highlight the need for greater investment in clinical trials. Conclusions: The influence of fermented foods on depression and anxiety through the bowelbrain axis is increasingly demonstrated by their functional properties. However, clinical evidence is still limited and has some significant limitations. Future quality research is required to evaluate its effectiveness.

Introducción: La aplicación terapéutica de la danza es una tendencia creciente con prometedores resultados en numerosas patologías. Por los beneficiosos efectos que ha demostrado sobre el estado emocional, la calidad de vida y la condición física de los pacientes, la danza puede jugar un papel en la pràctica de la fisioterapia. Hasta ahora, la evidencia documental es heterogénea y en general, el soporte científico insuficiente. Objetivo: Determinar los efectos de la danza sobre la salud física en comparación con los de una intervención fisioterapéutica equivalente. En concreto, sobre la capacidad cardiorrespiratoria, la movilidad, los efectos metabólicos y la percepción del dolor crónico. Material y métodos: Se emprende una revisión de la literatura de los últimos 10 años, para seleccionar estudios paralelos en que se ha comparado la danza con el ejercicio terapéutico en un grupo control y con resultados expresados en parámetros físicos medibles. Resultados: Se incluyeron 20 estudios clínicos con una muestra total de 819 pacientes distribuidos en 10 poblaciones patológicas. La intervención de danza fue diversa, la de control fue ejercicio terapéutico, aeróbico o stretching. La capacidad aeróbica mejoró de modo similar en ambos grupos, tanto en ancianos, rehabilitación cardiaca, obesidad, diabetes o estrés. Los efectos metabólicos fueron equivalentes. La movilidad se diversificó en los siguientes 4 aspectos: capacidad funcional, equilibrio, marcha y rango de movimiento articular. Los cuatro mejoraron significativamente más con la danza en ancianos y enfermos de Parkinson. El dolor se midió en osteoartritis, fibromialgia, en lumbalgia crónica y dismenorrea, mejorando significativamente más con la danza en las cuatro poblaciones. Conclusiones: La danza produce unos beneficios terapéuticos físicos equivalentes a la fisioterapia en diversos tipos de pacientes, pudiendo considerarse como un tratamiento rehabilitador alternativo. La danza puede ser de primera indicación en neurorehabilitación, rehabilitación cardiaca, obesidad/síndrome metabólico y dolor crónico músculo-esquelético. Un adecuado programa de danza puede contrarrestar el deterioro de la movilidad propio del envejecimiento. Se necesitan estudios comparativos a más largo plazo que puedan demostrar la eficiencia de la danza para influir en la evolución clínica de los pacientes. Introduction: Dance therapy is a growing trend showing promising results in several pathologies. Due to the benefits that dance has shown on the emotional state, quality of life and physical condition of patients, it can play a supporting role in the practice of physical therapy. The current documentary evidence is heterogeneous and the scientific support is in general insufficient. Aim: To determine the effects of dance on physical health compared to those of an equivalent physiotherapeutic intervention. Specifically, on cardiorespiratory capacity, mobility, metabolic effects and the perception of chronic pain. Material and methods: A literature review of the last 10 years is undertaken to select parallel studies in which dance has been compared with therapeutic exercise in a control group and with results expressed in measurable physical parameters. Results: Twenty clinical studies with a total sample of 819 patients distributed in ten pathological populations were included. The dance intervention was diverse, the control intervention was therapeutic, aerobic or stretching exercise. Aerobic capacity improved similarly in both groups, both in the elderly, cardíac rehabilitation, obesity, diabetes or stress. The metabolic effects were equivalent. Mobility was diversified in the following 4 aspects: functional capacity, balance, gait and range of joint movement. All four improved significantly more with dance in the elderly and in Parkinson's disease. Pain was measured in osteoarthritis, fibromyalgia, chronic low back pain and dysmenorrhea, significantly improving more with dance in the four populations. Conclusions: Dance produces physical benefits equivalent to physical therapy in various types of patients, and therefore can be considered as an alternative rehabilitative treatment. Dance may be the first indication in neurorehabilitation, in cardiac rehabilitation, in obesity / metabolic syndrome and in chronic musculoskeletal pain. An adequate dance program can counteract the deterioration of mobility typical of aging. Longer-term comparative studies are needed to demonstrate the efficiency of dance in influencing the clinical course of patients.

Aim: Older patients with chronic hepatitis C infection starting direct-acting antivirals (DAAs) are frequently prescribed multiple medications that may be categorized as inappropriate. Anticholinergic burden has been shown to be a predictor of adverse health and functional outcomes. Different scales are available to calculate anticholinergic burden. The aim of this study was to determine the prevalence of anticholinergic medication among older patients treated with DAAs and the risk factors associated using the Anticholinergic Cognitive Burden (ACB) scale, the Anticholinergic Risk Scale (ARS) and the Anticholinergic Drug Scale (ADS) and analyze the resulting safety consequences. Methods: Observational, retrospective cohort study of consecutive patients &ge, 65 years old receiving DAAs and taking concomitant medication. This study was conducted in accordance with the Strengthening the Reporting of observational studies in Epidemiology Statement. Results: 236 patients were included. The average age was 71.7 years, 73.3% cirrhotic, and 47% patients took &ge, 5 medicines. According to the ACB, ARS and ADS scales, 35.2% (n = 83), 10.6% (n = 25) and 34.3% (n = 81) of the patients were treated with anticholinergic medication. Two hundred-and-six (86%) patients presented any adverse events (AEs) during therapy. ARS scale showed a significant relationship between presence of anticholinergic medication and AEs. A large number of patients suffered anticholinergic events, with more events per patient in patients taking anticholinergic drugs. Conclusions: Older hepatitis C chronic patients are exposed to potentially inappropriate polypharmacy and anticholinergic risk, according to the ACB, ARS and ADS scales. The three scales showed different results. Only the ARS scale was associated with AEs, but the rate of anticholinergic effects per patient was significantly higher in patients with anticholinergic drugs, regardless of the scale used. Consider quality of pharmacotherapy when starting DAA with a multidisciplinary approach could improve health outcomes.

Introduction: breast cancer (BC) is the most common cancer in women and its relationship with dietary factors particularly dairy products, has been investigated trough several studies but up to now there are still not enough results to confirm the association between breast cancer and dairy products. Objective: the purpose of this systematic review was to expand the number of systematic reviews that to date exist on the relationship between dairy products consumption and risk of breast cancer. A comprehensive search of the PubMed, Scopus and Embase was performed from September 2005 to September 2018 in which one case control and cohorts’ studies were included. Results: eighteen studies were finally selected for the review (10 case-control and 8 cohorts’ studies). These studies reported several statistically significant associations (OR, HR, RR) between dairy product consumption and the risk of breast cancer. Seven case-control and four cohorts’ studies showed that dairy product consumption was inversely associated with the risk of breast cancer, on the other hand, a positive association was found in two case-control and non- significant association was found between dairy product consumption and the risk of breast cancer in the remaining studies (one case-control and four cohorts’ studies) Conclusion: although an inverse association was observed in most studies, it’s difficult to draw conclusions when the methodology methods to collect the dairy product intake and the servings or portions measurements were different in each study. On the other hand, not all studies used the same confounding variable to estimate risk. Introducción: el cáncer de mama (BC) es de los cánceres más comunes en mujeres, y su relación con los factores dietéticos y, en particular, con los productos lácteos, ha sido investigada a través de varios estudios, pero hasta ahora no hay resultados suficientes que confirmen la asociación entre cáncer de mama y productos lácteos. Objetivo: el objetivo de esta revisión fue ampliar y actualizar el número de revisiones sistemáticas que hasta día de hoy existen sobre la relación entre el consumo de productos lácteos y el cáncer de mama. Metodología: se realizó una búsqueda exhaustiva en las bases de datos PubMed, Scopus y Embase entre septiembre de 2005 y septiembre de 2018 en la que se incluyeron estudios de casos y controles y estudios de cohortes. Resultados: se seleccionaron 18 estudios (10 estudios de casos-controles y 8 estudios de cohorte). Siete casos-controles y cuatro estudios de cohorte mostraron que el consumo de productos lácteos tenía una asociación inversa con el riesgo de cáncer de mama y, por otro lado, en dos estudios de casos-controles se observó una asociación positiva. No se encontró una asociación significativa entre el consumo de productos lácteos y el cáncer de mama en los restantes estudios (1 caso-control y 4 cohortes). Conclusión: aunque se observó una asociación inversa en la mayoría de los estudios, es difícil sacar conclusiones cuando los métodos metodológicos para recolectar la ingesta de lácteos y las porciones o las mediciones de las porciones fueron diferentes en cada estudio. Por otro lado, no todos los estudios tienen en cuenta las mismas variables de confusión.

Background The prevalence of vision and hearing loss is higher amongst older individuals with dementia, as well as higher in long-term care settings than in the wider community. However, the incidence of sensory impairment is underreported and often goes untreated. In this study, we aimed to understand nurses’ current experiences of screening and caring for long-term care residents who have dementia and sensory impairment. Methods As part of a larger study on the sensory screening of long-term care residents with dementia, an environmental scan was conducted with front-line healthcare providers. We report here on the findings from the content analysis of individual, semi-structured interviews with nurses working in two long-term care homes in Southern Ontario, Canada. Twenty regulated nurses, including designated resident assessment coordinators, working full- or part-time with individuals who have dementia, participated across the two sites. All interviews were transcribed, and their contents reviewed and coded for themes by means of inductive thematic analysis. Results Following a systematic and recursive approach, three analysts identified several themes relating to: 1) the sensory screening process, 2) communication strategies, and 3) quality of life, sensory loss, and dementia. Participants reported on the strengths and limitations of screening procedures, what improvements should be made, which informal strategies are effective, and the continued professional development that is needed. Conclusions Nurses demonstrated insight into the facilitators and barriers to effective screening and care of residents with dementia and sensory impairments, and expressed the need for further education, more suitable screening tools, and formalised accountability within the screening process for vision and hearing loss in these long-term care residents. Electronic supplementary material The online version of this article (10.1186/s12877-018-0917-x) contains supplementary material, which is available to authorized users.

Introducció: Els estudis de Grau d'Infermeria es fonamenten majoritàriament en l'adquisició de competències per a la realització de procediments invasius, i això depèn en gran manera de la formació pràctica mitjançant la simulació clínica. En els últims anys, hi ha hagut un augment en el desenvolupament de tecnologia digital innovadora, entre les quals trobem la Realitat Augmentada (RA). Un dels seus usos prometedors en la formació de professionals de la salut es basa en simuladors amb utilitat clínica. La RA és una alternativa factible a l'aprenentatge tradicional de procediments tècnics. Objectiu: Avaluar l'habilitat tècnica adquirida pels estudiants d'infermeria de segon curs mitjançant l'aprenentatge basat en la realitat augmentada respecte a l'aprenentatge en simulació de Zona 0 i 1 per al procediment de l'extracció de sang arterial. Metodologia: Prova pilot d'un assaig clínic experimental per l'aprenentatge de la tècnica de la gasometria arterial amb dos grups paral·lels d'estudiants de segon curs del Grau d'Infermeria de la Facultat de Ciències de la Salut Blanquerna matriculats en l'assignatura de 'Simulacions clíniques 2'. En el Grup Experimental, l'aprenentatge es basarà en la realitat augmentada, i en el Grup Control, l'aprenentatge es basarà en la Simulació de Zona 0 i 1. Tots dos grups seran seguits de manera concurrent durant un període de temps determinat i es compararan els diferents resultats obtinguts en els dos grups de l'estudi. Per complir amb els criteris de qualitat d'un assaig clínic, es seguiran les guies de la declaració Consolidated Standards Of Reporting Trials (CONSORT). Consideracions ètiques: Per dur a terme aquesta investigació caldrà la seva aprovació pel Comitè d'Ètica de Recerca de la Universitat Ramon Llull (CER-URL). A més a més, es respectarà els principis ètics per a les recerques mèdiques en éssers humans descrits en la Declaració Helsinki, i el Codi Deontològic de les infermeres i infermers de Catalunya. Introduction: Nursing degree studies are mostly based on the acquisition of skills for performing invasive procedures, and this depends largely on practical training through clinical simulation. In the last few years, there has been an increase in the development of innovative digital technology, among which we find Augmented Reality (AR). One of its promising uses in the training of health professionals is based on simulators with clinical utility. AR is a feasible alternative to traditional learning of technical procedures. Objective: To assess the technical skill acquired by second-year nursing students through augmented reality-based learning with regard to Zone 0 and 1 simulation learning for the arterial blood collection procedure. Methodology: Pilot study of an experimental clinical trial by learning the arterial blood gas technique with two parallel groups of second year students of the Nursing Degree of the Blanquerna Faculty of Health Sciences enrolled in the subject of 'Clinical Simulations 2'. In the Experimental Group, learning will be based on augmented reality, and in the Control Group, learning will be based on Zone 0 and 1 Simulation. Both groups will be followed concurrently for a given period of time and the different results obtained in the two groups of the study will be compared. To meet the quality criteria of a clinical trial, the guidelines of the Consolidated Standards Of Reporting Trials (CONSORT). Ethical considerations: This research will require approval by the Research Ethics Committee of the Ramon Llull University (CER-URL). In addition, the ethical principles for medical research on human subjects described in the Helsinki Declaration and the Code of Ethics for Nurses in Catalonia will be respected.

La nutrició és un factor clau en la preparació de l’esportista. Una dieta equilibrada, variada i adequada a les necessitats individuals durant l’entrenament, la competició i la recuperació influenciarà positivament en el rendiment esportiu de les dones maratonianes. Objectiu: Observar l’adherència a les recomanacions nutricionals vigents en dones espanyoles maratonianes veganes, ovolactovegetarianes i omnívores que no competeixen en la categoria d’elit. Metodologia: Estudi observacional descriptiu transversal que es vol dur a terme en dones espanyoles de 20 a 65 anys que practiquen de forma no professional maratons d’asfalt. Per analitzar la seva ingesta se’ls demana contestar un Qüestionari de Freqüència de Consum i un Registre Dietètic de 3 dies. L’adherència a les recomanacions nutricionals esportives es mesura en tant per cent de desviació segons les recomanacions marcades pel llibre de Nutrició Esportiva de A. Jeukendrup. Es mesura el pes i es valora la composició corporal a través de mesures antropomètriques, calculant el % de massa grassa i el % de massa muscular. El nivell d’activitat física s’avalua amb un Registre d’Exercici Físic, i el rendiment esportiu a través del test de Cooper, la Courser Navette, el VO2max i el temps emprat en realitzar la Zurich Marató de Barcelona 2021. Per analitzar les variables dependents continues s’utilitza la prova ANOVA i per valorar les associacions entre l’adequació de la ingesta i la composició corporal i els tests i proves de rendiment esportiu el Coeficient de Correlació de Pearson. Es considera estadísticament significatiu quan el p valor és p

Este artículo explora el tratamiento informativo de la infografía de la prensa internacional para emprender de manera eficaz procesos de comunicación y divulgación de los hechos relativos a la Ciencia y Tecnología (CyT). La integración de un método de análisis de contenido, aplicado a una muestra seleccionada de mejores prácticas en materia de infografía de periódicos y revistas que han recibido reconocimiento internacional a través de los premios Malofiej (N=149), fueron codificadas y analizadas para identificar características y patrones detallados con base a tres ejes de estudio: el planteamiento informativo (¿qué se dice?), los objetos gráficos y su correspondencia (¿cómo se dice?) y la función que desempeñan los infográficos (¿para qué se dice?). Los resultados indican que estas piezas informativas emplean distintos planteamientos informativos que reflejan en sus mensajes, los cuales conllevan al uso particular de determinados recursos de expresión (objetos gráficos), desempeñando de manera conjunta, diversas funciones comunicativas por parte del emisor con respecto al público al que se dirige; lo anterior, llevó a la conformación y descripción de tres modelos de infografía científica de prensa. This article explores the informative treatment of the infographics of the international press to undertake the communication and dissemination processes of facts related to Science and Technology (S&T) in an efficient way. The integration of a content analysis method, applied to a selected sample of best practices in the field of infographics from newspapers and magazines, that have received international recognition through the Malofiej awards (N =149), were analyzed and coded in order to identify characteristics and detailed patterns based on three axes of study: the informative approach (what is said?), the graphic objects and their correspondence (how do you say?) and the role played by the infographics (what is it for?). The results indicate that these informative pieces use different informative approaches, that reflect in their messages, which lead to the particular use of certain expression resources (graphic objects), jointly performing diverse communication functions on the part of the issuer with respect to the public to which is directed. All the above led to the formation and description of three scientific models for press infographics.

Introduction: A low H/Q ratio is considered a relevant risk factor for ACL injury due to the reduced capacity for dynamic knee-joint stabilisation. The decline of this value after menarche in contrast to the rise in males makes adolescent girls more susceptible to ACL injuries. The main objective of the study is to determine a normative H/Q ratio value and hamstring and quadriceps strength values in healthy elite youth female basketball, handball and volleyball athletes. Participants: A total of 55 basketball (n=19), handball (n=21) and volleyball (n=15) female athletes were included in the study, all those belonging to the Catalan Technification Centre. Methods: The maximal isometric voluntary muscle contraction (IVMCmax) of quadriceps and hamstring were assessed using a fixed hand-held dynamometer (HHD). (Mark-10 series 3 Digital Force Gauge, Copiague, NY). Results: The H/Q ratio values fluctuates between 0.35 and 0.42, therefore, in accordance with other studies we observe that the pre-established ratio value of 0.6 as an injury risk cut-off point does not reflect all sports, sexes and ages . No statistically significant strength differences were observed by sport or dominance. Furthermore, a significant age effect was observed in relation to the quadriceps normalised strength peak torque (p = 0.02)

Antecedents: Actualment la figura del fisioterapeuta ha anat guanyant protagonisme i autonomia tant per la societat, les institucions i pels pacients. Aquesta autonomia, li ha fet adquirir més responsabilitats sobre aquests. A les consultes privades de fisioteràpia apareixen conflictes bioètics que requereixen d’una reflexió més exhaustiva per part del fisioterapeuta. Existeix literatura sobre la matèria però s'han realitzat escasses investigacions al respecte. Objectius: L’objectiu principal d'aquest estudi és identificar i descriure els conflictes ètics que existeixen en la consulta privada de fisioteràpia a Catalunya. Els objectius secundaris són definir què és un conflicte ètic i detectar si hi ha diferents conflictes ètics en la consulta privada de Catalunya segons l'àrea geogràfica de la consulta, els anys de professió del fisioterapeuta, l’especialitat de fisioteràpia, la situació de propietari o assalariat en la consulta i segons el gènere del fisioterapeuta. Metodologia: Es realitzarà un estudi de fenomenologia amb un disseny exploratori a través entrevistes grupals del tipus grups de discussió. Els grups de discussió estaran formats per 8 fisioterapeutes que treballin en consulta privada de fisioteràpia a Catalunya i la durada d'aquests serà de 60 minuts. Es realitzarà tants grups de discussió com siguin necessaris per a aconseguir la saturació d'informació. Les entrevistes grupals seran enregistrades mitjançant una gravadora de veu per a les seves posteriors anàlisis. Background: Lately, the figure of the physiotherapist has gained prominence, importance and autonomy for the society and institutions as well as for the patients. This autonomy has made the former acquire more responsibilities over the latter. There are many bioethical conflicts that appear in private physiotherapist consultations which require a more thorough reflection on the part of the physiotherapist.There is some literature though scarce research on the matter. Objectives: The main objective of this study is to identify and describe the ethical conflicts that exist in the private physiotherapist consultation in Catalonia. The secondary objectives are to define what an ethical conflict is and to detect if there are different ethical conflicts in the private consultation of Catalonia depending on the geographic location of the consultation, the experience and years of profession of the physiotherapist, the specialty of physiotherapy, the situation of the owner of the consult, and the gender of the physical therapist. Methodology: A phenomenological study with an exploratory design will be carried out by means of a series of group interviews of the kind “discussion group”. The discussion groups will consist of eight physiotherapists who work in private consults in Catalonia, and their duration will be 60 minutes. There will be as many discussion groups as necessary in order to reach the saturation of information. The group interviews will be taped by a voice recorder for further analysis.

Introducció: La insuficiència cardíaca representa un 2,5% del cost total d’assistència sanitària a Espanya, i una de les causes principals és la hipertensió arterial, associada a un consum elevat de sodi. Una intervenció nutricional en pacients amb insuficiència cardíaca hauria de valorar la ingesta de sodi amb una eina precisa i representativa de la dieta habitual. Objectius: Dissenyar i validar un qüestionari de freqüència de consum per estimar la ingesta de sodi en pacients amb insuficiència cardíaca a Catalunya. Metodologia: Estudi de validació que es realitzarà amb 380 participants de l’assaig clínic SALOMEH (SALt On Morbimortality Events in Heart Failure), pacients amb insuficiència cardíaca majors de 40 anys amb classificació funcional II i III de la NYHA (New York Heart Association). S’ha dissenyat un qüestionari de freqüència de consum d’aliments específic per sodi amb 55 ítems a partir de l’enquesta nutricional per a la població catalana (ENCAT 2002-2003), seleccionant aquells aliments que contribueixen en un 91,22% al consum total de sodi. Durant un any, es valorarà la ingesta dietètica de sodi mitjançant el qüestionari, recordatoris de 24 hores, registres dietètics i excreció urinària de sodi en 24 hores. S’utilitzaran coeficients de correlació per validar el qüestionari, s’avaluarà la reproductibilitat a l’inici i al final de l’estudi, i s’avaluarà la validesa correlacionant el consum mitjà de sodi del qüestionari amb el promig de sodi obtingut per les altres eines. Background: Heart failure represents 2,5% of the total health care costs in Spain, and one of the main causes is high blood pressure, which is associated with high sodium consumption. A nutritional intervention in patients with heart failure should assess sodium intake with an accurate and representative method of the usual diet. Objectives: Develop and validate a food frequency questionnaire to assess dietary sodium intake in patients with heart failure in Catalonia. Methods: à Validation study that will be performed on 380 participants of the clinical trial SALOMEH (SALt On Morbimortality Events in Heart Failure), heart failure patients older than 40 years with NYHA (New York Heart Association) classes II and III. A food frequency questionnaire specific for sodium has been developed with 55 items based on the nutritional survey for the Catalan population (ENCAT 2002-2003), selecting those foods that contribute 91,22% of total sodium consumption. For one year, dietary sodium intake will be estimated through the questionnaire, 24-hour recalls, dietary records and 24-hour dietary sodium excretion. Correlation coefficients will be used to validate the questionnaire. Reproducibility will be assessed at the beginning ant at the end of the study, and validity will be assessed by correlating the mean sodium intake from the questionnarie with the mean sodium intake obtained from other methods.

La menstruació és viscuda en la nostra societat com un procés fisiològic envoltat d'unes fortes connotacions socials i culturals. Aquestes connotacions solen anar relacionades amb aspectes negatius generant falsos mites i convertint la menstruació en un aspecte tabú. En l'actualitat, s'evidencia un canvi de concepció entre les noves generacions, tot i que els estereotips de gènere, els falsos mites i el tabú segueixen estant presents. L'objectiu general d’aquest estudi és: Descriure la percepció de les noies de 15 i 16 anys sobre la menstruació a la ciutat de Barcelona. La metodologia que s’utilitzarà serà mixta. El disseny de la metodologia quantitativa es basarà en un estudi observacional transversal amb caràcter descriptiu mitjançant l'escala METCON i la selecció de la mostra serà amb un mostreig probabilístic, de tipus conglomerat per barris de la ciutat de Barcelona, dels centres educatius que imparteixin 4t d'ESO. L'estudi qualitatiu tindrà un disseny fenomenològic descriptiu amb un mostreig no probabilístic de tipus opinionàtic, i la recollida de dades serà mitjançant una entrevista semiestructurada de grups triangulars. En les consideracions ètiques es tindrà en compte que per realitzar aquesta investigació caldrà l’aprovació de la mateixa pel Comitè d’Ètica de la Recerca de la Universitat Ramon Llull (CER-URL) i es tindran en compte els principis de la Declaració de Hèlsinki, el codi deontològic d'infermeria, la normativa de Bona Pràctica Clínica (BPC) i se seguirà la Llei Orgànica 3/2018 de Protecció de Dades Personals i Garantia dels Drets Digitals. Menstruation is socially seen as a physiological process surrounded by strong socio-cultural connotations. These connotations usually relate to negative aspects creating fake myths and making menstruation a taboo. Nowadays, it is starting to become evident that a change in conception among the new generations exists, even though gender stereotypes, fake myths and taboos are still present. The main objective of this study is to describe the perception of 15-16 years old girls about menstruation in the city of Barcelona. The methodology applied is mixed. The quantitative methodology will be based on a observational cross-sectional study using the METCON scale where the selection of the sample will follow a probabilistic conglomerate-type sampling of the different Barcelona suburbs where 4th ESO grade is taught. The qualitative study will follow a descriptive phenomenological design using a non-probabilistic sampling type. Semi structured interviews of triangular groups will be used to collect the data. In the ethical considerations of this study, the approval of the Comitè d’Ètica de la Recerca de la Universitat Ramon Llull (CER-URL) will be considered as a requirement, and the principles of The Declaration of Helsinki, ethics code for nursing and the Guideline for Good Clinical Practice will be taken into considereation, following the “Llei Orgànica 3/2018 de Protecció de Dades Personals i Garantia dels Drets Digitals.”

Este artículo expone algunos de los resultados obtenidos gracias a un estudio realizado por la Cátedra Ethos (Universitat Ramon Llull) y financiado por el Ayuntamiento de Barcelona. Se trata de una investigación destinada a captar la dimensión moral y social de la praxis de los usuarios de los Centros Deportivos Municipales de Barcelona. En primera instancia, nuestra pretensión fue analizar hasta qué punto estas personas establecían una relación positiva entre su actividad y determinados valores morales. En segundo lugar, también centramos nuestra atención en la manera como el deporte contribuía a mejorar o reforzar las relaciones sociales. A través de este informe hemos querido introducir elementos empíricos que nos permitan comprender mejor la autopercepción de los ciudadanos que utilizan este tipo de equipamientos deportivos. Gracias a este conocimiento estaremos en mejores condiciones para implementar mejoras que permitan generalizar socialmente la actividad deportiva. En definitiva, se trata de que la política deportiva actual siga promoviendo un deporte para todos. This article exposes some of the results obtained thanks to a study carried out by the Ethos Chair (Universitat Ramon Llull) and supported by the City Council of Barcelona. This is an investigation aimed at capturing the moral and social dimension of the praxis of the users of the Municipal Sports Centers of Barcelona. In the first instance, our aim was to analyze to what extent these people established a positive relationship between their activity and certain moral values. Secondly, we also focused our attention on how sport contributed to improve or reinforce social relations. Through this report we wanted to introduce empirical elements that allow us to better understand the self-perception of citizens who use this type of sports equipment. Thanks to this knowledge we will be in better conditions to implement improvements that allow socializing the sports activity socially. In short, it is about that the current sports policy continues to promote a sport for all.

Programa de Doctorat: Cures Integrals i Serveis de Salut El peu infantil pot presentar variacions en la seva postura i mobilitat. La postura es pot mesurar amb l’AHI i d’una forma més global amb el FPI-6. La mobilitat es pot definir amb el NDT i amb el MFW. L’objectiu és estimar els valors poblacionals de postura i mobilitat del peu en nens/es de 5-6 i 9-10 anys i relacionar-los entre ells i amb variables antropomètriques. S’han estimat els valors a partir d’una mostra de 415 nens i nenes, i s’ha trobat relació moderada entre la postura pronada del peu i un augment de la mobilitat mesurada amb el NDT en tota la mostra. Una disminució de AHI s’ha correlacionat amb un augment de la mobilitat en els nens de 9-10 anys. No s’ha trobat correlació forta entre la antropometria i la postura i la mobilitat, només dèbil entre AHI i els índexs de composició corporal. El pie infantil puede presentar variaciones en su postura y su movilidad. La postura se puede medir con el AHI y de una forma más global con el FPI-6. La movilidad se puede definir con el NDT y con el MFW. El objetivo es estimar los valores poblacionales de postura y movilidad del pie en niños/as de 5-6 i 9-10 y relacionarlos entre ellos y con variables antropométricas. Se han estimado los valores a partir de una muestra de 415 niños y niñas, y se ha encontrado relación moderada entre la postura pronada del pie y un aumento de la movilidad medida con el NDT en toda la muestra. Una disminución de AHI se ha correlacionado con un aumento de la movilidad en los niños de 9-10 años. No se ha encontrado correlación fuerte entre la antropometría y la postura y la movilidad, sólo débil entre AHI y los índices de composición corporal. The foot of children are variables in their posture and mobility. Posture can be measured with the AHI and more globally with the FPI-6. Mobility can be defined with the NDT and with the MFW. The objective is to estimate the population values of foot posture and mobility in children aged 5-6 and 9-10 years and to correlate them to each other and to anthropometric variables. The values have been estimated from a sample of 415 boys and girls. A moderate relationship has been found between the pronated posture and an increase in mobility measured with the NDT. A decrease in AHI has been correlated with an increase in foot mobility in 9-10 years old. No strong correlation was found between anthropometry and posture and mobility, only weak correlation between AHI and body composition indices.

Actually, there is scarce literature looking for the relationship between inter-limb asymmetries and performance in youth elite team sports. The main purpose of this cross-sectional study was to examine the relationships between inter-limb asymmetries and physical performance in youth elite team-sports players. A secondary objective was to evaluate the presence of between-sexes differences in inter-limb asymmetries in elite youth team sports players. Eighty-one young elite team-sports athletes (age: u-14 to u-18) performed the star excursion balance test in the anterior direction (SEBT ANT), a single leg vertical countermovement jump test (SLCMJ), the one leg hop test for distance (OLHT), a 30 m sprint test, and the V-cut test. Inter-limb asymmetries were calculated for SEBT ANT, SLCMJ and OLHT. Pearson r was used to analyse the relationships between inter-limb asymmetries and physical performance. Results showed significant (p < 0.05) but small (r = 0.26) relationships between SLCMJ asymmetries and 30 m sprint time for the total group. Significant negative correlations with small to moderate magnitude of correlation were also found between SLCMJ asymmetries and SLCMJ performance on the lowest performing limb for the total group (p < 0.05; r = -0.26), males (p < 0.01; r = -0.48) and females (p < 0.05; r = -0.30). Moreover, significant negative correlations with moderate and large magnitude were also present between OLHT asymmetries and OLHT performance on the lowest performing limb for the total group (p < 0.01; r = -0.44), males (p < 0.01; r = -0.56) and females (p < 0.01; r = -0.64). No correlations were observed between asymmetries and either the V-cut test or SEBT ANT performance. No correlation were observed between SEBT ANT asymmetries and physical performance. In addition, when comparing asymmetry values between sexes there were no significant differences in vertical (p = 0.06) and horizontal (p = 0.61) jumping tests. However, there were significant differences in asymmetry between sexes in the ANT SEBT (p = 0.04). In conclusion, the current study indicated that jumping asymmetries were associated with decrements in sprint speed and jumping performance. Therefore, assessing inter-limb asymmetries would be recommended to improve training interventions for youth elite team-sports athletes.

Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of hospital admissions and dyspnoea is its main symptom. Some studies have concluded that a new modality of acupuncture, called acupoint transcutaneous electrical nerve stimulation (acuTENS), could reduce dyspnoea in patients with COPD by increasing β-endorphin levels. However, those trials have been conducted mainly on patients in stable condition. This study aims to determine whether the administration of acuTENS can reduce dyspnoea in patients hospitalized for AECOPD. Methods A multicentre randomized control trial with blinding of participants and assessors will be conducted. A sample of 60 patients will be randomly assigned to receive 45 min of either real acuTENS or sham acuTENS treatment once a day for five consecutive days. The trial will be conducted at the “Hospital del Mar” in Barcelona (Spain) and the “Hospital Sant Joan de Déu de Manresa” in Manresa (Spain). The Borg scale at baseline and days 1 to 5 will be the primary outcome. Secondary outcomes will be the duration of the hospitalization, quantity of drugs administrated, expiratory peak flow adverse effects and mortality and readmissions at 3 months. Discussion AcuTENS is a non-pharmacological, non-invasive and inexpensive intervention. This trial will help to elucidate the potential role of acuTENS in the treatment of AECOPD. Trial registration ClinicalTrials.gov identifier: NCT02998957. Recruitment status: Recruiting. First posted: 21 December 2016. Last update posted: 2 October 2018. Trial registration dataset is available in Additional file 1. Protocol version 03. Issue date: 20 March 2018. Author: Carles Fernández.

Background Obstructive sleep apnoea (OSA) is a syndrome characterised by episodes of apnoea (complete cessation of breathing) or hypopnoea (insufficient breathing) during sleep. Classical symptoms of the disease - such as snoring, unsatisfactory rest and daytime sleepiness - are experienced mainly by men; women report more unspecific symptoms such as low energy or fatigue, tiredness, initial insomnia and morning headaches. OSA is associated with an increased risk of occupational injuries, metabolic diseases, cardiovascular diseases, mortality, and being involved in traffic accidents. Continuous positive airway pressure (CPAP) - delivered by a machine which uses a hose and mask or nosepiece to deliver constant and steady air pressure- is considered the first treatment option for most people with OSA. However, adherence to treatment is often suboptimal. Myofunctional therapy could be an alternative for many patients. Myofunctional therapy consists of combinations of oropharyngeal exercises - i.e. mouth and throat exercises. These combinations typically include both isotonic and isometric exercises involving several muscles and areas of the mouth, pharynx and upper respiratory tract, to work on functions such as speaking, breathing, blowing, sucking, chewing and swallowing. Objectives To evaluate the benefits and harms of myofunctional therapy (oropharyngeal exercises) for the treatment of obstructive sleep apnoea. Search methods We identified randomised controlled trials (RCTs) from the Cochrane Airways Trials Register (date of last search 1 May 2020). We found other trials at web-based clinical trials registers. Selection criteria We included RCTs that recruited adults and children with a diagnosis of OSA. Data collection and analysis We used standard methodological procedures expected by Cochrane. We assessed our confidence in the evidence by using GRADE recommendations. Primary outcomes were daytime sleepiness, morbidity and mortality. Main results We found nine studies eligible for inclusion in this review and nine ongoing studies. The nine included RCTs analysed a total of 347 participants, 69 of them women and 13 children. The adults' mean ages ranged from 46 to 51, daytime sleepiness scores from eight to 14, and severity of the condition from mild to severe OSA. The studies' duration ranged from two to four months. None of the studies assessed accidents, cardiovascular diseases or mortality outcomes. We sought data about adverse events, but none of the included studies reported these. In adults, compared to sham therapy, myofunctional therapy: probably reduces daytime sleepiness (Epworth Sleepiness Scale (ESS), MD (mean difference) -4.52 points, 95% Confidence Interval (CI) -6.67 to -2.36; two studies, 82 participants; moderate-certainty evidence); may increase sleep quality (MD -3.90 points, 95% CI -6.31 to -1.49; one study, 31 participants; low-certainty evidence); may result in a large reduction in Apnoea-Hypopnoea Index (AHI, MD -13.20 points, 95% CI -18.48 to -7.93; two studies, 82 participants; low-certainty evidence); may have little to no effect in reduction of snoring frequency but the evidence is very uncertain (Standardised Mean Difference (SMD) -0.53 points, 95% CI -1.03 to -0.03; two studies, 67 participants; very low-certainty evidence); and probably reduces subjective snoring intensity slightly (MD -1.9 points, 95% CI -3.69 to -0.11 one study, 51 participants; moderate-certainty evidence). Compared to waiting list, myofunctional therapy may: reduce daytime sleepiness (ESS, change from baseline MD -3.00 points, 95% CI -5.47 to -0.53; one study, 25 participants; low-certainty evidence); result in little to no difference in sleep quality (MD -0.70 points, 95% CI -2.01 to 0.61; one study, 25 participants; low-certainty evidence); and reduce AHI (MD -6.20 points, 95% CI -11.94 to -0.46; one study, 25 participants; low-certainty evidence). Compared to CPAP, myofunctional therapy may result in little to no difference in daytime sleepiness (MD 0.30 points, 95% CI -1.65 to 2.25; one study, 54 participants; low-certainty evidence); and may increase AHI (MD 9.60 points, 95% CI 2.46 to 16.74; one study, 54 participants; low-certainty evidence). Compared to CPAP plus myofunctional therapy, myofunctional therapy alone may result in little to no difference in daytime sleepiness (MD 0.20 points, 95% CI -2.56 to 2.96; one study, 49 participants; low-certainty evidence) and may increase AHI (MD 10.50 points, 95% CI 3.43 to 17.57; one study, 49 participants; low-certainty evidence). Compared to respiratory exercises plus nasal dilator strip, myofunctional therapy may result in little to no difference in daytime sleepiness (MD 0.20 points, 95% CI -2.46 to 2.86; one study, 58 participants; low-certainty evidence); probably increases sleep quality slightly (-1.94 points, 95% CI -3.17 to -0.72; two studies, 97 participants; moderate-certainty evidence); and may result in little to no difference in AHI (MD -3.80 points, 95% CI -9.05 to 1.45; one study, 58 participants; low-certainty evidence). Compared to standard medical treatment, myofunctional therapy may reduce daytime sleepiness (MD -6.40 points, 95% CI -9.82 to -2.98; one study, 26 participants; low-certainty evidence) and may increase sleep quality (MD -3.10 points, 95% CI -5.12 to -1.08; one study, 26 participants; low-certainty evidence). In children, compared to nasal washing alone, myofunctional therapy and nasal washing may result in little to no difference in AHI (MD 3.00, 95% CI -0.26 to 6.26; one study, 13 participants; low-certainty evidence). Authors' conclusions Compared to sham therapy, myofunctional therapy probably reduces daytime sleepiness and may increase sleep quality in the short term. The certainty of the evidence for all comparisons ranges from moderate to very low, mainly due to lack of blinding of the assessors of subjective outcomes, incomplete outcome data and imprecision. More studies are needed. In future studies, outcome assessors should be blinded. New trials should recruit more participants, including more women and children, and have longer treatment and follow-up periods.

IntroductionThe work-to-retirement transition involves a process of psychologically and behaviourally distancing oneself from the workforce that is often accompanied by other social changes. The person is confronted with new social roles, expectations, challenges and opportunities that can influence lifestyle and well-being. In the scientific literature, we find recent reports of interventions aimed at improving health and well-being in people at retirement age. However, there is still a gap of knowledge on how different interventions during retirement might improve health status. We intend to conduct a scoping review with the aim of describing interventions for improving well-being across the retirement transition.Methods and analysisThe methodological framework described by Arksey and O’Malley; the Joanna Briggs Institute guidelines as well as the Preferred Reporting Items for scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols statements will be followed. Eligibility criteria comprise of: (a) all type of original studies, review articles or reports published on journals as well as grey literature; (b) describing interventions to improve the well-being in adults across their retirement transition; (c) including participants before, during and after retirement; (d) all publications must describe variables associated with participants’ physical and/or psychological and/or social well-being and/or perceived quality of life related to these; (e) no language restriction and (f) published from January 2000 to March 2019. The main findings will be summarised using a narrative descriptive synthesis approach and grouped following the population, concept and context principles. A stakeholder meeting will be held to provide feedback on the findings and to develop next steps in research and practice.Ethics and disseminationApproval from a research ethics committee is not required, as no personal information will be collected. We plan to disseminate our research findings at different levels: scientific community, clinical and social arenas, as well as to healthcare leaders and policymakers and general population. The project has been registered at Open Science Framework with the name TRANSITS: work to retirement transition project.

Older adults; Physical activity; Adherence Adultos mayores; Actividad física; Adherencia Adults majors; Activitat física; Adherència Exercise is a form of physical activity (PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42017070892) of randomized clinical trials (RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active (e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active (e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian–Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up (standardized mean difference (SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I2 0%), but not at the one- or two-years follow-ups. No data were available on the mid- and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation. The present study was funded by United States Department of Health & Human Services National Institutes of Health (NIH), USA, and NIH National Institute on Aging (NIA), USA, (K24 AG057728).

IntroductionSITLESS is a randomised controlled trial determining whether exercise referral schemes can be enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity in the long term, in community-dwelling older citizens. The intervention is complex and requires a process evaluation to understand how implementation, causal mechanisms and context shape outcomes. The specific aims are to assess fidelity and reach of the implementation, understand the contextual aspects of each intervention site, evaluate the mechanisms of impact, and explore perceived effects.Methods and analysisFollowing the Medical Research Council guidance on complex interventions, a combination of qualitative and quantitative procedures is applied, including observational checklists and attendance registries, standardised scales (ie, Marcus’s Self-Efficacy Questionnaire, Physical Activity Self-Regulation Scale and the Lubben Social Network Scale) at baseline, postintervention and follow-up assessments, semistructured questionnaires gathering contextual characteristics, and participant observations of the sessions. Semistructured interviews and focus groups with the participants and trainers are conducted at postintervention and during the follow-up to explore their experiences. Outcomes from the standardised scales are analysed as moderators within the impact evaluation. Descriptive results on context and perceived effects complement results on impact. The qualitative and quantitative findings will help to refine the logic model to finally support the interpretation of the results on the effectiveness of the intervention.Ethics and disseminationThe study design was approved by the respective Ethical Committee of Ramon Llull University, Southern Denmark, Northern Ireland and Ulm University. Participation is voluntary, and all participants are asked to sign informed consent before starting the study. A dissemination plan operationalises how to achieve a social impact by reaching academic and non-academic stakeholders. A data management plan describes the specific data sets and regulates its deposition and curation. All publications will be open access.Trial registration numberNCT02629666; Pre-results.

[Background] High-density lipoprotein (HDL) functionality and low-density lipoprotein (LDL) atherogenic traits can describe the role of both particles on cardiovascular diseases more accurately than HDL- or LDL-cholesterol levels. However, it is unclear how these lipoprotein properties are particularly affected by different cardiovascular risk factors., [Objective] To determine which lipoprotein properties are associated with greater cardiovascular risk scores and each cardiovascular risk factor., [Methods] In two cross-sectional baseline samples of PREDIMED trial volunteers, we assessed the associations of HDL functionality (N = 296) and LDL atherogenicity traits (N = 210) with: 1) the 10-year predicted coronary risk (according to the Framingham-REGICOR score), and 2) classical cardiovascular risk factors., [Results] Greater cardiovascular risk scores were associated with low cholesterol efflux values; oxidized, triglyceride-rich, small HDL particles; and small LDLs with low resistance against oxidation (P-trend, [Conclusions] Dysfunctional HDL and atherogenic LDL particles are present in high cardiovascular risk patients. Dyslipidemia and male sex are predominantly linked to HDL dysfunctionality, whilst diabetes and advanced age are associated with LDL atherogenicity., This work was supported by: Agència de Gestió d’Ajuts Universitaris i de Recerca (2017 SGR 222), Fundació La Marató de TV3 (201512.31), and Instituto de Salud Carlos III (CB06/03/0028 and PI15/00047). A.H. was funded by Instituto de Salud Carlos III (CD17/00122), M.-T.S.-F. was supported by Agència de Gestió d’Ajuts Universitaris i de Recerca (2015 FI_B 01042), and M. Fitó was supported by Instituto de Salud Carlos III (CES12/025). CIBERs of Pathophysiology of Obesity and Nutrition (CIBEROBN) and Cardiovascular Diseases (CIBERCV) are initiatives of the Instituto de Salud Carlos III, Madrid, Spain.

Neuromuscular asymmetries have been previously associated with reduced performance. Similarly, maturation has shown that youth athletes may experience a loss of motor control, which could also lead to compromised physical performance. The present study aimed to evaluate and quantify the level of asymmetry among chronological and maturational groups. Forty-one youth tennis players performed the single leg countermovement jump (SLCMJ), star excursion balance test (SEBT) and a change of direction speed (CODS) test. Differences were found between the strongest and weakest limbs across all tests (p &lt, 0.001), and also for SEBT in the posteromedial direction (p = 0.02), SEBT composite score (p &lt, 0.01) in maturation groups, and for SEBT posterolateral direction (p = 0.03) and SEBT composite score (p = 0.01) in chronological groups. The SLCMJ showed the largest inter-limb asymmetries for the circa peak height velocity (PHV) group (19.31 &plusmn, 12.19%) and under-14 (U14) group (17.55 &plusmn, 9.90%). Chronological and maturation groups followed similar trends for inter-limb asymmetries, but the biological index showed larger asymmetry scores in the jumping test at PHV compared to that found in the chronological group (U14). These results show that inter-limb differences may be heightened during PHV. Practitioners can use this information to inform the decision-making process when prescribing training interventions in youth tennis players.

OBJECTIVES: Physical activity is key to improve the prognosis of chronic obstructive pulmonary disease (COPD). To help to tailor future interventions we aimed to identify the baseline characteristics of COPD patients which predict 12-month completion and response to a behavioral physical activity intervention. METHODS: This is a 12-month cohort study of the intervention arm of the Urban Training randomized controlled trial (NCT01897298), an intervention proven to be efficacious to increase physical activity. We considered baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics as potential determinants of completion and response. We defined completion as attending the 12-month study visit. Among completers, we defined response as increasing physical activity ≥1100 steps/day from baseline to 12 months, measured by accelerometer. We estimated the factors independently for completion and response using multivariable logistic regression models. RESULTS: Of a total of 202 patients (m (SD) 69 (9) years, 84% male), 132 (65%) completed the study. Among those, 37 (28%) qualified as responders. Higher numbers of baseline steps/day (OR [95% CI] 1.11 [1.02-1.21] per increase of 1000 steps, p

Los adolescentes crecen en una sociedad desigualitaria y sexista donde perviven roles y estereotipos de género. Es importante identificar y reducir dichos factores de riesgo, dado que las primeras manifestaciones de violencia de género se producen en la adolescencia, aumentando así el número de mujeres menores de 18 años residentes en España, que han sido víctimas de ésta en el 2017 en relación con los años anteriores. Por ello, se cree necesario realizar un estudio con objetivo general: describir las vivencias de los adolescentes en la etapa media (14 a 17 años) del municipio de Ibiza sobre sus relaciones de pareja. La metodología, será una investigación cualitativa con un diseño descriptivo de orientación a la comprensión llamado fenomenología. La recogida de datos se realizará por medio de entrevistas individuales semiestructuradas. El tipo de muestreo será intencional o de conveniencia, con una población de adolescentes de la etapa media, que tengan o hayan tenido una relación de pareja y sean residentes en el municipio de Ibiza, y además, nacidos en dicha isla. Para la elaboración del estudio, se requerirá la aprobación del Comité de Ética de investigación con seres humanos de las Islas Baleares. También se tendrá en cuenta la Declaración de Helsinki, la legislación vigente sobre la conservación y confidencialidad de datos de las personas participantes en la investigación, y la normativa ética a seguir con las investigaciones clínicas. Además, será imprescindible el consentimiento y asentimiento informado de los padres y los hijos respectivamente. Adolescents grow up in a discriminatory and sexist society where gender roles and stereotypes still persist. It is important to identify and reduce these risk factors, because the first incidents of gender violence occur in adolescence, thus increasing the number of women under 18 years of age living in Spain, who have been victims of this in 2017 during previous year. Consequently, it is considered necessary to carry out a study with a general objective: to describe the relationship experiences of adolescents in the middle stage (14 to 17 years) in Ibiza town. The methodology will be a qualitative research with a descriptive design oriented to understanding, called phenomenology. The data collection will be done through semi-structured individual interviews. The type of sampling will be intentional or at random, with a group of adolescents born in Ibiza of the middle stage, who have or have had a partner and are residents in the Municipality of Ibiza. For the preparation of the study, the approval of the Ethics Committee of research with human beings of the Balearic Islands will be required. The Declaration of Helsinki, the current legislation on the conservation and confidentiality of data of the people participating in the research, and the ethical regulations to follow with clinical investigations will also be taken into account. In addition, the consent and informed assent of the parents and children respectively will be essential.

Organizations in the 21th century have to address the problem of employee’s retention as it has direct and indirect costs for the organisation. In regards to this issue several theories have emerged pointing out the strong relationship between retention and employee’s motivation. This last topic is not trivial, as it includes factors from different disciplines such as the psychological or managerial ones. The aim of this paper is to analyse the current literature related to different work motivation theories in order to identify patterns, which might help to understand better the dynamics between motivation at work and its impact on employee retention. In order to do so a detailed revision of the literature has been done classifying the main motivational theories in needs, traits, values, and cognition. Results of the above analysis highlight the “satisfaction of a need” as a common denominator in the motivational theories. Need theories explain why someone must act but they do not explain why particular actions are followed in specific situations. One of the insights is that values are the ones that unveil what drives individuals to achieve a goal. Therefore it is vital for organizations to learn and understand which ones are the employees work values in order to retain them and keep them motivated

Objetivo: Conocer las experiencias de pacientes y cuidadores que conviven con la enfermedad pulmonar obstructiva crónica avanzada, el impacto de sus síntomas y las necesidades de atención que generan en su contexto funcional, emocional y social. Dise˜no: Estudio cualitativo. Perspectiva fenomenológica. Recogida de datos durante 2013-2015. Emplazamiento: Atención primaria, hospitalaria e intermedia. Osona (Barcelona). Participantes y/o contextos: Diez pacientes de atención primaria con enfermedad pulmonar obstructiva crónica avanzada, 10 cuidadores principales respectivos y 19 profesionales de atención primaria, 2 neumólogos, 2 de cuidados paliativos, implicados en su atención y un psicólogo clínico. Método: Muestreo teórico. Entrevistas semiestructuradas y en profundidad a pacientes, cuidadores y profesionales (47 entrevistas). Resultados: Las temáticas emergentes identificadas en las entrevistas de pacientes y cuidadores hacen referencia a la disnea, síntoma predominante sin un tratamiento efectivo y con un gran impacto en la vida de pacientes y cuidadores. Un síntoma con gran repercusión funcional, emocional y social al que es necesario adaptarse para sobrevivir. Conclusiones: La atención adecuada de los pacientes con enfermedad pulmonar obstructiva crónica, más allá de las medidas farmacológicas para controlar los síntomas respiratorios, pasa por la comprensión del sufrimiento, las pérdidas y las limitaciones que provoca en sus vidas y las de sus cuidadores. Un abordaje paliativo, holístico y cercano a sus vivencias reales, junto al empoderamiento para la adaptación a los síntomas debilitantes, podría contribuir a una vida mejor en la etapa final de la enfermedad., Aim: To understand the experiences of patients and caregivers living with advanced chronic obstructive pulmonary disease, the impact of their symptoms and care needs arising from a functional, emotional, and social context. Design: Qualitative study. Phenomenological perspective. Data were collected during 2013- 2015. Setting: Primary, secondary and intermediate care. Osona (Barcelona). Participants: The study included 10 Primary Care patients with advanced chronic obstructive pulmonary disease, their respective 10 caregivers, and 19 primary care professionals, as well as 2 lung specialists, 2 palliative care professionals involved in their care, and one clinical psychologist. Method: Theoretical sampling. Semi-structured and in-depth interviews with patients, caregivers, and professionals (47 interviews). Results: The emergent topics identified in patients and caregivers interviews refer to dyspnoea, the predominant symptom without effective treatment and with a major impact on patients and caregivers lives. A symptom with great functional, emotional and social repercussions to which they need to adapt in order to survive. Conclusions: Beyond pharmacological measures to control respiratory symptoms, proper care of patients with chronic obstructive pulmonary disease, requires understanding of suffering, the losses and limitations that it causes in their lives and those of their caregivers. A palliative, holistic and closer approach to their real experiences, together with an empowerment to adapt to debilitating symptoms, could contribute to a better life in the end-stages of the disease.

Hepatitis C; Dones; Drogues; Violència Hepatitis C; Mujeres; Drogas; Violencia Hepatitis C; Women; Drugs; Violence El objetivo de este estudio fue describir la prevalencia de violencia física y/o sexual experimentada por mujeres que usan drogas por vía inyectada (MUDVI) e identificar factores asociados. Se realizó un estudio transversal en 120 MUDVI usuarias de centros de reducción de daños mediante un cuestionario anónimo y recogida de muestras de fluido oral para estimar la prevalencia del VIH y de la hepatitis C. Los factores asociados a la presencia de violencia se analizaron mediante un modelo de regresión de Poisson con varianza robusta univariante y multivariante, obteniendo razones de prevalencia (RP) y sus intervalos de confianza al 95%. Los resultados muestran que la prevalencia de agresiones en los últimos 12 meses fue del 45,8% (42,2% agresiones físicas y 11,9% agresiones sexuales). A nivel multivariante, las variables asociadas a la presencia de violencia fueron estar sin domicilio fijo (RP=1,59; IC: 1,07-2,38), ejercer el trabajo sexual (RP=1,65; IC: 1,19-2,29), haber sufrido alguna infección de transmisión sexual (RP=1,49; IC: 1,04-2,15) y/o inyectarse drogas no de forma diaria (RP=2,29; IC: 1,49-3,54). Este estudio pone de manifiesto la importancia de establecer protocolos de detección, y derivación a la red de atención a la violencia de género, dentro de los centros de la red de atención a las drogodependencias, así como el desarrollo de estrategias multinivel que tengan en cuenta no solamente factores individuales sino también otros aspectos sociales y/o estructurales que pueden estar jugando un papel relevante a la hora de abordar este problema. The aim of this study was to describe the prevalence of physical and/ or sexual violence experienced by women who inject drugs (WWID) and identify associated factors. A cross-sectional study was conducted among 120 WWID in a network of harm reduction centres using an anonymous questionnaire. Oral fluid samples were also collected to estimate the prevalence of HIV and hepatitis C. Univariate and multivariate Poisson regression models with robust variance were performed to identify the factors associated with experiencing violence, obtaining prevalence ratios (PR) and their 95% confidence intervals. The results showed that the prevalence of violence reported by WWID in the last 12 months was 45.8% (42.2% physical and 11.9% sexual aggression). In multivariate analysis, variables associated with experiencing violence were homelessness (PR = 1.59; CI: 1.07-2.38), reporting exchanges of sex for money or drugs (PR = 1.65; CI: 1.19- 2.29), reporting a previous sexually transmitted infection (PR = 1.49; CI: 1.04-2.15) and/or injecting drugs less frequently than daily (RP = 2.29; CI: 1.49-3.54). This study highlights the importance of establishing detection protocols and systems of referral to the network of attention to women suffering violence, within the centres of the drug addiction care network, as well as the development of multilevel strategies that take into account not only individual factors but also other social and/or structural aspects that may be playing a relevant role in addressing this problem.

(1) Background: The work-to-retirement transition involves a process of psychologically and behaviorally distancing oneself from the workforce that is often accompanied by other social changes, which can influence health and well-being. However, research on interventions targeting the work-to-retirement transition to improve health status is limited. Our objective was to summarize and describe interventions aiming to improve well-being across the retirement transition, (2) Methods: We conducted a scoping review following the methodological framework described by Arksey and O&rsquo, Malley, the Joanna Briggs Institute guidelines as well as the PRISMA-ScR statements, we systematically searched articles and gray literature to identify interventions and policies that aimed to improve well-being across the retirement transition. (3) Results: 15 publications were included, which comprised both experimental designs (n = 10) and systematic reviews (n = 5). (4) Conclusions: More research on how to promote overall well-being during the work-to-retirement transition is needed. The results of this scoping review show that most reported interventions address one single lifestyle behavior, and that relevant social determinants of health have been barely considered in their design. Future investigations need to consider vulnerable groups and country-specific structural conditions. Adopting a patient and public involvement approach will contribute to developing interventions that address the significant needs of those in the transition to retirement.

Introducció: El dèficit de vitamina D és cada cop més prevalent a nivell mundial, afectant en especial a grups de risc com les dones embarassades, on els requeriments de la vitamina es troben augmentats. Més de la meitat de les dones gestants espanyoles presenten dèficit, i això té conseqüències directes sobre el pes del fetus. Una prescripció generalitzada de suplementació de vitamina D durant l’embaràs, no està acceptada pels possibles efectes tòxics que podria tenir una sobre-dosificació, és per això, que en aquest estudi s’intentarà prevenir el baix pes al néixer dels nadons de dones deficitàries, mitjançant una intervenció dietètica (dieta + exposició solar). Objectiu: Avaluar si una intervenció dietètica de vitamina D (dieta + exposició solar) en dones embarassades que presenten dèficit, de l’àrea urbana de Barcelona, afavoreix a presentar un pes igual o superior als 2500g en els nadons a terme en el moment del part. Metodologia: Es realitzarà un assaig clínic experimental, amb un grup control i un grup d’intervenció, per aleatorització sistemàtica amb simple cec. L’estudi tindrà una durada de 12 mesos, però la intervenció en sí serà de 3, coincidint amb el tercer trimestre d’embaràs. Es farà un seguiment dels dos grups mitjançant visites de control. El grup experimental rebrà una intervenció dietètica que consistirà en recomanacions alimentàries amb una dieta rica amb vitamina D i recomanacions sobre exposició solar, en comparació amb el grup control, que rebrà recomanacions generals saludables per l’etapa d’embaràs corresponent. Introduction: The vitamin D deficiency is increasingly prevalent worldwide, affecting especially risk groups such as pregnant women, where this vitamin requirement is increased. More than half of the expecting women in Spain have deficiency, and this has direct consequences on the weight of the foetus. A generalized prescription of vitamin D supplementation during pregnancy is not accepted by the possible toxic effects that could have an over dosage. For this reason, this study will try to prevent the low birth weight of the babies of deficient women, through a dietary intervention (diet + sun exposure). Objective: Evaluate whether a dietary intervention on vitamin D (diet + sun exposure) in deficient pregnant women in the urban area of Barcelona, favours having a weight equal to or greater than 2500g in new-borns at the time of delivery. Methodology: An experimental clinical trial will be carried out with a control group and an intervention group, for systematic randomization with simple-blind. The study will last for 12 months, but the intervention itself will be only 3, coinciding with the third trimester of pregnancy. The two groups will be tracked by means of control visits. The experimental group will receive a dietary intervention especially focussed on vitamin D, that will consist of a diet rich in this micronutrient and recommendations on sun exposure, compared to the control group, which will receive general healthy recommendations for the corresponding pregnancy stage.

Introducció: Sembla que el cronotip vespertí, un nivell elevat de jet lag social i un horari del sopar en unes hores reservades per dormir podrien estar jugant un paper en l’obesitat. Aquest fet en adolescents està poc estudiat però, s’està començant a veure que el rellotge social d’aquest grup poblacional podria estar involucrat en generar una desincronització del seu rellotge biològic creant alteracions en el seu pes corporal. Objectiu general: Conèixer la relació que té el pes corporal amb el cronotip, el jet lag social i l’horari del sopar dels adolescents de Barcelona. Metodologia: Aquest estudi descriptiu analitza l’associació entre l’índex de massa corporal (IMC) i el cronotip, el jet lag social i l’horari del sopar en els adolescents de 16 a 18 anys que estan cursant batxillerat a Barcelona. Es seleccionaran adolescents d’almenys un institut de cada districte de la ciutat. Per tal d’obtenir les dades necessàries, es realitzarà dos qüestionaris als participants, la versió espanyola del “Morningness-Eveningness Scale for Children (MESC) i el Munich ChronoType Questionnaire (MCTQ) adaptat en adolescents. Aquests permetran aconseguir informació sobre el tipus de cronotip (matutí, intermig, vespertí) i sobre el grau de jet lag social de cada participant respectivament. En el qüestionari MESC s’inclouran dos preguntes extres; una per saber quan sopen els participants i l’altra per valorar el grau d’activitat física d’aquests. A més, per tal d’obtenir una referència del pes corporal dels adolescents, se’ls mesurarà el pes i l’alçada per determinar l’IMC. Quan es tinguin totes les variables, es comparà cadascuna amb les tres categories de l’IMC (normopès, sobrepès i obesitat) per veure com varia el pes corporal en funció d’aquestes. Introduction: It seems that the evening chronotype, high levels of social jet lag and dinner timings during hours reserved for sleeping could be playing an important role in obesity. Even this fact is still little studied in adolescents, it is beginning to be observed that the social clock of this population group could be involved in generating a desynchronization of its biological clock and therefore creating alterations in its body weight. General objective: Find out the relationship that body weight has with the chronotype, the social jet lag and the adolescents' dinner timing. Methodology: This descriptive study analyzes the association between body mass index (BMI) and the chronotype, the social jet lag and the dinner timing among adolescents between 16 and 18 years old who are taking a baccalaureate in Barcelona. Adolescents of at least one institute from each city district will be selected. In order to obtain the necessary information, the participants will have to answer two questionnaires, the Spanish version of the "Morningness-Eveningness Scale for Children” (MESC) and the “Munich ChronoType Questionnaire” (MCTQ) adapted for adolescents. These will help to obtain information on the type of chronotype (morning, intermediate, evening) and on the degree of social jet lag of each participant respectively. Two additional questions will be included in the MESC questionnaire; one to find out when the participants have dinner and the other to evaluate the degree of their physical activity. In addition, in order to obtain a reference of the corporal weight of the adolescents, weight and height will be measured to determine their BMI. Once all variables are available, each one will be compared with the three categories of BMI (normal weight, overweight and obesity) to see how the body weight varies depending on them.

Older people usually present with adverse drug events (ADEs) with nonspecific symptoms such as cognitive decline, recurrent falls, reduced mobility, and/or major deterioration. The aims of this study were to assess the ADEs of patients with dementia and presenting neuropsychiatric/behavioral, and psychological symptoms in dementia (BPSD) and to categorize and identify the principal factors that allow to prevent ADEs, and separately ADEs that result in falls. To that end, a one-year prospective study in a psychogeriatric ward (July 2015 to July 2016) was performed. All patients admitted to this ward were eligible for enrolment. Patients who met any of the following criteria were excluded from the study: Patients without cognitive impairment, a length of stay under 7 days, and palliative or previous psychiatric pathology. We included 65 patients (60% women, 84.9 years &plusmn, 6.7) with mild to moderate cognitive impairment, moderate to severe functional dependence, and a high prevalence of geriatric syndromes and comorbidity. A total of 87.7% were taking five or more drugs (mean 9.0 &plusmn, 3.1). ADEs were identified during the interdisciplinary meeting and the follow up by clinical record. Sixty-eight ADEs (81.5% patients) were identified, of which 73.5% were not related to falls. From these, 80% were related to drugs of the nervous system. The Naranjo algorithm determined that 90% of ADEs were probable. The severity of the ADEs was Category E in 34 patients (68%). The number of preventable ADE according to the Schumork&ndash, Thornton test was 58%. The main ADE was drowsiness/somnolence (27.7%). ADEs related to falls represented a 26.5%. The balance between effective treatment and safety is complex in these patients. A medication review in interdisciplinary teams is an essential component to optimize safety prevention.

Introducció: La implicació de la dona en el món de l’esport indoor provoca un augment en el risc de lesions, sobretot els esquinços de turmell. Tenint en compte la varietat de lesions que presenten ambdós sexes, es destaca la implicació del cicle menstrual en la dona degut al nombre de canvis hormonals que pateix durant el cicle, estant lligada la fatiga muscular durant la pràctica esportiva. L’objectiu de l’estudi és investigar si la fase lútia de la menstruació es relaciona amb un augment de la fatiga muscular i una major presència d’esquinços de turmell. Metodologia: Estudi pilot. La mostra està composta per 30 jugadores de basquetbol i futbol sala d’entre 18 i 35 anys des del gener fins abril. S’ha registrat mensualment l’etapa del cicle menstrual de cada jugadora juntament amb la força explosiva del salt vertical (CounterMovement Jump, CMJ), l’estat de benestar (Wellness Score), la laxitud lligamentosa (escala de Beighton), la dismenorrea, la flexibilitat i el dolor percebut durant la sessió d’entrenament. L’anàlisi estadística descriptiva de les principals variables es va realitzar a través del programa SPSS. Per a poder demostrar si les dades eren estadísticament significatives (treballades amb un nivell de significació de 0,05), es va realitzar un anàlisi de la variància (ANOVA). Resultats: Es van registrar 7 lesions en 4 mesos totals d’exposició, les quals 3 eren d’esquinç de turmell. No es s’han trobat diferències estadísticament significatives que demostrin que la fase lútia relacionada amb l’augment de fatiga muscular fos el causant de la lesió. Conclusions: La menstruació és un canvi hormonal constant que pot intervenir en l’esport. No s’han trobat resultats estadísticament significatius per a confirmar que la fase lútia és relacionada amb un augment de fatiga muscular i provocar esquinços de turmell. Introduction: The involvement of women in indoor sports causes an increase in the risk of injuries, especially ankle sprains. Considering the variety of injuries presented by both genders, the implication of the menstrual cycle in women due to the number of hormonal changes suffered during the cycle is highlighted, with muscular fatigue linked during sports practice. The objective of the study is to investigate whether the luteal phase of menstruation is related to an increase in muscle fatigue and a greater presence of ankle sprains. Methods: This is a pilot study. The sample is made up of 30 basketball and football players between 18 and 35 years old from January to April. The menstrual cycle stage of each player has been recorded monthly along with the vertical jump (CounterMovement Jump, CMJ), the Wellness score, the ligament laxity (Beighton scale), dysmenorrhoea, the flexibility and pain perceived during the training session. The descriptive statistical analysis of the main variables was carried out through the SPSS program. To be able to demonstrate if data were statistically significant (worked with a significance level of 0.05), an analysis of the variance (ANOVA) was performed. Outcomes: There were 8 injuries in 4 total months of exposure, 3 of which were ankle sprains. No statistically significant differences have been found that demonstrate that the luteal phase related to the increase in muscle fatigue was the cause of the injury. Conclusion: Menstruation is a constant hormonal change that can intervene in sport. No statistically significant results were found to confirm that the luteal phase is related to an increase in muscle fatigue and causes ankle sprains.

Objective: To determine whether the appearance of a radial extracorporeal shock wave device affects clinical outcomes in chronic plantar fasciitis. Study design: Randomized controlled parallel assessor-blinded clinical trial. Material and methods: A total of 135 patients were assigned to 3 groups: group I, standard radial extracorporeal shock wave device; group II, standard radial extracorporeal shock wave device modified to give a more sophisticated appearance; group III, standard radial extracorporeal shock wave device modified to give a more austere appearance. The radial extracorporeal shock waves emitted by the 3 devices were identical. Primary outcome was foot function, measured with the Foot Function Index. Secondary outcomes were pain at different times, measured with a visual analogue scale, and plantar fascia thickness, measured with ultrasound. Results: All variables decreased significantly from baseline assessment, in all 3 groups and at all time-points: 1, 2, 4 and 14 months after the last session (p

Introducció: Actualment, el síndrome del túnel carpià (STC) constitueix una de les malalties professionals més prevalents als països industrialitzats. L’augment de la prevalença i incidència del STC als últims anys ha comportat un augment de les baixes laborals i de la despesa pels sistemes de salut. L’evidència científica actual no contempla un tractament “Gold Standard” que ajudi a guiar al professional de la salut entre l’àmplia varietat de tractaments conservadors. És precisament la determinació de l’eficiència de les intervencions el que permetrà optimitzar els recursos dels sistemes de salut, amb la finalitat d’augmentar la qualitat de vida dels pacients amb la quantitat necessària de recursos. Objectiu general: Valorar si l’addició de la neurodinàmica a un protocol de teràpia manual pot ajudar a millorar la funcionalitat del canell en treballadors amb STC que realitzen tasques d’alta exposició a factors de risc ocupacionals de canell. Metodologia: El disseny d’estudi és un assaig clínic controlat, aleatoritzat amb simple cec. S’aplicaran 2 intervencions terapèutiques per separat i conjuntament per valorar l’efectivitat de la neurodinàmica en quant a la millora de la funció del canell a curt i mig termini. La població d’estudi està formada per treballadors de diferents gremis de Barcelona amb risc de patir STC. Aplicabilitat: Beneficiar els treballadors i alhora els seus gremis amb la disminució de la pèrdua de jornades laborals i proporcionar futures línies de investigació que ajudin a establir un tractament conservador del STC sense controvèrsia científica. Introduction: Currently, carpal tunnel syndrome (CTS) is one of the most prevalent occupational diseases in industrialized countries. The increase in the prevalence and incidence of CTS over the last few years has led to an increase in sick leave and health expenditure. The current scientific evidence does not contemplate a Gold Standard treatment that helps guide the healthcare professional among the wide variety of conservative treatments. It is precisely the determination of the efficiency of the interventions which will allow optimizing the resources of the health systems, in order to increase the quality of life of the patients with the necessary amount of resources. Main objective: The main objective is to assess whether the addition of neurodynamics to a manual therapy protocol can help improve the functionality of the wrist in CTS workers who perform tasks of high exposure to occupational risk factors of the wrist. Methodology: The study design is a controlled clinical trial, randomized with simple blind. Two therapeutic interventions will be separately and jointly applied to assess the effectiveness of neurodynamics in terms of improving the function of the wrist in the short and medium term. The study population is made up of workers from different guilds of Barcelona at risk of suffering CTS. Aplicability: Aid workers and at the same time labor unions to benefit from the reduction of the loss of work days and also provide future research guidelines that will establish a conservative treatment of CTS without scientific controversy.

Antecedentes: La diabetes gestacional se produce cuando la función pancreática de la embarazada no es suficiente para superar la resistencia a la insulina producida por los cambios en las hormonas diabetógenas de la placenta. Es un importante factor de riesgo de complicaciones materno fetales y del neonato, y aumenta el riesgo de diabetes tipo 2 en la mujer y su descendencia, por lo que la gestante requiere de un control glucémico estricto. La nutrición es la primera línea de tratamiento. Las pacientes se enfrentan a una pendiente de aprendizaje muy empinada, ya que desde el diagnóstico (semana 24 a 28) hasta la finalización del embarazo (semana 40) tienen que aprender lo relativo a la autogestión de su enfermedad. Desde los años 1980 se están llevando a cabo iniciativas de telemedicina en diabetes, pero aún hay pocos estudios en diabetes gestacional. Revisiones sistemáticas y meta-análisis recientes concluyen que existen limitaciones en término de número, tamaño y alcance de los estudios, pero que no comprometen la calidad de la atención. Objetivo general: Evaluar si el uso de una app de educación diabetológica y monitorización de variables que complemente el tratamiento convencional, en mujeres con diabetes gestacional, produce mejores resultados de control metabólico y bienestar materno-fetal y promueve la adquisición de hábitos saludables en comparación con las pacientes seguidas por el protocolo estándar. Metodología: Ensayo clínico controlado aleatorizado, abierto, con dos grupos paralelos, que se llevará a cabo en un hospital de tercer nivel. En ambos grupos se compararán las variables antropométricas, clínicas y analíticas que conforman el bienestar materno-fetal, desde el momento del diagnóstico hasta tres mes postparto. La app pondrá énfasis en el tratamiento dietético, la educación nutricional, el fomento del ejercicio físico y de otros hábitos de vida saludables, la educación acerca de la diabetes gestacional y la monitorización de variables clínicas. Background: Gestational diabetes occurs when the pancreatic function of the pregnant woman is not sufficient to overcome the insulin resistance produced by changes in the diabetogenic hormones of the placenta. It is an important risk factor for maternal and fetal complications, and it increases the risk of type 2 diabetes in women and their offspring; therefore, the pregnant woman requires a strict glycemic control. Nutrition is the first line of treatment. Patients face a very steep learning slope, since from the diagnosis (week 24 to 28) until the end of pregnancy (week 40) they have to learn everything about self-management of their disease. Since the 1980s, telemedicine initiatives in diabetes have been carried out, but there are still few studies on gestational diabetes. Systematic reviews and recent metaanalysis conclude that there are limitations in terms of number, size and scope of studies, but that they do not compromise the quality of care. Aim: To evaluate if the use of a an app with education content and monitoring of clinical variables that complements conventional treatment in women with gestational diabetes, produces better results of metabolic control and maternal-fetal wellbeing and promotes the acquisition of healthy habits, compared to patients followed by the standard protocol. Methods: Open randomized controlled clinical trial with two parallel groups, to be carried out in a tertiary hospital. In both groups, anthropometric, clinical and analytical variables regarding maternal-fetal wellbeing will be compared, from the moment of diagnosis to three months postpartum. The app will emphasize dietary treatment, nutritional education, the promotion of physical exercise and other healthy lifestyles, education about gestational diabetes and monitoring of clinical variables.

Several professional groups, which are not health professionals, are more likely to witness situations requiring basic life support (BLS) due to the nature of their job. The aim of this study was to assess BLS learning after 150 min of training in undergraduate students of sports science and their retention after eight months. Participants trained on BLS (150-min session: 30 theory, 120 practice). After training (T1) and after 8 months (T2), we evaluated their performance of the BLS sequence and two minutes of cardiopulmonary resuscitation (CPR). At T1, the 23 participants presented a mean score of 72.5 &plusmn, 21.0% in the quality of the CPRs (compressions: 78.6 &plusmn, 25.9%, ventilation: 69.9 &plusmn, 30.1%). More than 90% of the participants acted correctly in each step of the BLS sequence. At T2, although the overall quality of the CPR performed did not decrease, significant decreases were observed for: correct hand position (T1: 98.2 &plusmn, 8.8, T2: 77.2 &plusmn, 39.7%), compression depth (T1: 51.4 &plusmn, 7.9, T2: 56.0 &plusmn, 5.7 mm), and compression rate. They worsened opening the airway and checking for breathing. In conclusions, participants learned BLS and good-quality CPR after the 150-min training session. At eight months they had good retention of the BLS sequence and CPR skills. Training on airway management and the position of the hands during CPR should be reinforced.