38 research outputs found
Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial
Background: Technological support using e-health mobile applications (m-health) is a promising strategy to improve
the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are
determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation
programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer
patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus
an integral strategy to improve Quality of Life in breast cancer survivors.
Methods: This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be
eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass
Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for
hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of
the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face
rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care
information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality
of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core
and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the
Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making
Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota
Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema.
Discussion: This study has been designed to seek to address the new needs for support and treatment of breast cancer
survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of
health professionals in this type of patients.
Trial registration: ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016).The study was funded by the Spanish Ministry of Economy and Competitiveness
(Plan Estatal de I + D + I 2013-2016), Fondo de Investigación Sanitaria del Instituto
de Salud Carlos III (PI14/01627), Fondos Estructurales de la Unión Europea (FEDER)
and by the Spanish Ministry of Education (FPU14/01069). This is part of a Ph.D.
Thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of
the University of Granada, Spain
The EVIDENT diet quality index is associated with cardiovascular risk and arterial stiffness in adults
Life-threatening infections in children in Europe (the EUCLIDS Project): a prospective cohort study
Background: Sepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe.
Methods: The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures.
Findings: 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4–93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0–80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8–100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis.
Interpretation: Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients
Biological invasion of European tomato crops by Tuta absoluta: ecology, geographic expansion and prospects for biological control
Morphodynamic interactions of continental shelf, beach and dunes: The Cabopino dune system in Southern Mediterranean Spain
Distinguishing Sediment Bedforms from Sediment Deformation in Prodeltas of the Mediterranean Sea
12 pages, 5 figuresMost Mediterranean prodeltas show undulated sediments on the foresets of their Holocene wedges. These features have been described all along the Mediterranean and interpreted as either soft sediment deformation or, more recently, as sediment bedforms. We present a detailed analysis of these features using ultrahighresolution seismic and bathymetric data, as well as geotechnical information and
hydrodynamic time series and hydrographic transects. We show that the characteristics of the sediment undulations (morphology and configuration of the reflections down section and between adjacent undulations) are incompatible with a genesis by sediment deformationThe data on the Iberian prodeltas was acquired in the frame of the Spanish projects PRODELTA (REN2002-02323). We thank captain and crew of R/V L’Atalante (campagne PRISME 2007) and funding from French ANR projects ISIS and DANACOR. Data for some areas of the continental shelf (Ter prodelta) were acquired by “Secretaría General del Mar” of the “Ministerio de Medio Ambiente, y Medio Rural y Marino” and provided free of charge. Borehole geotechnical data was acquired in the frame EC funded project PROMESS-1 (EVR1-CT-2002-40024). Hydrodynamic transects and instrumented moorings were funded by the Office of Naval Research, NICOP Grant N00014-02-1-0252. The “Generalitat de Catalunya” is acknowledged for support through an excellence research group grant (2009-SGR-146). J. Déverchère (UBO-IUEM, Brest) and K. Yelles (CRAAG, Algiers) are thanked for discussions about the Algerian shelf. Reviews by Homa Lee and Michele Rebesco greatly improved the submitted version of the manuscriptPeer reviewe