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Introduction: A healthy diet is especially important during menopause, a period which increases the risk of various health problems. We analyzed the diet of periand postmenopausal Spanish women and the degree of compliance with current recommendations.Material and Methods: We studied 3574 women 45-68 years old who attended breast cancer screening programmes in 7 centres (A Coruña, Barcelona, Burgos, Palma de Mallorca, Pamplona, Valencia and Zaragoza). Diet information was collected using a food frequency questionnaire validated for the Spanish population. For the assessment of compliance with current guidelines we used the recommendations by the Spanish Society of Community Nutrition for food groups intake and by the Spanish Federation of Nutrition, Food and Dietetics for energy, vitamins and minerals intake.Results: The 29% of women were obese and 42% overweight. The average caloric intake was 2.053 kcal (SD 480). The general energy profile was: 43% of the energy from the carbohydrates, 36% from fats, and 20% from proteins. There was a low vitamin D intake in all centres of the study, with an overall mean intake of 2.14 mg/day. A deficit of vitamin E intake in A Coruña and Burgos was also detected. Intake of dairy products and vegetables was high in all the study centers. The consumption of fruits and vegetables was very heterogeneous, with high intakes observed in Mallorca and Valencia and low for both food groups in A Coruña. The olive oil intake was high in all centers except Burgos with 74.3% of the women studied below the recommended 3 servings per day.Conclusions: A diet with less fat and protein and a higher consumption of vegetables, nuts and foods rich in carbohydrate might balance the energy intake and improve the quality of the diet correcting the low intakes of vitamins D and E. These recommendations are especially important in cities far from the Mediterranean coast where more breaches have been detected over the current recommendations with a lower adherence to the Mediterranean diet. [ABSTRACT FROM AUTHOR]

Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant patients, affecting between 10% and 30% of candidates. Historically, HPS was considered a contraindication for liver transplantation due to its association with high mortality rates. However, recent studies have shown improvements in pulmonary function post-transplant, leading to the inclusion of these patients as candidates. Despite this progress, approximately one-fifth of liver transplant recipients develop severe postoperative hypoxia, further complicating their clinical course and contributing to increased mortality. The management of post-transplant HPS involves various strategies, including extracorporeal membrane oxygenation (ECMO), although its use remains infrequently reported. Theoretical models suggest that oxygenation typically improves within 10 days post-transplant, while resolution of HPS may take 6-12 months, making ECMO an attractive possibility as a bridge to recovery in this population. We present a case were ECMO was used in this context., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Currently there is a shortage of general practitioners (GP), and this is expected to increase in the coming years. Despite this need, it is a specialty that is supposedly little demanded, leaving specialized training places unfilled in recent years. The purpose of this study is to present new parameters to more objectively measure the demand and the relationship between supply and demand., Methods: A database was used with the results of the places assigned in the MIR calls from 2002 to 2023. The calculated parameters were quoting index (CI), quote order, the order of top demand and the order of total demand of the GP specialty. The software R version 4.3.02 was used for statistical analysis., Results: The specialty quotation and top demand have remained constant during the study period, while there has been a slight and progressive worsening of the total demand. Nevertheless, the total demand for Family Medicine in the last call for MIR exam was higher than that for specialties such as urology, neurology, ENT, endocrinology, oncology, intensive care medicine or neurosurgery, among others., Conclusions: In contrast to the subjective perception of the worsening attractiveness Family Medicine in the last MIR calls, using objective parameters, we found that the attractiveness of the specialty, measured as quotation (supply/demand ratio) and demand, has remained stable (with a slight worsening of total demand)., (Copyright © 2024 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The objective was to analyze the effect of a reduction of the net height and the court size and serve limitations on the technical-tactical actions, physical actions, and psychological aspects in youth volleyball players., Methods: The sample was 29 under-14 female volleyball players (three regional club teams). A quasi-experimental design was implemented to assess the effect of modification in three tournaments. The independent variables were: a) official rules tournament (no changes in the rules), b) Experimental Tournament 1 (reduction in the net height from 2.10 m to 2 m, no jump serves, and a maximum of two serves per player and rotation), and c) Experimental Tournament 2 (reduction in net height from 2.10 m to 2 m, reduction in court size from 9 × 9 m to 8 × 8 m, no jump serves, and a maximum of two serves per player and rotation). The dependent variables were: ball contact done (type), quality and efficacy of the technical actions, team game phases occurrence, quality and efficacy, continuity index, number of jumps, player's jump load in the take-off and landing, number of hits, average heart rate, Rate of Perceived Effort, time between ball contacts, serve velocity, perceived individual and collective self-efficacy, perceived enjoyment, and perceived satisfaction., Results: Experimental Tournament 1 involved an increase in the efficacy of serves and a decrease in the efficacy of side-out phases. The imbalance between serve and reception did not impact game continuity but reduced the attack and blocks. Experimental Tournament 2 involved a decrease in the efficacy of serves and an increase in the efficacy of side-out phases. The balance between serve and reception increased reception efficacy, the occurrence of attacks and blocks, game continuity, and players' effort. players' effort., Discussion: Scaling the net and court and adapting the serve rules (Experimental Tournament 2) resulted in game dynamics for these U-12 teams that were more similar to those of posterior stages of player through the balance between serve and reception and the adaptation of the net height and court size., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Palao, Ureña, Moreno and Ortega-Toro.)

Background: Hypoadrenocorticism is an important differential for hypercalcemia. The etiology of hypercalcemia in hypoadrenocorticism in dogs is unclear., Objective: To review the prevalence of hypercalcemia and use statistical models to identify clinical, demographic, and biochemical variables associated with hypercalcemia in dogs with primary hypoadrenocorticism., Animals: One hundred ten dogs with primary hypoadrenocorticism; 107 with recorded total calcium (TCa), 43 recorded ionized calcium (iCa)., Methods: Multicenter retrospective observational study at 4 UK referral hospitals. Univariable logistic regression analyses were performed to assess the association between independent variables of signalment, hypoadrenocorticism type (glucocorticoid only deficient hypoadrenocorticism [GHoC] vs glucocorticoid and mineralocorticoid deficient hypoadrenocorticism [GMHoC]), clinicopathological variables and hypercalcemia. Hypercalcemia was defined as elevated TCa, an elevated iCa, or both elevated TCa and iCa (Model 1) or as elevated iCa (Model 2)., Results: Overall prevalence of hypercalcemia was 34.5% (38/110). The odds of hypercalcemia (Model 1) were increased (P < .05) in dogs with GMHoC ([vs GHoC], OR [odds ratio] = 3.86, 95% confidence interval [CI] 1.105-13.463), higher serum creatinine (OR = 1.512, 95% CI 1.041-2.197), and higher serum albumin (OR = 4.187, 95% CI 1.744-10.048). The odds of ionized hypercalcemia (Model 2) were increased (P < .05) with reduced serum potassium concentration (OR = 0.401, 95% CI 0.184-0.876) and younger age (OR = 0.737, 95% CI 0.558-0.974)., Conclusions and Clinical Importance: This study identified several key clinical and biochemical variables associated with hypercalcemia in dogs with primary hypoadrenocorticism. These findings aid understanding of the pathophysiology and etiology of hypercalcemia in dogs with primary hypoadrenocorticism., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Physical activity has been shown to improve the health and well-being of students, athletes and the general population, especially when it is properly monitored and responses are evaluated. However, data are mostly gathered without considering a valuable element, participants' perceptions. Therefore, the objective was to know the perception of volleyball student-athletes when using different monitoring and response tools that assess well-being, workloads, responses to workloads, and academic demands. A qualitative study using semi-structured interviews with female volleyball student-athletes ( n = 22) was used to know players' perceptions when using a wellness/well-being questionnaire, session ratings of perceived exertion (sRPE), and countermovement jumps (CMJ), and consider academic demands. Results show that the wellness questionnaire and sRPE increased student-athletes' awareness of well-being and readiness to perform, improved self-evaluation, self-regulation, and self-demand. However, motivation and overcoming challenges were based on the CMJ. Academic demands affected 82% of student-athletes, altering stress, fatigue, and sleep quality. Nonetheless, sport was seen as an activity that helped with academic commitments. Therefore, the wellness questionnaires and the sRPE facilitated self-awareness and positive dispositions toward self-regulation. Simultaneous intensive academic demands and training can produce mutual positive effects if the variables of physical and mental loads are harmonized in the critical academic and sports periods.

Objectives: We aimed to characterize the proportion of clients presenting to community pharmacies with influenza-like illness (ILI) and the severity of their illness; the proportion with detectable influenza A, influenza B, and other pathogens (i.e., parainfluenza I, II, and III, adenovirus, respiratory syncytial virus, human metapneumovirus); and to describe their self-medication practices., Methods: A cross-sectional study was conducted in six pharmacies in Guatemala City. Study personnel collected nasopharyngeal and oropharyngeal swabs from participants who met the ILI case definition and who were self-medicating for the current episode. Participants were tested for influenza A and B and other pathogens using real-time RT-PCR. Participants' ILI-associated self-medication practices were documented using a questionnaire., Results: Of all patients entering the pharmacy during peak hours who responded to a screening survey (n = 18,016) 6% (n = 1029) self-reported ILI symptoms, of which 45% (n = 470/1029) met the study case definition of ILI. Thirty-one percent (148/470) met inclusion criteria, of which 87% (130/148) accepted participation and were enrolled in the study. Among 130 participants, nearly half tested positive for viral infection (n = 55, 42.3%) and belonged to groups at low risk for complications from influenza. The prevalence of influenza A was 29% (n = 35). Thirteen percent of the study population (n = 17) tested positive for a respiratory virus other than influenza. Sixty-four percent of participants (n = 83) reported interest in receiving influenza vaccination if it were to become available in the pharmacy. Medications purchased included symptom-relieving multi-ingredient cold medications (n = 43/100, 43%), nonsteroidal anti-inflammatory drugs (n = 23, 23%), and antibiotics (n = 16, 16%). Antibiotic use was essentially equal among antibiotic users regardless of viral status. The broad-spectrum antibiotics ceftriaxone and azithromycin were the most common antibiotics purchased., Conclusions: During a typical influenza season, a relatively low proportion of all pharmacy visitors were experiencing influenza symptoms. A high proportion of clients presenting to pharmacies with ILI tested positive for a respiratory virus. Programs that guide appropriate use of antibiotics in this population are needed and become increasingly important during pandemics caused by respiratory viral pathogens., (© 2022. The Author(s).)

The aim of the research was to know the perception of high-level volleyball players of the changes produced (in relation to the previous season) in the efficiency of the training process, after a match analysis intervention program based on the Constraint-led Approach (CLA). The sample consisted of 11 players from a women's volleyball team. The protocol of the intervention program consisted of providing objective, contextualised and systematic information to the coach (adapted to his needs) that would allow understanding the different real game contexts. We used semi-structured interviews to assess players' perceptions. The athletes perceived changes in training, both in their preparation and development, specifically in greater involvement and organisation in preparing the training; in an increase in the specificity and suitability of training tasks according to individual needs; in the representativeness of the restrictions of the game; in a more tactical approach; in the variability of task and in the accountability to achieve the objective proposed. In addition, in the preparation and development for competition, the players detected more game planning; a deeper analysis of the opponents; an objective selection of the most relevant data, an increase in the depth of match analysis and the inclusion of the weekly meeting with the use of video compared to the previous season. These results expose the benefits of coaches incorporate programmes to obtain objective information about the game in their training process., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Fernández-Echeverría, Mesquita, González-Silva and Moreno.)

Background: Spain has been one of the countries most affected by the COVID-19 pandemic., Objective: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease., Methods: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records., Results: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥80 years: 46.0%)., Conclusions: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality., (Copyright © 2020 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The aim of this study was to assess the effectiveness of an intervention for improving postural habits among cleaning personnel, to prevent musculoskeletal disorders., Methods: We designed a specific intervention for cleaning personnel, consisting of a set of continuous actions focused on promoting good postural habits and physical activity. The intervention was implemented over two different years (initial implementation and replication phases) in a sample of workers in the general building cleaning subsector who belonged to different work centers of the same company. The evaluation of the intervention consisted of self-reported worker feedback and recording of habits by an external observer., Results: In the initial implementation phase, we observed a 92% increase in participants who reported they always or almost always adopt good postural habits during cleaning tasks. In the replication phase, this improvement was sustained by about 67% of participants. The main improvements were observed in: bending knees and hips, keeping the back straight, alternating use of arms and using support while bending forward. The external observation of postural habits corroborated the improvement reported by the workers., Conclusions: This intervention approach, consisting of different actions, could be continued over time, facilitating worker empowerment, and may be effective in improving the postural habits of cleaning workers in the short term. More research is needed to assess whether the change in habits is maintained over the long term and what its effect would be on the reduction of musculoskeletal disorders.

The aim of this investigation was to establish the criteria of service, reception and set that determine setting efficacy in world-class top-level volleyball. The study sample consisted of 4.113 gaming actions (1.371 serve actions, 1.371 reception actions, and 1.371 set actions), corresponding to the observation of four matches for each of the 12 best ranked teams in the Volleyball World Championship - a total of 23 matches. The criteria were: in-game role of the server, serve zone, type of serve, striking technique and serve direction; receiver player, reception zone, and reception efficacy; setting zone, type of set, setting technique, setting efficacy, a set's area, and set tempo. Multinomial logistic regression showed that criteria related to reception (reception efficacy) and to set (setting zone, type of set, a set's area, and set tempo) determined set efficacy. Specifically, positive and negative receptions and settings from acceptable and non-acceptable zones reduced perfect setting. In contrast, the jump set toward zones three and six and the first and second tempo increased perfect setting. Serve criteria did not determine set efficacy. This study can guide trainers and players in the training process., (Copyright © 2020 González-Silva, Fernández-Echeverría, Conejero and Moreno.)

Finding new targets to control or reduce seizure activity is essential to improve the management of epileptic patients. We hypothesized that activation of the pre-synaptic and inhibitory metabotropic glutamate receptor type 7 (mGlu7) reduces spontaneous seizures. We tested LSP2-9166, a recently developed mGlu7/4 agonist with unprecedented potency on mGlu7 receptors, in two paradigms of epileptogenesis. In a model of chemically induced epileptogenesis (pentylenetetrazole systemic injection), LSP2-9166 induces an anti-epileptogenic effect rarely observed in preclinical studies. In particular, we found a bidirectional modulation of seizure progression by mGlu4 and mGlu7 receptors, the latter preventing kindling. In the intra-hippocampal injection of kainic acid mouse model that mimics the human mesial temporal lobe epilepsy, we found that LSP2-9166 reduces seizure frequency and hippocampal sclerosis. LSP2-9166 also acts as an anti-seizure drug on established seizures in both models tested. Specific modulation of the mGlu7 receptor could represent a novel approach to reduce pathological network remodeling., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Although the etiology of Bipolar Disorder (BD) remains unknown, a strong genetic component to the pathogenesis and risk for this disorder has been widely hypothesized. Several risk genes for BD have been identified; of these, the purinergic P2 × 7 receptor (P2 × 7R) constitutes a pro-inflammatory receptor and a potential risk gene candidate. The purpose of the present study was to assess the frequency of the 1513 A > C P2RX7 polymorphism (rs3751143; Glu496Ala), which leads to receptor loss-of-function, in 154 BD patients versus 184 control subjects. The existence of a differential modulation of P2 × 7R was also analyzed in 22 euthymic BD patients, in comparison to 18 healthy controls. Our data show a decrease in 1513C allele frequency (p = 0.045) and a potential increase in 1513 A A/AC (p = 0.055) genotype frequency in BD patients, compared to controls, indicating an enhanced function of the pro-inflammatory P2 × 7 receptor in BD subjects. Interestingly, no differences in P2RX7 gene and protein expression were found between euthymic BD patients and matched healthy controls. In conclusion, our results suggest that P2 × 7R might play a role in the pathophysiology of BD and add new information regarding this receptor as a potential biomarker for the prediction and diagnosis of the disorder., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The objective of this study was to determine the variables that predicted serve efficacy in elite men's volleyball, in sets with different quality of opposition. 3292 serve actions were analysed, of which 2254 were carried out in high quality of opposition sets and 1038 actions were in low quality of opposition sets, corresponding to a total of 24 matches played during the Men's European Volleyball Championships held in 2011. The independent variables considered in this study were the serve zone, serve type, serving player, serve direction, reception zone, receiving player and reception type; the dependent variable was serve efficacy and the situational variable was quality of opposition sets. The variables that acted as predictors in both high and low quality of opposition sets were the serving player, reception zone and reception type. The serve type variable only acted as a predictor in high quality of opposition sets, while the serve zone variable only acted as a predictor in low quality of opposition sets. These results may provide important guidance in men's volleyball training processes.

Introduction: High mammographic density is one of the main risk factors for breast cancer. Although several occupations have been associated with breast cancer, there are no previous occupational studies exploring the association with mammographic density. Our objective was to identify occupations associated with high mammographic density in Spanish female workers., Methods: We conducted a population-based cross-sectional study of occupational determinants of high mammographic density in Spain, based on 1476 women, aged 45-68 years, recruited from seven screening centers within the Spanish Breast Cancer Screening Program network. Reproductive, family, personal, and occupational history data were collected. The latest occupation of each woman was collected and coded according to the 1994 National Classification of Occupations. Mammographic density was assessed from the cranio-caudal mammogram of the left breast using a semi-automated computer-assisted tool. Association between mammographic density and occupation was evaluated by using mixed linear regression models, using log-transformed percentage of mammographic density as dependent variable. Models were adjusted for age, body mass index, menopausal status, parity, smoking, alcohol intake, educational level, type of mammography, first-degree relative with breast cancer, and hormonal replacement therapy use. Screening center and professional reader were included as random effects terms., Results: Mammographic density was higher, although non-statistically significant, among secondary school teachers (e β = 1.41; 95%CI = 0.98-2.03) and nurses (e β = 1.23; 95%CI = 0.96-1.59), whereas workers engaged in the care of people (e β = 0.81; 95%CI = 0.66-1.00) and housewives (e β = 0.87; 95%CI = 0.79-0.95) showed an inverse association with mammographic density. A positive trend for every 5 years working as secondary school teachers was also detected (p-value = 0.035)., Conclusions: Nurses and secondary school teachers were the occupations with the highest mammographic density in our study, showing the latter a positive trend with duration of employment. Future studies are necessary to confirm if these results are due to chance or are the result of a true association whose causal hypothesis is, for the moment, unknown., (Copyright © 2017 Elsevier Inc. All rights reserved.)

This study, grounded in Self-Determination Theory (Deci and Ryan, 1985, 2002) was aimed to determine the influence of a cognitive-motivational intervention program, to improve the basic psychological need satisfaction of autonomy and competence, autonomous motivation, procedural knowledge, perceived performance and sport commitment, in youth volleyball players. Participants included 34 Under-19 female volleyball players. A quasi-experimental design was carried out with an experimental group (n = 16; M = 17.45; SD = .45) and a control group (n = 18; M = 16.64; SD = .70). The experimental group followed a multidimensional intervention program comprised of 24 sessions held over three months (two training sessions per week). It was based on two strategies: giving athletes the possibility of choice in specific training tasks (proposing training situations with several action alternatives) and questioning (cognitively involving players through tactical questions). A repeated-measures MANOVA 2 (group: experimental and control) x 2 (time: pre-test and post-test) was used to analyse the effect of Group x Time interaction. The results of the inter-group analysis showed significant differences in the post-test measurement between the experimental group and the control group (in favour of the experimental group) in the variables: basic psychological need satisfaction of autonomy and competence, autonomous motivation, procedural knowledge, perceived performance and sport commitment. Given the relevance of the cognitive-motivational processes, not only for performance but also for sport commitment, this intervention has important implications for sport coaching.

One of the main factors defining intestinal drug absorption is the solubility of the compound in the gastrointestinal environment. This study reports the solubility of a series of 27 commonly used acidic, neutral and basic drugs in human intestinal fluid samples collected from the duodenum or jejunum of healthy volunteers under fasted state conditions. The interindividual variability as well as the impact of factors such as pH, sampling site and bile salts on the solubility in human intestinal fluids was investigated. The solubility measurements were evaluated using a statistical experimental design. Variability in solubility across volunteers and sampling sites was highly compound-specific and appeared to be substantial for weak acids and bases and for lipophilic drugs. Both pH of the samples and the abundance of amphiphilic components were responsible for the variability observed in the solubility values obtained. The results confirm strong interindividual differences in intraluminal solubility, especially for compounds with high lipophilicity and/or compounds with a pKa value within the physiological pH range. It is important to recognize this variability in intestinal drug solubility as it may considerably influence the therapeutic outcome among patients., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Growing evidence supports the existence of neurobiological trait abnormalities in individuals at genetic risk for bipolar disorder. The aim of this study was to examine potential differences in brain-derived neurotrophic factor, cytokines, oxidative stress, and telomere length markers between patients with bipolar disorder, their siblings, and healthy controls., Methods: Thirty-six patients with bipolar disorder type I, 39 siblings, and 44 healthy controls were assessed. Serum levels of brain-derived neurotrophic factor, interleukin-6, interleukin-10, tumor necrosis factor-α, C-C motif chemokine 11, C-C motif chemokine 24, and 3-nitrotyrosine were measured, as were the activities of glutathione peroxidase, glutathione reductase, and glutathione S-transferase. Telomere length (T/S ratio) was measured using quantitative polymerase chain reaction., Results: Telomere length was different between the 3 groups (P = .041) with both patients and siblings showing a shorter T/S ratio compared with healthy controls. Patients showed increased levels of interleukin-6 (P = .005) and interleukin-10 (P = .002) compared with controls as well as increased levels of interleukin-6 (p = 0.014) and CCL24 (P = .016) compared with their siblings. C-C motif chemokine 11 levels were increased in siblings compared with controls (P = .015), and a similar tendency was found in patients compared with controls (P = .045). Glutathione peroxidase activity was decreased in patients compared with controls (P = .006) and siblings (P = .025). No differences were found for the other markers., Conclusions: The present results suggest that unaffected siblings may present accelerated aging features. These neurobiological findings may be considered as endophenotypic traits. Further prospective studies are warranted., (© The Author 2017. Published by Oxford University Press on behalf of CINP.)

Recent evidence points to the involvement of the purinergic signaling in the pathophysiology of bipolar disorder. The aim of this study was to assess the serum levels of adenosine and to evaluate its relation to functioning in 24 euthymic patients with bipolar disorder type I and in 25 matched healthy controls. Subjects were evaluated using the functioning assessment short test. Serum purine levels were measured by high pressure liquid chromatography. Our results show a decrease in serum adenosine levels in bipolar disorder patients compared with controls (t= -4.8, df= 43.96, p<0.001). Moreover, a significant negative correlation was found between patient adenosine levels and depression scale scores (r= -0.642, p= 0.001). Higher functional impairment was linked to lower levels of adenosine in patients (rho= -0.551, p= 0.008). Taken together, our results provide evidence for a purinergic imbalance in bipolar disorder, specifically an adenosinergic dysfunction. Our results also indicate a relation between adenosine levels and the functional impairment caused by the disorder, which could demonstrate a potential relation of adenosine levels in worsening of symptoms., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

The main objective of this study was to analyse the variables that predicted setting efficacy in complex I (KI) in volleyball, in formative categories and depending on gender. The study sample was comprised of 5842 game actions carried out by the 16 male category and the 18 female category teams that participated in the Under-16 Spanish Championship. The dependent variable was setting efficacy. The independent variables were grouped into: serve variables (a serve zone, the type of serve, striking technique, an in-game role of the server and serve direction), reception variables (a reception zone, a receiver player and reception efficacy) and setting variables (a setter's position, a setting zone, the type of a set, setting technique, a set's area and tempo of a set). Multinomial logistic regression showed that the best predictive variables of setting efficacy, both in female and male categories, were reception efficacy, setting technique and tempo of a set. In the male category, the jump serve was the greatest predictor of setting efficacy, while in the female category, it was the set's area. Therefore, in the male category, it was not only the preceding action that affected setting efficacy, but also the serve. On the contrary, in the female category, only variables of the action itself and of the previous action, reception, affected setting efficacy. The results obtained in the present study should be taken into account in the training process of both male and female volleyball players in formative stages.

Objective:: To assess cognitive performance and psychosocial functioning in patients with bipolar disorder (BD), in unaffected siblings, and in healthy controls., Methods:: Subjects were patients with BD (n=36), unaffected siblings (n=35), and healthy controls (n=44). Psychosocial functioning was accessed using the Functioning Assessment Short Test (FAST). A sub-group of patients with BD (n=21), unaffected siblings (n=14), and healthy controls (n=22) also underwent a battery of neuropsychological tests: California Verbal Learning Test (CVLT), Stroop Color and Word Test, and Wisconsin Card Sorting Test (WCST). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chi-square test; multivariate analysis of covariance was used to examine differences in neuropsychological variables., Results:: Patients with BD showed higher FAST total scores (23.90±11.35) than healthy controls (5.86±5.47; p < 0.001) and siblings (12.60±11.83; p 0.001). Siblings and healthy controls also showed statistically significant differences in FAST total scores (p = 0.008). Patients performed worse than healthy controls on all CVLT sub-tests (p < 0.030) and in the number of correctly completed categories on WCST (p = 0.030). Siblings did not differ from healthy controls in cognitive tests., Conclusion:: Unaffected siblings of patients with BD may show poorer functional performance compared to healthy controls. FAST scores may contribute to the development of markers of vulnerability and endophenotypic traits in at-risk populations.

The objective of this study was to apply a decision training programme, based on the use of video-feedback and questioning, in real game time, in order to improve decision-making in volleyball attack actions. A three-phase quasi-experimental design was implemented: Phase A (pre-test), Phase B (Intervention) and Phase C (Retention). The sample was made up of 8 female Under-16 volleyball players, who were divided into two groups: experimental group (n = 4) and control group (n = 4). The independent variable was the decision training program, which was applied for 11 weeks in a training context, more specifically in a 6x6 game situation. The player had to analyze the reasons and causes of the decision taken. The dependent variable was decision-making, which was assessed based on systematic observation, using the "Game Performance Assessment Instrument" (GPAI) (Oslin, Mitchell, & Griffin, 1998). Results showed that, after applying the decision training program, the experimental group showed a significantly higher average percentage of successful decisions than the control group F(1, 6) = 11.26; p = .015; η2 p = .652; 95% CI [056, 360]. These results highlight the need to complement the training process with cognitive tools such as video-feedback and questioning in order to improve athletes' decision-making.

Objective: To examine the association between two dietary patterns (Western and Mediterranean), previously linked to breast cancer risk, and mammographic density., Methods: This cross-sectional study included 3,584 women attending population-based breast cancer screening programs and recruited between October 7, 2007, and July 14, 2008 (participation rate 74.5%). Collected data included anthropometric measurements; demographic, obstetric, and gynecologic characteristics; family and personal health history; and diet in the preceding year. Mammographic density was blindly assessed by a single radiologist and classified into four categories: less than 10%, 10-25%, 25-50%, and greater than 50%. The association between adherence to either a Western or a Mediterranean dietary pattern and mammographic density was explored using multivariable ordinal logistic regression models with random center-specific intercepts. Models were adjusted for age, body mass index, parity, menopause, smoking, family history, hormonal treatment, and calorie and alcohol intake. Differences according to women's characteristics were tested including interaction terms., Results: Women with a higher adherence to the Western dietary pattern were more likely to have high mammographic density (n=242 [27%]) than women with low adherence (n=169 [19%]) with a fully adjusted odds ratio (ORQ4vsQ1) of 1.25 (95% confidence interval [CI] 1.03-1.52). This association was confined to overweight-obese women (adjusted ORQ4vsQ1 [95% CI] 1.41 [1.13-1.76]). No association between Mediterranean dietary pattern and mammographic density was observed., Conclusion: The Western dietary pattern was associated with increased mammographic density among overweight-obese women. Our results might inform specific dietary recommendations for women with high mammographic density.

This study applied an intervention program, based on video feedback and questioning, to expert female volleyball players to improve their tactical knowledge. The sample consisted of eight female attackers (26 ± 2.6 years old) from the Spanish National Volleyball Team, who were divided into an experimental group (n = 4) and a control group (n = 4). The video feedback and questioning program applied in the study was developed over eight reflective sessions and consisted of three phases: viewing of the selected actions, self-analysis and reflection by the attacker, and joint player-coach analysis. The attackers were videotaped in an actual game and four clips (situations) of each of the attackers were chosen for each reflective session. Two of the clips showed a correct action by the attacker, and two showed an incorrect decision. Tactical knowledge was measured by problem representation with a verbal protocol. The members of the experimental group showed adaptations in long-term memory, significantly improving their tactical knowledge. With respect to conceptual content, there was an increase in the total number of conditions verbalized by the players; with respect to conceptual sophistication, there was an increase in the indication of appropriate conditions with two or more details; and finally, with respect to conceptual structure, there was an increase in the use of double or triple conceptual structures. The intervention program, based on video feedback and questioning, in addition to on-court training sessions of expert volleyball players, appears to improve the athletes' tactical knowledge., (© The Author(s) 2016.)

Background: Studies investigating inflammatory markers in post-traumatic stress disorder (PTSD) have yielded mixed results. The aim of our study was to compare concentrations of inflammatory markers in patients with PTSD compared with healthy controls., Methods: We did a meta-analysis and meta-regression of studies comparing inflammatory markers between patients with PTSD and healthy controls by searching PubMed, Embase, Scopus, Web of Science, and PsycINFO for articles published between Jan 1, 1960, and April 7, 2015. From eligible studies (ie, cross-sectional studies or baseline data from longitudinal studies of peripheral blood cytokine concentrations that compared adults with PTSD with healthy controls), we extracted outcomes of interest, such as mean and SD of peripheral blood cytokines, the time of day blood was collected, whether the study allowed patients with comorbid major depressive disorder in the PTSD group, whether patients were medication free, and severity of PTSD symptoms. We undertook meta-analyses whenever values of inflammatory markers were available in two or more studies. A random-effects model with restricted maximum-likelihood estimator was used to synthesise the effect size (assessed by standardised mean difference [SMD]) across studies., Findings: 8057 abstracts were identified and 20 studies were included. Interleukin 6 (SMD 0.88; p=0.0003), interleukin 1β (SMD 1.42; p=0.045), and interferon γ (SMD 0.49; p=0.002) levels were higher in the PTSD group than in healthy controls. Subgroup meta-analysis of patients who were not given medication showed higher tumour necrosis factor α (TNFα; SMD 0.69, 95% CI 0.35-1.02; p<0.0001) in the PTSD group than the control group in addition to the aforementioned cytokines. TNFα (SMD 1.32, 0.13-2.50; p=0.003), interleukin 1β (SMD 2.35, 0.01-4.68; p=0.048), and interleukin 6 (SMD 1.75, 0.97-2.53; p<0.0001) levels remained increased in the PTSD group in a subgroup meta-analysis of studies that excluded comorbid major depressive disorder. Illness duration was positively associated with interleukin 1β levels (b=0.33, p<0.0001) and severity with interleukin 6 (b=0.02, p=0.042). A model composed of several variables-presence of comorbid major depressive disorder, use of psychotropic medications, assay used, and time of day blood was collected-explained the large amount of heterogeneity between interleukin 1β, interleukin 6, and C-reactive protein studies. Egger's linear regression test revealed a potential publication bias for interleukin 1β. Additionally, for most inflammatory markers, study heterogeneity was reported to be high (I(2)>75%)., Interpretation: PTSD is associated with increased interleukin 6, interleukin 1β, TNFα, and interferon γ levels. This information might be useful for consideration of chronic low-grade inflammation as a potential target or biomarker in PTSD treatment. Use of psychotropic medication and presence of comorbid major depressive disorder were important moderators that might explain the inconsistency between results of previous studies. Our search strategy used a range of databases and we made exhaustive effort to acquire data by contacting the authors. Notably, high levels of between-study heterogeneity were recorded for most cytokine variables measured in our analysis. However, meta-regression analysis could explain a large amount of this heterogeneity., Funding: None., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: The Parental Bonding Instrument (PBI) examines parent-child bonds and attachment during the first 16 years. Our study aims to compare PBI scores between patients with schizophrenia and bipolar disorder (BD)., Methods: We analyzed PBI scores in 59 patients with schizophrenia, 36 with BD and 52 healthy controls using ANCOVA, with age, gender and years of education as covariates. Bonferroni correction was used to adjust for multiple comparisons. PBI has maternal and paternal scores, each one with two domains: care and overprotection., Results: In PBI maternal and paternal care domains, patients with schizophrenia showed significantly higher scores when compared with BD patients (p<0.001). However, when compared with healthy controls, patients with schizophrenia only showed significantly higher scores of PBI maternal care domain (p=0.037). BD patients showed significantly lower PBI care scores compared with healthy controls (maternal score: p=0.016; paternal score: p<0.001). In PBI maternal and paternal overprotection domain, BD patients showed significantly higher scores compared with patients with schizophrenia (p=0.004; p=0.021) and healthy controls (p=0.014; p=0.008); while no significant difference was observed between patients with schizophrenia and healthy controls. "P values" are according to Bonferroni correction., Conclusion: There are significant differences in the perception of attachment between schizophrenia and BD. This finding may shed some light to better understand the prodromal symptoms of each disorder., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Exercise is a potential treatment for depression. However, few studies have evaluated the role of adjunct exercise in the treatment of severely major depressed inpatients. The goal of this study was to evaluate the effects of add-on exercise on the usual treatment of severely depressed inpatients., Methods: Fifty participants were randomized to an exercise (exercise + usual treatment) or a control (usual treatment) group. Twenty-five patients were randomly allocated to each group. The participants in the exercise group performed three sessions per week throughout the hospitalization period, with a goal dose of 16.5 kcal/kg/week plus the usual pharmacological treatment. Depressive symptoms and the Quality of Life (QoL) of the participants were assessed at the baseline, the second week, and discharge., Results: A significant group × time interaction was found for depressive symptoms and the physical and psychological domains of QoL. Differences between groups occurred at the second week and discharge with respect to depressive symptoms and the physical and psychological domains of QoL. There was no difference in the remission rate at discharge (48% and 32% for the exercise and control group, respectively). An NNT of 6.25 was found. No significant baseline characteristics predict remission at discharge., Conclusion: Add-on exercise is an efficacious treatment for severely depressed inpatients, improving their depressive symptoms and QoL. Initial acceptance of exercise remains a challenge., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: Impaired stress resilience and a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis are suggested to play key roles in the pathophysiology of illness progression in bipolar disorder (BD), but the mechanisms leading to this dysfunction have never been elucidated. This study aimed to examine HPA axis activity and underlying molecular mechanisms in patients with BD and unaffected siblings of BD patients., Methods: Twenty-four euthymic patients with BD, 18 siblings of BD patients, and 26 healthy controls were recruited for this study. All subjects underwent a dexamethasone suppression test followed by analyses associated with the HPA axis and the glucocorticoid receptor (GR)., Results: Patients with BD, particularly those at a late stage of illness, presented increased salivary post-dexamethasone cortisol levels when compared to controls (p = 0.015). Accordingly, these patients presented reduced ex vivo GR responsiveness (p = 0.008) and increased basal protein levels of FK506-binding protein 51 (FKBP51, p = 0.012), a co-chaperone known to desensitize GR, in peripheral blood mononuclear cells. Moreover, BD patients presented increased methylation at the FK506-binding protein 5 (FKBP5) gene. BD siblings presented significantly lower FKBP51 protein levels than BD patients, even though no differences were found in FKBP5 basal mRNA levels., Conclusions: Our data suggest that the epigenetic modulation of the FKBP5 gene, along with increased FKBP51 levels, is associated with the GR hyporesponsiveness seen in BD patients. Our findings are consistent with the notion that unaffected first-degree relatives of BD patients share biological factors that influence the disorder, and that such changes are more pronounced in the late stages of the illness., (© The Author 2014. Published by Oxford University Press on behalf of CINP.)

Exercise can be an effective treatment for depression. Although the efficacy of exercise is well established, little is known concerning the biological changes associated with the antidepressant effects of exercise. A randomized, controlled trial was conducted to evaluate the effects of adding exercise to the usual treatment on the thiobarbituric acid-reactive substances (TBARS) and brain-derived neurotrophic factor (BDNF) serum levels of severely depressed inpatients. Twenty-six participants were randomized to an exercise group (n=15, exercise+treatment as usual) or a control group (n=11, treatment as usual). The participants in the exercise group completed a targeted dose of 16.5 kcal/kg/week of aerobic exercise, three times per week, throughout their hospitalizations. The control group did not exercise during their hospitalizations. The mean hospitalization length was of 21.63 (4.5)×23.82 (5.7) days for exercise and control groups, respectively. The exercise group performed a median of nine sessions. After adjusting for previous tobacco use, a significant group×time interaction was found for TBARS serum levels (p=0.02). A post hoc Bonferroni test revealed differences between the exercise and control groups at discharge. A significant time effect (p<0.001) but no group×time interaction was found (p=0.13) for BDNF serum levels. Adding exercise to the usual treatment of severely depressed inpatients decreases the TBARS serum levels of severely depressed inpatients after 3 weeks. Adding exercise had no additional effects on BDNF serum levels.

Background: The pathophysiology of bipolar disorder (BD) includes several systemic alterations, such as inflammatory markers, oxidative stress, and DNA damage. Most of these parameters may be related to dysfunctions in cellular resilience mechanisms reported in patients, such as endoplasmic reticulum stress and mitochondrial damage. As a consequence, these impairments can ultimately lead to cell death. Therefore, the aim of this study was to assess cell death and viability in peripheral blood mononuclear cells (PBMCs) from patients with BD and controls., Methods: Ten euthymic patients with BD type I and seven age- and sex-matched healthy controls were recruited and had peripheral blood collected by venipuncture in heparine tubes. PBMCs were isolated from total blood, followed by measurement of cell viability by trypan blue exclusion, and apoptosis and necrosis by anexin V/propidium iodide (PI) staining., Results: Cell viability did not significantly differ between groups, as well as the percentage of cells in necrosis or in late apoptosis/necrosis. However, the percentage of cells in early apoptosis was higher in patients when compared with controls (p=0.002)., Limitations: This is a preliminary study with relatively small sample size., Conclusions: The systemic toxicity along with dysfunctional cell resilience mechanisms reported in patients with BD may be inducing apoptosis in PBMCs. A deeper look into the clinical relevance of such findings is warranted., (© 2013 Elsevier B.V. All rights reserved.)

The importance within sport expertise of cognitive factors has been emphasised in many research studies. Adaptations that take place in athletes' long-term memories are going to condition their decision-making and performance, and training programmes must be developed that improve these adaptations. In our study, we provide a tactical-cognitive training programme based on video-feedback and questioning in order to improve tactical knowledge in tennis players and verify its effect when transferred to athletes' decision-making. 11 intermediate tennis players participated in this study (12.9 ± 0.7 years old), distributed into two groups (experimental, n = 5; control, n = 6). Tactical knowledge was measured by problem representation and strategy planning with a verbal protocol. Decision-making was measured by a systematic observation instrument. Results confirm the effectiveness of a combination of video-feedback and questioning on cognitive expertise, developing adaptations in long-term memory that produce an improvement in the quality of tactical knowledge (content, sophistication and structure). This, in turn, is transferred to the athletes' decision-making capacity, leading to a higher percentage of successful decisions made during game play. Finally, we emphasise the need to develop effective programmes to develop cognitive expertise and improve athletes' performance, and include it in athletes' formative stages.

Cognitive deficits have been recognized as a core feature of schizophrenia (SZ) and are present in most patients. Verbal memory (VM), working memory (WM), and executive function (EF) are domains commonly impaired in patients with SZ. These latter domains have been related to the genetic risk of the disorder characterizing as possible endophenotypes. In order to study neurocognitive endophenotypes in a Brazilian population with elevated genetic risks to develop SZ, we measured VM (Hopkins Verbal Learning Test Revised), WM (Letter-Number Sequencing and Digit Span) and EF (Stroop Test) in 90 subjects (45 unaffected siblings of patients with SZ and 45 matched healthy controls). No differences were found in EF and WM (Letter-Number Sequencing and Digit Span). However, in VM, siblings of patients performed worse than controls on the immediate recall and delayed recall. Our results suggest that VM impairment could be considered an endophenotype of SZ., (© 2013 Elsevier B.V. All rights reserved.)

Objective: To describe teachers treated for dysphonia and vocal cord nodules by the public health system in Navarra (Spain), to describe associated factors and to identify the proportion of these cases registered as occupational diseases., Methods: Cases of dysphonia occurring in persons between the age of 18 and 65 years, registered between May 2010 and June 2011, and treated in a specific unit (Speech Unit) of Otorhinolaryngology Services were identified. Information on occupation, sex and clinical diagnosis was collected. For teachers, additional information was obtained on smoking habits, teaching level and prior training in speech disorders and their prevention. Cases declared as occupational diseases were identified from the official Register of Occupational Diseases of Navarra., Results: 135 teachers (18% of all dysphonia patients in the sample) were treated for dysphonia in the Speech Unit (87% women). Being female was 3-fold higher among teachers than other occupations (crude prevalence odds ratio = 3.5; 95% confidence interval, 95%CI, 2.1-5.9). Female teachers were also 6.5 years (95%CI, 1.7-11.4) younger than male teachers. No association was found between smoking and risk of vocal cord nodules or dysphonia. Only 20% of teachers treated had received training on speech disorders and their prevention. Nine out of 83 cases of vocal cord nodules diagnosed in professional voice users were officially declared as occupational diseases; in all cases, these were teachers., Conclusions: Dysphonia in teachers is a frequent reason for visiting a specialty clinic. Among these professionals, women showed a higher risk of suffering from vocal cord nodules. Most cases of vocal cord nodules in our sample were not reported as occupational diseases., (Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.)

The main goal of this research was to analyze the relationship between the amount of practice accumulated in training and the level of cognitive expertise achieved by volleyball players who are still in training. Another goal was to determine the number of training hours per week needed to improve knowledge significantly. The study's sample was composed of 520 volleyball players between the ages of 12 and 16 years. The independent variable was the amount of training, defined as the number of weekly hours that the volleyball player devoted to training. The dependent variable was cognitive expertise, measured by declarative knowledge and procedural knowledge. A univariate analysis of variance was done to examine the relationship between the number of weekly hours and the declarative and procedural knowledge reached by volleyball players in the athletic formation training stages. Statistical significance was set at p < 0.05. There were significant differences in knowledge according to the number of weekly training hours (p < 0.001). These results confirm that there is a relationship between the quantity of practice and the development of cognitive expertise. It is recommended that young players dedicate at least 4 hours weekly to training to achieve a significant improvement in cognitive expertise.

Objective: The objective of this study was to examine reliability and validity of the Japanese version of the Inventory of Violence and Psychological Harassment (IVAPT) (Pando, 2006), a 22-item measure of psychological harassment at work and presence and intensity of psychological violence widely used in Latin American countries., Methods: The IVAPT was translated into Japanese, and the translation was amended through a small pretest and a back-translation and finalized. A total of 1,810 out of 4,072 civil servants completed a questionnaire including the IVAPT., Results: Cronbach's alpha of the scale was 0.97 for psychological violence and 0.94 for psychological harassment at work. An exploratory factor analysis showed that the first factor explained 64.5% of the total variance. Data did not well fit to previously reported one- or three-factor structures. Psychological violence and harassment at work were more frequent among older respondents. Intensity of psychological violence was well concordant with other scales of workplace bullying, i.e., Leymann Inventory of Psychological Terrorization (LIPT) and Negative Acts Questionnaire-Revised (NAQ-R), and psychological harassment at work was well concordant with the NAQ-R., Conclusions: The Japanese version of the IVAPT showed high internal consistency reliability. While the first factor explained a large proportion of the variance, the IVAPT seems to have a unique factor structure in the Japanese sample. Concurrent validity of the IVAPT was supported by the comparison with the other scales.

Background: Mammographic density (MD) is regarded as an intermediate phenotype in breast cancer development. This association study investigated the influence of 14 breast cancer susceptibility loci identified through previous genome-wide association studies on MD among the participants in the "Determinants of Density in Mammographies in Spain" (DDM-Spain) study., Methods: Our study covered a total of 3348 Caucasian women aged 45-68years, recruited from seven Spanish breast cancer screening centres having DNA available. Mammographic density was blindly assessed by a single reader using a semiquantitative scale. Ordinal logistic models, adjusted for age, body mass index and menopausal status, were used to estimate the association between each genotype and MD., Results: Evidence of association with MD was found for variant rs3803662 (TOX3) (Odds Ratio (OR)=1.13, 95% Confidence Interval (CI)=1.03-1.25), and marginal evidence of association for susceptibility loci rs3817198 (LSP1) (OR=1.09, 95% CI=1.00-1.20) and rs2981582 (FGFR2) (OR=0.92, 95% CI=0.84-1.01). Two other loci were associated with MD solely among pre-menopausal women, namely, rs4973768 (SLC4A7) (OR=0.83, 95% CI=0.70-1.00) and rs4415084 (MEPS30) (OR=1.22, 95% CI=1.00-1.49)., Conclusions: Our findings lend some support to the hypothesis which links these susceptibility loci to MD., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

We report on the combined action of a cw diode laser and a train of ultrashort pulses when each of them drives one step of the 5S-5P-5D two-photon transition in rubidium vapor. The fluorescence from the 6P(3/2) state is detected for a fixed repetition rate of the femtosecond laser while the cw-laser frequency is scanned over the rubidium D(2) lines. This scheme allows for a velocity selective spectroscopy in a large spectral range including the 5D(3/2) and 5D(5/2) states. The results are well described in a simplified frequency domain picture, considering the interaction of each velocity group with the cw laser and a single mode of the frequency comb.

The main objective of the research was to analyse the cognitive expertise of volleyball players, according to their level of practice and age, as well as to verify the existing difference in the knowledge of individuals of the same age but with different levels of practice. The study sample was comprised of 535 individuals ages 12 to 16 years. The independent variables were the level of practice, i.e., playing category in training and in competition (Under-14 and Under-16), and the age. The dependent variables were declarative knowledge and procedural knowledge. An analysis of variance was performed to examine the influence of the level of practice on the declarative knowledge and procedural knowledge of the volleyball players in training stages. There were significant differences both in declarative knowledge and in procedural knowledge according to level of practice. Significant differences were also observed between consecutive ages at different levels of practice. These results show that the level of practice in training and competition is a more relevant factor than the change of age in development of specific knowledge of the sport.

Differences in the tactical knowledge of tennis players are described using the expert-novice approach to examine problem representation and strategy planning in 6 pre-professionals and 6 intermediate tennis players, by means of the McPherson and Thomas protocol for analysing verbal reports during game play. Statistical analyses indicated significant differences in conceptual content, structure, and sophistication. These pre-professional tennis players had greater, more elaborated, and sophisticated tactical knowledge; with expertise, more complex structures are developed in long-term memory. Specific training programmes to improve tennis players' tactical knowledge and cognitive skills may be desirable.

Background: Physical exercise has been extensively researched as a therapeutic option for treatment of major depression., Methods: In a randomized controlled trial, we analyze the effects of aerobic physical exercise as an add-on strategy for treatment of severe depressed inpatients. The exercise has a "Dose" of 16.5 kcal/kg/week, three times a week during all the hospitalization., Results: Our preliminary results show that there is no significant difference in scores of Hamilton in the second week between groups (Mean[SD]=8.2[5.96] × 11.18[5.03], p=0.192). However, there is a significant reduction in Hamilton scores of patients in exercise group at discharge (Mean[SD]=5.93[4.46] × 9.45[3.56], p=0.041). Regarding Quality of Life (QoL), no significant difference were found between groups in the second week in physical domain (Mean[SD]=56.98[8.96] × 54.54[9.18], p=0.511) and psychological domain (Mean[SD]=50.88[13.88] × 42.04[12.42], p=0.106). However, there is a significant difference in psychological domain (Mean[SD]=55.88[9.92] v 41.66[13.04], p=0.004) and a trend but no statistical significance in the physical (Mean[SD]=58.80[9.14] × 52.12[8.70], p=0.07) at discharge., Limitations: Many patients receive different treatment strategies, like ECT (1 patient at exercise group × 3 at control group). Other limitation is the small number of participants included until this moment., Conclusion: Our preliminary results suggest that physical exercise could be a feasible and effective add-on strategy for treatment of severe depressed inpatients, improving their depressive symptoms and QoL., (Copyright © 2011 Elsevier B.V. All rights reserved.)