L-Citrulline and its effect in endurance sports, a sistematic review

En los últimos años, el estudio del suplemento L-Citrulina ha cobrado importancia debido a sus posibles efectos sobre el rendimiento deportivo. La L-Citrulina es un aminoácido no esencial que se obtiene a través de fuentes tanto vegetales como animales. Es precursor del Óxido Nítrico y de la Arginina, que intervienen de forma protagonista durante el ciclo de la urea. Estos factores presuponen que el consumo de este suplemento podrá tener ciertos beneficios sobre el rendimiento deportivo. Por lo tanto, el objetivo de este estudio fue el de realizar una revisión sistemática con la que comprobar la eficacia de la L-Citrulina o el Malato de L-Citrulina sobre varios parámetros determinantes en el rendimiento deportivo: potencia, resistencia, trabajo, así como en las siguientes otras variables: percepción subjetiva del esfuerzo y factores fisiológicos. El estudió estuvo centrado en deportes de resistencia en concreto. Para ello, se realizó una búsqueda de la literatura existente hasta la fecha de aquellos estudios que analizaban el rendimiento deportivo en deportes de resistencia tras el consumo de L-Citrulina. Se obtuvieron un total de 7 trabajos con los que se realizó esta revisión sistemática. Tras el análisis de los trabajos encontrados, se podría decir que la L-Citrulina o Malato de L-Citrulina tiene un efecto positivo sobre el rendimiento deportivo. Sin embargo, se debería de establecer un consenso en la estandarización de los test realizados en los estudios para poder afirmar con evidencia significativa que este suplemento tiene una afectación clara sobre el rendimiento de los deportistas.In the last years, the study of L-Citrulline as a supplement has been gaining interest due to its possible applications over the performance in sports. L-Citrulline is a non-essential aminoacid which can be obtained from vegetable or animal sources. This supplement is a precursor of Nitric Oxide, Arginine and has a principal role in the urea cycle. These factors presuppose that the consume of this ergogenic aid could have positive effects over the sport performance. The purpose of this study was to make a systematic review with which verify the efficacy of L-Citrulline or Citrulline Malate over various determinants parameters over the sport performance and other variables such as perception of effort and physiological factors in endurance sports. To achieve this objective, a research of the existent studies referred to the analysis of the sport performance after the consumption L-Citrulline was made. Finally, 7 studies were obtained and used to make this systematic review. After the analysis of the collected data it can be said that L-Citrulline or Citrulline Malate might have a positive impact over the sport performance. Nevertheless, a consensus must be made in order to achieve the standardization of the protocols and test used in the different studies to say that this supplement has a significant positive impact over the athletes performance

Cultural adaptation and validation of the Transcultural Self-Efficacy Tool for use with undergraduate nursing students in Spain.

BACKGROUND: The provision of culturally competent care helps reduce healthcare inequalities. There is a positive association between the cultural competence of nursing professionals and patient satisfaction, and also between nurses' self-efficacy and patients' adherence to treatment. While training in this respect is important, the self-assessment of skills should also be addressed. AIMS: To produce a culturally-validated Spanish-language version of the Transcultural Self-Efficacy Tool (TSET) for use in undergraduate nursing studies, and to evaluate its implementation within the Spanish educational system. METHODS: This cultural adaptation and psychometric validation study was carried out with student nurses from two universities. International standards were followed for the translation and cultural adaptation of the questionnaire. All students completed the questionnaire twice, the second time 14days after the first. Those who took the Transcultural Care course at the University of Malaga also completed the questionnaire a third time, after concluding this study subject. The reliability, discriminatory capacity, stability and sensitivity to change of the questionnaire were tested and confirmed, and a confirmatory factor analysis was performed. RESULTS: A total of 286 students took part in this study. Overall, the TSET obtained a reliability score of 0.978, according to Cronbach's alpha test. In relation to nationality of origin, the discriminatory capacity of the questionnaire was -1.067 (-1815 a -0,320)=0.005. Stability, assessed at 14days using the intraclass correlation coefficient, was 0.901 (0.873 a 0.923) <0.001. The before-after sensitivity to change for those who took the Transcultural Care course was 1.820 (1558 a 2083) <0.001. CONCLUSIONS: This Spanish-language version of the TSET is culturally suitable for the educational context of undergraduate nursing students in Spain, and its psychometric validation was performed with satisfactory results. Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved

Spanish adaptation and validation of the Cultural Competence Assessment Tool (CCATool) for undergraduate nursing students

Aim To analyse and validate a contextually adapted version of the Papadopoulos’ Cultural Competence Assessment Tool (CCATool) for Spanish undergraduate nursing students Background Globalization has driven and intensified international migration. Thus, nurses must treat patients of many different cultural origins. Accordingly, both cultural competence and an appropriate tool with which to evaluate it are required. Methods The CCATool questionnaire was adapted for use in a Spanish context and was evaluated through a questionnaire completed by 262 undergraduate nursing students. Seven days later, the same students completed the questionnaire, without any intervention, and a subgroup of 144 students completed the questionnaire for a third time after taking a course in Transcultural Care. The reliability, sensitivity and stability of the questionnaire were assessed. Results The reliability of the questionnaire obtained an adequate Cronbach's alpha of 0.81. Stability was assessed at seven days, using the intraclass correlation coefficient, which showed good/excellent results. Moreover, the questionnaire was able to detect the changes related to the nursing educative programme, thus highlighting a good sensitivity of the tool. Conclusion Cultural competence is an essential element of nurses’ education, and instruction in this area should begin as soon as possible. In addition, an appropriate evaluation system is required. For this purpose, the present study describes and analyses a valid, reliable tool for use with undergraduate nursing students in Spain. (...)The project was funded by the University of Malaga as part of the Teaching Innovation Project (PIE19-045). Funding for open access charge: Universidad de Málag

Complementary music therapy for cancer patients in at-home palliative care and their caregivers: protocol for a multicentre randomised controlled trial

Background Patients with advanced cancer, receiving at-home palliative care, are subject to numerous symptoms that are changeable and often require attention, a stressful situation that also impacts on the family caregiver. It has been suggested that music therapy may benefit both the patient and the caregiver. We propose a study to analyse the efficacy and cost utility of a music intervention programme, applied as complementary therapy, for cancer patients in palliative care and for their at-home caregivers, compared to usual treatment. Method A randomised, double-blind, multicentre clinical trial will be performed in cancer patients in at-home palliative care and their family caregivers. The study population will include two samples of 40 patients and two samples of 41 caregivers. Participants will be randomly assigned either to the intervention group or to the control group. The intervention group will receive a seven-day programme including music sessions, while the control group will receive seven sessions of (spoken word) therapeutic education. In this study, the primary outcome measure is the assessment of patients' symptoms, according to the Edmonton Symptom Assessment System, and of the overload experienced by family caregivers, measured by the Caregiver Strain Index. The secondary outcomes considered will be the participants' health-related quality of life, their satisfaction with the intervention, and an economic valuation. Discussion This study is expected to enhance our understanding of the efficacy and cost-utility of music therapy for cancer patients in palliative care and for their family caregivers. The results of this project are expected to be applicable and transferrable to usual clinical practice for patients in home palliative care and for their caregivers. The approach described can be incorporated as an additional therapeutic resource within comprehensive palliative care. To our knowledge, no previous high quality studies, based on a double-blind clinical trial, have been undertaken to evaluate the cost-effectiveness of music therapy. The cost-effectiveness of the project will provide information to support decision making, thereby improving the management of health resources and their use within the health system

Somatotypes and hand-grip strength analysis of elite cadet sambo athletes

The objectives of this research were to establish somatotype and hand-grip strength between elite cadet male and female sambo athletes divided by weight categories. A total of 97 elite cadet sambo athletes, participants of the World Cadets Sambo Championships 2018 participated in the study. Male and female sambo athletes were divided by official weight categories. Anthropometrical variables were taken in order to calculate somatotypes and hand-grip strength. A one-way analysis of variance and Tukey's post hoc tests were used to compare group differences by weight categories. Results of this study provide the first description of somatotype and hand-grip strength of elite male and female cadet sambo athletes in relation to weight category. A typical somatotype in male sambo athletes was endomorphic mesomorphs with a predominance of musculoskeletal tissue, while female athletes differed concerning weight category. Overall, an increase in handgrip strength across weight categories was noted. Hand-grip strength increases linearly from the lightest to the heaviest weight category except in -66 and -84 kg in male athletes. Differences in handgrip strength of female athletes were detected between the lightest group and last six groups in all three variables in favor of last six as well as -44 and kg -48 kg compared with the heaviest. To the best of our knowledge, this study provides the first normative data of somatotype and hand-grip strength analyses in relation to age, gender, and weight categories of cadet sambo athletes. The anthropometric profile of sambo athletes changed according to their weight category. Mesomorphy was the most dominant somatotype component in male athletes, while female had three different types of somatotype component in relation to weight category. In conclusion, we found differences in hand-grip strength related to weight category, which can be linked to the muscle mass of athletes. Future studies should focus on somatotype and strength handgrip values of international compared to national level sambo athletes

Cultural adaptation and validation of the Family Nursing Practice Scale (FNPS) for use with Spanish-speaking Nursing Degree students

Aim. The task proposed was to conduct a cultural adaptation of the Family Nursing Practice Scale and to assess the psychometric properties of the resulting instrument. Background. Nursing students must obtain sufficient personal competence and confidence to act with patients and their families. For this purpose, an assessment scale is needed to inform teachers of the student’s progress and to determine whether further training or changes in teaching methods are required. Design. A cross-sectional study design was used. Methods. The researchers conducted this study with 202 students of nursing at two Spanish universities. In the cultural adaptation, the following steps were followed: definition of concepts, translation, back translation, expert group review and implementation by a pilot group with a subsequent cognitive interview. Internal consistency was determined by Cronbach’s alpha. Reliability was verified by an initial application of the scale, followed by a repetition after seven days, analysing the results obtained in terms of the intraclass correlation coefficient, the construct validity (by Spearman’s non-parametric correlation test) and confirmatory factor analysis (using JASP 0.16.4 statistical software). Results. Cronbach’s alpha resulted in 0.95. Spearman's correlation coefficient Family Nursing Practice Scale total with the course year was –0.26 < 0.001. The intraclass correlation coefficient for the total score of the scale was 0.91. The confirmatory factor analysis was performed on a model in which the total score for the scale was considered in relation to the two subscales, and each subscale in relation to its constituent ítems […] Conclusions. These results indicate that the Spanish version presents good internal consistency, construct validity and reliability. Moreover, the confirmatory factor analysis confirms that it presents a good fit to the model initially proposed for this scale for Nursing Degree students.Funding for open access charge: Universidad de Málaga / CBU

Intervention to improve quality of sleep of palliative patient carers in the community: protocol for a multicentre randomised controlled trial

Background: Sleep disorders are commonly experienced by community caregivers for persons with cancer, with at least 72% reporting moderate to severe disorders. A consequence of this condition, which is associated with the presence of overload in the caregiver, is the increased risk of clinical depression. The aim of this study is to evaluate the effects of music on the sleep quality achieved by informal caregivers for cancer patients receiving home palliative care. In addition, we will assess the influence of specific variables that could modify these effects, analyse the correlates related to nocturnal wakefulness and consider the diurnal consequences according to the sleep characteristics identified. Methods: This single-blind, multicentre, randomised clinical trial will focus on informal providers of care for cancer patients. Two samples of 40 caregivers will be recruited. The first, intervention, group will receive seven music-based sessions. The control group will be masked with seven sessions of therapeutic education (reinforcing previous sessions). Outcomes will be evaluated using the Pittsburgh Sleep Quality Index, a triaxial accelerometer, EuroQol-5D-5L, the Caregiver Strain Index, the Epworth Sleepiness Scale and the Client Satisfaction Questionnaire. The caregivers' satisfaction with the intervention performed will also be examined. Discussion: This study is expected to extend our understanding of the efficacy of music therapy in enhancing the sleep quality of caregivers for patients receiving home palliative care. To our knowledge, no reliable scientific investigations of this subject have previously been undertaken. Music is believed to benefit certain aspects of sleep, but this has yet to be proven and, according to a Cochrane review, high-quality research in this field is necessary. One of the main strengths of our study, which heightens the quality of the randomised clinical trial design, is the objective assessment of physical activity by accelerometry and the use of both objective and subjective measures of sleep in caregivers. Music therapy for the caregivers addressed in this study is complementary, readily applicable, provokes no harmful side effects and may produce significant benefits

Effects of hydroxytyrosol dose on the redox status of exercised rats: the role of hydroxytyrosol in exercise performance

Background: Hydroxytyrosol (HT) is a polyphenol found in olive oil that is known for its antioxidant effects. Here, we aimed to describe the effects of a low and high HT dose on the physical running capacity and redox state in both sedentary and exercised rats. Methods: Male Wistar rats were allocated into 6 groups: sedentary (SED; n = 10); SED consuming 20 mg/kg/d HT (SED20; n = 7); SED consuming 300 mg/kg/d HT (SED300; n = 7); exercised (EXE; n = 10); EXE consuming 20 mg/kg/d HT (EXE20; n = 10) and EXE consuming 300 mg/kg/d HT (EXE300; n = 10). All the interventions lasted 10 weeks; the maximal running velocity was assessed throughout the study, whereas daily physical work was monitored during each training session. At the end of the study, the rats were sacrificed by bleeding. Hemoglobin (HGB) and hematocrit (HCT) were measured in the terminal blood sample. Moreover, plasma hydroperoxide (HPx) concentrations were quantified as markers of lipid peroxidation. Results: In sedentary rats, HT induced an antioxidant effect in a dose-dependent manner without implications on running performance. However, if combined with exercise, the 300 mg/kg/d HT dosage exhibited a pro-oxidant effect in the EXE300 group compared with the EXE and EXE20 groups. The EXE20 rats showed a reduction in daily physical work and a lower maximal velocity than the EXE and EXE300 rats. The higher physical capacity exhibited by the EXE300 group was achieved despite the EXE300 rats expressing lower HGB levels and a lower HCT than the EXE20 rats. Conclusions: Our results suggest that a high HT dose induces a systemic pro-oxidant effect and may prevent the loss of performance that was observed with the low HT dose.This study was supported by the grant #3650 managed by Fundación General Empresa-Universidad de Granada, and by the investigation group CTS-454 “Impacto fisiológico del estrés oxidativo, deporte, actividad física y salud

Relationship of accelerometer-measured inactivity and sleep efficiency with body mass index in prefrail elders

A decrease of body mass and body mass index (BMI) in frail and prefrail elders leads to adverse events, increasing the risk of morbimortality in this vulnerable population. Nevertheless, these events might be also modulated by physical inactivity and sleep quality. To analyse the relationship between physical inactivity time and sleep efficiency with the BMI of prefrail elders. This pilot study of the FRAGSALUD project included a first batch of 20 prefrail elders (13 women and 7 men, aged 73±6 years). Prefrailty was classified according to Fried criteria, meeting at least one criteria. Physical inactivity time (min/day) and sleep efficiency values were obtained using a GeneActiv triaxial accelerometer, set to 40Hz, and worn on the wrist of the non-dominant hand, 24 hours a day for seven consecutives days. Body mass and height were registered in order to calculate BMI. Spearman correlations were performed. Those prefrail elders with higher BMI showed a better sleep efficiency (r = 0.82, p 0.05). In our study, the higher the BMI presented, the better sleep efficiency achieved by prefrail elders, what has been previously related with a better quality of life and wellbeing. However, although sedentary behaviour and inactivity have been highlighted as relevant health factors, in our patients there was not found a relationship between inactivity and the BMI of prefrail elders. Future results of this project will show the impact on these outcomes of a health educational program in frail a prefrail elders.FEDE

Un programa educativo es capaz de reducir el riesgo de fragilidad con un aumento de la fuerza en mayores: Resultados preliminares del ensayo clínico FRAGSALUD

Introducción: Mejorar la salud y calidad de vida de las personas mayores es un reto de la sociedad actual donde el papel de la educación pueden jugar un papel clave. Método: Análisis de una primera tanda del proyecto FRAGSALUD, en 39 mayores frágiles o prefrágiles que fueron aleatorizados al grupo control (n = 21) o al grupo intervención (n = 17). Este último recibió cuatro sesiones educativas consistentes en: i) concienciación sobre la fragilidad, ii) recomendaciones de actividad física, iii) recomendaciones nutricionales, y iv) trabajo cognitivo y bienestar social y mental. Posteriormente se realizó un seguimiento telefónico con una llamada mensual. El grupo control siguió con sus hábitos. Se evaluó antes de la intervención (pre-test) y 6 meses después (post-test) los resultados del test sit-to-stand consistente en sentarse y levantarse de una silla 5 veces seguidas lo más rápido posible con los brazos cruzados en el pecho. Para el análisis estadístico se analizó la diferencia pre-post con una prueba no paramétrica de comparación de muestras independientes, considerándose significativo si p< 0,05. Resultados: Tras los 6 meses de seguimiento, los resultados preliminares del proyecto FRAGSALUD muestran que el grupo intervención disminuyó el tiempo de ejecución del test sit-to-stand en 6,5±14,3 segundos, mientras que el grupo control mantuvo valores medio similares tardando 0,2±11,9 segundos más en realizar el test. Las diferencias entre grupos fueron significativas con un p valor de 0,015 en la prueba U de Mann-Whitney para muestras independientes. Conclusión: El test sit-to-stand evalúa la fuerza del tren inferior donde mayor tiempo de ejecución supone menor nivel de fuerza. Esta variable es de gran importancia para las personas mayores al aumentar la agilidad y el equilibrio, evitando caídas y sus consecuencias. El programa tuvo un impacto beneficioso para la salud de los mayores frágiles y pre-frágiles.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Proyectos I+D+I en el marco del Programa Operativo FEDER Andalucía 2014-2020, referencia UMA20-FEDERJA-154