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Acceso libre en la web del editor, In the context of the COVID‐19 pandemic, this paper provides recommendations for medical eye care during the easing of control measures after lockdown. The guidelines presented are based on a literature review and consensus among all Spanish Ophthalmology Societies regarding protection measures recommended for the ophthalmologic care of patients with or without confirmed COVID‐19 in outpatient, inpatient, emergency and surgery settings. We recommend that all measures be adapted to the circumstances and availability of personal protective equipment at each centre and also highlight the need to periodically update recommendations as we may need to readopt more restrictive measures depending on the local epidemiology of the virus. These guidelines are designed to avoid the transmission of SARS‐CoV‐2 among both patients and healthcare staff as we gradually return to normal medical practice, to prevent postoperative complications and try to reduce possible deficiencies in the diagnosis, treatment and follow‐up of the ophthalmic diseases. With this update (5th) the Spanish Society of Ophthalmology is placed as one of the major ophthalmology societies providing periodic and systematized recommendations for ophthalmic care during the COVID‐19 pandemic., Unidad Docente de Inmunología, Oftalmología y ORL, Fac. de Óptica y Optometría, TRUE, pub

Objectives: The International Commission on Radiological Protection recommends managing patient and occupational doses as an integrated approach, for the optimisation of interventional procedures. The conventional passive personal dosimeters only allow one to know the accumulated occupational doses during a certain period of time. This information is not enough to identify if there is a lack of occupational radiation protection during some procedures. This paper describes the use of a dose management system (DMS) allowing patient and occupational doses for individual procedures to be audited. Methods: The DMS manages patient and occupational doses measured by electronic personal dosimeters. One dosemeter located at the C-arm is used as a reference for scatter radiation. Data have been collected from five interventional rooms. Dosimetry data can be managed for the whole procedure and the different radiation events. Optimisation is done through auditing different sets of parameters for individual procedures: patient dose indicators, occupational dose values, the ratio between occupational doses, and the doses measured by the reference dosemeter at the C-arm, and the ratio between occupational and patient dose values. Results: The managed data correspond to the year 2021, with around 4500 procedures, and 8000 records on occupational exposures. Patient and staff dose data (for 11 cardiologists, 7 radiologists and 8 nurses) were available for 3043 procedures. The DMS allows alerts for patient dose indicators and occupational exposures to be set. Conclusions: The main advantage of this integrated approach is the capacity to improve radiation safety for patients and workers together, auditing alerts for individual procedures. Advances in knowledge: The management of patient and occupational doses together (measured with electronic personal dosimeters) for individual interventional procedures, using dose management systems, allows alerting optimisation on high-dose values f, Depto. de Radiología, Rehabilitación y Fisioterapia, Fac. de Medicina, TRUE, pub

Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain Department of Psychiatry, Hospital Miguel Servet, University of Zaragoza, 50009 Zaragoza, Spain Primary Care Teaching Unit for Zaragoza Healthcare District 1, 50018 Zaragoza, Spain Department of Health Psychology, Miguel Hernández University, 03202 Elche, Spain Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain Barcelona Public Health Agency (ASPB), 08023 Barcelona, Spain Public Health Agency of Catalonia (ASPCAT), 08005 Barcelona, Spain, Gambling disorder in youth is an emerging public health problem, with adolescents and young adults constituting a vulnerable age group for the development of gambling-related problems. Although research has been conducted on the risk factors for gambling disorder, very few rigorous studies can be found on the efficacy of preventive interventions in young people. The aim of this study was to provide best practice recommendations for the prevention of disordered gambling in adolescents and young adults. We reviewed and synthesized the results of existing RCTs and quasi-experimental studies covering nonpharmacological prevention programs for gambling disorder in young adults and adolescents. We applied the PRISMA 2020 statement and guidelines to identify 1483 studies, of which 32 were included in the systematic review. All studies targeted the educational setting, i.e., high school and university students. Most studies followed a universal prevention strategy, that particularly targeted adolescents, and an indicated prevention strategy for university students. The reviewed gambling prevention programs generally showed good results in terms of reducing the frequency and severity of gambling, and also regarding cognitive variables, such as misconceptions, fallacies, knowledge, and attitudes towards gambling. Finally, we highlight the need to develop more comprehensive prevention programs that incorporate rigorous methodological and assessment procedures before they are widely implemented and disseminated., Instituto de Investigación Sanitaria Aragón: Hospital Universitario Miguel Servet, Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Departmento de Psicología y Sociología (Universidad de Zaragoza), Instituto de Investigación Sanitaria de Navarra, Hospital Miguel Servet: Departamento de Psiquiatría, Unidad de Atención Primaria del Sector Sanitario de Zaragoza, Distrito 1, Universidad Miguel Hernández: Departamento de Psicología de la Salud, Universidad Complutense de Madrid: Departamento de Salud Pública y Materno-Infantil, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Agencia de Salud Pública de Barcelona, Agencia de Salud Pública de Catalunya, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

Producción Científica, The aims of the study were to analyze the effects of a 12-week maximal strength- training program on injury incidence, injury burden, and physical fitness in semi-professional soccer players and to compare the perceived exertion load and well-being state between injured and non-injured soccer players. Twenty semi-professional male soccer players participated in this study. Participants were randomly allocated to an experimental group (EG, n = 10 players), who performed a maximal strength-training program, or to a control group (CG, n = 10 players), who only performed their regular soccer training. Physical fitness was measured at baseline and after the training program. In addition, the injury incidence, burden, training/match load, and the state of well-being of the players were recorded. The EG showed significant improvements in vertical jumps, change in direction ability, linear sprints, repeated sprint ability, isometric strength (p < 0.003; effect size = 1.78–11.86), and quadriceps–hamstring imbalance in both legs (p < 0.001; effect size = 2.37–3.71) in comparison to the CG. In addition, the EG players showed a significantly (p < 0.05) lower injury burden (p < 0.001, relative risk = 5.05, 95% confidence interval = 3.27–7.79). This study demonstrated the beneficial effects of a 12-week maximal strength-training program on physical fitness attributes and injury burden in semi-professional soccer players., Ministerio de Ciencia e Innovación/Agencia Estatal de Investigación (AEI) y Unión Europea NextGenerationEU/PRTR - (grant (RYC2021- 031072-I))

La osteoporosis se caracteriza por la disminución de la masa ósea y la pérdida de resistencia del hueso, que aumenta el riesgo de fracturas. Un considerable número de mujeres padecen osteoporosis, especialmente aquellas mayores de 50 años. Esta cifra ascenderá en los próximos años, lo que la convierte en un grave problema de salud pública. El abordaje nutricional se presenta como una herramienta fundamental en la prevención y el manejo de la osteoporosis postmenopáusica., Grado en Enfermería

Producción Científica, Emotional instability and stress are the main disturbances that condition the learning process, affecting both teachers and students. The main objective of this review is to analyze the influence of stress and emotions (as part of stress) on the learning environment. Stress is a physiological mechanism that the organism develops to adapt and survive external and internal challenges. In this context, stress tends to be seen as a negative condition in the learning process when it is chronic. Extreme stress situations, such as the COVID-19 pandemic, can generate anxiety and frustration in students. However, other studies indicate that controlled stress can positively enhance the learning process. On the other hand, the quality and intensity of emotions resulting from stress can influence as well the learning process. Positive emotions are healthy and can promote optimal learning. Emotions lead to sentimental, cognitive, behavioral, and physiological changes, which will have a strong influence on intellectual performance. The activation of coping strategies constitutes a key mechanism for dealing positively with problems and challenges, generating positive emotions essential for the self-regulation of learning. In conclusion, correct management of emotions in stressful situations could promote effective learning through enhanced attention and capacity to solve problems.

Las redes sociales componen una nueva forma de comunicación, haciendo que pasemos cada vez más tiempo conectadas a ellas. El uso excesivo de estas, más de dos horas al día, repercute en otros aspectos como sería el académico. Ligado a este problema aparece la procrastinación académica, el retraso injustificado de tareas. Actualmente el enfoque contra la adicción a las redes sociales y la procrastinación se centra más en lo pedagógico. Por lo que, establecer intervenciones de enfermería es un campo poco explorado. Para ello se realizó una investigación sobre el estudiantado y el profesorado de la Escuela Universitaria de Enfermería de Palencia. Se envió de forma masiva un cuestionario ad hoc, que incluía las siguientes escalas validadas: Cuestionario de Adicción a las Redes Sociales y la versión en español de Procrastination Assessment Scale-Student. Con el fin de conocer el nivel de adicción, las principales razones para procrastinar y como estas dos variables se relacionan con la edad y entre sí. En los resultados obtenidos se vio que la muestra invertía entre una y dos horas diarias en las redes sociales, presentando un nivel de adicción leve. El uso excesivo es el factor más predominante y las principales razones para procrastinar fueron: la búsqueda de excitación, perfeccionismo y ansiedad ante la evaluación. Se vio que la edad influye negativamente en la adicción y en las razones de procrastinación de igual forma que la adicción influye en el rendimiento y razones de procrastinación. En conclusión, para la muestra, la educación para la salud sería la intervención de enfermería que más se ajusta dado que, por el momento presentan un nivel leve de adicción., Grado en Enfermería

Producción Científica, Hemophilia is a chronic, congenital/hereditary and X-linked disease, characterized by an insufficiency of factors VIII or IX, which are necessary for blood clotting. Those affected by hemophilia often suffer from particular psychosocial problems, both in the acceptance, coping, treatment and self-management of their disease and in their family and social relationships, which are often mediated by these circumstances. The aim of this study was to explore the experiences of people with hemophilia or their family members, of in a specific region of Spain, regarding the impact of having hemophilia. Structured interviews were conducted and developed, using the studies of the World Federation of Hemophilia and Osorio-Guzmán et al. as a guide, as well as a literature review of qualitative work on hemophilia. Data were analyzed using a six-step thematic analysis. A total of 34 interviews were thematically analyzed. The results showed that three key themes emerged from the data: (1) the daily impact of having hemophilia, (2) uncertainty about the disease, (3) the role of associations and (4) support from institutions. The results make it clear that the disease has a major impact on their lives (work, family, leisure and personal environment). The main conclusion is that hemophilia has a negative impact on the daily lives of patients, families and caregivers., Ministerio de Ciencia, Innovación y Universidades - (grant PID2021-126019NB-I00)

Producción Científica, (1) Background: Strength training (ST) and aerobic training (AT) are the most recommended interventions in patients with knee OA. These recommendations are supported by high-quality evidence, but it is still unknow whether one type of exercise is superior to the other. Thus, the aim was to investigate whether one type of exercise (ST or AT) is superior to the other for improving pain and physical function in patients with knee osteoarthritis. (2) Methods: A systematic review and meta-analysis was carried out following the PRISMA statement. The search strategy was conducted in PubMed, PEDro, Scopus, Web of Science and Cochrane Library databases. Randomized controlled trials comparing ST and AT on pain intensity and physical function in patients with knee osteoarthritis were included. Methodological quality and risk of bias were assessed with a PEDro scale and risk-of-bias tool, respectively. The certainty of evidence was evaluated using GRADE guidelines. (3) Results: Four studies (6 publications) were included. The qualitative and quantitative synthesis showed that ST produces no more improvement in pain intensity (SMD after intervention: 0.02; 95%CI: −0.15, 0.19; I2: 0%; three studies; 426 patients) and physical function (SMD after intervention: 0.07; 95%CI: −0.10, 0.24; I2: 0%; three studies; 426 patients) compared to AT in patients with knee osteoarthritis. The certainty of evidence was rated as very low. (4) Conclusions: Both type of exercises showed clinical benefits in people with knee osteoarthritis, but no differences between ST and AT were found.

Producción Científica, Diabetic retinopathy (DR) is a neurodegenerative disease characterized by the presence of microcirculatory lesions. Among them, microaneurysms (MAs) are the first observable hallmark of early ophthalmological changes. The present work aims to study whether the quantification of MAs, hemorrhages (Hmas) and hard exudates (HEs) in the central retinal field could have a predictive value on DR severity. These retinal lesions were quantified in a single field NM-1 of 160 retinographies of diabetic patients from the IOBA’s reading center. Samples included different disease severity levels and excluded proliferating forms: no DR (n = 30), mild non-proliferative (n = 30), moderate (n = 50) and severe (n = 50). Quantification of MAs, Hmas, and HEs revealed an increasing trend as DR severity progresses. Differences between severity levels were statistically significant, suggesting that the analysis of the central field provides valuable information on severity level and could be used as a clinical tool to assess DR grading in the eyecare routine. Even though further validation is needed, counting microvascular lesions in a single retinal field can be proposed as a rapid screening system to classify DR patients with different stages of severity according to the international classification.

Producción Científica, A new artificial intelligence-based approach is proposed by developing a deep learning (DL) model for identifying the people who violate the face mask protocol in public places. To achieve this goal, a private dataset was created, including different face images with and without masks. The proposed model was trained to detect face masks from real-time surveillance videos. The proposed face mask detection (FMDNet) model achieved a promising detection of 99.0% in terms of accuracy for identifying violations (no face mask) in public places. The model presented a better detection capability compared to other recent DL models such as FSA-Net, MobileNet V2, and ResNet by 24.03%, 5.0%, and 24.10%, respectively. Meanwhile, the model is lightweight and had a confidence score of 99.0% in a resource-constrained environment. The model can perform the detection task in real-time environments at 41.72 frames per second (FPS). Thus, the developed model can be applicable and useful for governments to maintain the rules of the SOP protocol., Universidad King Khalid - (Project RGP.2/162/44)

Producción Científica, The identification and appropriate management of patients at risk of suffering from acute chest pain (ACP) in prehospital care are not straightforward. This task could benefit, as occurs in emergency departments (EDs), from cardiac enzyme assessment. The aim of the present work was to derive and validate a scoring system based on troponin T (cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), and D-dimer to predict 1-year mortality in patients with ACP. This was a prospective, multicenter, ambulance-based cohort study of adult patients with a prehospital ACP diagnosis who were evacuated by ambulance to the ED between October 2019 and July 2021. The primary outcome was 365-day cumulative mortality. A total of 496 patients fulfilled the inclusion criteria. The mortality rate was 12.1% (60 patients). The scores derived from cTnT, NT-proBNP, and D-dimer presented an AUC of 0.802 (95% CI: 0718-0.886) for 365-day mortality. This AUC was superior to that of each individual cardiac enzyme. Our study provides promising evidence for the predictive value of a risk score based on cTnT, NT-proBNP, and D-dimer for the prediction of 1-year mortality in patients with ACP. The implementation of this score has the potential to benefit emergency medical service care and facilitate the on-scene decision-making process., Junta de Castilla y León, Gerencia Regional de Salud - (grant GRS 2131/A/20)

Introducción: El insomnio es el trastorno de sueño más prevalente. Su prevalencia a nivel mundial oscila entre 10-25%. Se ha observado que, debido a ciertos factores de riesgo, los estudiantes de Ciencias de la Salud tienen una elevada prevalencia de mala calidad de sueño e insomnio, influyéndoles negativamente en el rendimiento académico. Objetivos: El objetivo general del presente trabajo es recopilar la información existente sobre los factores de riesgo del insomnio de los estudiantes de Ciencias de la Salud (centrándonos en Enfermería) y su relación con el rendimiento académico. Material y Métodos Se realizó una revisión bibliográfica durante los meses de enero a mayo de 2023. Se utilizaron diferentes páginas web de asociaciones de referencia (ANESARCO, SES y AASM) y bases de datos científicas (Pubmed, Dialnet, Scielo, Elsevier, NANDA y Google Académico). Los criterios de inclusión fueron: palabras del mismo campo semántico que el insomnio (calidad de sueño, somnolencia diurna…) y estudios de calidad y originales. Resultados y Discusión: Se descubrió mayor prevalencia de insomnio en mujeres, minorías étnicas y entre los más jóvenes. Del mismo modo, se observó que las mujeres y personas con cronotipo vespertino tenían menor rendimiento académico. En cuanto a factores de riesgo se refiere, se encontró que el estrés, el alcohol, la nicotina, el café y el uso excesivo de dispositivos tecnológicos alteraban la arquitectura del sueño, produciendo entre otros trastornos, el insomnio. Conclusión: Existe una significativa evidencia entre el insomnio y el rendimiento académico en los estudiantes de Enfermería y Ciencias de la Salud. Los factores de riesgo encontrados en el presente trabajo son elementos modificables que una temprana intervención podría moldear. Favoreciendo no sólo la salud de los futuros pacientes sino la salud de los estudiantes y futuros profesionales también, permitiéndoles adquirir una formación óptima y completa., Grado en Enfermería

Producción Científica, Background: Combining sports and studies could be stressful, but beneficial for the athletes’ career development. This study explores resources and barriers in the combination of the sports and academic life spheres during the lifespan of elite Spanish track-and-field athletes. Methods: Seven elite Spanish track-and-field athletes participated in a semistructured interview about their experiences to establish a dual career combining sports and studies/work. Interpretive phenomenological analysis (IPA) followed to analyze data. Results: Findings show that elite Spanish track-and-field athletes face educational and institutional barriers to developing a dual career. Time management, social support, and additional resources could play a key role in the success or failure to develop a dual career. Conclusions: This study shows that, to overcome dual-career barriers, athletes are resourceful if social support is provided at both the micro (coaches, families, etc.) and macro (political and educational institutions) levels. It also shows that pursuing an academic career can help in alleviating inherent tensions to athletic life and in finding personal balance., Universidad Europea de Madrid - (grant 2019/UEM18)

Producción Científica, (1) Background: The Modified Sequential Organ Failure Assessment (mSOFA) is an Early Warning Score (EWS) that has proven to be useful in identifying patients at high risk of mortality in prehospital care. The main objective of this study was to evaluate the predictive validity of prehospital mSOFA in estimating 2- and 90-day mortality (all-cause) in patients with acute cardiovascular diseases (ACVD), and to compare this validity to that of four other widely-used EWS. (2) Methods: We conducted a prospective, observational, multicentric, ambulance-based study in adults with suspected ACVD who were transferred by ambulance to Emergency Departments (ED). The primary outcome was 2- and 90-day mortality (all-cause in- and out-hospital). The discriminative power of the predictive variable was assessed and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC). (3) Results: A total of 1540 patients met the inclusion criteria. The 2- and 90-day mortality rates were 5.3% and 12.7%, respectively. The mSOFA showed the highest AUC of all the evaluated scores for both 2- and 90-day mortality, AUC = 0.943 (0.917–0.968) and AUC = 0.874 (0.847–0.902), respectively. (4) Conclusions: The mSOFA is a quick and easy-to-use EWS with an excellent ability to predict mortality at both 2 and 90 days in patients treated for ACVD, and has proved to be superior to the other EWS evaluated in this study., Junta de Castilla y León, Gerencia Regional de Salud - (grant GRS 1903/A/19 and GRS 2131/A/20)

La obesidad infantojuvenil se ha convertido en una epidemia global con unos porcentajes de prevalencia elevados. Para abordar este problema y evitar sus posibles comorbilidades, se han planteado diferentes tipos de intervenciones, entre ellas, el uso de las aplicaciones móviles que promuevan la actividad física para conseguir reducir el índice de masa corporal de los usuarios, aprovechando la gran evolución que han objetado las tecnologías en la última década., Grado en Enfermería

Introducción: la Organización Mundial de la Salud considera el tabaco como una epidemia mundial causante de millones de muertes. En 2020, España comenzó la financiación de varios tratamientos farmacológicos para la deshabituación tabáquica, y en febrero de 2023, la Consejería de Sanidad ha sustituido uno de esos tratamientos por la citisina, considerándose igualmente efectiva, con menos eventos adversos y menor coste. Se trata de un fármaco agonista parcial de los receptores de nicotina que ayuda a dejar de fumar reduciendo los síntomas de abstinencia de la nicotina. Una variedad de ensayos y revisiones de citisina indican su eficacia en la cesación tabáquica, siendo la principal y más común de las variables analizadas la tasa de abstinencia a los 6 meses. También se ha demostrado que al comenzar la financiación de un fármaco se incrementan las tasas de deshabituación. Objetivos: plantear un estudio de investigación que analice la influencia de la reciente financiación de citisina en el área de salud de Palencia, realizando un estudio descriptivo de la citisina prescrita, con las características sociodemográficas de los pacientes, a los que además se les realizarán entrevistas a los 9 meses del inicio de su proceso de deshabituación. Material y métodos: estudio observacional descriptivo de las historias clínicas informatizadas. Se realizará un muestreo aleatorio simple. Las variables se han seleccionado y agrupado procedentes de los ensayos analizados. Los criterios de inclusión serán ser pacientes con proceso abierto de deshabituación tabáquica con citisina, en los dos meses anteriores (pre) y posteriores (post) a la financiación de citisina. Los criterios de exclusión han sido elegidos para evitar los sesgos producidos en estudios anteriores sobre financiación de medicación para dejar de fumar. El estudio se llevará a cabo por dos profesionales sanitarios durante 8 meses de duración., Grado en Enfermería

Producción Científica, The objective of this research was to study the relationship between the body weight and diet, physical activity, and other habits among freshmen students by sex, and to determine whether these habits have changed during the post-era of the COVID-19 pandemic. A serial cross-sectional study with data from 11 Spanish universities was carried out. In total, 10,096 first-year university students (73.2% female, mean age = 19.0 ± 1.5 years) completed an online self-administered questionnaire between 2012 and 2022. For some analyses, questionnaires were categorized by the year in which the survey was filled out as Before COVID-19, Lockdown, and New Normal. In total, 72.9% of participants were within the normal weight range, and 17.7% of men and 11.8% of women were overweight (p < 0.001). The students who did not meet the WHO criteria of physical activity, spent more than 7 h per day sitting, and skipped breakfast had a higher prevalence of obesity (p < 0.05). According to the period of study, the prevalence of overweight/obesity Before COVID-19 was 16.1% (95% CI: 15.4–16.9%), while in Lockdown the prevalence was significantly higher (20.2, 95% CI: 17.1–23.8) and in New Normal it was 18.9% (CI: 15.7–22.5). Moreover, the study suggests that during the Lockdown period, there was a reduction in the practice of physical activity and an increase in the prevalence of a healthy diet. For all these, it is necessary to propose public health interventions that improve the lifestyles of university students., Ministerio de Sanidad, Servicios Sociales e Igualdad, Plan Nacional sobre Drogas - (grant 2010|145, 2013|034,2020|030), Instituto de Salud Carlos III - (grant PI16/01947), Fondo Social Europeo y Junta de Castilla y León,Consejería de Educación - (grant EDU/842/2022)

Producción Científica, Bacteremia has been associated with severity in some infections; however, its impact on the prognosis of urinary tract infections (UTIs) is still disputed. Our goal is to determine the risk factors for bacteremia and its clinical impact on hospitalized patients with complicated community-acquired urinary tract infections. We conducted a prospective observational study of patients admitted to the hospital with complicated community-acquired UTIs. Clinical variables and outcomes of patients with and without bacteremia were compared, and multivariate analysis was performed to identify risk factors for bacteremia and mortality. Of 279 patients with complicated community-acquired UTIs, 37.6% had positive blood cultures. Risk factors for bacteremia by multivariate analysis were temperature ≥ 38 °C (p = 0.006, OR 1.3 (95% CI 1.1–1.7)) and procalcitonin ≥ 0.5 ng/mL (p = 0.005, OR 8.5 (95% CI 2.2–39.4)). In-hospital and 30-day mortality were 9% and 13.6%, respectively. Quick SOFA (p = 0.030, OR 5.4 (95% CI 1.2–24.9)) and Barthel Index <40% (p = 0.020, OR 4.8 (95% CI 1.3–18.2)) were associated with 30-day mortality by multivariate analysis. However, bacteremia was not associated with 30-day mortality (p = 0.154, OR 2.7 (95% CI 0.7–10.3)). Our study found that febrile community-acquired UTIs and elevated procalcitonin were risk factors for bacteremia. The outcomes in patients with bacteremia were slightly worse, but without significant differences in mortality.

Introducción: En las últimas décadas, la infertilidad se ha incrementado en el continente europeo y especialmente en España. La edad es un factor determinante, pero la fertilidad puede verse también condicionada por factores ambientales modificables, como la alimentación. En los últimos años, ha tomado importancia el papel del estado nutricional en la salud reproductiva. El objetivo general de este trabajo es actualizar el conocimiento sobre la relación entre la nutrición y la fertilidad, así como la eficacia de la intervención nutricional en pacientes en búsqueda de embarazo. Material y métodos: Se ha realizado una revisión bibliográfica sistemática a través de una estrategia de búsqueda estructurada en diferentes bases de datos durante los meses de diciembre de 2022 a marzo de 2023. Se aplicaron unos criterios de exclusión e inclusión y se llevó a cabo una lectura crítica para la selección de los artículos. Resultados: Los patrones dietéticos antiinflamatorios han demostrado tener un impacto positivo en la fertilidad, que puede verse perjudicada por la inflamación desencadenada por el estilo de vida occidental. La valoración del estado nutricional permite enfocar el abordaje hacia la optimización de la composición corporal. El enfoque integral de la intervención en la infertilidad ha mostrado ser efectivo. Discusión: Establecer un patrón alimentario saludable dirigido a reducir el estado de inflamación junto a una mejora de la composición corporal apoyada en el ejercicio físico tiene un efecto positivo para la fertilidad en personas que buscan el embarazo. Un abordaje nutricional orientado a la pareja puede mejorar su fertilidad y repercutir positivamente a largo plazo. La enfermera tiene competencias para el manejo nutricional de estos pacientes, aportando al equipo multidisciplinar una perspectiva holística, cuidados profesionales y estrategias de educación para la salud., Grado en Enfermería

Producción Científica, Wolfram syndrome (WS) is a rare neurodegenerative disease usually of autosomal recessive origin. There is limited research about sensorineural hearing loss, despite it being a fundamental entity. It is important to broaden the study of this disease and specify a set of tests required for an adequate assessment of patients for efficient monitoring and control. The fundamental objective of this research is to understand WS from a biomedical perspective in order to help in its diagnosis, follow-up, and control. Pure tones audiometry, tympanometry, speech perception, the speech intelligibility index without aid, and testing at high frequencies were among the audiological measurements utilised since they were deemed suitable for standardised follow-up. Mixed linear models were used to examine the effects of age, time, or mean interaction in pure-tone (IPT), the average of high frequencies (HFA), auditory brainstem response (ABR), and brainstem auditory evoked potentials (BAEP). The genetic analysis allowed mutations to be classified into three phenotype-genotype groups, where the phenotype indicated the severity of the hearing loss. Patients with homozygous gene changes had a more severe neurosensory phenotype. The early discovery of sensorineural hearing loss and WS is crucial since it allows intensive follow-up and treatment of the person affected from the start., Sistema Sanitario Público de Andalucía (FPS 2020).- (project AP-0009-2020-C1-F2)

Producción Científica, Seasonal influenza is an acute respiratory infection caused by the influenza virus which constitutes a significant public health issue associated with high morbidity and mortality. The aim of this study was to investigate changes in attitudes, perceptions, and practices regarding influenza vaccination in the Spanish adult population during the COVID-19 pandemic, as well as their vaccination intentions, with special attention paid to those over 65 years old and in high-risk groups. To this end, a cross-sectional study was conducted through 2219 telephone interviews, and the results were compared with results obtained a year earlier. Regarding the reasons for deciding to get vaccinated in the 2022/23 season, a significant increase was observed in vaccine confidence (36.7% vs. 42.8%), social responsibility (32.5% vs. 43.8%), and in awareness of the importance of vaccination due to COVID-19 (21.7% vs. 25.4%). Advanced age (OR 2.8, 95% CI 2.0–3.9), belonging to high-risk groups (OR 2.7, 95% CI 2.0–3.7), and prior vaccination (OR 25.3, 95% CI 19.5–32.7) emerged as significant predictors for the intent to receive the influenza vaccine in the 2022/23 season. Continuously observing shifts in perceptions and behaviors related to influenza immunization is crucial to pinpoint factors that may influence the willingness to receive the vaccine and, in this way, design public health strategies that achieve a greater acceptance of it.

Producción Científica, Exposure to traffic-related air pollution (TRAP) generates oxidative stress, with downstream effects at the metabolic level. Human studies of traffic density and metabolomic markers, however, are rare. The main objective of this study was to evaluate the cross-sectional association between traffic density in the street of residence with oxidative stress and metabolomic profiles measured in a population-based sample from Spain. We also explored in silico the potential biological implications of the findings. Secondarily, we assessed the contribution of oxidative stress to the association between exposure to traffic density and variation in plasma metabolite levels. Traffic density was defined as the average daily traffic volume over an entire year within a buffer of 50 m around the participants’ residence. Plasma metabolomic profiles and urine oxidative stress biomarkers were measured in samples from 1181 Hortega Study participants by nuclear magnetic resonance spectroscopy and high-performance liquid chromatography, respectively. Traffic density was associated with 7 (out of 49) plasma metabolites, including amino acids, fatty acids, products of bacterial and energy metabolism and fluid balance metabolites. Regarding urine oxidative stress biomarkers, traffic associations were positive for GSSG/GSH% and negative for MDA. A total of 12 KEGG pathways were linked to traffic-related metabolites. In a protein network from genes included in over-represented pathways and 63 redox-related candidate genes, we observed relevant proteins from the glutathione cycle. GSSG/GSH% and MDA accounted for 14.6% and 12.2% of changes in isobutyrate and the CH2CH2CO fatty acid moiety, respectively, which is attributable to traffic exposure. At the population level, exposure to traffic density was associated with specific urine oxidative stress and plasma metabolites. Although our results support a role of oxidative stress as a biological intermediary of traffic-related metabolic alteratio, Ministerio de Ciencia e Innovación de España, Agencia Española de Investigación (AEI) - (projects PID2019-108973RB-C21 and C22), Ministerio de Economía y Competitividad y Fondo Europeo de Desarrollo Regional (FEDER) - (projects PI15/00071 y PI22CIII/00029) ), Generalitat Valenciana - (grants IDIFEDER/2021/072, CIAICO/2022/181 and INVEST/2023/180)

Producción Científica, Artificial intelligence has made substantial progress in medicine. Automated dental imaging interpretation is one of the most prolific areas of research using AI. X-ray and infrared imaging systems have enabled dental clinicians to identify dental diseases since the 1950s. However, the manual process of dental disease assessment is tedious and error-prone when diagnosed by inexperienced dentists. Thus, researchers have employed different advanced computer vision techniques, and machine- and deep-learning models for dental disease diagnoses using X-ray and near-infrared imagery. Despite the notable development of AI in dentistry, certain factors affect the performance of the proposed approaches, including limited data availability, imbalanced classes, and lack of transparency and interpretability. Hence, it is of utmost importance for the research community to formulate suitable approaches, considering the existing challenges and leveraging findings from the existing studies. Based on an extensive literature review, this survey provides a brief overview of X-ray and near-infrared imaging systems. Additionally, a comprehensive insight into challenges faced by researchers in the dental domain has been brought forth in this survey. The article further offers an amalgamative assessment of both performances and methods evaluated on public benchmarks and concludes with ethical considerations and future research avenues.

Producción Científica, The first waves of the COVID-19 pandemic were times of great change in the lives of university students and their families in Spain. The aim of this study was to explore the psychosocial aspects and preventive measures carried out during the COVID-19 pandemic by students and family members of the nursing degree students of the University of Valladolid (Spain). The number of people surveyed was 877, by means of an ad hoc questionnaire. Relationships between variables were established by means of the Chi-square test and Student’s t-test. In addition, multivariate logistic regression was generated. The significance level used was 0.05. Students and family members maintained preventive measures= such as hand washing, correct use of masks =in closed places, avoiding crowds and maintaining social distance, but at low rates (close to 20% in all cases). Regarding psychosocial aspects, 41.07% of the participants suffered from anxiety and loneliness, while 5.2% needed to take drugs to reduce anxiety or sleep and 66.07% were dependent on technology. Suicidal behavior is related to stress, anxiety, loneliness, poor family relationships, psychotropic drug use and technology abuse. The pandemic has caused life changes in university students and their families at the psychosocial level, generating high figures of suicidal ideation regardless of age. Preventive measures adopted to control the pandemic have not been followed for the most part.

Producción Científica, This study explores the perception of social and educational quality of life in minors with rare diseases (RDs). Two meta-analyses were performed, applying the random effects model. Results: Regarding the social Quality of Life, the meta-sample consisted of k = 40 samples, with a total population of 1943 children (mean age = 9.42 years), of whom 687 (35.3%) were girls, 615 (31.4%) were boys and 641 (33%) did not report their sex. The effect size was large (mean size = 7.68; p < 0.000; 99% Confidence Interval; lower limit = 7.22; upper limit = 8.14). The results of the meta-regression and model analysis showed the importance of the measurement instrument (Paediatric Quality-of-Life Inventory and Prototypes of the Quality of life) and the dissimilarity of perception among caregivers. The nationality and the type of RD were not relevant. With respect to the educational Quality of Life, the meta-sample consisted of k = 19 samples, with 699 minors (mean age = 10.3 years), of whom 266 (38%) were girls, 242 (34.6%) were boys and 191 (27.4%) did not report their sex. The effect size was large (mean size = 7.15; p < 0.000; 99% CI; lower limit = 6.35; upper limit = 7.94). The meta-regression and comparison of models showed that the type of RD was essential. The measurement instrument was a moderating variable, especially the Parent version Paediatric Quality-of-Life Inventory. This study reveals the need for further research on RDs and their social–educational effects., Universidad de Valladolid - (PROYEMER-2021- 62)

Producción Científica, In patients with human immunodeficiency virus (HIV), adherence to treatment is affected by the adverse effects of treatment, the presence of additional comorbidities, the complexity of dosage, and family and community support. However, one recent circumstance that was likely to have influenced therapeutic adherence was the COVID-19 pandemic and the applied containment measures. An observational retrospective study of a sample of patients with HIV was conducted to establish the relationship between sociodemographic, clinical, and pharmacological variables and therapeutic adherence before and after the pandemic. Adherence was measured using the validated simplified medication adherence questionnaire (SMAQ) and medication possession rate. A statistical analysis was performed to determine the mean, standard deviation, and median of the quantitative variables and the frequencies of the qualitative variables, and the relationship between the dependent and independent variables was analysed using the chi-squared test and Student’s t-test. No statistically significant differences were found between treatment adherence measured before and 22 months after the start of the pandemic. Sex, occupation, treatment regimen, viral load levels, and COVID-19 disease status did not influence adherence during either period. However, the age of patients with HIV had an impact on adherence during both periods (p = 0.008 and p = 0.002, respectively), with the age group under 45 years being less adherent. In addition, experiencing adverse drug reactions (ADRs) was shown to have an impact on adherence before the pandemic (p = 0.006) but not afterwards. The COVID-19 pandemic was not shown to have an impact on the degree of adherence to antiretroviral treatment in patients with HIV. Instead, adherence was influenced by patient age and ADR occurrence; therefore, measures must be taken in this regard. The SMAQ demonstrated sensitivity in assessing adherence.

Producción Científica, (1) Background: Musculoskeletal disorders are the second cause of disability in the world. The International Classification of Functioning Disability and Health (ICF) is a tool for systematically describing functioning. Outcome measures for musculoskeletal disorders and functioning concepts embedded in them have not been described under the ICF paradigm. The objective of this scoping review was to identify ICF categories representing the researcher’s perspective and to compare them with the ICF core set for post-acute musculoskeletal conditions. (2) Methods: This review was conducted as follows: (a) literature search using MEDLINE/PubMed, CINAHL, Web of Science, and Scopus databases; (b) study selection applying inclusion criteria (PICOS): musculoskeletal conditions in primary care, application of physiotherapy as a treatment, outcome measures related to functioning, and experimental or observational studies conducted in Western countries during the last 10 years; (c) extraction of relevant concepts; (d) linkage to the ICF; (e) frequency analysis; and (f) comparison with the ICF core set. (3) Results: From 540 studies identified, a total of 51 were included, and 108 outcome measures were extracted. In the ICF linking process, 147 ICF categories were identified. Analysis of data showed that 84.2% of the categories in the ICF core set for post-acute musculoskeletal conditions can be covered by the outcome measures analyzed. Sixty-eight relevant additional ICF categories were identified. (4) Conclusion: Outcome measures analyzed partially represent the ICF core set taken as a reference. The identification of additional categories calls into question the applicability of this core set in primary care physiotherapy units.

Producción Científica, (1) Background: We present the protocol of a randomized controlled trial designed to evaluate the benefit of a novel clinical decision support system for the management of patients with COVID-19. (2) Methods: The study will recruit up to 500 participants (250 cases and 250 controls). Both groups will receive the conventional telephone follow-up protocol by primary care and will also be provided with access to a mobile application, in which they will be able to report their symptoms three times a day. In addition, patients in the active group will receive a wearable smartwatch and a pulse oximeter at home for real-time monitoring. The measured data will be visualized by primary care and emergency health service professionals, allowing them to detect in real time the progression and complications of the disease in order to promote early therapeutic interventions based on their clinical judgement. (3) Results: Ethical approval for this study was obtained from the Drug Research Ethics Committee of the Valladolid East Health Area (CASVE-NM-21-516). The results obtained from this study will form part of the thesis of two PhD students and will be disseminated through publication in a peer-reviewed journal. (4) Conclusions: The implementation of this telemonitoring system can be extrapolated to patients with other similar diseases, such as chronic diseases, with a high prevalence and need for close monitoring., Junta de Castilla y León e Instituto de Salud Carlos III - (grant COV20/00539)

El objetivo principal de este TFG es conocer y profundizar en la prevención de la drogodependencia en el aula de educación infantil. Abordando la importancia de intervenir desde edades tempranas. Para ello se ha realizado un recorrido bibliográfico para conocer que son las drogas y su prevalencia entre la población más joven. Se exponen los factores de riesgo asociados al consumo de drogas y cuáles son los factores de protección. También se plantea el tema de la educación para la salud y como trabajarlo con los alumnos de infantil. Además, se realiza de una investigación para conocer los programas y planes nacionales que actualmente se están llevando a cabo en el aula de Educación Infantil para la prevención de la drogodependencia., Grado en Educación Infantil

Producción Científica, Scleroderma or systemic sclerosis (SSc) is an autoimmune disease affecting the connective tissue, characterized by fibrosis of the skin and internal organs. There is currently no curative treatment available, so therapeutic action is aimed at a symptomatic treatment of the affected organs. The development of biotechnology has made it possible to implement certain biological drugs that could represent a window of opportunity to modulate the evolution and symptomatology of scleroderma with greater efficacy and less toxicity than conventional treatments. This study aimed to review the current evidence critically and systematically on the effects of biological drugs on the pulmonary function, skin disease, and health status of patients afflicted by diffuse cutaneous systemic sclerosis (dcSSc). Three electronic databases (Pubmed, Dialnet, and Cochrane Library Plus) were systematically searched until the cut-off date of October 2022. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included original articles in English and Spanish with a controlled trial design, comparing biological drug treatments (tocilizumab, belimumab, riociguat, abatacept, and romilkimab) with a control group. The methodological quality of the studies was assessed using the McMaster quantitative form and the PEDro scale. A total of 383 studies were identified, 6 of them met the established criteria and were included in the present systematic review. A total of 426 patients treated with tocilizumab, belimumab, riociguat, abatacept, and romilkimab were included. The results showed substantial non-significant (p < 0.05) improvement trends after treatment with the biological drugs included in this review for the modified Rodnan Scale Value, Forced Vital Capacity, and Carbon Monoxide Diffusion Test; however, no benefits were shown on the Health Assessment Questionnaire–Disability Index when compared to the control group. Biol, Caja Rural de Soria - (project SO-12-2022)

Durante el presente trabajo incidiremos en la importancia de la actividad física y la salud para llevar a cabo un estilo de vida saludable. La actividad física no debe plantearse únicamente en el área de Educación Física, sino que debe ser transversal a lo largo del currículo de Educación Primaria, así como algo habitual en el ocio y en el día a día. Adquirir hábitos saludables y mantenerlos durante toda la vida garantiza salud, energía y bienestar físico y psíquico., Grado en Educación Primaria

Producción Científica, Optimal quality of professional life can allow coping with stressful situations and avoiding fatigue. This is instrumental in jobs undergoing very demanding situations, such as nurses working in Emergency Departments. In this study, we investigated the relationship between functional and physiological indicators and the quality of professional life in nurses of Emergency Departments of two public hospitals. Fifty-nine professionals participated in the study. Cortisol (an indicator of stress) and post-test lactate (an indicator of fatigue) were analyzed in saliva and in the blood, respectively, at the beginning and at the end of the morning shift. The CVP-35 survey (Spanish version of the QPL-35 questionnaire) was used to assess the quality of professional life. Post-dynamometry circulating lactate levels increased significantly; meanwhile, salivary cortisol decreased in participants at the end of the working shift. Regarding dynamometry, no significant changes were observed. CVP-35/QPL-35 scores did not show significant changes in participants from both hospitals in all dimensions analyzed. In conclusion, nurses participating in the study displayed adaptation to stress accompanied by an acceptable level of professional quality of life. However, certain fatigue appears at the end of the working day. Altogether, results suggest that a better organization must be implemented at work, improving ergonomic, safe, and healthy conditions.

El principal objetivo de este trabajo es analizar, dar a conocer y determinar en que se puede mejorar la comunicación interna en el Complejo Hospitalario Universitario Insular Materno Infantil, centrándonos en la Subdirección de RRHH. Para ello se han realizado varias entrevistas, eligiendo de forma concienzuda a los entrevistados, donde se muestran las relaciones entre subdirecciones, así como el uso y conocimiento de las herramientas y medios comunicativos existentes en sus lugares de trabajo. Un plan de comunicación interna óptimo, es esencial para la gestión de recursos humanos, siendo uno de los pilares fundamentales para el crecimiento y buen desarrollo de las organizaciones. La digitalización en el proceso de comunicación interna junto con los aplicativos informáticos, se han convertido en vitales, sobre todo en entornos hospitalarios, como es el caso, donde se necesita agilidad e inmediatez en la fluidez de la comunicación interna para una toma de decisiones acertada., Grado en Relaciones Laborales y Recursos Humanos

Producción Científica, Background: Immune recovery in people living with HIV (PLWHIV) is a residual aspect of antiretroviral treatment (ART) in most patients, but in a non-negligible proportion of them, the CD4+ lymphocytes count, or CD4/CD8 ratio remains suboptimal. Methods: We performed a model of the immune response after 24 weeks of switching to a 2DR with DTG plus 3TC in a retrospective multicenter cohort of undetectable and experienced patients using significant predictor variables associated with the parameters or situations defined as success and failure. Clinical variables studied were CD4+ and CD8+ lymphocyte count, percentage of CD4, and CD4/CD8 ratio. These parameters were assessed at baseline and 24 weeks after the switch. Based on the evolution of each variable, four categories of immune response and four categories of non-immune response were defined. Immune response was defined as CD4+ count > 500 cells/mm3, %CD4 > 30%, CD8+ count < 1000 cells/mm3 and CD4/CD8 ratio ≥ 0.9. Non-response is just the opposite. Results: In our different models of immunological response, the presence of stage of AIDS (p = 0.035, p = 0.065) and current age over 50 years (p = 0.045) are postulated as statistically significative limiting factors in achieving an improvement in CD4, %CD4, CD8, and CD4/CD8 ratio. Late HIV diagnosis (p = 0.156), without statistical significance, enhanced late the previous variables. In contrast, conditions where patients start with CD4 > 500 cells/mm3 (p = 0.054); CD4 > 30% (p = 0.054, p = 0.084); CD8 < 1000 cells/mm3 (p = 0.018), and CD4/CD8 ≥ 0.9 (p = 0.013, p = 0.09) are detected as stimulating or conducive to DTG plus 3TC treatment success. Conclusion: These models represent a proof of concept that could become a valuable tool for clinicians to predict the effects of DTG plus 3TC on immunological responses prior to the switch in undetectable pre-treated PLWHIV with immune dysfunction. The main predictors for immunological failure were late HIV diagnosis, stage of A

A través del presente Trabajo Fin de Grado (TFG) pretendo plasmar a grandes rasgos la repercusión positiva de la actividad física en los diferentes ámbitos de la vida de los niños en edad escolar dentro de nuestra sociedad actual. Asimismo, quiero mostrar el papel tan primordial que juega la comunidad educativa en el más amplio sentido integrada por maestros, familias, cuidadores… en el desarrollo físico, cognitivo y psicosocial del menor, así como analizar las consecuencias de la utilización de las nuevas tecnologías en sus diferentes comportamientos. También comprobaremos si la actividad física llevada a cabo en el aula es suficiente o necesita ser reforzada y qué efecto tiene la distribución del tiempo no lectivo en los alumnos de Educación Primaria. El broche final de este trabajo lo pone la elaboración del Plan de Fomento de la Actividad Física en concreto en el contexto del centro escolar seleccionado., Grado en Educación Primaria

La finalidad de este TFG es dar visibilidad al problema de la adicción a las apuestas online, que afecta especialmente a la juventud. Según diversos estudios e informes, se ha observado un incremento significativo de la participación de los jóvenes en apuestas deportivas y juegos de azar en línea, el cual se ha visto impulsado por la facilidad de acceso y la disponibilidad de plataformas de apuestas en Internet, así como por las agresivas estrategias de publicidad y marketing que intentan mostrar el juego como una actividad más de entretenimiento, inocua y exenta de riesgo, cuando en realidad no lo es. El objetivo general de esta investigación es conocer la ludopatía de la juventud relacionada con las apuestas deportivas. A tal fin, se han articulado una serie de objetivos específicos para contextualizar esta problemática como son: conocer el origen y evolución de las apuestas deportivas, análisis del mercado del juego como unidad de negocio, así como de sus estrategias de marketing y publicidad, conocimiento de los criterios diagnósticos de la ludopatía y estudio de la adicción de las apuestas en los jóvenes. La vulnerabilidad de los jóvenes dada su inexperiencia y su escaso conocimiento de los riesgos asociados al juego, hace que muchos de ellos, llevados por la posibilidad de ganar dinero rápido, apostando poco, acaben atrapados en un bucle que les lleva a jugar de forma compulsiva sin atisbar el peligro. Pensar en el juego como una forma más de ocio, es un error de graves consecuencias como así ponen de manifiesto los testimonios de jóvenes adictos recogidos en este trabajo. La consulta documental y bibliográfica de diferentes estudios y textos, así como el estudio de datos cuantitativos relacionados con este tema, han permitido recopilar la información necesaria para sustentar el contenido de este trabajo, justificar su realización y llegar a la siguiente conclusión: la adicción a las apuestas online de los jóvenes y adolescentes se ha convertido en un problema, Grado en Publicidad y Relaciones Públicas

Las casas de apuestas son negocios cada vez más proliferantes en nuestros barrios, y atraen progresivamente a colectivos más jóvenes. La ludopatía, a su vez, es un problema que afecta cada vez a un mayor sector poblacional, y en especial entre el sector más joven. Una vez vista la evidente relación entre el aumento de las casas de apuestas y los casos de ludopatía, hemos investigado acerca de la importancia del juego en el desarrollo cognitivo y estudiado las casas de apuestas y la ludopatía desde el ámbito psicopatológico y legal. Por último, hemos analizado desde el punto de vista narrativo y conductual diversos spots de diversas casas de apuestas. El objetivo de este trabajo persigue averiguar las estrategias publicitarias y sesgos cognitivos que inducen las diferentes empresas de casas de apuestas en sus comunicaciones comerciales para atraer a los clientes y qué factores influyen en el desarrollo de una posible adicción a los Trastornos por Juegos de Apuesta (TJA), Grado en Publicidad y Relaciones Públicas

La diabetes es una enfermedad metabólica crónica que se caracteriza por niveles elevados de azúcar en sangre. Está alcanzando niveles epidémicos mundiales, siendo una de las enfermedades más prevalentes en la actualidad. Para favorecer el autocontrol de la enfermedad y corregir los estilos de vida de aquellas personas que la sufren es vital la educación para la salud impartida por los profesionales de enfermería en las consultas de Atención Primaria. El objetivo de este trabajo es conocer y analizar los conocimientos de la población diabética del Área de Salud Oeste de Valladolid sobre diabetes para valorar y justificar la necesidad de impartir educación sanitaria sobre este tema. Se trata de un estudio observacional, descriptivo y de corte transversal realizado por medio de un cuestionario validado, anónimo y voluntario, en los pacientes diabéticos que acuden a la consulta de retinografía del Centro de Salud Arturo Eyries. La muestra final se compuso de 474 participantes. Se realizó un análisis estadístico mediante el programa informático Excel. Se analizaron las 474 encuestas cumplimentadas. El 40,9% fueron hombres y el 59,1% mujeres. El rango de población que más participó fue aquellos con edades comprendidas entre 61 y 80 años. Los resultados obtenidos demuestran que la población diagnosticada de diabetes no posee los conocimientos suficientes sobre la enfermedad y no llevan a cabo un buen estilo de vida para evitar complicaciones. Según la evidencia científica y los resultados de este proyecto, se justifica la necesidad de invertir más tiempo en educación para la salud en las consultas de enfermería de Atención Primaria., Grado en Enfermería

Producción Científica, The aim of the study was to evaluate the impact of a specific training within the framework of the Best Practice Spotlight Organization® programme, on nurses' evidence-based practice competence and the practice environment in two hospitals. The study sample were 204 nurses working at medical and surgical inpatient units at two hospitals involved in the Best Practice Spotlight Organization® programme. They were classified into two groups: those who had received specific training within the framework of the programme, called trained-champions (n = 66), and those who had not yet received training, control group (n = 138). The trained-champions exhibited better evidence-based practice competence values than the control group in all dimensions (p < 0.001), with a higher difference in means in the “Utilisation” dimension (−0.80; CI:-0.99,-0.60) and the “Knowledge” dimension (−0.63; CI:-0.88,-0.38). The conclusions are that Specific EBP training within the framework of the Best Practice Spotlight Organization® programme has succeeded in nurses (trained-champions) obtaining better EBP competence than others without this training.

El estado de salud es un indicador importante a la hora de conocer el bienestar social. A través de este trabajo se va a analizar el estado de salud autopercibido de la población española, empleando para ello los datos proporcionados por la Encuesta de Condiciones de Vida (ECV), una herramienta utilizada por los gobiernos y otros organismos para recopilar información sobre variables relacionadas con la pobreza, condiciones de vida, desigualdades y empleo. Así, se analizará el efecto de una serie de variables de carácter multidimensional sobre la probabilidad de que un individuo se encuentre en buen estado de salud, con el fin de establecer relaciones que permitan concluir cuáles son los factores que influyen en mayor medida en la salud de las personas. Para ello, se llevará a cabo un análisis descriptivo, que se completará con un análisis econométrico mediante la estimación y posterior análisis de un modelo logit., Health status is an important indicator of social well-being. This report will analyse the self-perceived health status of the Spanish population, using data provided by the Statistics on Income and Living Conditions (SILC), a tool used by governments and other organisations to collect information on variables related to poverty, living conditions, inequalities, and employment. Thus, we will analyse the effect of a series of multidimensional variables on the probability that an individual is in good health, in order to establish relationships that allow us to conclude which factors have the greatest influence on people's health. To this end, a descriptive analysis will be carried out, which will be completed with an econometric analysis through the estimation and subsequent analysis of a logit model., Departamento de Economía aplicada, Grado en Administración y Dirección de Empresas

Most effective anticancer drugs normally generate considerable cytotoxicity in normal cells; therefore, the preferential activation of apoptosis in cancer cells and the reduction of toxicity in normal cells is a great challenge in cancer research. Natural products with selective anticancer properties used as complementary medicine can help to achieve this goal. The aim of the present study was to analyze the effect of the addition of bee products [propolis (PR) or royal jelly (RJ) or propolis and royal jelly (PR+RJ), 2–10%] to thyme (TH) and chestnut honeys (CH) on the differential anticancer properties, mainly the cytotoxic and pro-apoptotic effects, in normal and cancer hepatic cells. The cytotoxic effects of samples were analyzed using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay (0–250 mg/mL) and the effects on apoptosis were analyzed using cell cycle analysis, TdT-dUTP terminal nick-end labeling (TUNEL) assay, DR5 (Death Receptor 5) and BAX (BCL-2-Associated X) activation, and caspases 8, 9, and 3 activities. Both honey samples alone and honey mixtures had no or very little apoptotic effect on normal cells. Antioxidant honey mixtures enhanced the apoptotic capacity of the corresponding honey alone via both extrinsic and intrinsic pathways. Of all the samples, chestnut honey enriched with 10% royal jelly and 10% propolis (sample 14, CH+10RJ+10PR) showed the highest apoptotic effect on tumor liver cells. The enrichment of monofloral honey with bee products could be used together with conventional anticancer treatments as a dietary supplement without side effects. On the other hand, it could be included in the diet as a natural sweetener with high added value., Ministerio de Ciencia e Innovación, Sección Dptal. de Nutrición y Ciencia de los Alimentos (Veterinaria), Sección Deptal. de Farmacia Galénica y Tecnología Alimentaria (Veterinaria), Fac. de Veterinaria, TRUE, pub

Durante el presente trabajo incidiremos en la importancia de la actividad física y la salud para llevar a cabo un estilo de vida saludable. La actividad física no debe plantearse únicamente en el área de Educación Física, sino que debe ser transversal a lo largo del currículo de Educación Primaria, así como algo habitual en el ocio y en el día a día. Adquirir hábitos saludables y mantenerlos durante toda la vida garantiza salud, energía y bienestar físico y psíquico., Grado en Educación Primaria

Access to ART and health services is guaranteed under universal coverage to improve life expectancy and quality of life for HIV patients. However, it remains unknown whether patients of different socioeconomic background equally use different types of health services., Depto. de Economía Aplicada, Estructura e Historia, Fac. de Ciencias Económicas y Empresariales, TRUE, pub

En este trabajo se incorpora una nómina bibliográfica de 34 discursos publicados, relacionados con la educación física, leídos en la Universidad Central de Madrid entre 1853 y 1914, con el objeto de alcanzar el grado de Doctor en Medicina. En un estudio preliminar, a modo de discusión, se describen, se interpretan y se valoran estas aportaciones en los campos temáticos descubiertos. Finalmente se destaca la contribución bibliográfica y la influencia que ejercieron algunos médicos para construir un espacio científico y profesional propio de la educación física en la medicina. [ABSTRACT]This study includes a reference list of 34 speeches published, related to physical education, that were read at the Complutense University of Madrid between 1853 and 1914, in order to achieve the degree of Doctor of Medicine. In a preliminary study, by way of discussion, describe, interpret and value these contributions in the subject fields discovered. Finally, the literature highlights the contribution and influence that some physicians to build their own scientific and professional space for physical education in medicine., Biblioteca Histórica Marqués de Valdecilla, UCM. Biblioteca, TRUE, pub

Thanks to the effort of several supranational and national institutions, the concept of «workplace health promotion» has grown stronger with time and has become widespread. It goes beyond the goal of avoiding harm in order to advance in the pursuit of the best possible health level. Health is identified here, following the concept stated by the WHO, with integral well-being and the improvement of the quality of life. Therefore, this represents a further step in the legal evolution of health at workplace conception. From the first logic consisting in damage reparing – that goes back to the Law of 1900 of Work Accidents– it advances on to the logic of preventing these harmful consequences. Now the third stage focuses on an even more ambitious objective: the promotion of the best attainable health level. Collective bargaining is an ideal channel to develop the measures in which this ambitious goal has to be implemented. But there is an additional value that only the collective agreement offers. It implies the way in which commitments, that are freely adopted, turn into authentic behavioral imperatives, as a consequence of the free exercise of the autonomy of the will. Faced with such ambitious objectives in the interest of health, the due respect for the freedom to run a business and the limits of State intervention require a reduction in the degree of imperativeness of the debit position of the employer. It rather turns into a joint commitment with the employee. It should also be taken into account that public health objectives play an important roll in this area of occupational health promotion. The company is considered an ideal catalyst to achieve them. However, the respect of entrepreneurial freedom and the interdiction of interventionism demand not to impose but to promote and encourage the entrepreneur, which, in fact has important benefits for the business organization such as increasing productivity, reducing absenteeism, retaining employees´ loyalty… The righ, Gracias al impulso de diversas instituciones supranacionales y nacionales va abriéndose un espacio cada vez mayor el concepto de «promoción de la salud en el trabajo», que supera la lógica de evitar daños para avanzar en la de procurar el mejor estado de salud posible. La salud se identifica aquí, en el sentido marcado por la Organización Mundial de la Salud, con el bienestar integral y la mejora de la calidad de vida. Esto representa por tanto un siguiente paso en la evolución jurídica de la concepción de la protección de la salud de los trabajadores, que desde la lógica de la reparación de daños –cuyos orígenes se remontan a la Ley de 1900 de Accidentes de Trabajo– pasa a la lógica de prevención de dichas consecuencias lesivas, para en un tercer estadio aspirar a un objetivo aún más ambicioso, que es el de la promoción del mejor nivel de salud alcanzable. La negociación colectiva es un canal idóneo para desarrollar las medidas en que este objetivo tan ambicioso ha de concretarse. Pero es que además, hay un valor adicional que solo ofrece el convenio colectivo, porque supone el canal a través del cual compromisos que son adoptados libremente, como consecuencia del libre ejercicio de la autonomía de la voluntad, pasan a convertirse en auténticos imperativos de conducta exigibles a empresario y trabajador. Ante objetivos tan ambiciosos en aras de la salud, el respeto al derecho a la libertad de empresa y la interdicción del intervencionismo estatal exigen rebajar el grado de imperatividad de la posición de débito del empresario, en aras de un compromiso conjunto con el trabajador. También se debe tener en cuenta que en este espacio de la promoción de la salud laboral se proyectan objetivos de salud pública. Se considera a la empresa un catalizador idóneo para alcanzarlos. Pero de nuevo el respeto de la libertad de empresa y la interdicción del intervencionismo exigen no imponer sino impulsar e incentivar al empresario, lo que por otro lado tiene importantes ventajas, Depto. de Derecho del Trabajo y Seguridad Social, Fac. de Ciencias Económicas y Empresariales, TRUE, pub

Se plantea una nueva noción de salud integral, que contempla la variable cultural. La necesidad de mediación intercultural en el sistema sanitario esta justificada por el aumento de usuarios inmigrantes que requieren servicios sanitarios y la necesidad de responder desde el sistema sanitario a unos cuidados sanitarios de calidad. El mediador intercultural en salud ejerce de puente entre el sistema sanitario y los dis- tintos grupos étnicos, traduciendo a los profesionales sanitarios la simbología cultu- ral de origen en torno a la salud, para que estos puedan comprender el porqué de las distintas actitudes (factor étnico)., Depto. de Trabajo Social y Servicios Sociales, Fac. de Trabajo Social, TRUE, pub

El objetivo del artículo consiste en describir las principales propuestas orientadas a garantizar la sostenibilidad del Sistema Nacional de Salud (SNS), a partir de la revisión de los informes de diagnóstico y recomendaciones más relevantes que han sido publicados desde el comienzo de la crisis. Entre las propuestas más recurrentes aparecen la financiación selectiva de las tecnologías, la reorganización hacia una mayor atención a la cronicidad y una mejor coordinación entre niveles asistenciales y con la red sociosanitaria, y el impulso de la atención primaria. También abundan las relativas a la reforma del gobierno de la sanidad. Asimismo, el artículo examina brevemente las medidas adoptadas hasta el momento con el fin de reforzar la sostenibilidad del sistema, y de qué modo los servicios de urgencia pueden contribuir a este objetivo., The purpose of this paper is to describe the main proposals for ensuring national health service sustainability, in the light of a review of the most relevant diagnostic reports and guidelines published since the onset of the economic crisis. The following proposals are among the most frequently mentioned in the literature: selective financing of technology, reorganization to provide more care for chronic conditions and better coordination between levels of care and the network of social and health care services, and the reinforcement of primary care. Also commonly suggested is the reform of health care governance. Likewise, the authors briefly examine the measures adopted to date to promote the system’s sustainability and discuss how the emergency department can further this aim., Depto. de Economía Aplicada, Pública y Política, Fac. de Ciencias Económicas y Empresariales, TRUE, pub

La literatura reciente en la evaluación coste-beneficio de los proyectos sanitarios prefiere seguir la línea de la economía medioambiental y acercarse a una posición welfarista en la determinación de los cambios en el bienestar que continuar la hipótesis del capital humano, que había proporcionado en las últimas décadas unos notables resultados en los modelos de evaluación costebeneficio en la Economía de la Educación., The recent literature on cost-benefit analysis in Health Economics normally follows the methodology accepted by the Environmental Economics rather than the classical Human Capital hypothesis adopted successfully by the Economics of Education. In this paper we try to argue what could be the main reasons for such an investigation line., Instituto Complutense de Estudios Internacionales, TRUE, pub

Objective: To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Method: Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. Results: The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. Discussion: The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher., Objetivo: Evaluar si existen diferencias relevantes entre los valores de prevalencia de sobrepeso y obesidad infantil en función de los tipos de criterios utilizados (Fundación Orbegozo, International Obesity Task Force, Organización Mundial de la Salud), y el modo en que su uso afecta a las tendencias sobre obesidad registradas para ambos sexos en España entre 2005 y 2011. Método: Estudio transversal, en una población de entre 2 y 15 años de edad. Se usaron tres criterios diagnósticos de sobrepeso y obesidad. Resultados: Los niños, según los tres criterios utilizados, presentaron valores superiores de sobrepeso y obesidad en comparación con las niñas. Las cifras más bajas de sobrepeso y obesidad se observaron al emplear las tablas de Orbegozo. Discusión: Las prevalencias de sobrepeso y obesidad varían de manera significativa según los criterios utilizados para definir sobrepeso y obesidad. Los percentiles de la Fundación Orbegozo proporcionan las estimaciones más bajas, y los estándares de crecimiento de la Organización Mundial de la Salud las más altas., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub