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Background: The healthcare professional who performs sedation for digestive endoscopy procedures is usually the nurse. Therefore, knowledge and training on the part of the nurse is an important factor for the correct sedation of the patient and may affect, among other factors, the quality of health care and the recovery and well-being of the patient., Objective: To determine the training opportunities and resources available to the specialists involved in digestive endoscopy services in hospitals in Spain in which sedation is performed by the nursing staff., Methods: This was a descriptive cross-sectional study performed in the Digestive Endoscopy Service at Toledo University Hospital and nearby hospitals in central Spain. The sample consisted of 75 nurses who administer sedation in digestive endoscopic procedures., Results: Regarding the training of nurses, the vast majority were generalist nurses, and only a small percentage obtained specialized training through ongoing training. Most had been working in the service for more than two years, and very few had previous experience in sedation, although the vast majority currently applied sedation. Life support training was also critical. There were significant differences in the availability of resources between different hospitals., Conclusions: The training of nurses who perform sedation in digestive endoscopy services could be improved since there is a high proportion of personnel without specific training in sedation before starting to work in the service. It is crucial to implement targeted and ongoing training programs to improve competencies in this area, as they are essential to ensure the safety and effectiveness of the procedure. Given the variability in resources and personnel training that exists between different hospitals, it seems important to establish standards at the institutional level.

Background: Despite the availability of numerous treatments for Crohn disease, there are patients who do not respond to any therapy, thereby diminishing their quality of life. The aim of this review is to analyze the efficacy and safety of autologous hematopoietic stem cell transplantation therapy for refractory Crohn disease., Methods: This work is a systematic review with meta-analysis conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses. Electronic databases such as PubMed, Scopus, Web of Science, and ClinicalTrials were consulted. The searches were carried out in August 2024. To evaluate the efficacy of autologous hematopoietic stem cell transplantation in inducing remission, the mean and standard deviation of the Crohn's Disease Activity Index pre- and post- treatment were used, and a fixed-effects meta-analysis was conducted. Additionally, to assess the efficacy in perianal fistulas, a random-effects meta-analysis was performed, collecting data on the number of subjects with fistulas at the beginning and end of the intervention. All 95% confidence intervals were calculated, and the I2 statistic was used to assess the heterogeneity of the outcome variables., Results: A total of 609 records were identified from databases, with 12 studies selected for inclusion in the review. Immediate intervention proved effective in inducing a decrease in the Crohn Disease Activity Index compared to late intervention with conventional therapies. Moreover, the meta-analysis demonstrated efficacy for Crohn disease and associated fistulas with a mean decrease in the CDAI of -217.53 ± 14.3. When evaluating the efficacy of the procedure in perianal fistulas, a risk ratio of 0.47 with a 95% CI of [0.26, 0.86] was obtained. However, the procedure showed adverse effects, such as infections, acute renal failure or deaths., Conclusion: Systemic autologous hematopoietic stem cell transplantation has shown efficacy in patients who fail to achieve remission of their Crohn disease with conventional therapies. This procedure has also demonstrated efficacy in treating perianal fistulas. However, it is essential to carefully evaluate de implementation of this procedure due to the associated risks., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Aim: To describe the latest scientific evidence regarding community-based interventions performed on patients in need of palliative care worldwide., Introduction and Background: Given the rise of chronic diseases, their complexities and the fragility of patients, we are facing around 56.8 million people in need of palliative care. Community-based healthcare, particularly palliative care, can address social inequalities and improve the biopsychosocial health of disadvantaged populations. Therefore, primary care, as the main health referent in the community, has a central role in the care of these patients., Methods: This is an integrative review from January 2017 to June 2022 that follows the PRISMA statement and has been registered in PROSPERO. PubMed, Cuiden, the Web of Science (WoS), Cochrane and LILACS were the five databases searched. The scientific quality assessment of the articles was carried out following the CASPe methodology. Study selection was carried out by two researchers, A.V.L. and J.M.C.T., using the inclusion and exclusion criteria mentioned below. In cases of doubt or discrepancy, a third author (J.R.S.) was consulted., Results: The interventions mentioned in the 16 articles analysed were classified under the following categories: music therapy, laughter therapy, spiritual and cognitive interventions, aromatherapy, interdisciplinary and community-based teams, advance care planning and community, volunteering, telemedicine and care mapping., Example: Educating people to talk about different ethical issues could improve their quality of life and help develop more compassionate cities., Conclusions: We have identified interventions that are easily accessible (laughter therapy, telemedicine or music therapy), simple enough to be carried out at the community level and do not incur high costs. This is why they are recommended for people with palliative care needs in order to improve their quality of life.

Excessive alcohol consumption is a major public health issue that can negatively affect behavior among university students. The objective of this study was to estimate the frequency of alcohol consumption in nursing students as well as to describe the pattern of alcohol consumption after COVID-19 lockdown. A descriptive, cross-sectional observational study was carried out, in which 1162 degree-level nursing students were evaluated. Sociodemographic characteristics, lifestyles and levels of physical activity were determined using the International Physical Activity Questionnaire: Short Form (IPAQ-SF), and alcohol consumption was determined using the ISCA (Systematized Alcohol Consumption Questionnaire) and AUDIT (Alcohol Use Disorders Inventory Test) questionnaires. According to the AUDIT questionnaire, 36.7% of the students met the criteria for excessive alcohol consumption (26.8% men vs. 39.9% women; p < 0.001). The prevalence of hazardous drinkers was found to be 10.2% (95% CI 5.6-11.7), with the difference between men and women being statistically significant. The IPAQ-SF questionnaire indicated that 26.1% of students were sedentary. No relationship was observed between alcohol consumption and the level of physical activity. The frequency of hazardous drinkers was significantly higher in women (OR: 2.2) and in smokers (OR: 4.2). In conclusion, approximately 10% of nursing students can be considered hazardous drinkers, with significant differences between the sexes. The percentage is higher in women and in smokers. Strategies should be created that encourage healthy lifestyles, emphasizing preventive activities against excessive alcohol consumption. Furthermore, given the differences in excessive alcohol consumption between men and women, it would be advisable to include the gender perspective in these activities.

(1) Background: The aim is to ascertain health science students’ attitudes towards tattoos and their association with healthy lifestyles and socio-demographic variables. (2) Methods: Descriptive study conducted on pharmacy, medical and nursing students (n = 423). To ascertain attitudes towards tattoos, we used the Attitudes Towards Tattoos Scale. Other variables were physical activity, healthy diet, harmful habits and socio-demographic variables. (3) Results: A total of 12.6% (95% CI 9.1−16.2) of students reported having a tattoo; 58.9% did not regard tattoos as a health risk. In terms of attitudes, the mean score in the range of 7−35 (7—most unfavourable to 35—most favourable) was 22.6 (SD 5.2; 95% CI: 22.0−23.2). Scores were higher (p < 0.05) among women (23.1; SD: 5.3), persons aged <20 years (23.6; SD: 5.0) and smokers (23.9; SD: 4.6). Attitudes were found to be more favourable (p < 0.05) in nursing students than in pharmacy or medical students. No relationship was observed with physical activity, healthy diet or drug use. (4) Conclusions: The attitude to tattoos is most favourable among women, persons aged under 20 years and nursing students. In terms of health habits, attitudes are more favourable among smokers, regardless of their level of physical activity, compliance with healthy eating guidelines or consumption of alcohol or other drugs.

To examine the performance of a novel low-cost, ultra-compact, and attractive auditory feedback device for training laypeople in external chest compressions (ECCs), we conducted a quasi-experimental cross-sectional study from September to November 2021 at the Faculty of Nursing of Albacete, University of Castille-La Mancha, Spain. The ECC sequence was performed in the laboratory with the new device for basic hands-on CPR training. Results: One hundred college students were included in this study. The compression rate/min with the new device was 97.6, and the adequate %ECC was 52.4. According to the status of body mass index (BMI) and muscle strength of the upper limbs in the bivariate analysis, it was observed that the new device discriminated between those who performed correct ECCs according to their BMI and muscle strength and those who did not, which led to significantly influenced results in terms of the percentage of ECCs with correct depth. Conclusions: The new ultra-compact auditory feedback device "Salvando a Llanetes ® " demonstrated utility for teaching and learning ECCs in basic CPR. We can affirm that the analyzed device is an adequate, safe and economical method for teaching "CPR Hands-Only™" to the general population.

Objective: The objective of this study was to evaluate the efficacy and safety of intranasal midazolam as part of a paediatric sedation and analgesic procedure during the suturing of traumatic lacerations in paediatric emergency departments., Methodology: A systematic review of clinical trials was completed in July 2021. The databases consulted were PUBMED, SCOPUS, WEB OF SCIENCE, NICE and Virtual Health Library., Eligibility Criteria: randomised and nonrandomised clinical trials. Two independent, blinded reviewers performed the selection and data extraction. The participants were 746 children, of whom, 377 received intranasal midazolam. All of the children were admitted to an emergency department for traumatic lacerations that required suturing. The quality of the articles was evaluated with the Jadad scale. This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines., Results: Nine studies were included in the review. The intranasal administration of midazolam in healthy children produces anxiolysis and minimal/moderate sedation without serious side effects. Although there are combinations of parenteral drugs that produce deeper sedation, they also have greater adverse effects. No significant differences in the initiation of sedation and the suture procedure were found between the intranasal route and the parenteral route., Conclusions: The use of intranasal midazolam in healthy children produces sufficiently intense and long-lasting sedation to allow for the suturing of traumatic lacerations that do not present other complications; therefore, this drug can be used effectively in paediatric emergency departments.

(1) Background: The aim was screening the performance of nine Early Warning Scores (EWS), to identify patients at high-risk of premature impairment and to detect intensive care unit (ICU) admissions, as well as to track the 2-, 7-, 14-, and 28-day mortality in a cohort of patients diagnosed with an acute neurological condition. (2) Methods: We conducted a prospective, longitudinal, observational study, calculating the EWS [Modified Early Warning Score (MEWS), National Early Warning Score (NEWS), VitalPAC Early Warning Score (ViEWS), Modified Rapid Emergency Medicine Score (MREMS), Early Warning Score (EWS), Hamilton Early Warning Score (HEWS), Standardised Early Warning Score (SEWS), WHO Prognostic Scored System (WPSS), and Rapid Acute Physiology Score (RAPS)] upon the arrival of patients to the emergency department. (3) Results: In all, 1160 patients were included: 808 patients were hospitalized, 199 cases (17%) required ICU care, and 6% of patients died (64 cases) within 2 days, which rose to 16% (183 cases) within 28 days. The highest area under the curve for predicting the need for ICU admissions was obtained by RAPS and MEWS. For predicting mortality, MREMS obtained the best scores for 2- and 28-day mortality. (4) Conclusions: This is the first study to explore whether several EWS accurately identify the risk of ICU admissions and mortality, at different time points, in patients with acute neurological disorders. Every score analyzed obtained good results, but it is suggested that the use of RAPS, MEWS, and MREMS should be preferred in the acute setting, for patients with neurological impairment.

Objectives: Develop and semantically validate an instrument to assess the knowledge and attitudes of adolescents towards cardiopulmonary resuscitation (CPR)., Methods: Validation study of an instrument to evaluate the knowledge and attitudes of adolescents towards CPR, developed in three phases: (i) development of the evaluation instruments by the authors; (ii) content validation performed by 14 expert judges in the area using the content validity index for analysis; and (iii) semantic validation carried out with the participation of 30 adolescents between 11 and 13 years old., Results: In the content validation, the questions on CPR knowledge obtained a content validity index (CVI) between 0.92 and 1.00, with a general index of 0.98; and the questions about attitudes obtained an IVC between 0.85 and 1.00, with a general index also of 0.98. Regarding semantic validation, three questions were modified in the knowledge assessment instruments and five in the attitude assessment instrument., Conclusions: Semantic and content validation of the instruments studied showed that they are suitable for assessing the knowledge and attitudes of adolescents related to CPR, so their use is recommended in the evaluation of training actions in this population group., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright� by the Universidad de Antioquia.)

Childhood obesity has become a public health problem. Parents play an important role in the transmission of feeding habits and the detection of their child's weight status. The aim was to analyse the prevalence of overweight/obesity and to determine the relationship between children's weight status, different feeding practices and weight misperception. A cross-sectional study was conducted in randomly selected schools. The children's weight status was measured, and a questionnaire was used to identify the feeding practices applied by parents and their perception of their children's weight. The sample comprised 127 children aged 4 and 5 years and 189 aged 10 and 11. Differences were observed between parental feeding practices and weight status, monitoring being the most used practice. Parents use less pressure to eat and more restriction if their children have overweight or obesity. Misperception of weight was 39.6%, being higher in overweight children, who were perceived as normal weight in 53.19%. Children classified as obese were perceived as overweight in 88.23%. The use of inappropriate eating practices shows a need for health education in parents according to weight status. In addition, the parents' perception should be improved to increase early detection of overweight and start actions or seek professional help.

Objective: To evaluate the reliability and validity of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) in persons with arterial hypertension undergoing pharmacological treatment, along with its convergent validity with degree of control of blood pressure levels, therapeutic adherence, and tolerability of antihypertensive drugs., Methods: Observational cross-sectional study conducted on a sample of 484 persons. Treatment satisfaction was evaluated with the SATMED-Q, an instrument consisting of 17 items with six dimensions. Other variables were blood pressure, antihypertensive drugs, adverse effects, therapeutic adherence, and participants' characteristics., Results: Cronbach's alpha was 0.916. Factor analysis revealed six factors that could account for 89.97% of total variance. The test-retest reliability analysis yielded an intraclass correlation coefficient of 0.910 (95% CI = 0.806-0.959). In a possible range of 0 through 100 points, participant satisfaction with treatment ranged from 38.2 to 100 (mean 79.9 (SD = 12.9; 95% CI = 78.8-81.0); median 80.9). SATMED-Q scores were higher among persons who reported experiencing no adverse effects (82.5 ± 11.6 SD vs. 68.7 ± 11.9 SD; p < 0.001). Satisfaction levels were significantly lower among subjects not complying with the treatment (73.2 ± 12.9 vs. 82.1 ± 12.1; p < 0.001), and significantly higher among those presenting with controlled blood pressure levels (82.1 ± 12.1 SD vs. 77.5 ± 13.3 SD; p < 0.001)., Conclusions: The SATMED-Q showed high internal consistency and good stability in the reliability analysis. It is an appropriate instrument for evaluating satisfaction with antihypertensive treatment, both in routine clinical practice and in community pharmacy or clinical research settings.

Aims: Analyse the compliance of criteria recommended by the European Resuscitation Council (ERC) in the layperson First Aid (FA) and Cardiopulmonary resuscitation (CPR) books published in Spanish., Methods: A review of FA literature published in Spain, carried out through a systematic literature search procedure. We drew up a checklist with clarifications, based on different responses to twenty categories published in November 2015 by the ERC. The validity of the questions was analysed using the Fleiss' Kappa measure of inter-rater reliability, with a value >0.7 being deemed valid and questions displaying the lowest level of agreement being excluded., Results: Eight texts obtained from the limited search of materials published between 2016-2020 in the ISBN 13 database were analysed. Evaluation of eight texts ranging from 47 to 328 pages in length showed that only three included the upgraded 2015 CPR recommendations. Twenty categories/items were analysed, after exclusion of categories/items that displayed a low consistency. None of the handbooks was in total compliance with the new CPR recommendations, and only one included 70% of the recommendations. Seven categories were included in more than 50% of the texts, and nine categories were not included in any of them., Conclusions: There is a gap between the 2015 CPR recommendations and those published in Spanish FA handbooks. The ERC Guidelines should serve to standardise FA and CPR training materials. Systematic analysis of compliance with scientific societies' recommendations for FA handbooks enables detection of guidelines and patterns that need to be updated and adapted., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Oral mucositis (OM) is a common side effect of cancer therapies. It causes ulcerative, painful lesions in the oral cavity that can provoke malnutrition, increased risk of infection, longer hospital stays, and seriously affect the quality of life. Cooling the mucosa with oral cryotherapy (OC) during and/or after chemotherapy is the most accessible and tolerable intervention available. The aim of this study is to define the efficacy of OC for preventing OM induced by chemotherapy/radiotherapy in adult patients with cancer. Secondary endpoints include associated problems as pain. A systematic search was performed using the Pubmed, WOS (Web of Science), Cochrane Library, CINAHL, and BVS databases for articles published up to 2010. After inclusion and exclusion criteria were applied, a total of eight articles were analyzed in this review. In seven of the eight articles, the incidence of OM of all grades was significantly lower in the OC group compared with the no-OC group. Use of opioids and level of pain were also significantly reduced. OC is an effective intervention to reduce the incidence of OM induced by chemotherapy as well as the associated severity and pain. Based on these results, OC with only water or with chamomile, associated or not with other mouthwash therapies, is an effective intervention to reduce the incidence of OM induced by chemotherapy as well as the associated severity and pain.

A cross-sectional study was conducted to evaluate 199 health sciences students in the city of Iquitos. Their socio-demographic characteristics, lifestyle, level of physical activity, type of food, substance abuse, and prevalence of overweight and obesity were ascertained using purpose-validated questionnaires, i.e., the Systematic Alcohol Consumption Interview (Interrogatorio Sistematizado de Consumos Alcohólicos/ISCA), a questionnaire on the frequency of dietary intake (CFCA), the International Physical Activity Questionnaire (IPAQ), and anthropometric measurements. The prevalence of overweight (body mass index (BMI) of 25.0-29.9 kg/m 2 ) was 26.5% (95% CI = 19.9-33.0%) and that of obesity (BMI ≥ 30.0 kg/m 2 ) was 7.9% (95% CI = 3.8-12.1%). A total of 34.4% of students (95% CI = 27.4-41.4%) presented with a BMI > 25 kg/m 2 . The frequency of overweight was significantly higher in persons aged over 20 years (OR = 2.5) and smokers (OR = 3.2), and the frequency of obesity was significantly higher in older students (OR = 4.1) and males (OR = 5.5). In conclusion, a considerable proportion of health sciences students in the Amazonia region presented with a high BMI. The proportion of students with overweight was higher among students aged over 20 years and smokers, while that of obesity was also higher among males. In the university setting, the development of more overweight- and obesity-preventive activities and educational interventions would therefore be desirable.

Introduction and Objectives: Several interventions can improve low-density lipoprotein cholesterol (LDL-C) control. Our main objective was to evaluate the efficacy of a combined intervention to improve LDL-C control in patients with hypercholesterolemia. The study also assessed the efficacy of the intervention in improving adherence (pharmacological, diet, and exercise)., Methods: A multicenter, parallel group, randomized clinical trial (primary care) was conducted in 358 adults diagnosed with hypercholesterolemia, whether receiving prior drug therapy or not. We compared 178 participants who received the combined intervention (written material, self-completed registration cards, and messages to mobile telephones) with 178 controls. The main outcome variable was the proportion of participants with adequate LDL-C control (target levels of the European guidelines on dyslipidemia and cardiovascular risk) at 24 months., Results: At 24 months, the mean reduction in LDL-C was significantly higher in the intervention group (23.8mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6mg/dL [95%CI, 8.9-20.4]; P=.034). The mean LDL-C decrease was 13.1%±28.6%. At 1 year, the proportion of participants with adequate control was significantly higher in the intervention group than in the control group (43.7% vs 30.1%; P=.011; RR, 1.46). Adherence was significantly higher in the intervention group, both to drug therapy (77.2% vs 64.1%; P=.029) and exercise (64.9% vs 35.8; P<.001), but not to diet., Conclusions: The combined intervention significantly reduced LDL-C (by more than 13% at 2 years) and improved the degree of LDL-C control in patients with hypercholesterolemia at 1 year., (Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: The aim is to determine whether there is an association between perceived health status, healthy eating and other lifestyles in people over 50 years old., Design: Cross-sectional study., Setting: 8 Basic Health Zones from the Health Area of Albacete., Participants: A total of 781 subjects, randomly selected by simple random sampling., Main Measurements: variables: self-rated quality of life (EuroQol 5D), dietary habits (questionnaire on frequency of food consumption), physical activity (IPAQ questionnaire), toxic habits, health problems (International Classification of Primary Care) and sociodemographic characteristics., Results: The mean age was 61.4 years (SD: 6.6) and the proportion of women was 60.1%. On a scale of 0-100 the mean score in the perceived health status was 74.0 (SD: 15.2). This score had a weak correlation with the number of healthy eating criteria (r=0.078; P=.03). A linear trend (P=.001) was observed between exercise intensity and better self-rated health. The score was lower in smokers (70.9±15.6 vs 74.9±15.1 SD; P=.004). In the multiple regression, the number of healthy eating criteria remained an association with the score on perceived health status (P=.04), after adjusting the model for sociodemographic characteristics, number of health problems, and toxic habits., Conclusions: In people over 50years of age the level of self-rated health is associated with the fulfilment of the criteria of a healthy diet, which is independent of other health habits and main sociodemographic variables., (Copyright © 2016 Elsevier España, S.L.U. All rights reserved.)

In countries where cervical cancer screening programmes are conducted on an opportunistic basis, an active search for women at risk should be made to increase coverage. The objective of our study was to assess the effectiveness of three primary care interventions consisting of providing written, telephone and face-to-face information to increase screening participation among women over the age of 25 years. A randomized experimental study with only one post-test control group was conducted on women aged 25-70 years. A total of 1676 women were randomly distributed into four groups and the following interventions were implemented: written briefing; telephone briefing; an invitation to attend a group meeting and no briefing (control group). The women were evaluated 2 years after the intervention. The outcome variable was participation or nonparticipation in cervical cancer screening. It proved possible to interview a total of 1122 women. Among the groups, homogeneity was tested in terms of sociodemographic characteristics and health-related variables. Women who had undergone cytological testing in the 2 years preceding evaluation had a lower mean age (P<0.001) than women who had not done so (45.5±11.0 vs. 48.8±13.0 years). The proportion of women who had participated in screening was as follows: 35.3% in the written information group [95% confidence interval (CI) 29.8-40.9]; 38.4% in the telephone information group (95% CI 32.5-44.2); 29.3% in the face-to-face information group (95% CI 22.8-35.7) and 26.1% in the control group (95% CI 21.2-30.9), with this difference proving statistically significant (P=0.005). Logistic regression showed that only the interventions based on written or telephone briefing were effective vis-à-vis the control group. In conclusion, both written and telephone information can serve to improve women's participation in opportunistic cervical cancer screening. Current preventive strategies could be optimized by means of simple interventions within the scope of health professionals.

Background: It has been hypothesized that body mass index (BMI) and muscle strength (MS) of the rescuers are predictors of adequate external chest compressions (ECC). The aims of this study were: (a) to analyze, in college students, the relationship between BMI and MS with adequate ECC parameters; and (b) to examine whether the association between BMI and adequate ECC parameters is mediated by MS., Methods: A cross-sectional analysis of the evaluation of a CPR performance test involving students (n=63). We determined BMI and MS. After previous training, participants performed cardiopulmonary resuscitation on a mannequin for 20 minutes. PROCESS macro developed by Preacher and Hayes was used to assess whether the association between BMI and ECC was mediated by MS., Results: Underweight subjects achieved lower results than those with normal weight and overweight/obese in several dependent variables including: correct compression depth (P<.001) and adequate ECC (P<.001). This differences remained after adjusting for muscle strength except for the compression rate (P=.053). Moreover, participants in the low MS quartile were lower in both correct compression depth (P=.001) and adequate ECC (P<.001) than participants in the medium/high quartile after adjusting for confounding variables. The effect of BMI on adequate ECC was partially mediated by MS. Similar results were obtained in the analysis of the mediator role of MS in the relationship between BMI and correct compression depth., Conclusions: The ability to provide adequate ECC is influenced by the rescuer's MS. Rescuers should be advised to exercise arm strength to improve the quality of CPR., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background and Objective: Participation in colorectal cancer (CRC) screening varies widely among different countries and different socio-demographic groups. Our objective was to assess the effectiveness of three primary-care interventions to increase CRC screening participation among persons over the age of 50 years and to identify the health and socio-demographic-related factors that determine greater participation., Methods: We conducted a randomized experimental study with only one post-test control group. A total of 1,690 subjects were randomly distributed into four groups: written briefing; telephone briefing; an invitation to attend a group meeting; and no briefing. Subjects were evaluated 2 years post-intervention, with the outcome variable being participation in CRC screening., Results: A total of 1,129 subjects were interviewed. Within the groups, homogeneity was tested in terms of socio-demographic characteristics and health-related variables. The proportion of subjects who participated in screening was: 15.4% in the written information group (95% confidence interval [CI]: 11.2-19.7); 28.8% in the telephone information group (95% CI: 23.6-33.9); 8.1% in the face-to-face information group (95% CI: 4.5-11.7); and 5.9% in the control group (95% CI: 2.9-9.0), with this difference proving statistically significant (p < 0.001). Logistic regression showed that only interventions based on written or telephone briefing were effective. Apart from type of intervention, number of reported health problems and place of residence remained in the regression model., Conclusions: Both written and telephone information can serve to improve participation in CRC screening. This preventive activity could be optimized by means of simple interventions coming within the scope of primary health-care professionals.

Introduction and Objectives: Plant stanol consumption may improve long-term cholesterol control. The aim of the present study was to evaluate the effectiveness of 2g/day of plant stanols in reducing low-density lipoprotein cholesterol levels in patients with hypercholesterolemia., Methods: This randomized, double-blind, and placebo-controlled study included 182 adults diagnosed with hypercholesterolemia. A yogurt drink containing 2g of plant stanols was administered to 91 participants in the intervention group; 91 participants in the control group received unsupplemented yogurt. The primary end point was the change in the lipid profile at 12 months., Results: Low-density lipoprotein cholesterol levels at 12 months were significantly more reduced in the stanol intervention group than in the control group: 13.7 (95% confidence interval, 3.2-24.1) mg/dL (P=.011). A reduction of more than 10% in low-density lipoprotein cholesterol was achieved by a significantly higher proportion of participants in the intervention group (relative risk=1.7; 95% confidence interval, 1.1-2.7). In this group, the mean (standard deviation) level of low-density lipoprotein cholesterol decreased by 11.0% (23.9%)., Conclusions: Our results confirm that administration of plant stanols at a dosage of 2 g/day for 12 months significantly reduces (by slightly more than 10%) the concentrations of low-density lipoprotein cholesterol in individuals with hypercholesterolemia. Trial registration (www.ClinicalTrials.gov): Current Controlled Trials NCT01406106., (Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Aims: To estimate the frequency of alcohol consumption among nursing students and describe their behaviour patterns in relation to excessive consumption., Background: Most alcohol-related problems appear in individuals who indulge in hazardous consumption, with hazardous drinkers constituting a priority in the field of preventive activities. According to previous studies, there is a high proportion of hazardous drinkers among university students., Design: Descriptive cross-sectional study., Methods: Over the course of the 2012-2013 academic year, we assessed 1060 nursing degree students, ascertaining their socio-demographic characteristics, lifestyle and alcohol consumption by means of the Systematic Alcohol Consumption Interview (Interrogatorio Sistematizado de Consumos Alcohólicos/ISCA) and Alcohol Use Disorders Inventory Test (AUDIT)., Results: Hazardous alcohol consumption was observed in 43·4% of students. Moreover, 14·9% of men and 18·7% of women met criteria for hazardous drinkers, without any statistically significant difference between the sexes. The frequency of hazardous drinkers was significantly higher among participants aged under 21 years, those living outside the family nucleus and smokers., Conclusion: A considerable proportion of students show evidence of hazardous alcohol consumption and, while there are no sex-related differences, the proportion of hazardous drinkers tends to be higher among the youngest subjects, smokers and persons living outside the family nucleus. Alcohol-prevention activities should envisage greater protection of university settings, particularly where future health professionals are involved., (© 2014 John Wiley & Sons Ltd.)

Background: In subjects with hypercholesterolaemia, cholesterol values remain above guideline levels. One of the limiting factors to the achievement of goals in such patients is therapeutic non-adherence. The aim of this study is to assess the effectiveness of an intervention designed to improve control of hypercholesterolaemic patients, consisting of a combined strategy that would include the delivery of printed information, treatment-compliance check cards and the dispatch of text messages as complementary measures in support of the intervention at the general practitioner's practice., Methods/design: A randomised, parallel-group clinical trial will be conducted at the family medicine outpatient facilities of eight health centres in three of Spain's Autonomous Regions (Comunidades Autónomas), covering a total of 358 subjects aged 18 years or over with diagnosis of hypercholesterolaemia. Patients in the intervention group will be supplied with printed material with information on the disease and its management, mobile-telephone text messages with guideline summaries, reminders of forthcoming appointments and/or arrangements for making new appointments in the event of non-attendance, and self-report cards to check compliance with recommendations. Both groups -intervention and control- will receive routine recommendations from their physicians in accordance with current European clinical practice guidelines for hypercholesterolaemia and cardiovascular risk management. As regards the measurements to be made, the main variable is the proportion of subjects who attain the low density lipoprotein cholesterol levels set as a target across a follow-up period of 24 months. The secondary variables are as follows: adherence to recommendations on lifestyle and adherence to drug treatment; variation in lipid profiles and cardiovascular risk levels; appearance of cardiovascular events; physical activity; food consumption; smoking habit; anthropometric measures; blood pressure; health problems; use of hypolipidaemic agents; socio-demographic data; beliefs and expectations about preventive recommendations; and degree of satisfaction with the combined strategy., Discussion: Should this intervention prove effective, a recommendation could be issued on the application of this combined strategy to subjects with hypercholesterolaemia. It is a simple, relatively inexpensive intervention., Trial Registration: ClinicalTrials.gov: NCT02314663.

Background: In the field of preventive activities, early identification of excessive alcohol consumption is essential. The simplicity of existing instruments for detecting hazardous drinking makes for ready assimilation in university students., Objective: To ascertain nursing students' level of knowledge about alcohol prevention activities and assess their skills, acquired through self-assessment of their own alcohol consumption, in managing tools designed to detect hazardous drinkers., Design: Before and after intervention study., Material and Methods: We assessed 1060 nursing students and ascertained their level of knowledge about excessive alcohol consumption. Following an educational intervention in which students were taught to use the recommended screening instruments in clinical practice through self-assessment of their own consumption (Systematic Interview of Alcohol Consumption and Alcohol Use Disorders Inventory Test), we tested the skills acquired in detecting hazardous drinkers and their knowledge of alcohol prevention activities., Results: Initially, the concept of hazardous drinker was known by only 24.1% of students and the method of quantifying alcohol consumption by only 3.1%. The prevalence of hazardous drinkers was 17.9% (95% CI: 15.5-20.3). After the educational intervention, 95.8% of students stated that they understood the concept of hazardous drinker and 92.5% stated that they understood how to quantify alcohol consumption, with these proportions being significantly higher than those obtained at baseline (p<0.001). When asked about the intervention's usefulness, 91.3% viewed it favourably., Conclusion: By using a simple educational intervention, nursing students can improve their knowledge and skill detection of hazardous drinkers and quantification of alcohol consumption. These concepts allow for students to be satisfactorily introduced into the prevention activities during their university education. After assessing their own consumption, a considerable proportion of students realise that they are indulging in excessive alcohol consumption, which could in turn make for greater awareness of the problem among future health professionals., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background and Objective: the scientific community supports the appropriateness of colorectal cancer screening, and there is consensus on the need to raise awareness about the significance of prevention among both health care professionals and the population. The goal was to record the attitude of primary care providers towards colorectal cancer screening, as well as the main barriers to both patient and provider participation., Methods: a cross-sectional, observational study was performed of 511 professionals in Albacete Health District. Variables included views on screening effectiveness and cost-effectiveness, acceptance by providers and patients, barriers to participation, frequency of prevention recommendations, and education needs., Results: most (76 %) considered screening was effective; 85 % said acceptance of fecal occult blood testing was intermediate or high, and 68.2 % this is also the case for colonoscopy when needed; 71.9 % would recommend screening should a population-based program be implemented (currently only 9.7 % recommends this). Correspondence analysis revealed that recommendation is more common when assigned populations are smaller., Conclusions: most providers consider screening is both effective and acceptable for patients. In today´s situation, where screening is only performed in an opportunistic manner, the proportion of professionals who commonly recommend screening for the mid-risk population is low, especially when assigned populations are huge.

Objectives: To evaluate the perceived health status of elderly patients with insomnia, whether primary, secondary to a medical illness, or associated with another mental disorder., Methods: We conducted a cross-sectional study in a representative sample of 926 persons aged over 65 years. A psychiatric interview was used to verify the presence of insomnia (DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth ed., revised text). Interviews were conducted by health professionals to assess perceived health status (EuroQol-5D), health problems, and socio-demographic characteristics., Results: The prevalence of primary insomnia was 8.9% (95% CI: 7.1-11.0), that of insomnia associated with another mental disorder was 9.3% (95% CI: 7.5-11.4) and that of insomnia secondary to medical illness was 7.0% (95% CI: 5.4-8.9). Patients with insomnia who used hypnotics/sedatives scored lower in self-reported health (57.6; 95% CI: 53.7-61.4), significantly lower (p<0.05) than participants with insomnia not taking these drugs (65.1; 95% CI: 53.7-61.4). The mean health status score in individuals without insomnia was 0.87 and was significantly lower (p<0.05) in persons with any type of insomnia: 0.80 in primary insomnia, 0.73 in insomnia secondary to a mental disorder and 0.76 in insomnia associated with medical illness., Conclusions: Health status was worse in older people with insomnia, whether primary, secondary to other mental illnesses or organic, and when the elderly patients consumed hypnotics/sedatives. Limitations were less severe in primary insomnia., (Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.)