Cuantificación de las demandas de carrera en hockey hierba femenino mediante el uso de umbrales individualizados. [Quantification of the running demands in women`s field hockey using individualized thresholds].

El objetivo de este estudio fue analizar las demandas de carrera del hockey hierba femenino utilizando valores relativos para determinar los umbrales de intensidad. 15 jugadoras (23,7 ± 4,1 años) fueron monitorizadas en partidos de competición oficial, utilizando un sistema de posicionamiento global (GPS). Para determinar los umbrales relativos de intensidad de carrera se usaron el test 30-15IFT y la velocidad máxima de sprint. Los resultados muestran que existen diferencias significativas entre analizar la carrera de alta intensidad de las jugadoras de hockey con valores absolutos y valores relativos pasando de 479,8 ±134,9 m a 1116,3 ± 281,4 m); Tamaño del efecto ± 90% LC = 2,78 (2,17-3,38), distancias que se ajustan más a los esfuerzos de las jugadoras. Sin embargo, el número de sprint realizados disminuyó (de 6,26 a 3,59). Se concluye que el uso de umbrales relativos incrementa la distancia recorrida a alta intensidad en jugadoras de hockey hierba. Abstract The objective of this study was to analyze the running demands of women’s field hockey, using relative values to determine intensity thresholds. 15 players (23,7 ± 4,1 years) were monitored in official competition matches, using a global positioning system (GPS). To determine the thresholds relative to the intensity of the race, the 30-15IFT test and the maximum sprint speed were used. The results show that there are significant differences between the analysis of high-speed running of the hockey players with absolute and relative values, increasing from 479.8 ± 134,9 m to 1116,3 ± 281,4 m; Effect size ± 90% CL = 2,78 (2,17-3,38), distances that are more accurate to the player’s effort. However, the sprint number was decreased (from 6,26 to 3,59). The use of relative thresholds increases high-intensity running in women’s field hockey

Social inequalities in multimorbidity patterns in Europe: A multilevel latent class analysis using the European Social Survey (ESS)

Multimorbidity is associated with lower quality of life, greater disability and higher use of health services and is one of the main challenges facing governments in Europe. There is a need to identify and characterize patterns of chronic conditions and analyse their association with social determinants not only from an individual point of view but also from a collective point of view. This paper aims to respond to this knowledge gap by detecting patterns of chronic conditions and their social determinants in 19 European countries from a multilevel perspective. We used data from the ESS round 7. The final sample consisted of 18,933 individuals over 18 years of age, and patterns of multimorbidity from 14 chronic conditions were detected through Multilevel Latent Class Analysis, which also allows detecting similarities between countries. Gender, Age, Housing Location, Income Level and Educational Level were used as individual covariates to determine possible associations with social inequalities. The goodness-of-fit indices derived in a model with six multimorbidity patterns and five countries clusters. The six patterns were "Back, Digestive and Headaches", "Allergies and Respiratory", "Complex Multi -morbidity", "Cancer and Cardiovascular", "Musculoskeletal" and "Cardiovascular"; the five clusters could be associated with some geographical areas or welfare states. Patterns showed significant differences in the cova-riates of interest, with differences in education and income being of particular interest. Some significant dif-ferences were found among patterns and the country groupings. Our findings show that chronic diseases tend to appear in a combined and interactive way, and socioeconomic differences in the occurrence of patterns are not only of the individual but also of group importance, emphasising how the welfare states in each country can influence in the health of their inhabitants

Body composition and sexual hormones for the glucose control of autoimmune diabetes in males: are they necessary to predict diabetes-related complications?

BackgroundGlucose control in diabetes is essential for avoiding diabetes-related complications.AimTo determine the impact of body composition and sexual hormones in glucose control and diabetes-related complications, in males with autoimmune diabetes.Patients and methodsThirty-nine patients with autoimmune diabetes and flash glucose monitoring were included. A morphofunctional nutritional evaluation with bioelectrical impedance vector analysis (BIVA), abdominal adipose tissue ultrasound, rectus femoris ultrasound and biochemical parameters, was performedResultsStrong, positive correlations were observed between body composition parameters, biochemical variables and sexual hormones (p<0.05). Adipose tissue measured by BIVA and ultrasound was more significantly associated with glucose control (including time in range >70%, glucose variability <36% determined by flash glucose monitoring; p<0.05) and the presence of microvascular/macrovascular complications (p<0.05) than lean mass. After adjusting by the duration of diabetes, BMI, abdominal circumference, fat mass and phase angle increased the risk for microvascular complications (OR 1.32(1.00 – 1.73), OR 1.06(1.00 – 1.12), OR 1.14(1.01 – 1.20), 0R 0.3(0.10 – 0.91) respectively; for macrovascular complications: BMI OR 1.38(1.04 – 1.84) and fat mass OR 1.26(1.00 – 1.58)]. Sexual hormone levels did not influence on glucose control or the development of diabetes-related complications.ConclusionAnthrpometric parameters, especially adipose tissue, were associated with glucose control and variability determined by flash glucose monitoring. Furthermore, changes in fat and lean mass were associated with the presence of microvascular and macrovascular complications. Thus, a comprehensive nutritional evaluation might be useful for the evaluation of males with autoimmune diabetes, in order to identify patients with increased risk of complications

Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic

Background: The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities. Methods: This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model. Results: We obtained a model with five patterns (entropy = 0.727): ‘Relative Healthy’, ‘Cardiometabolic’, ‘Musculoskeletal’, ‘Musculoskeletal and Mental’, and ‘Complex Multimorbidity’. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression. Conclusions: We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments17 página

The experiences of home care nurses in regard to the care of vulnerable populations: a qualitative study

Home care nurses have become the main references in home care for vulnerable patients. In patients’ homes they offer comprehensive and continuous care to both the vulnerable population and their families. The aim of this qualitative study was to explore experiences and perspectives of home care nurses regarding the care of vulnerable patients in Spain. We conducted in-depth semi-structured interviews with 15 home care nurses working with a vulnerable population. From a data analysis, two themes and four subthemes emerged: (1) “barriers to providing home care to vulnerable populations”, with the following subthemes: “the particularities of the patient and their home caregivers” and “perceived barriers for the involvement of home care nurses in the care”; and (2) “the emotional cost of home care” with the subthemes “home care is draining for caregivers” and “the impact of home care on the home care nurses”. These findings show us that nurses face a number of difficulties in home care for vulnerable patients. The training of nurses in certain competencies and skills by the social health services would enhance the quality of care offered to these patients

Development of a prediction model for short-term remission of patients with Crohn’s disease treated with anti-TNF drugs

Therapy with anti-tumor necrosis factor (TNF) has dramatically changed the natural history of Crohn’s disease (CD). However, these drugs are not without adverse events, and up to 40% of patients could lose efficacy in the long term. We aimed to identify reliable markers of response to anti-TNF drugs in patients with CD. A consecutive cohort of 113 anti-TNF naive patients with CD was stratified according to clinical response as short-term remission (STR) or non-STR (NSTR) at 12 weeks of treatment. We compared the protein expression profiles of plasma samples in a subset of patients from both groups prior to anti-TNF therapy by SWATH proteomics. We identified 18 differentially expressed proteins (p ≤ 0.01, fold change ≥ 2.4) involved in the organization of the cytoskeleton and cell junction, hemostasis/platelet function, carbohydrate metabolism, and immune response as candidate biomarkers of STR. Among them, vinculin was one of the most deregulated proteins (p < 0.001), whose differential expression was confirmed by ELISA (p = 0.054). In the multivariate analysis, plasma vinculin levels along with basal CD Activity Index, corticosteroids induction, and bowel resection were factors predicting NSTR

Booster effect after SARS-CoV-2 vaccination in immunocompromised hematology patients with prior COVID-19

Patients with hematological malignancies have been excluded from the new zoonotic coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) vaccine trials despite being at higher risk for SARS-CoV-2 disease (COVID-19)-related mortality. However, most health authorities worldwide have designated these patients as a priority for COVID-19 vaccination, even in the absence of efficacy data in these highly immunosuppressed patients. In addition, on 12 August 2021, the US Food and Drug Administration amended the emergency use authorizations for the Pfizer-BioNTech and Moderna COVID-19 vaccines to allow for the use of an additional dose in immunocompromised individuals, such as solid organ transplant recipients or equivalently immunosuppressed patients

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Promoción de la salud y entornos saludables

A forestar forestalAplicaci&oacute;n de un programa educativo participativo en salud&nbsp; bucal a una comunidad de adultos mayoresBiblioteca m&oacute;vil y su implementaci&oacute;n en el hospital Padre HurtadoConsumo de riesgo de alcohol en Chile: una propuesta innovadora de intervenci&oacute;nDise&ntilde;o de un programa interactivo de promoci&oacute;n de la salud vocal para NB1Encuentro formativo en promoci&oacute;n de salud y gesti&oacute;n de entornos saludables para TenoExperiencia docente: programa intersectorial de promoci&oacute;n/prevenci&oacute;n en preescolares de comunas vulnerables, Regi&oacute;n MetropolitanaFiltrado glomerular, m&eacute;todo preventivo aparici&oacute;n de fibrosis sist&eacute;mica nefrog&eacute;nica por gadolinio en examen de RMImplementaci&oacute;n de consejer&iacute;as en vida sana en APS, Regi&oacute;n de los R&iacute;osMedicina preventiva en feria libre de la poblaci&oacute;n San Gregorio: Cecof San Gregorio, Contagiando SaludMetodolog&iacute;a innovadora en la ense&ntilde;anza de una ectoparasitosisPrevenci&oacute;n de accidentes por mon&oacute;xido de carbono en edificios, Providencia 2002-2009Programa de promoci&oacute;n y prevenci&oacute;n en salud bucal para preescolaresPromoviendo h&aacute;bitos saludables en los vecinos de Re&ntilde;aca Alto, Vi&ntilde;a del Mar, 2009Rol de la capacitaci&oacute;n en la implementaci&oacute;n de acciones para la prevenci&oacute;n de la obesidadSatisfacci&oacute;n usuaria en el Cesfam Natales a un a&ntilde;o de su funcionamientoTres estrategias publicitarias y de comunicaci&oacute;n aplicadas al consumo de alcohol de bajo riesgoTropa de la salud: uso de los medios como forma de promover la salu