Associations between physical activity and comorbidities in people with COPD residing in Spain: A cross-sectional analysis

There is a high prevalence of comorbidities among patients with chronic obstructive pulmonary disease (COPD). Comorbidities are likely common in patients with any COPD degree and are associated with increased mortality. The aim of this study was to determine the prevalence of thirty-one different COPD comorbidities and to evaluate the association between physical activity (PA) levels in people with COPD residing in Spain. Cross-sectional data from the Spanish National Health Survey 2017 were analysed. A total of 601 adults (52.2% females) with COPD aged 15 to 69 participated in this study. PA (exposure) was measured with the International Physical Activity Questionnaire (IPAQ) short form and comorbidities (outcomes) were self-reported in response to the question “Have you ever been diagnosed with…?” Multivariable logistic regression, in three different models, was used to assess this association. Results showed a high prevalence of comorbidities (94%), these being chronic lumbar back pain (38.9%), chronic allergy (34.8%), arthrosis (34.1%), chronic cervical back pain (33.3%), asthma (32.9%) and hypertension (32.8%) the most prevalent. Low PA level was significantly associated with urinary incontinence (2.115[1.213–3.689]), chronic constipation (1.970[1.119–3.459]), cataracts (1.840[1.074–3.153]), chronic anxiety (1.508[1.002–2.269]) and chronic lumbar back pain (1.489[1.044–2.125]). Therefore, people with COPD should increase their PA levels in order to reduce their risk of comorbidities and increase their quality of life

Levels of physical activity in Spanish asthmatics: A cross-sectional study

Background and objectives: 339 million people in the world suffer from asthma. Regular physical activity (PA) could help in its control. Therefore, the aim of this research was to determine the level of PA in Spanish people with asthma considering variation by, age, sex, education, marital status, living together, smoking habits, alcohol intake and body mass index (BMI). Materials and Methods: 1014 Spanish people from 15 to 69 years were included in the study. Data of the Spanish Health Survey (year 2017) were analysed. PA levels were measure with the international physical activity questionnaire short version (IPAQ-SF). PA was categorized as low, moderate and high, and analyzed by sample characteristics. Mann-Whitney U test, Kruskall Wallis H and crosstabs were used to calculate statistical significance (p < 0.05). Results: On average, Spanish asthmatics engaged in a weekly volume of 2228.9 metabolic equivalent of task (MET)·min/week. Males revealed significantly higher PA than females (2516.8 vs. 2019.5 MET·min/week; p = 0.005), younger participants (<30 years) compared to people aged 30–60 years and older than 60 years (2699.0; 2243.2; 1619.3 MET·min/week; p < 0.001) and those with tertiary level of education than those without secondary (2368.3 vs. 2168.3 MET·min/week; p = 0.001). Level of PA was lower in those married (p = 0.001) and/or living together (p = 0.010). Alcohol consumers showed a higher level than the participants who did not drink (2378.3 vs. 1907.9 MET·min/week; p = 0.001), but no significant differences were found within current, past and never smokers (p = 0.890). Obese asthmatics engaged in less PA than their normal weight and overweight peers (p < 0.001). Overall, moderate level was significantly the most frequent (47.7%), but 31.6% showed a low level. Conclusions: Three out of ten Spanish people with asthma do not achieve PA recommendations, so PA programs should be executed to make people aware of its benefits in asthma control, focusing on those groups with lower PA levels

Body image and lifestyle (physical activity, diet, alcohol and tobacco) of sport sciences’ students

Un estilo de vida sedentario puede aumentar la probabilidad de sufrir enfermedades no transmisibles como las cardiovasculares. El objetivo de este estudio fue analizar si algunos comportamientos (como beber o fumar) afectan además a la imagen corporal que se tiene de sí mismo, ya que la discrepancia entre la imagen percibida y la deseada puede relacionarse con enfermedades mentales. La muestra estuvo compuesta por 134 universitarios de Ciencias de la Actividad Física y del Deporte de la Universidad de Murcia. Se analizó variables relacionadas con la actividad física, hábitos alimentarios, consumo de alcohol y tabaco y por último con la imagen corporal. Se utilizó un cuestionario que incluía las siluetas de Stunkard para analizar la percepción de la imagen corporal de los participantes. Se usó el programa estadístico SPSS 20.0 y el Microsoft Office Excel 2007. Se apreció insatisfacción corporal en ambos sexos, sobre todo en fumadores, así como en mujeres, que preferirían ser más delgadas. Los sujetos encuestados mostraron llevar una vida activa, por encima del de otros estudios y sin diferencias de género. Aquellos que estaban satisfechos con su imagen corporal o deseaban verse más grandes empleaban más tiempo en ejercicios vigorosos que el resto.People's lifestyles can increase the risk of suffering non-communicable diseases. The purpose of this study was to analyse if these behaviours (such as drinking or smoking) may affect the body image we have of ourselves; as discrepancy between perceived and desired body image can be linked to mental illnesses. The sample was formed by 134 students of Physical Activity and Sport Sciences from Murcia University. Variables associated to physical activity, dietary habits, alcohol and tobacco consumption and body image were studied. A survey with Stunkard silhouettes was used in order to analyse body image perception from the subjects. SPSS 20.0 and Microsoft Office Excel 2007 were used. Body dissatisfaction was found in both sexes, mainly in smokers and women (who preferred to be thinner). The participants showed a high physical activity level, higher than in other studies and with no gender differences. Those who were satisfied with their body image or would like to see themselves bigger, did more vigorous physical activity than the others

Low Range of Shoulders Horizontal Abduction Predisposes for Shoulder Pain in Competitive Young Swimmers

The prevalence of shoulder pain (SP) among competitive swimmers is high, and may profoundly restrict their ability to compete. This prospective cohort study investigated the association between 3 blocks of performance factors (anthropometric characteristics, sport experience and training regimen) and the presence of SP. The aims of the present study were: (a): to determine the profile of shoulder flexibility in young swimmers, (b) to analyze whether a restricted range of movement (ROM) could be a predictor of subsequent SP in young swimmers. 24 competitive young swimmers were measured in the 2016 pre-season. Measures of passive maximal shoulder extension (SE), flexion (SF), horizontal abduction (SHAB), abduction (SAB), horizontal adduction (SHADD), external (SER) and internal (SIR) rotation ROMs were taken. SP was prospectively monitored during the subsequent season using questionnaires. The data was analyzed via a binary logistic regression and ROC curves were calculated. At the follow-up, 16 swimmers (50%) had developed unilateral SP. Only reduced SHAB ROM was associated with SP [SP group 36.6° vs. pain-free group 41.5°; p = 0.005, d = -0.96 (moderate effect sizes)]. Using the coordinates of the curves, the angle of SHAB ROM that most accurately identified individuals at risk of developing SP was determined to be 39° (sensibility 0.656 and 0.375 specificity). Swimmers with limited ROM (≤39°) have 3.6 times higher risk of developing SP than swimmers with normal ROM (&gt;39°). This study clearly shows that low range of SHAB is a risk factor for developing SP in competitive young swimmers. In the studied data, a SHAB range of 39° was found to be the most appropriate cut-off point for prognostic screening

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

Educación Superior y Pandemia. Aprendizajes y buenas prácticas en Iberoamérica

La aportación actual no entra en analizar aspectos generales de la pandemia (naturaleza, origen, extensión general y en el país, etc.) o de otras situaciones que se derivan del confinamiento, por considerar que son suficientemente conocidos. Tampoco pretende realizar una recensión de informes sobre la temática elaborados por organismos como la UNESCO-IESALC, el Banco Mundial, el BID o la CRUE y revisar las aportaciones de investigadores de la temática. Más bien trata de aportar concreciones y dimensiones prácticas de la Educación Superior de cada país que puedan ayudar en los aspectos de organización y gestión de estas instituciones. En este sentido considera aspectos referidos a: (1) Desarrollo de las enseñanzas: alteraciones en la duración y estructura de los títulos; modificaciones de objetivos, metodologías y sistemas de evaluación; atención a colectivos vulnerables; etc.(2) Organización institucional: atención a las personas (gestión del alumnado, profesorado y personal de administración y servicios, rol de los directivos, etc.); infraestructuras; desarrollo de procesos (matriculación, gestión administrativa y económica, etc.); y resultados (académicos como tasa de aprobados, nivel de abandono u otros; y no académicos). (3) Vinculación con el entorno: actuaciones de y con la comunidad o colaboraciones significativas. Incluye el escrito de cada país con referencias y reflexiones sobre los anteriores aspectos, así como algunas experiencias de interés y, por último, reflexiones, valoraciones y retos sobre la gestión en los momentos de confinamiento y reapertura, con la idea de identificar aprendizajes significativos y orientaciones de cara a la actuación en la situación actual y similares que se puedan producir en el futuro. Las diferentes aportaciones se centran en la enseñanza universitaria, incluyendo los estudios superiores, que en muchos países tienen gran importancia y desarrollo, y tratan de proporcionar una visión general de los diferentes países sin obviar descender a las particularidades concretas que exigen el identificar buenas prácticas o medidas específicas de organización y desarrollo de la formación. Hablamos del trabajo de 41 especialistas de 13países iberoamericanos que permiten conocer y analizar las actuaciones por países, pero también realizar un estudio de las iniciativas que se han tomado en todos los países considerando algunos de los tópicos que considera el Informe. En todo caso, cabe destacar la actualidad y trascendencia del tema y la rapidez por trasladar a la sociedad un Informe detallado sobre las actuaciones universitarias existentes y sus resultados

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries