Have Health Inequalities Increased during the COVID-19 Pandemic? Evidence from Recent Years for Older European Union Citizens

Reducing inequality is one of the current challenges that most societies are facing. Our aim was to analyze the evolution of inequalities in self-assessed health among older Europeans in a time period spanning the 2008 economic crisis and the COVID-19 health crisis. We used data from Waves 2, 4 and 8 of the Survey of Health, Ageing and Retirement in Europe. We used inequality indices that accept ordinal variables. Our empirical results suggest that average inequality declines over time. Gender significantly influences the results. Some of the countries with the highest level of inequality are Denmark and Sweden, and some with the lowest are Estonia and the Netherlands. Our results may be of interest for the development of public policies to reduce inequalities. Special attention should be paid to vulnerable groups, such as the elderly

Space Race: An Interactive Digital Tool in the Classroom. Are You Ready?

This document presents an interdisciplinary teaching experience based on Game-based Learning as an educational methodology complementary to the Flipped Classroom pedagogical approach in higher education. The tool used was the Space Race application integrated into the free Socrative software. A more active and meaningful learning has been promoted in the student with its implementation. Likewise, it has allowed the face-to-face classes to be energized, creating a relaxed atmosphere. The reflective and critical use of technological applications and mobile devices in the classroom has also been encouraged. The use of the Space Race has increased the participation of students in the classroom, their motivation and interest, collaborating in the development of skills and abilities. This tool has been very useful to obtain bidirectional teacher-student feedback in real time. As a result, a more cooperative, reflective and meaningful learning has been obtained

Systematic review of the effect of aquatic therapeutic exercise in breast cancer survivors

Spanish Ministry of Education Culture and Sport, Grant/Award Number: FPU17/00939; Universidad de Granada/CBUABackground: Aquatic therapeutic exercise can be equally effective or even superior to land-based exercise in improving several clinical variables. However, there is still a lack of knowledge on the effects compared to land-based interventions particularly in breast cancer (BC) patients. Objective: The objective of this study is to examine the effects of aquatic therapeutic exercise on pain, shoulder mobility, lymphedema, cardiorespiratory fitness, muscle strength, body composition, pulmonary function, cancer-related fatigue (CRF) and health-related quality of life (HRQoL) and which parameters are effective compared to similar land-based interventions. Methods: The databases used were PubMed, Scopus, Web of Science, Cochrane Library and CINAHL, retrieving 145 articles. Results: Eleven studies were included. Aquatic therapeutic exercise is feasible, safe, well tolerated and achieved high percentages of adherence. As for the assessed outcomes, moderate to large improvements were found compared to usual care or to land-based physical exercise interventions in pain, shoulder range of motion, pulmonary function, HRQoL, cardiorespiratory fitness and muscle strength. Inconclusive results were found for lymphedema, body composition and CRF. Conclusions: Aquatic therapeutic exercise interventions using a combination of endurance, strength, mobility, stretching and breathing exercises resulted in improvements in common side effects of BC and its treatments. More studies on CRF, body composition and lymphedema need to be done to further evaluate the impact of the intervention on these outcomes.Spanish Ministry of Education Culture and Sport FPU17/00939Universidad de Granada/CBU

Surgical Treatment of Obesity. Special Mention to Roux-en-Y Gastric Bypass and Vertical Gastrectomy

Introduction: The prevalence of obesity has increased exponentially in recent decades, being one of the diseases that most affects global health. It is a chronic disease associated with multiple comorbidities, which lead to a decrease in life expectancy and quality of life. It requires a multidisciplinary approach by a specialized medical team. Obesity can be treated with conservative or with surgical treatments that will depend on the characteristics of the patient. Objective/Methodology: The referenced surgery can be performed using different surgical techniques that are analyzed in the present work through an exhaustive narrative bibliographic review in the PubMed and Cochrane databases, as well as in UpToDate. Results: Currently, those most used are restrictive techniques, specifically vertical gastrectomy and mixed techniques, with gastric bypass being the “gold standard”. Conclusions: In order to choose one technique or another, the characteristics of each patient and the experience of the surgical team must be taken into account

Salt sheet extrusion and emplacement within the South-Central Pyrenean fold-and-thrust belt: the Les Avellanes Diapir case-of-study

A detailed geological map of the Les Avellanes salt Diapir (South-Central Pyrenees, Spain) that includes both the diapir body and adjacent areas is presented to understand the diapir evolution and geometry. Structural, stratigraphical, and sedimentary data north and south of the diapir is used to infer the timing of its emplacement. The northern diapir boundary is characterized by a set of extensional faults oblique to the main Pyrenean trend, while the southern boundary is an extrusive salt sheet that overlays the late Eocene-early Oligocene sequence in three adjacent sub-basins. Salt extrusion occurred due to synorogenic folding.The topography created as salt extruded trapped the arrival of external sediments from the north, blocking the transport pathways southward. Low sedimentation rates southwards allowed for the lateral salt extrusion, advancing southwards from the feeder. The salt sheet emplacement was postdated by Oligocene conglomerates, indicating that the salt extrusion was a relatively quick event.</p

Effect of Supervised Resistance Training on Arm Volume, Quality of Life and Physical Perfomance Among Women at High Risk for Breast Cancer-Related Lymphedema: A Study Protocol for a Randomized Controlled Trial (STRONG-B)

The study is funded by ANID+FONDEF/XVII Concurso Nacional de Proyectos de Investigacion y Desarrollo en Salud, Fonis (SA20I0060).Objectives: To determine the preventive effects of supervised resistance training on arms volume, quality of life, physical performance, and handgrip strength in Chilean women at high risk for breast cancer-related lymphedema (BCRL) undergoing chemotherapy. Design: Randomized control trial. Participants: One hundred and six women at high risk for breast cancer-related lymphedema aged 18 to 70 years. Interventions: Participants will be randomized into two groups: [a] intervention, who will receive 12 weeks of supervised resistance training (STRONG-B) during adjuvant chemotherapy; and [b] control, who will receive education to promote lymphatic and venous return, maintain range of motion, and promote physical activity. Main Outcome Measures: The primary outcome will be arms volume measured with an optoelectric device (perometer NT1000). Secondary outcomes will be quality of life, handgrip strength, and physical performance. Primary and secondary outcomes will be measured at baseline, just after the intervention, and 3 and 6 months after. Statistical analysis will be performed following intention-to-treat and per-protocol approaches. The treatment effect will be calculated using linear mixed models. Discussion: The STRONG-B will be a tailored supervised resistance training that attempts to prevent or mitigate BCRL in a population that, due to both intrinsic and extrinsic factors, will commonly suffer from BCRL.ANID+FONDEF/XVII Concurso Nacional de Proyectos de Investigacion y Desarrollo en Salud, Fonis SA20I006

A COVID-19 Rehabilitation Prospective Surveillance Model for Use by Physiotherapists

This research was funded by the Spanish Ministry of Education Culture and Sport (FPU17/00939), the University of Granada Excellence Actions (Unit of Excellence in Exercise and Health).We would like to thank Adrian Burton for his language assistance.The long-term sequelae of coronavirus disease 2019 (COVID-19) are only now beginning to be defined, but it is already known that the disease can have direct and indirect impacts mainly on the cardiorespiratory and neuromuscular systems and may affect mental health. A role for rehabilitation professionals from all disciplines in addressing COVID-19 sequelae is recognised, but it is essential that patient assessment be systematic if health complications are to be identified and treated and, if possible, prevented. The aim is to present a COVID-19 prospective surveillance model based on sensitive and easily used assessment tools, which is urgently required. Following the Oxford Centre for Evidence-Based Medicine Level of Evidence Tool, an expert team in cardiorespiratory, neuromuscular and mental health worked via telemeetings to establish a model that provides guidelines to rehabilitation professionals working with patients who require rehabilitation after suffering from COVID-19. A COVID-19 prospective surveillance model is proposed for use by rehabilitation professionals and includes both face-to-face and telematic monitoring components. This model should facilitate the early identification and management of long-term COVID-19 sequelae, thus responding to an arising need.Spanish Ministry of Education Culture and Sport FPU17/00939University of Granada Excellence Actions (Unit of Excellence in Exercise and Health

A case report: Acute abdominal pain caused by a mesenteric cyst in a 20 years old female patient

Mesenteric cysts are documented as rare intra-abdominal benign tumors, whose etiology and classification controversy still exists. They are considered the rarest variety between the abdominal cysts and both its low incidence and the mistaken belief that was a trivial process without apparent symptoms, had contributed to their scarce knowledge. This study aimed to present a mesenteric cyst case with focal acute inflammation and four lymph nodes with follicular lymphoid hyperplasia. The study was performed 20-year-old female patient, examined in emergency department for abdominal pain 12 hours of evolution located in flank and left upper quadrant, with mild improvement after analgesic treatment, accompanied with mild fever. The patient presented left paramedian cystic formation measuring 4 cm in size with echogenic content inside. Exploratory laparoscopy treatment of emergency was proposed. The postoperative course was favourable remaining afebrile, no abdominal pain and good tolerance to oral intake, so it was hospital discharged within 72 hours of surgery. The diagnosis was mesenteric cyst with focal acute inflammation and four lymph nodes with follicular lymphoid hyperplasia. In conclusion, the type of surgery depended on the size of the cyst, its location in the peritoneal cavity and the experience of the surgeon. Laparoscopy technique was used as a first option

Fluid evolution from extension to compression in the Pyrenean Fold Belt and Basque-Cantabrian Basin: A review

We propose a review to discuss the large number of studies dealing with the fluid history in extensional and compressional sedimentary basins that evolved along the Iberian-Eurasian plate boundary during the full Mesozoic-Cenozoic Wilson Cycle in the Pyrenean fold belt and the Basque-Cantabrian Basin. We integrate classic and modern geochemical and geochronological datasets used in fluid studies with the current tectonic knowledge of the studied area. Late Hercynian fluid systems were dominated by Carboniferous-early Permian magmatic intrusions related to large-scale lithospheric delamination at the end of the collision, which caused the accumulation of skarns at depths of 8000–10,000 m during contact metamorphism. During the Mesozoic extension, early and widespread shallow burial dolomitization of Jurassic and Early-Cretaceous carbonates occurred at burial depths of 500–1000 m due to seawater influx. From Albian to Cenomanian, along the North Pyrenean extensional fault zone, contact metamorphism processes occurred in association with mantle-derived and deep-crustal fluids at temperatures higher than 300 °C, which interacted with Triassic evaporites and formation and marine waters and depths of 2000–3000 m. Away from this fault, fluid systems were dominated by hydrothermal dolomitization and the accumulation of Znsingle bondPb mineralization along diapir walls and faults, whereas in the less extended and proximal domains of the extensional system, fluids were formation waters at temperatures up to 150 °C. The Alpine compressional fluid history registers the increasing influence of meteoric fluids as the foreland basin became overfilled and fluid flow occurred at depths of 2.5–4 km in tectonic units detached in Triassic evaporites and of >4 km in units rooted at depth with the Paleozoic basement. Along and across strike differences in the fluid evolution of the Pyrenees are attributed to changes in the structure of the cover and basement tectonic units, the westward decrease of shortening and in the oblique directions of Upper Triassic successions, which acted as very efficient seals for deep-sourced fluids. Subvertical walls of diapirs are baffles for fluid flow, whereas fracturing and deposition of porous halokinetic successions are effective conduits. Evaporite detachments compartmentalize paleohydrological systems during tectonic deformation, although they may be breached by fluids reaching lithostatic pressures. In large evaporite-bearing provinces, fluid systems may share common patterns during successive extensional and compressional tectonic events, as documented in the Western Mediterranean Mesozoic extensional rift system. In this area, metal-bearing and deep-sourced fluids interacted with Triassic sulphates and organic matter, triggering the accumulation sulphides in rock porosity. However, more research is needed in other large-scale evaporitic provinces of different ages to identify common fluid flow patterns.publishedVersio

Geofluid behaviour in successive extensional and compressional events: a case study from the southwestern end of the Vallès-Penedès Fault (Catalan Coastal Ranges, NE Spain)

The structural position of the Upper Jurassic-Lower Cretaceous carbonates located in the central part of the Catalan Coastal Ranges corresponds to the southwestern end of the Vallès-Penedès Fault. This fault was reactivated at different times during successive extensional and compressional events and several generations of fractures and cementations were formed