Gender Differences in Symptoms, Health-Related Quality of Life, Sleep Quality, Mental Health, Cognitive Performance, Pain-Cognition, and Positive Health in Spanish Fibromyalgia Individuals: The Al-Ándalus Project

Objective. To test the gender differences in tenderness, impact of fibromyalgia, health-related quality of life, fatigue, sleep quality, mental health, cognitive performance, pain-cognition, and positive health in Spanish fibromyalgia patients and in age-matched nonfibromyalgia individuals from the same region. To test the optimal cut-off score of the different tender points for women and men. Methods. A total of 405 (384 women) fibromyalgia versus 247 (195 women) nonfibromyalgia control participants from southern Spain (Andalusia) took part in this cross-sectional study. The outcomes studied were assessed by means of several tests. Results. In the fibromyalgia group, men showed better working memory than women (all, P<0.01), whereas sleep latency was lower in women compared to men (P=0.013). In the nonfibromyalgia group, men showed higher pain threshold in all the tender points (all, P<0.01), except in right and left lateral epicondyle. Furthermore, men showed better working memory than women (all, P<0.01), whereas memory performance was better in women compared to men (all, P≤0.01). Conclusion. The results of the present study do not support consistent evidence of gender differences in fibromyalgia-related symptoms. However, it seems that detriment of some symptoms (especially pain) in fibromyalgia men compared with their nonfibromyalgia counterparts is greater than those of fibromyalgia women compared with their nonfibromyalgia peers

Первичная сексуально−эротическая дезадаптация как причина внебрачных связей супругов

Показаны закономерности развития, проявления и течения сексуально−эротической формы первичной дезадаптации супругов, имеющиеся у них варианты и разновидности сексуальной дезадаптации. Описаны причины, частота и характер обусловленных этой формой дезадаптации внебрачных связей, моральные качества и личностные особенности супругов, способствующие совершению ими супружеских измен. Дается рекомендация учитывать полученные в исследовании данные при психотерапевтической коррекции сексуально−эротической дезадаптации и разработке системы психопрофилактики сопровождающего ее внебрачного секса.The regularities of development, manifestations and course of sexual−erotic form of primary spouse dysadaptation as well as the variants and varieties of dysadaptation are shown. The causes, frequency and character of extramarital relations due to this form of dysadaptation, moral qualities and personality peculiarities of the spouses providing marital unfaithfulness are described. It is recommended to consider the received information in psychopreventive correction of sexual−erotic dysadaptation and working out the system of psychoprevention of the extramarital sex

Association of objectively measured physical activity and sedentary time with health-related quality of life in women with fibromyalgia: The al-Ándalus project

Purpose: To examine the association of physical activity (PA) intensity levels and sedentary time with health-related quality of life (HRQoL) in women with fibromyalgia and whether patients meeting the current PA guidelines present better HRQoL. Methods: This cross-sectional study included 407 women with fibromyalgia aged 51.4 § 7.6 years. The time spent (min/day) in different PA intensity levels (light, moderate, and moderate-to-vigorous physical activity (MVPA) and sedentary time were measured with triaxial accelerometry. The proportion of women meeting the American PA recommendations (>150 min/week of MVPA in bouts >10 min) was also calculated. HRQoL domains (physical function, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health), as well as physical and mental components, were assessed using the 36-item Short-Form Health Survey. Results: All PA intensity levels were positively correlated with different HRQoL dimensions (rpartial between 0.10 and 0.23, all p < 0.05). MVPA was independently associated with social functioning (p < 0.05). Sedentary time was independently associated with physical function, physical role, bodily pain, vitality, social functioning, and both the physical and mental component summary score (all p < 0.05). Patients meeting the PA recommendations presented better scores for bodily pain (mean = 24.2 (95%CI: 21.3-27.2) vs. mean = 20.4 (95%CI: 18.9-21.9), p = 0.023) and better scores for social functioning (mean = 48.7 (95%CI: 43.9-44.8) vs. mean = 42.3 (95%CI: 39.8-44.8), p = 0.024). Conclusion: MVPA (positively) and sedentary time (negatively) are independently associated with HRQoL in women with fibromyalgia. Meeting the current PA recommendations is significantly associated with better scores for bodily pain and social functioning. These results highlight the importance of being physically active and avoiding sedentary behaviors in this population.This study was supported by the Spanish Ministries of Economy and Competitiveness (I+D+i DEP2010-15639; I+D+I DEP2013-40908-R, BES-2014- 067612) and the Spanish Ministry of Education (FPU 13/ 01088; FPU 15/00002)

Physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engage in reproductive and productive work: the al-Ándalus project

We acknowledge Springer and Clinical Rheumatology for publishing our scientific article: Álvarez-Gallardo, I. C., Estévez-López, F., Torres-Aguilar, X. C., Segura-Jiménez, V., Borges-Cosic, M., Soriano-Maldonado, A., Camiletti-Moirón, D., García-Rodríguez, I. C., Munguía-Izquierdo, D., Sierras-Robles, Á., Delgado-Fernández, M., & Girela-Rejón, M. J. (2019). Physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engage in reproductive and productive work: the al-Ándalus project. Clinical Rheumatology, 38(12), 3585-3593. https://doi.org/10.1007/S10067-019-04750-8Introduction/objectives: Reproductive labour refers to activities and tasks directed at caregiving and domestic roles, such as cleaning, cooking, and childcare. Productive labour refers to activities that involve economic remuneration. The aim of the present study was to analyse physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engaged, or did not engage, in productive work. Method: This cross-sectional study comprised 276 women with fibromyalgia from Andalusia (southern of Spain). Levels of physical activity (light, moderate, and vigorous) and sedentary behaviour were measured by an accelerometer. Physical fitness and cognitive performance were measured with a battery of performance-based tests. Results: More hours/week of homemaker-related tasks were associated with higher time spend in light physical activity and lower sedentary behaviour (P < 0.001 and P < 0.05, respectively). Furthermore, in comparison with those who only engaged in reproductive labour, women with fibromyalgia who engaged in productive work showed lower levels of sedentary behaviour and higher levels of light and moderate physical activity, physical fitness (except muscular strength), and cognitive performance (all, P < 0.05). Conclusions: Altogether, our findings suggest that productive work is consistently related to better physical and cognitive functioning in women with fibromyalgia. If future research corroborates causality of our findings, then, to maintain women with fibromyalgia engaging in productive work may be strived for not only because of societal or economic reasons but also for better health. However, we should keep in mind that people with fibromyalgia have a chronic condition, and therefore, adaptations at the workplace are imperative.Key Points• Women with fibromyalgia, who spend more time in reproductive labour, have higher levels of light physical activity and lower sedentary behaviour; however, it is associated with poorer general health (as lower physical fitness or cognitive performance).• Household tasks are often seen as a responsibility associated with the gender roles that women with fibromyalgia perform, despite the feelings of incapacity they cause. Policies focused on reducing reproductive labour demands for fibromyalgia patients (i.e. social help on housework or childcare) might facilitate the inclusion of daily active behaviours.• People with fibromyalgia who engage in productive work seem to have better health outcomes than those who have not; however, we cannot forget that adaptations and flexibility at the workplace are imperative

Identification of candidate genes associated with fibromyalgia susceptibility in southern Spanish women: the al‑Ándalus project

Candidate-gene studies on fibromyalgia susceptibility often include a small number of single nucleotide polymorphisms (SNPs), which is a limitation. Moreover, there is a paucity of evidence in Europe. Therefore, we compared genotype frequencies of candidate SNPs in a well-characterised sample of Spanish women with fibromyalgia and healthy non-fibromyalgia women.This work was supported by the Spanish Ministry of Economy and Competitiveness [I+D+i DEP2010-15639, I+D+i DEP2013-40908-R to M.D.-F.; BES-2014-067612 to F.E.-L.]; the Spanish Ministry of Education [FPU2014/02518 to M.B.-C.]; the Consejería de Turismo, Comercio y Deporte, Junta de Andalucía [CTCD-201000019242-TRA to M.D.-F.]; Consejería de Salud, Junta de Andalucía [PI-0520-2016 to M.D.-F.], and the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). This work is part of a Ph.D. Thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spai

Objective and subjective measures of physical functioning in women with fibromyalgia: what type of measure is associated most clearly with subjective well-being?

Purpose: To find modifiable factors that are related to subjective well-being would be valuable for improving interventions in fibromyalgia. Physical activity, sedentary behaviour, and physical fitness may represent potential areas to optimize treatment regimens. In fibromyalgia, there is a discordance between clinical observations and patient-reported outcomes (objective and subjective assessments). Therefore, the present study aims at analyzing the associations of objective and subjective evaluations of physical activity, sedentary behaviour, and physical fitness with subjective well-being and determine if and how objective and subjective associations differ. Methods: In this population-based cross-sectional study participated 375 women with fibromyalgia from the al-Ándalus project (Spain). Physical activity, sedentary behaviour, and physical fitness were objectively (accelerometers and performance testing) and subjectively (questionnaires) measured. Participants self-reported their levels of positive affect, negative affect, and life satisfaction. Results: In the most conservative multivariate analysis, we found independent associations of the objective measures of physical activity with positive affect and life satisfaction and sedentary behaviour with positive affect. No such relationship was seen with subjective measures of the same behaviours. Moreover, we observed that objective and subjective physical fitness evaluations were independent of each other related to subjective well-being. Conclusions: Independent associations of the objective measures (but not the subjective assessments) of physical activity with positive affect and life satisfaction, and of sedentary behaviour with positive affect were observed. However, objective measures and subjective appraisals of physical fitness appear to be independently related to well-being, which should be considered when developing physical exercise interventions for fibromyalgia.Implications for rehabilitation The analysis of concurrent associations of objective and subjective evaluations of physical functioning with subjective well-being offers indications for modifiable targets in rehabilitation that can improve well-being in fibromyalgia. Exercise-based rehabilitation may help women with fibromyalgia to improve subjective well-being, particularly positive affect. Rehabilitation should focus on both the objective physical performance of women with fibromyalgia and on their perceptions of what they can do physically. When rehabilitation aims at enhancing positive affect or life satisfaction by changing the lifestyle of women with fibromyalgia, physical activity and sedentary behaviour should be objectively monitored

Land- and water-based exercise intervention in women with fibromyalgia: the al-andalus physical activity randomised controlled trial

Background The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. Methods/Design One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia.This study was supported by the Consejeria de Turismo, Comercio y Deporte (CTCD-201000019242-TRA), the Spanish Ministry of Science and Innovation (I + D + I DEP2010-15639, grants: BES-2009-013442, BES-2011-047133, RYC-2010-05957, RYC-2011-09011), the Swedish Heart-Lung Foundation (20090635), the Spanish Ministry of Education (AP-2009-3173), Granada Research of Excelence Initiative on Biohealth (GREIB), Campus BioTic, University of Granada, Spain and European University of Madrid. Escuela de Estudios Universitarios Real Madrid. 2010/04RM

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Physical fitness assessment and its association with quality of life in people with firbromialgia

Fibromyalgia is a disorder of unknown etiology, characterized by widespread chronic pain and multiple comorbidities. Fibromyalgia has a larger impact on the physical function and health-related quality of life (HRQoL) of those with the condition. Physical fitness seems to be closely related to symptomatology and fibromyalgia severity. Indeed some physical fitness tests have been demonstrated to discriminate between the presence or absence of fibromyalgia. The overall objective of the present Doctoral Thesis has been to analyse the validity, reliability and feasibility of instruments to assess physical fitness in women with fibromyalgia, as well as to provide age-specific reference values of physical fitness and to compare them with age-matched controls. Additionally, the association of physical fitness with HRQoL was assessed in this population. To address these aims, four studies were conducted in the context of a Pilot project and the main research project (the alÁndalus project). Study I was carried out with 100 women with fibromyalgia that participated in the Pilot project. Study II was performed with 101 women with fibromyalgia of the Pilot project (reliability sub-study), plus 415 women with fibromyalgia and 195 control participants of the al-Ándalus project (validity sub-study). Study III involved 489 people with fibromyalgia (including 21 men) and 415 controls (including 55 men), and Study IV included 466 women with fibromyalgia, all belonging to the al-Ándalus project (main project). Physical fitness was assessed with the Senior Fitness Test battery and handgrip test. Self-reported physical fitness was measured with the International FItness Scale (IFIS) and HRQoL was measured with the 36-item Short-Form Health Survey. The main findings and conclusions of this Doctoral Thesis were: i) The Senior Fitness Test battery, and the handgrip test demonstrated good reliability in the measurement of physical fitness in women with fibromyalgia. These tests were quick and easy to administer, and as such feasible to use with this population; ii) The IFIS was demonstrated to be a useful tool to identify women with fibromyalgia who had very low physical fitness and distinguish them from those with higher physical fitness levels. Furthermore, the IFIS has demonstrated moderate test-retest reliability in women with fibromyalgia; iii) Physical fitness levels of people with fibromyalgia from Andalusia are very low in comparison with age-matched healthy controls; iv) High physical fitness was consistently associated with better HRQoL in women with fibromyalgia. Muscle strength was independently associated with the physical component of HRQoL, whereas flexibility and cardiorespiratory fitness were independently associated with the mental component. The results of this Doctoral Thesis have provided valid, reliable and feasible tools to measure physical fitness in people with fibromyalgia, as well as, age-specific reference values of physical fitness of a geographically representative sample of the south of Spain. Results also suggest that a better physical fitness could contribute to a better HRQoL in women with fibromyalgia. Future intervention studies, based on the results of this Doctoral Thesis, will increase the knowledge about the preventive and therapeutic value of exercise and physical fitness in this population.Tesis Univ. Granada. Departamento de Educación Física y Deportiv