Physical activity and lifestyles in University of Health Sciences Post-Confinement

Este trabajo tiene como objetivo conocer el estado de salud física, emocional y hábitos de vida saludable en términos de: adherencia a la dieta mediterránea, consumo de alcohol y drogas, y realización de actividad física de los estudiantes del Grado en Fisioterapia de la Universidad de Cádiz y su posible interacción con la enfermedad de Covid-19 una vez que se ha vuelto a la presencialidad en las aulas. Se plantea un estudio de corte transversal en una muestra de 134 estudiantes a los que a través de un cuestionario online se les ha recogido información sociodemográfica, relacionada con la enfermedad Covid-19; hábitos de alimentación (cuestionario PREDIMED); hábitos de consumo de alcohol y drogas (cuestionarios AUDIT y DAST-10); hábitos de actividad física (cuestionario IPAQ); y percepción de la calidad de vida relacionada con la salud (cuestionario SF12). Se realiza un análisis descriptivo y comparativo entre cuestionarios y un análisis factorial. La calidad de vida relacionada con la salud se ve afectada principalmente por el sexo y el padecimiento del Covid-19. Se obtienen tres componentes principales con el análisis factorial que explican el 59,48% de la variabilidad encontrada con los cuestionarios presentando tres perfiles claramente diferenciados: estudiantes con hábitos tóxicos; estudiantes con hábitos saludables pero mala percepción de su estado de salud; y estudiantes con una buena percepción de su estado de salud, pero mala adherencia a la dieta mediterránea y a la realización de actividad física. Es necesario establecer programas de promoción de hábitos de vida saludable conjuntamente con programas de refuerzo emocional en futuros profesionales de las ciencias de la salud. This work aims to know the state of physical, emotional health and healthy lifestyle habits in terms of: adherence to the Mediterranean diet, the consumption of alcohol and drugs and physical activity in students of the Degree in Physiotherapy of the University of Cádiz and its possible interaction with the Covid-19 disease once they has returned to face-to-face in the classrooms. A cross-sectional study is proposed in a sample of 134 students who, through an online questionnaire, have been collected sociodemographic information related to the Covid-19 disease; eating habits (PREDIMED questionnaire); alcohol and drug consumption habits (AUDIT and DAST-10 questionnaires); physical activity (IPAQ questionnaire); and perception of health-related quality of life (SF12 questionnaire). A descriptive and comparative analysis is carried out between questionnaires and a factor analysis. Health-related quality of life is mainly affected by sex and Covid-19 disease. Three main components are obtained with factor analysis that explain 59.48% of the variability found with the questionnaires presenting three clearly differentiated profiles: students with toxic habits; students with healthy habits but poor perception of their state of health; and students with a good perception of their state of health but poor adherence to the Mediterranean diet and physical activity. It is necessary to establish programs to promote healthy lifestyle habits together with emotional reinforcement programs in future health sciences professionals

Competencias entre fisioterapeutas y educadores físicos-deportivos respecto al ejercicio físico y terapéutico: una revisión narrativa

El ejercicio físico-terapéutico es una reciente herramienta nacida de la fusión del ejercicio físico y la rehabilitación. Debido a su corta edad, no cuenta con un nivel de estructuración definido, originando conflictos entre fisioterapeutas y educadores físico-de- portivos. El objetivo de esta revisión es analizar la bibliografía disponible para buscar unos criterios consensuados. Se realizó una búsqueda en PubMed, utilizando una estrategia basada en la combinación de términos relacionados con el ejercicio físico, el ejercicio terapéutico y su utilización como tratamiento de diversas patologías. Se analizaron un total de 60 programas, de los cuales en tan sólo 4 se especifica el ejercicio terapéutico con respecto al ejercicio físico. Por lo tanto, concluimos que existe una inestabilidad legal en España en cuanto a competencias profesionales, siendo la carga formativa académica universitaria insuficiente para hacer frente a las necesidades de la población general

Sun Exposure during Water Sports: Do Elite Athletes Adequately Protect Their Skin against Skin Cancer?

Excessive sun exposure is the main avoidable cause of skin cancer. Outdoor sports performed without adequate photoprotection are risky practices in this respect. This study examines whether elite athletes in water sports (specifically surfing, windsurfing, and sailing) take appropriate measures to protect their skin from the sun, and whether there are differences in this respect according to age, gender, or sports discipline. This study is based on a questionnaire-based health survey. World championship competitors completed a self-administered questionnaire on their sun protection and exposure habits, as well as sunburns during the last sports season. In total, 246 participants, with an age range of 16-30 years, completed the questionnaire. Of these, 49.6% used inadequate sun protection. Those who protected their skin appropriately tended to be older than those who did not (average age = 23.28 and 20.69 years, respectively; p = 0.000). There were no significant differences in sun protection habits between male and female athletes. The rate of sunburn was very high (76.7%). A high proportion (22.5%) of participants never used sunscreen. Elite athletes in water sports are at real risk of skin lesions from overexposure to the sun, associated with inadequate photoprotection practices. Campaigns to raise awareness and to promote the early detection of skin cancer should target these risk groups

Continuous ultrafiltration during extracorporeal circulation and its effect on lactatemia: A randomized controlled trial

Introduction. Hyperlactatemia occurs during or after extracorporeal circulation in the form of lactic acidosis, increasing the risk of postoperative complications and the mortality rate. The aim of this study was to evaluate whether continuous high-volume hemofiltration with volume replacement through a polyethersulfone filter during the extracorporeal circulation procedure decreases postoperative lactatemia and its consequences. ||Materials and methods. This was a randomized controlled trial. Patients were randomly divided into two groups of 32: with or without continuous high-volume hemofiltration through a polyethersulfone membrane. Five patients were excluded from each group during the study period. The sociodemographic characteristics, filter effects, and blood lactate levels at different times during the procedure were evaluated. Secondary endpoints were studied, such as the reduction in the intubation time and time spent in ICU. ||Results. Lactatemia measurements performed during the preoperative and intraoperative phases were not significantly different between the two groups. However, the blood lactate levels in the postoperative period and at 24 hours in the intensive care unit showed a significant reduction and a possible clinical benefit in the hemofiltered group. Following extracorporeal circulation, the mean lactate level was higher (difference: 0.77 mmol/L; CI 0.95: 0.01–1.53) in the nonhemofiltered group than in the hemofiltered group (p<0.05). This effect was greater at 24 hours (p = 0.019) in the nonhemofiltered group (difference: 1.06 mmol/L; CI 0.95: 0.18–1.93) than in the hemofiltered group. The reduction of lactatemia is associated with a reduction of inflammatory mediators and intubation time, with an improvement in liver function. || Conclusions. The use and control of continuous high-volume hemofiltration through a polyethersulfone membrane during heart-lung surgery could potencially prevent postoperative complications. The reduction of lactatemia implied a reduction in intubation time, a decrease in morbidity and mortality in the intensive care unit and a shorter hospital stay.14 páginas

Satisfaction Level and Performance of Physiotherapy Students in the Knowledge of Musculoskeletal Disorders through Nearpod: Preliminary Reports

Physiotherapists are at high risk for musculoskeletal disorders. There is a need in academia to address workers’ health issues at the time of graduation. Nearpod is an educational application founded on a web-based learning tool. In the field of Health Sciences, the use of Nearpod has been scarce. The objective of this study was to determine the level of satisfaction with using this interactive tool and to assess the influence of using Nearpod in class on students’ performance while dealing with the topic of musculoskeletal disorders in third-year Degree in Physiotherapy students during the 2021–2022 academic year. The participants were students at the University of Cadiz. They were randomly divided into two groups, a control group using a PowerPoint presentation and an experimental group using the interactive Nearpod application. The experimental group took two surveys to determine their satisfaction with the method used. Students also took a multiple-choice test to assess the knowledge acquired. In the surveys, a high percentage of satisfaction was obtained (97.62% and 99.39%). There were no significant differences in the scores obtained by the two groups, although there were significant differences in response time in favor of the experimental group (p = 0.022). Although studies should be carried out with larger samples and on different subjects, it seems that Nearpod is a tool with great potential for teaching the study of musculoskeletal disorders.16 página

Hamstring extensibility in female elite soccer players

El objetivo de este estudio fue evaluar la extensibilidad de la musculatura isquiosural en futbolistas femeninas de élite. Se realizó un estudio descriptivo transversal en una muestra de 75 jugadoras de élite de fútbol de cuatro categorías: Sub12 (n=20, edad: 11,42 ± 0,90 años), Sub15 (n=21, edad: 13,38 ± 1,50 años), Provincial (amateur) (n=15, edad: 17,13 ± 1,85 años), y Nacional (profesional) (n=20, edad: 22,80 ± 5,25 años). Como instrumentos de medición se utilizaron el test sit and reach (SRT) y el test de flexión profunda (FP) de tronco. Los valores medios presentados en el SRT fueron de 9,74 ± 5,62 cm. para el grupo Sub12, 13,86 ± 4,82 cm. para el grupo Sub15, 9,73 ± 3,58 cm para el grupo Provincial (amateur) y 7,55 ± 8,39 cm para el grupo Nacional (profesional). En el SRT las participantes del grupo Sub15 obtuvieron resultados significativamente superiores que las participantes del grupo Nacional (p<.05), mientras que en la prueba FP el grupo Sub12 obtuvo resultados significativamente superiores que el grupo Nacional (p<.05). En el análisis de correlaciones bivariadas, se observaron correlaciones moderadas entre la altura y los resultados en las pruebas de FP (r=.561; p<.05) y SRT (r=.491; p<.05) en el grupo Sub12. En conclusión, los resultados de este estudio indican que la extensibilidad isquiosural de las jugadoras de élite de fútbol estudiadas es limitada, por lo que deberíamos implementar programas específicos de estiramientos de la musculatura isquiosural en futbolistas féminas desde las categorías inferiores hasta las categorías profesionales. Palabras clave. flexibilidad, fútbol femenino, flexión profunda, sit and reach test.The aim of this study was to evaluate hamstring extensibility in female elite soccer players. A descriptive transversal study was carried out with a sample of 75 female elite soccer players into four categories: Under12 (n=20, age: 11,42 ± 0,90 years), Under15 (n=21, age: 13,38 ± 1,50 years), Provincial (amateur) (n=15, age: 17,13 ± 1,85 years), and National (professional) (n=20, age: 22,80 ± 5,25 years). The sit and reach test (SRT) and the deep trunk flexion test were used as measurement tools. The average values showed in the SRT were 9,74 ± 5,62 cm. for the Under12 group, 13,86 ± 4,82 cm. for the Under15 group, 9,73 ± 3,58 cm for the Provincial (amateur) group and 7,55 ± 8,39 cm for the National (professional) group. In the SRT the members of Under15 group showed significantly higher results than the members of National group (p<.05), while in the deep trunk flexion test the Under12 group showed significantly higher results than the National group (p<.05). In the analysis of bivariate correlations, in the Under12 group moderate correlations were observed between height and scores in the deep trunk test (r = .561; p <.05) and SRT (r = .491; p <.05). In conclusion, the results of this study indicate that the hamstring extensibility in female elite soccer players studied is limited, so we should implement stretching specific programs of the hamstring muscles in female soccer players from the lower categories to the professional categories. Key words. flexibility, female soccer, deep trunk, sit and reach test

What Sun Protection Practices Should Be Adopted by Trainee Teachers to Reduce the Risk of Skin Cancer and Other Adverse Outcomes?

Excessive sun exposure and insufficient protection are the main risk factors for the onset of melanoma and non-melanoma skin cancer (the most common types of cancer suffered by fair-skinned populations) and other adverse effects on the skin and eyes. Epidemiological data highlight the scant awareness of this risk among young people and the high rates of sunburn often recorded among this population. The main aim of the present study is to examine sun exposure and protection behavior by university students. A cross-sectional questionnaire-based study was undertaken to investigate sun exposure and protection practices among students of education sciences at a university in southern Spain. The data obtained were used to perform a descriptive, comparative analysis, by groups and by gender, of photoprotection and skin self-examination practices. The reliability and validity of the questionnaire were both tested. Of the 315 students who completed the questionnaire, 74.6% had suffered at least one sunburn during the previous year. Few made frequent use of sunscreen or protective clothing and 89.5% did not self-examine their skin. The metric properties of the questionnaire revealed its excellent reliability and validity. Among the Spanish university students considered, there was little awareness of the risk of excessive sun exposure, self-protection was insufficient, the potential exposure to dangerous levels of ultraviolet radiation was high, and most had suffered one or more sunburns in the last year. Intervention strategies should be implemented to highlight the risks involved and the need for more appropriate sun protection practices. Information campaigns should be conducted in this respect so that, when these students become teachers, they will have adequate knowledge of the risks involved and of the benefits of addressing this problem effectively, and will ultimately transfer these health education competences to their own students

Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods. The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or "Basic Stable Input of Care" (BSIC), coded by its principal function or "Main Type of Care" (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison

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

Anticipatory Antifungal Treatment in Critically Ill Patients with SARS-CoV-2 Pneumonia

Background. The aim of this study was to investigate the incidence of COVID-19-associated pulmonary aspergillosis (CAPA) in critically ill patients and the impact of anticipatory antifungal treatment on the incidence of CAPA in critically ill patients. Methods. Before/after observational study in a mixed intensive care unit (ICU) of a university teaching hospital. The study took place between March 2020 and June 2022. Inclusion criteria were critically ill patients with severe SARSCoV- 2 pneumonia requiring invasive mechanical ventilation. Two analysis periods were compared according to whether or not antifungal therapy was given early. Results. A total of 160 patients with severe SARS-CoV-2 pneumonia and invasive mechanical ventilation were included. The incidence of CAPA in the first study period was 19 out of 58 patients (32.75%); during the second period, after implementation of the intervention (anticipatory antifungal therapy), the incidence of CAPA decreased to 10.78% (11 out of 102 patients). In patients with CAPA under invasive mechanical ventilation, the mortality rate decreased from 100% to 64%. Conclusions. Anticipating antifungal treatment in patients with SARS-CoV-2 pneumonia under invasive mechanical ventilation was associated with a decrease in the incidence and mortality of pulmonary aspergillosis