Programa de Rehabilitación Cardiaca coordinado por Enfermería: resultados de Euroaction en España

Las enfermedades cardiovasculares (ECV) siguen siendo la causa principal de muerte entre los europeos y en todo el mundo. Los factores que contribuyen a la carga de las enfermedades cardiovasculares y las enfermedades crónicas relacionadas tiene que ver con el estilo de vida, y es fundamental entender que este concepto generalmente se basa en los patrones de comportamiento a lo largo de la vida. Los programas de RHBC son una herramienta preventiva, que han demostrado revertir las prácticas poco saludables, reemplazar los factores de riesgo por comportamientos sanos y se han implementado con éxito en una variedad de entornos, en pacientes con enfermedad coronaria y en la población general, tanto a nivel hospitalario, como a nivel comunitario. Objetivo: evaluar el impacto inmediato a las 16 semanas (16S) y al año de un programa de Rehabilitación Cardiaca (RHBC) multidisciplinar, coordinado por enfermería y enfocado en la familia, en pacientes con cardiopatía isquémica (CI) sobre el cumplimiento de los objetivos recomendados por las guías europeas sobre prevención secundaria, y cambios en el estilo de vida, comparado con el cuidado habitual. Metodología: estudio de base poblacional analítico, experimental, prospectivo y longitudinal. Este estudio refleja los datos de España, dentro del estudio global de Euroaction en el que participaron seis países. En España, se llevó a cabo en la Comunidad Valenciana, incluyendo dos hospitales ubicados en dos departamentos distintos de salud: departamento 19 Alacant, Hospital General y departamento 10 Valencia Dr. Peset. El periodo de estudio abarcó de abril 2003 a abril 2005 y se incluyeron sujetos pertenecientes a la población dependiente de estos hospitales con diagnóstico de SCA en el periodo indicado. Un total de 626 pacientes fueron identificados de forma consecutiva, en el hospital de intervención (INT) y en el hospital control (CONT). En el hospital intervención se llevó a cabo un programa de RHBC durante 8 semanas dirigido a los/las pacientes con CI y sus familiares. Los principales criterios de valoración medidos al año fueron los cambios en el estilo de vida, el control de la tensión arterial (TA), de lípidos y la prescripción de fármacos cardioprotectores. Resultados: un mayor porcentaje de consecución de objetivos se obtuvo al año del acontecimiento coronario en el hospital de intervención con respecto al cuidado habitual en el consumo de fruta y verdura (INT 97.2% vs 51% CONT, p ≤ 0.001) y de pescado graso (INT 58 % vs CONT 17%, p ≤ 0.001), en el cumplimiento de las recomendaciones sobre actividad física (INT 30% vs CONT 8.9%, p ≤ 0.001), en la tensión arterial < 140/90mmH (INT 70.4% vs CONT 45.8%, p ≤ 0.001), así como en los niveles de niveles de LDL (INT 87.2% vs CONT 69.4% p ≤ 0.05). Conclusión: los programas de RHBC basados en el seguimiento, educación para la salud y con implicación de la familia, obtienen mejores resultados que el cuidado habitual. Para lograr el potencial establecido para la prevención y rehabilitación cardiovascular, necesitamos programas locales de cardiología preventiva adaptados a los distintos países atendiendo a las diferencias geográficas y culturales

La pintura de José Cusachs en el Museo Histórico Militar de Valencia a través de su estudio y conservación

[ES] El presente artículo tiene como objeto dar a conocer distintas obras sobre lienzo de uno de los más destacados pintores de la segunda mitad del siglo XIX: José Cusachs y Cusachs (1851-1908), dos de gran formato, Muerte del teniente Rochera en Vic, de 1897 y La toma del fuerte del Collado de Alpuente firmada y fechada en 1900, y dos retratos de dos Capitanes de artillería, Don Juan Resino y Represa y Don Eduardo Temprado y Pérez, datados ambos en 1898. Esta compilación de obras estará expuesta en una sala dedicada a José Cusachs en el Museo Histórico Militar, sede del Acuartelamiento San Juan de Ribera desde 1898, situado en Valencia. Las obras de gran formato representan dos escenas militares y de batalla con un detallado programa iconográfico: La muerte del teniente Rochera en Vic, documenta el fallecimiento del teniente en la tercera guerra carlista. En La toma del fuerte del Collado de Alpuente se recrea la batalla de la conquista del castillo del Poyo. Las obras presentaban diferentes estados de conservación, apreciándose básicamente suciedad superficial, amarilleamiento de barniz y descohesiones puntuales alrededor de zonas con pérdidas ya tratadas en intervenciones anteriores. Gotor Frías, G.; León Zafra, V.; Robles De La Cruz, C.; Alfonso Buigues, M. (2023). La pintura de José Cusachs en el Museo Histórico Militar de Valencia a través de su estudio y conservación. Editorial Universitat Politècnica de València. 337-344. https://doi.org/10.4995/Icomos2022.2022.1540133734

Effects of Leucine Administration in Sarcopenia:A Randomized and Placebo-controlled Clinical Trial

Treating sarcopenia in older individuals remains a challenge, and nutritional interventions present promising approaches in individuals that perform limited physical exercise. We assessed the efficacy of leucine administration to evaluate whether the regular intake of this essential amino acid can improve muscle mass, muscle strength and functional performance and respiratory muscle function in institutionalized older individuals. The study was a placebo-controlled, randomized, double-blind design in fifty participants aged 65 and over (ClinicalTrials.gov identifier NCT03831399). The participants were randomized to a parallel group intervention of 13 weeks' duration with a daily intake of leucine (6 g/day) or placebo (lactose, 6 g/day). The primary outcome was to study the effect on sarcopenia and respiratory muscle function. The secondary outcomes were changes in the geriatric evaluation scales, such as cognitive function, functional impairment and nutritional assessments. We also evaluated whether leucine administration alters blood analytical parameters and inflammatory markers. Administration of leucine was well-tolerated and significantly improves some criteria of sarcopenia in elderly individuals such as functional performance measured by walking time (p = 0.011), and improved lean mass index. For respiratory muscle function, the leucine-treated group improved significantly (p = 0.026) in maximum static expiratory force compared to the placebo. No significant effects on functional impairment, cognitive function or nutritional assessment, inflammatory cytokines IL-6, TNF-alpha were observed after leucine administration compared to the placebo. The use of l-leucine supplementation can have some beneficial effects on sarcopenia and could be considered for the treatment of sarcopenia in older individuals

Divulgación científica: aprender haciendo y coevaluando

[EN] Objective/s: To assess the process of acquiring competence in scientific dissemination among students at the La Fe School of Nursing in Valencia. Development of the innovation: Four cycles of group work were implemented. Each group creates scientific dissemination documents focused on a work topic related to the subject of Physical Activity and Health Promotion in Nursing. Each work is co-evaluated by peers using an analytical rubric, with 10 learning domains, and this evaluation is returned before the creation of the next document. At the end of the 4 work cycles, 8 teachers external to the activity assessed the dissemination papers using the same co-assessment rubric, anonymously and blinded. Results: Acquisition of competence in the domains studied showed significant improvements with repetition of the tasks. The study differentiated by groups shows that learning becomes uniform in 6 of the 10 competencies, showing significant differences in learning between groups in 4 of the domains. Conclusions: Repetition of the task and co-assessment improves the acquisition of competences in science popularisation. The moment of greatest evolution occurs between the second and third repetition of the task, slowing down this benefit between the third and fourth repetition.[ES] Objetivo: Valorar el proceso de adquisición de la competencia en divulgación científica del alumnado de la Escuela de Enfermería de la Fe de Valencia. Desarrollo de la innovación: Se implementaron cuatro ciclos de trabajo grupal. Cada grupo crea documentos de divulgación científica centrados en una temática de trabajo relacionada con la asignatura de Actividad física y Promoción de la salud en Enfermería. Cada trabajo es coevaluado por pares mediante rúbrica analítica, con 10 dominios de aprendizaje, y se devuelve esta evaluación antes de la creación del siguiente documento. Finalizados los 4 ciclos de trabajo, 8 docentes externos a la actividad valoraron los documentos de divulgación utilizando la misma rúbrica de coevaluación, de forma anónima y cegada. Resultados: La adquisición de competencia en los dominios estudiados mostraron mejoras significativas con la repetición de las tareas. En el estudio diferenciado por grupos se muestra que el aprendizaje se vuelve uniformen en 6 de las 10 competencias, mostrando diferencias significativas de aprendizaje entre grupos en 4 de los dominios. Conclusiones: La repetición de la tarea y la coevaluación mejora la adquisición de competencias en divulgación científica. El momento de mayor evolución se produce entre la segunda y tercera repetición de la tarea, ralentizando este beneficio entre la tercera y cuarta repetición.García-Martinez, P.; Saus-Ortega, C.; García-Molina, P.; Balaguer-López, E.; Celda-Belinchón, L.; Sosa-Palanca, E.; Buck Sainz-Rozas, P.... (2022). Divulgación científica: aprender haciendo y coevaluando. Editorial Universitat Politècnica de València. 161-172. https://doi.org/10.4995/INRED2022.2022.1583516117

Effect of a Prebiotic Formulation on Frailty Syndrome:A Randomized, Double-Blind Clinical Trial

Aging can result in major changes in the composition and metabolic activities of bacterial populations in the gastrointestinal system and result in impaired function of the immune system. We assessed the efficacy of prebiotic Darmocare Pre® (Bonusan Besloten Vennootschap (BV), Numansdorp, The Netherlands) to evaluate whether the regular intake of this product can improve frailty criteria, functional status and response of the immune system in elderly people affected by the frailty syndrome. The study was a placebo-controlled, randomized, double blind design in sixty older participants aged 65 and over. The prebiotic product was composed of a mixture of inulin plus fructooligosaccharides and was compared with placebo (maltodextrin). Participants were randomized to a parallel group intervention of 13 weeks’ duration with a daily intake of Darmocare Pre® or placebo. Either prebiotic or placebo were administered after breakfast (between 9–10 a.m.) dissolved in a glass of water carefully stirred just before drinking. The primary outcome was to study the effect on frailty syndrome. The secondary outcomes were effect on functional and cognitive behavior and sleep quality. Moreover, we evaluated whether prebiotic administration alters blood parameters (haemogram and biochemical analysis). The overall rate of frailty was not significantly modified by Darmocare Pre® administration. Nevertheless, prebiotic administration compared with placebo significantly improved two frailty criteria, e.g., exhaustion and handgrip strength (p &lt; 0.01 and p &lt; 0.05, respectively). No significant effects were observed in functional and cognitive behavior or sleep quality. The use of novel therapeutic approaches influencing the gut microbiota–muscle–brain axis could be considered for treatment of the frailty syndrome

Conocimiento pesquero tradicional y sostenibilidad en el Puerto de Jávea

Fishing has undergone many changes throughout history. Being a very important activity that provides food and employment, it is important to take care of the marine environment to ensure its continuity. The growing environmental and social crisis affecting the Spanish Mediterranean coast has been revealed and made us rethink the effectiveness of the Common Fisheries Policy (FAO, 2011). In analyzing the failure of the Common Fisheries Policy was necessary to make a reform, analyze another point of view that is not only scientific and economic, and decentralize to address specific cases that would understand how people interact with the environment around him. In this line, the present study is planned to analyze the traditional fishing port of Jávea, for it focuses on the opinion of fishermen and poses a dual purpose, on the one hand "study the knowledge and practices in small-scale fisheries in Jávea", on the other hand "analyze these local knowledge and practices from the point of view of sustainability, both social and environmental", for this we will use a quantitative and qualitative methodology focused on the protagonists of fishing: the fishermen.La pesca ha sufrido numerosos cambios a lo largo de la historia. Siendo una actividad muy importante que nos proporciona alimentos y empleo, es necesario cuidar del medio marino para garantizar su continuidad. La creciente crisis ambiental y social que afecta al litoral mediterráneo español se ha puesto de manifiesto y nos ha hecho replantearnos la eficacia de la Política Pesquera Común (FAO, 2011). Al analizar el fracaso de la Política Pesquera fue necesario hacer una reforma de la misma, analizar otro punto de vista que no fuera solo científico y económico, y descentralizarla para abordar casos concretos que permitiesen comprender cómo el hombre interactúa con el medio que le rodea. En esta línea, el presente trabajo se plantea analizar la pesca tradicional en el puerto de Jávea, para ello se centra en la opinión de los pescadores y se plantea un doble objetivo, por una parte "estudiar el conocimiento y prácticas tradicionales en la actividad pesquera a pequeña escala en Jávea" por otra parte "analizar estos conocimientos y prácticas locales desde el punto de vista de la sostenibilidad, tanto social como ambiental", para ello utilizaremos una metodología cuantitativa y cualitativa centrada en los protagonistas de la pesca: los pescadores.Buigues Ortolá, C. (2014). Conocimiento pesquero tradicional y sostenibilidad en el Puerto de Jávea. Universitat Politècnica de València. http://hdl.handle.net/10251/45355Archivo delegad

Circadian Variations and Associated Factors in Patients with Ischaemic Heart Disease

Circadian rhythms have been identified in cardiovascular diseases, and cardiovascular risk factors can modify the circadian rhythm. The purpose of this study was to describe the onset of ischaemic heart disease symptomatology in relation to the date and time, the day of the week of presentation, the season, AMI location and severity and the level of influence of individual patient characteristics in a retrospective cross-sectional study involving 244 ischaemic heart disease patients from the intensive care unit of La Ribera Hospital (Spain). The onset of pain was more frequent in the morning, the season with the highest frequency of ischaemic events was winter, and the lowest incidence was during weekends. Regarding the severity of ischaemic heart disease, the circadian rhythm variables of weekdays vs. weekends and seasons did not show a significant association. The length of hospital stay was associated with the onset of pain in the afternoon. The onset of pain at night was associated with the subendocardial location of the infarction. In conclusion, living in a Mediterranean country, the Spanish population showed a circadian pattern of AMI, where the onset of pain has an influence on AMI location and on the length of hospital stay and is the same in patients with different individual risk factors

Salivary IL-6 Concentration Is Associated with Frailty Syndrome in Older Individuals

Background: One of the physiological changes that is most closely associated with frailty is the increase in pro-inflammatory cytokines, and IL-6 in particular. Most studies have demonstrated this association using blood samples. We analyzed the relationship between frailty syndrome, individual frailty criteria, and IL-6 levels obtained by saliva tests. Methods: A cross-sectional pilot study was performed among women institutionalized in nursing homes. Frailty was defined as having three or more of the following components: low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed; prefrailty was defined as having one or two of those components. Results: There was a significant and positive correlation between the frailty score and salivary IL-6 concentration. Regarding the associations between IL-6 and individual dichotomized frailty criteria, there were significant differences in salivary IL-6 concentration in two frailty criteria: weight loss (p = 0.002) and low physical activity (p = 0.007). Receiver operating characteristic curve analysis showed that IL-6 concentration significantly (p &lt; 0.05) (although moderately) discriminated patients that progressed in the frailty syndrome (the area under the curve value was 0.697 with 95% CI 0.566&ndash;0.827). Conclusions: Salivary IL-6 concentration can be used as potential biomarker of frailty syndrome and as a tool to monitor the effects of interventions in frail individuals

Family Fishing and Environment: the Case of Xàbia in Spain

[EN] Traditional fishing on the Spanish Mediterranean coast is at a critical juncture. The sector is facing an environmental, economic and social crisis that is threatening its survival. Overexploitation of fish stocks, the fishing industry and increased costs are among the causes leading to the current situation (FAO, 2010).The different fishing policies have led to the imposition of an ever more restrictive and conservationist legislation, resulting from the desire to protect marine environment and ensure the sustainability of the fishing industry. However, in a sector which is very hostile to legislation, many of the measures are failing because they are difficult to implement and to monitor.The authors would like to thank the Spanish Economy and Competitiveness Ministry for its support throughout the Research Project (CSO2013-41972-P)Miret Pastor, LG.; Herrera Racionero, P.; Buigues Ortolá, C. (2014). Family Fishing and Environment: the Case of Xàbia in Spain. The CIHEAM watch letter. 31. http://hdl.handle.net/10251/62457S3

Psycho-Social Factors in Patients with Cardiovascular Disease Attending a Family-Centred Prevention and Rehabilitation Programme: EUROACTION Model in Spain

Background: Coronary heart disease (CHD) persists as the leading cause of death worldwide. Cardiovascular prevention and rehabilitation (CVPR) has an interdisciplinary focus, and includes not only in physiological components, but it also addresses psycho-social factors. Methods: The study analysed the Spanish psycho-social data collected during the EUROACTION study. In Spain, two hospitals were randomised in the Valencia community. Coronary patients were prospectively and consecutively identified in both hospitals. The intervention hospital carried out a 16-week CVPR programme, which aimed to assess illness perceptions and establish healthy behaviours in patients and their partners. Results: Illness perceptions were significantly and inversely associated with anxiety and depression. Low levels of anxiety were associated with better self-management of total cholesterol (p = 0.004) and low-density lipoprotein-cholesterol (p = 0.004). There was concordance at one year among patients and partners who participated in the programme related to anxiety (p p p < 0.001). Conclusions: The EUROACTION study emphasised the importance of assessing psycho-social factors in a CVPR programme and the inclusion of family as support in patients’ changes in behaviour