Carcelén González, Raquel

Objetivos: Describir el apoyo emocional y la competencia profesional percibida por las mujeres que han sufrido una pérdida por muerte intrauterina, y analizar la asociación entre la relación paciente-profesional y la intensidad del duelo y otras variables relacionadas con la pérdida. Por otra parte, se pretende conocer la existencia de variables predictoras del duelo por muerte intrauterina. Metodología: Estudio observacional, descriptivo y retrospectivo, en el que han participado 95 mujeres que tuvieron una o más pérdidas espontáneas del embarazo en los últimos 5 años. Se analizó la intensidad del duelo (adaptación española validada de la escala de duelo Perinatal Grief Scale, con puntuaciones de 16 a 80: a mayor puntuación, mayor intensidad del duelo) y la interacción con los profesionales sanitarios durante la pérdida (encuesta validada de la calidad de la atención en muerte intrauterina, con puntuaciones de 13 a 65: a mayor puntuación, mayor calidad en la atención percibida). Resultados: Un 90,5% de las mujeres presenta un duelo activo, y la media de intensidad de duelo es de 38,8 ± 9,8. La media obtenida en la interacción con los profesionales sanitarios fue de 39,2 ± 10,2. El duelo fue predicho por la interacción con el personal sanitario (R2 ajustado= 0,281), por la semana de la pérdida (R2 ajustado= 0,38) y por el tiempo transcurrido desde la pérdida (R2 ajustado= 0,409). Conclusiones: Existe una relación inversa entre la calidad de la atención percibida por las participantes durante la pérdida y la intensidad del duelo, que es la principal variable predictora del duelo en las mujeres de esta muestra.

‘Living Better’, a self-administered web-based intervention, designed to facilitate lifestyle changes, has already shown positive short- and medium-term health benefits in patients with an obesity–hypertension phenotype. The objectives of this study were: (1) to examine the long-term (3-year) evolution of a group of hypertensive overweight or obese patients who had already followed the ‘Living Better’ program; (2) to analyze the effects of completing this program a second time (reintervention) during the COVID-19 pandemic. A quasi-experimental design was used. We recruited 29 individuals from the 105 who had participated in our first study. We assessed and compared their systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), eating behavior, and physical activity (PA) level (reported as METs-min/week), at Time 0 (first intervention follow-up), Time 1 (before the reintervention), and Time 2 (post-reintervention). Our results showed significant improvements between Time 1 and Time 2 in SBP (􀀀4.7 (􀀀8.7 to 􀀀0.7); p = 0.017), DBP (􀀀3.5 (􀀀6.2 to 􀀀0.8); p = 0.009), BMI (􀀀0.7 (􀀀1.0 to 􀀀0.4); p < 0.001), emotional eating (􀀀2.8 (􀀀5.1 to 􀀀0.5); p = 0.012), external eating (􀀀1.1 (􀀀2.1 to 􀀀0.1); p = 0.039), and PA (Time 1: 2308 2266; Time 2: 3203 3314; p = 0.030, Z = 􀀀2.17). Statistical analysis showed no significant differences in SPB, DBP, BMI, and eating behavior between Time 0 and Time 1 (p > 0.24). Implementation of the ‘Living Better’ program maintained positive long-term (3-year) health benefits in patients with an obesity–hypertension phenotype. Moreover, a reintervention with this program during the COVID-19 pandemic produced significant improvements in blood pressure, BMI, eating behavior, and PA.

Introduction. Breast cancer is the world’s most prevalent malignancy, with an increasing incidence and a predisposition for postpubertal females from all cultural and ethnic backgrounds. More recently, oral Fusobacterium nucleatum species have been observed in cancerous human breast tissue, drawing attention to the role of microbes in cancer pathogenesis. Objectives. Investigating oral Fusobacterium nucleatum species as potential biomarkers for female-speci2c breast cancer. Methods. A systematic search in )e Central Register of Controlled Trials, EMBASE, EBSCO, NCBI, and MEDLINE databases was undertaken from the 1st January, 1983–31st March, 2022. Articles included were in English and based on women between the ages of 18–96 years with con2rmed gingivitis/periodontal disease and breast cancer diagnoses from registered specialists. Authors extracted data independently, and a meta-analysis of risk estimations measuring associations between oral Fusobacterium nucleatum species and female-speci2c breast cancer was elucidated via calculated relative risks and 95% con2dence intervals. Results. AXIS tool analysis revealed 78.70% of articles with a positive correlation between oral Fusobacterium nucleatum and female-speci2c breast cancer. )e risk of breast cancer development increased with signi2cant levels of oral Fusobacterium nucleatum due to gingivitis/ periodontitis (relative risk � 1.78, 95% con2dence interval � 1.63–1.91). Low-moderate statistical heterogeneity was found (I2 � 41.39%; P � 0.02), and the importance of periodontal status on breast cancer pathogenesis was determined (relative risk � 1.24, 95% con2dence interval � 1.01–1.30). Conclusions. Oral Fusobacterium nucleatum species are a risk factor for breast cancer development, thus elevating their biomarker potentiality.

Background: The ‘Living Better’ web-based programme has shown short- and long-term benefits for body composition and psychological variables in obese patients with hypertension by promoting a healthier lifestyle. To further explore the potential of this programme, in this work we aimed to explore the possible effect of the patient’s ‘own doctor’ appearing in the video content of the Living Better intervention. (2) Methods: A total of 132 patients were randomly assigned either to the experimental (EG, n = 70) or control (CG, n = 62) group (with a doctor the patient knew as ‘their own’ or an ‘unknown doctor’, respectively). The body mass index (BMI), motivation towards physical activity (PA), PA levels, motivation to change one’s eating habits, adherence to the Mediterranean diet, and eating behaviour were all assessed and compared at baseline and post-intervention (12 weeks). (3) Results: The results of this study confirmed the positive effects of the Living Better programme on BMI and external eating style, with significant improvements in these variables in both groups. In addition, in the EG there was higher intrinsic motivation to change eating behaviour (mean difference of 0.9, 95% CI [0.1, 1.6], p = 0.032) and lower amotivation (mean difference of −0.6, 95% CI [−1.2, −0.1], p = 0.027) compared to the CG. (4) Conclusions: This study suggests that the presence of the patients’ own doctor in the audiovisual content of the Living Better intervention did not have significant additional benefits in terms of BMI or external eating style. However, their presence did improve intrinsic motivation and amotivation related to eating habits.

España se sitúa a la cabeza en consumo de drogas en Europa y, en particular en consumo, y prevalencia de cocaína y cannabis. Sin embargo, la percepción de las drogodependencias como un problema de salud no está instaurada en la sociedad. Con el fin de evaluar como tratan los medios técnico-profesionales especializados en salud la problemática de las drogodependencias en España, se analizan en este estudio la cobertura de información, las sustancias referidas y el valor de intensidad formal de un total de 147 textos, comparándolos con la cobertura hallada en agenda científica en un período de 6 meses. La metodología aplicada es el análisis de contenido de tipo categorial y evaluativo. Los resultados obtenidos indican que la cobertura en estos medios es reducida, la presencia de noticias relacionadas con la cocaína y el cannabis es baja, especialmente en comparación con la agenda científica y que la intensidad con que se tratan esta problemática es media. Todo ello, permite concluir que la problemática de las drogodependencias no es un tema prioritario en la agenda mediática de los soportes, técnico profesionales existiendo diferencias significativas en relación a la agenda científica.

To assess the effects of a progressive resistance training program at different intensities on health-related quality of life, anxiety, and motivation towards engaging in physical activity among older people. Prospective, municipal multicenters, non-randomized controlled trial. 76 older adults were assigned to: vigorous intensity (n = 19), vigorousmoderate intensity (n = 21), moderate intensity (n = 19), or control group (n = 17). The exercise groups performed six exercises with elastic bands per session, twice a week, for 8 months. Vigorous intensity, vigorous-moderate intensity and moderate intensity group performed 6, 10 and 15 repetitions, respectively. Health-related quality of life was assessed using the 36-Item Short Form Health Survey, trait and state anxiety using the State-Trait Anxiety Inventory, and motivation towards engaging in physical activity using the Behavioural Regulation in Exercise Questionnaire. The moderate intensity group showed a significant increase in the summary of the physical components of health-related quality of life (p = 0.001; ηp2 = 0.158) and a significant decrease in external regulation (p = 0.002; ηp2 = 0.145) and amotivation (p = 0.013; ηp2 = 0.97). In contrast, the vigorous intensity group showed a significant increase in state anxiety (p = 0.004; ηp2 = 0.076) and a significant decrease in introjected regulation (p = 0.018; ηp2 = 0.097). Moderate intensity strength training programs are best suited for older adults because they improve health-related quality of life and decrease less self-determined forms of regulation, all without increasing anxiety states.

Background: Virtual reality (VR) is used as a distraction measure during painful clinical procedures associated with the use of needles. These procedures include vaccinations, blood draws, or the administration of medications, which can cause children to feel increased levels of pain and fear. Objective: The objective of this study was to collect and analyze the current evidence regarding the effectiveness of VR as a tool to distract children from pain and fear during needle procedures as compared to that of standard techniques. Methods: A systematic review and meta-analysis was performed. We included randomized clinical trials (RCTs) or quasi-RCTs with participants younger than 21 years who underwent needle procedures in which the main distraction measure used was VR and where the main outcome measure was pain. The databases searched included the PubMed, Web of Science, Scopus, PsycINFO, CINAHL, and Cochrane libraries. In this systematic review, the studies were analyzed by applying the Critical Appraisal Skills Program guide in Spanish and the Jadad scale. In the meta-analysis, the effect size of the studies was analyzed based on the results for pain and fear in children. Results: From 665 unique search results, 21 studies were included in this systematic review, most of which reported low methodological quality. The study sample cohorts ranged from a minimum of 15 participants to a maximum of 220 participants. Ten studies were included in the meta-analysis. The global effect of using VR as a distraction measure was a significant reduction in pain (inverse variance [IV] –2.37, 95% CI –3.20 to –1.54; Z=5.58; P<.001) and fear (IV –1.26, 95% CI –1.89 to –0.63; Z=3.92; P<.001) in children in the experimental groups. Conclusions: The quality of the studies was mostly low. The main limitations were the impossibility of blinding the participants and health care personnel to the VR intervention. Nonetheless, the use of VR as a distraction measure was effective in reducing pain and fear in children during procedures involving needles.