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BACKGROUND: Nursing clinical competence assessment has acquired a special relevance at the undergraduate and postgraduate levels in recent years. In this context, the Objective Structured Clinical Assessment (OSCA) has emerged as a valid and feasible method of assessing nursing competence. The Satisfaction with Nursing Skill Examination: Objective Structured Clinical Assessment (SINE-OSCA) scale is a valid and reliable 10-item measure that has been developed to evaluate nursing students' satisfaction with the OSCA in the Australian context. Given the importance that OSCA has gained in Spain, it is necessary to validate this tool to be used in one of the most spoken languages in the world. OBJECTIVES: The purpose of the study was to carry out a modification of the SINE-OSCA, cross-cultural adaptation and a psychometric analysis of the new S-OSCA with Spanish nursing students. DESIGN: A multicenter study of questionnaire development and validation was carried out in 2023 in four Spanish university nursing centers. The study was carried out in 3 phases: design, pilot implementation, and construct validation. PARTICIPANTS/SETTING: The total population of students from these centers amounted to 1350 students. The final sample consisted of 364 nursing students, selected by convenience sampling. METHODS: The process of translation and cultural adaptation of SINE-OSCA to the Spanish population was carried out following the guidelines proposed by Beaton et al. Content validation, Internal consistency and temporal reliability were evaluated. RESULTS: The S-OSCA presents values in the psychometric indicators (V AIKEN, Bland-Altman diagram, and IVC Lawshe) that exceed the cut-off values established even considering the lower limit of the confidence intervals. This spanish version of the SINE-OSCA has a Cronbach's alpha value that is slightly higher than that reported for that original version (0.928 CI 95 % (0.913-0.94)). Regarding temporal reliability, the S-OSCA scale was completed in 40 nursing students at two times separated by an interval of 15 days. The Intraclass Correlation Coefficient (ICC) obtained was 0.974 CI 95 % (0.952-0.986). CONCLUSIONS: The S-OSCA instrument proves to be robust enough to guarantee the quality of its results up to 15 days post-OSCA.
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Competência Clínica , Avaliação Educacional , Psicometria , Estudantes de Enfermagem , Humanos , Estudos Transversais , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários , Psicometria/instrumentação , Psicometria/métodos , Espanha , Feminino , Masculino , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Avaliação Educacional/métodos , Avaliação Educacional/normas , Reprodutibilidade dos Testes , Satisfação Pessoal , Adulto , Bacharelado em Enfermagem/normas , Bacharelado em Enfermagem/métodos , Adulto JovemRESUMO
This study aimed to assess the enhancement of physical fitness and quality of life through an 8-week strength training program in male adolescent soccer players aged between 12 and 13 years. A lower body muscle group intervention was performed, with 17 players in the experimental group (EG) and 15 players in the control group (CG). The EG carried out soccer training complemented by specific strength work. Pre- and post- intervention assessments included body composition, jump height, speed with change of direction, maximum speed in 20 m, movement velocity in back-squat, perceived fatigue effort, academic performance, and quality of life. A general linear repeated measures model analysis was used considering each variable, the interaction between groups (EG, CG) and time (basal, 8-week), to analyze the differences between and within groups. The results showed a reduction in fat in the upper limbs and trunk, improvements in jump height, maximum speed of 20 m, and changes of direction, and increased quality of life (p < 0.05) in the EG. It was concluded that a strength program could improve some components of physical performance in male adolescent soccer players.
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The persistent condition of COVID-19 is characterized by a wide range of symptoms that have had a significant impact on both the health status and occupational life of the population. In this observational and multicenter study, the relationship between the sociodemographic and clinical profile of Spanish patients diagnosed with long COVID, and the work-related disability resulting from this pathology was analyzed. The analysis included 689 responses. A descriptive analysis of the variables recorded was performed, together with a bivariate analysis to determine associations between work-related disability and variables such as gender, age, health status, disabling symptoms or comorbidities. The results obtained highlight fatigue and lack of concentration (brain fog) as the most incapacitating symptoms among patients diagnosed with long COVID. Multivariate analysis revealed that time since diagnosis (OR: 0.57, CI95%: 0.36-0.89, p: 0.013), concomitant renal insufficiency (OR: 4.04, CI95%: 1.42-11.4, p: 0.008), and symptoms like fatigue (OR: 0.56, CI95%: 0.33-0.99) and tremors (OR: 2.0, CI95%: 1.06-3.69, p: 0.029), were associated with work-related disability. These findings highlight the need to improve the health and work-related management of this condition in the healthcare system. Besides risk factor control, it is suggested to pay special attention to determining the appropriate timing of medical leave work reintegration, along with coordination between primary care and occupational health services to ensure the gradual and tailored return of patients with long COVID to the workforce.
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Beetroot juice (BJ) has been used as a sport supplement, improving performance in resistance training (RT). However, its effect on the modulation of the autonomic nervous system has not yet been widely studied. Therefore, the objective of this randomized double-blind crossover study was to assess the effect of acute BJ supplementation compared to placebo in blood pressure (BP), heart rate (HR), heart rate variability (HRV) and internal load during RT measure as Root Mean Square of the Successive Differences between adjacent RR intervals Slope (RMSSD and RMSSD-Slope, respectively). Eleven men performed an incremental RT test (three sets at 60%, 70% and 80% of their repetition maximum) composed by back squat and bench press with. HR, HRV and RMSSD-Slope were measured during and post exercise. As the main results, RMSSD during exercise decrease in the BJ group compared to placebo (p = 0.023; ES = 0.999), there were no differences in RMSSD post-exercise, and there were differences in RMSSD-Slope between groups in favor of the BJ group (p = 0.025; ES = 1.104) with a lower internal load. In conclusion, BJ supplementation seems to be a valuable tool for the reduction in the internal load of exercise during RT measured as RMSSD-Slope while enhancing performance.
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Treinamento Resistido , Masculino , Humanos , Treinamento Resistido/métodos , Frequência Cardíaca/fisiologia , Estudos Cross-Over , Sistema Nervoso Autônomo/fisiologia , Pressão Sanguínea , Método Duplo-CegoRESUMO
OBJECTIVES: The main purpose of this study was to review the evidence about the effectiveness of exercise in patients with overweight or obesity suffering from knee osteoarthritis. METHODS: Randomized clinical trials (RCTs) published between January 2002 and May 2022 were included. RESULTS: A total of 64 articles were identified, of which six met the criteria for meta-analysis. The pain scale score was higher in the control group (mean difference 0.95; confidence interval 0.42-1.47; p < 0.001; I2 = 44%). The physical function scale (lower scores indicate lower levels of symptoms or physical disability) presented a higher score in the control group (mean difference 3.74; confidence interval 0.85-6.53; p < 0.05; I2 = 56%). Moreover, the intervention group achieved a greater distance (meters) walking in a 6 min interval (mean difference 38.18; confidence interval 20.01-56.35; p < 0.001; I2 = 0%). CONCLUSIONS: Exercise interventions seem effective in improving quality of life in people with overweight or obesity suffering from knee osteoarthritis, reducing pain and improving physical function.
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Osteoartrite do Joelho , Sobrepeso , Exercício Físico , Humanos , Obesidade/terapia , Osteoartrite do Joelho/terapia , Sobrepeso/terapia , DorRESUMO
BACKGROUND: Beetroot juice (BRJ) is used as an ergogenic aid, but no previous study has analyzed the effect this supplement has on the production of explosive force and muscular endurance in physically active women. HYPOTHESIS: BRJ improves explosive force and muscular endurance in the lower limbs of physically active women. STUDY DESIGN: Randomized double-blind crossover study. LEVEL OF EVIDENCE: Level 3. METHODS: Fourteen physically active women performed a countermovement jump (CMJ) test, a back squat test for assessing velocity and power at 50% and 75% of one-repetition maximum (1RM), and the number of repetitions on a muscular endurance test consisting of 3 sets at 75% of 1RM in a resistance training protocol comprising 3 exercises (back squat, leg press, and leg extension). The participants performed the test in 2 sessions, 150 minutes after ingesting 70 mL of either BRJ (400 mg of nitrate) or a placebo (PLA). RESULTS: A greater maximum height was achieved in the CMJ after consuming BRJ compared with a PLA (P = 0.04; effect size (ES) = 0.34). After a BRJ supplement at 50% 1RM, a higher mean velocity [+6.7%; P = 0.03; (ES) = 0.39 (-0.40 to 1.17)], peak velocity (+6%; P = 0.04; ES = 0.39 [-0.40 to 1.17]), mean power (+7.3%; P = 0.02; ES = 0.30 [-0.48 to 1.08]) and peak power (+6%; P = 0.04; ES = 0.20 [-0.59 to 0.98]) were attained in the back squat test. In the muscular endurance test, BRJ increased performance compared with the PLA (P < 0.00; ηp2 = 0.651). CONCLUSION: BRJ supplements exert an ergogenic effect on the ability to produce explosive force and muscular endurance in the lower limbs in physically active women. CLINICAL RELEVANCE: If physically active women took a BRJ supplement 120 minutes before resistance training their performance could be enhanced.
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Substâncias para Melhoria do Desempenho , Treinamento Resistido , Feminino , Humanos , Estudos Cross-Over , Suplementos Nutricionais , Atletas , Poliésteres/farmacologia , Força Muscular , Músculo EsqueléticoRESUMO
Older age and comorbidities in hemodialysis patients determines the use of tunneled catheters as vascular access despite their reported clinical and mortality disadvantages. This prospective matched study analyzes the impact of permanent catheters on inflammation and mortality in hemodialysis patients; We studied 108 patients, 54 with AV-fistula (AVF) and 54 with indwelling hemodialysis catheters (HDC) matched by sex, age, diabetes and time under renal-replacement therapy comparing dialysis efficacy, inflammation and micro-inflammation parameters as well as mortality. Cox-regression analysis was applied to determine predictors of mortality, HDC patients presented higher C-reactive-protein (CRP) blood levels and percentage of pro-inflammatory lymphocytes CD14+/CD16+ with worse dialysis-efficacy parameters. Thirty-six-months mortality appeared higher in the HDC group although statistical significance was not reached. Age with a Hazard Ratio (HR) = 1.06, hypoalbuminemia (HR = 0.43), hypophosphatemia (HR = 0.75) and the increase in CD14+/CD16+ monocyte count (HR = 1.02) were predictors of mortality; elder patients dialyzing through HDC show increased inflammation parameters as compared with nAVF bearing patients, although they do not present a significant increase in mortality when matched by covariates. Increasing age and percentage of pro-inflammatory monocytes as well as decreased phosphate and serum-albumin were predictors of mortality and indicate the main conclusions or interpretations.
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Derivação Arteriovenosa Cirúrgica , Cateteres Venosos Centrais , Idoso , Humanos , Inflamação , Estudos Prospectivos , Diálise Renal/efeitos adversosRESUMO
A great deal of evidence has been gathered on the use of creatine as an ergogenic supplement. Recent studies show greater benefits when creatine ingestion is performed close in time to training, but few studies tackle the way that circadian rhythms could influence creatine consumption. The aim of this study was therefore to observe the influence circadian rhythms exert on sports performance after creatine supplementation. Our method involved randomly assigning fourteen women players of a handball team into two groups in a single-blind study: one that consumed the supplement in the morning and one that consumed it in the evening, with both groups following a specific training program. After twelve weeks, the participants exhibited a decreased fat percentage, increased body weight and body water, and improved performance, with these results being very similar in the two groups. It is therefore concluded that, although circadian rhythms may influence performance, these appear not to affect creatine supplementation, as creatine is stored intramuscularly and is available for those moments of high energy demand, regardless of the time of day.
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Desempenho Atlético , Creatina , Ritmo Circadiano , Suplementos Nutricionais , Feminino , Humanos , Método Simples-CegoRESUMO
Health professionals and students in training are key for early diagnosis of cancer. The objective of this study was to evaluate the awareness of Family Medicine (FM) residents and Medicine and Nursing undergraduate students in Spain regarding the European Code Against Cancer (ECAC). This was a descriptive, cross-sectional, and multicenter study. LOCATION: Teaching Units of FM of Cordoba and Ceuta and Schools of Medicine and Nursing of the Universities of Cordoba and Francisco de Vitoria of Madrid (Spain). PARTICIPANTS: residents of FM and Medicine and Nursing undergraduate Spanish students. INTERVENTION: self-administered questionnaire to assess the awareness about the ECAC. A total of 651 subjects participated (52.4% [95% CI 48.5-56.2] Nursing students, 34% [95% CI 30.3-37.6] Medicine students, and 13.6% [95% CI 11.0-16.3] FM residents). Of the total subjects participated, 74.8% were women. Mean age: 22.34 years (standard deviation, 4.68; range, 18-52; 95% CI, 21.98-22.70). A total of 76.8% (95% CI 73.5-80.1) declared to be unaware of the ECAC. Those referring to be aware of the ECAC mainly knew it through degree subjects (7.5% [95% CI 5.5.5-9.6]). Residents of FM (p < 0.001), older participants (p < 0.001), and those belonging to the Teaching Units (p = 0.002) showed a better awareness of the ECAC. Our findings reveal the unawareness on the ECAC in three out of four participants. The access to the advice described in the ECAC through the Medicine and Nursing Schools and FM Teaching Units is poor. The awareness of the ECAC of postgraduate residents is higher than that the awareness of the undergraduate students.
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Neoplasias , Estudantes de Medicina , Estudantes de Enfermagem , Adulto , Estudos Transversais , Medicina de Família e Comunidade , Feminino , Humanos , Neoplasias/diagnóstico , Espanha , Inquéritos e Questionários , Adulto JovemRESUMO
The objective of this study was to evaluate the impact of a comprehensive anti-smoking health program conducted over twelve years at a regional university hospital in southern Spain. Prevalence of tobacco was compared retrospectively using data collected during occupational health assessments (n = 4291). Bivariate and logistic regression analyses were carried out to evaluate tobacco consumption differences according to age, sex, professional category, and workplace building. The results show a reduction in the active smoking rate among hospital staff evaluated (from 22.8% to 19.8%) with significant differences between non-health and health workers. Accumulated smoking consumption fell to 13.45 ± 14.60 packs/year with men presenting a higher consumption (p < 0.001). The predictive variables of tobacco use were sex (greater consumption among men, p = 0.021), number of cigarettes (greater consumption among professionals who smoked less than 1 pack/day, p < 0.001), and time smoking (greater use among professionals with more than 10 years smoking, p < 0.001). There was a higher rate of staff smokers at the hospital building with a majority of mental health inpatients. This study provides a practical example of making the optimum use of digital medical records in the evaluation of a comprehensive anti-smoking health program.
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Recursos Humanos em Hospital , Fumantes , Humanos , Estudos Retrospectivos , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
The ingestion of beetroot juice (BJ) has been associated with improvements in physical performance in endurance sports, however the literature on resistance training (RT) is scarce. The aim of this study was to investigate the acute effects of BJ compared to a placebo (PLA) on muscular endurance and movement concentric velocity during RT. Twelve healthy men performed an incremental RT test (back squat and bench press) with three sets, at 60%, 70%, and 80% of their repetition maximum (1-RM). Movement velocity variables, total number of repetitions performed until concentric failure, blood lactate, and ratings of perceived effort post-training were measured. A higher number of repetitions were recorded with BJ compared to those with PLA (13.8 ± 14.4; p < 0.01; effect size (ES) = 0.6). Differences were found at 60% 1-RM (9 ± 10; p < 0.05; ES = 0.61) and 70% 1-RM (3.1 ± 4.8; p < 0.05; ES = 0.49), however, no differences were found at 80% 1-RM (1.7 ± 1; p = 0.12; ES = 0.41). A greater number of repetitions was performed in back squat (13.4 ± 13; p < 0.01; ES = 0.77), but no differences were observed in bench press (0.4 ± 5.1; p = 0.785; ES = 0.03). No differences were found for the rest of the variables (p > 0.05). Acute supplementation of BJ improved muscular endurance performance in RT.
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Desempenho Atlético/fisiologia , Beta vulgaris , Sucos de Frutas e Vegetais , Substâncias para Melhoria do Desempenho/farmacologia , Preparações de Plantas/farmacologia , Adulto , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Masculino , Músculo Esquelético/efeitos dos fármacos , Nitratos , Treinamento Resistido , Adulto JovemRESUMO
INTRODUCTION: The aim of the study is to analyse the prevalence of smoking among resident physicians at a regional university hospital. In addition, we examined the trends in the smoking behaviour of physicians in relation to results obtained in other studies carried out previously at this hospital, as well as those published nationally and internationally METHOD: A cross-sectional observational study evaluating tobacco consumption in young physicians was carried out at the level of secondary healthcare in a regional university hospital in Cordoba, Spain. All the study subjects were resident physicians who underwent a mandatory preliminary occupational health examination between 2012 and 2016. There was no sampling selection as anyone who took this examination was considered to be within the target population. We calculated the proportions of smokers, former smokers and non-smokers, with 95% CIs. Univariate and multivariate analyses (binary logistic regression) were used to analyse the results (P<0.05). RESULTS: The response rate was 99.4%, with a sample size of 324 out of a possible 326 physicians. The average age was 28.6±3.7-DT-(95% CI 28.2 to 29.0), and 62.3% (202/324; 95% CI 57.3 to 67.2) were women. Smoking prevalence was 6.5% (21/324; 95% CI 3.5 to 9.3) with a further 5.2% (17/324; 95% CI 2.7 to 7.8) being ex-smokers. There were no significant differences in the prevalence of tobacco consumption according to age (P=0.266), sex (9.0% for men and 5.0% for women; P=0.128), medical specialty (P=0.651) or year of residency (P=0.975). A 52.7% decline in the number of young physician smokers was noted between 1986 and 2016 (95% CI -44.0 to -63.5), together with a 64.4% increase in non-smokers (95% CI 55.2 to 77.3). CONCLUSIONS: We observed a significantly low prevalence of tobacco use among trainee physicians in the cohort, an effect of new antismoking laws, with positive role model implications for new physicians and medical students.
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Hospitais Universitários , Internato e Residência , Médicos/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional , Prevalência , Política Antifumo , Espanha/epidemiologiaRESUMO
The aim of this study was to evaluate the Spanish population's knowledge of and beliefs regarding the European Code Against Cancer (ECAC) recommendations. This was a cross-sectional, observational, multicentric study that used self-administered surveys. Ten individuals, between the ages of 15 and 69 years old, were enrolled by each participating primary care professional in their respective surgery consultations. This study used 2058 individuals who were recruited by 205 professionals from 106 health centres. Their average age was 41.5 years (52.2% women). The majority believe that smoking [94.1%; 95% confidence interval (CI): 93.1-95.2], sun exposure (91%; 95% CI: 89.7-92.3) and alcoholism (72.1%; 95% CI: 70.1-74.1) are factors related to cancer. The least relevant are infection by the hepatitis B virus (25.7%; 95% CI: 23.8-27.7) and having multiple sexual partners (25%; 95% CI: 23.1-26.9). In all, 86.7% (95% CI: 85.2-88.2) had never heard about the ECAC. Patients adequately identify the carcinogenic effect of tobacco, alcohol or sun exposure. Moreover, they inadequately identify having hepatitis B and multiple sexual partners as being related to cancer. A large majority of individuals have not heard of the ECAC, which raises the need to conduct outreach campaigns at an institutional level and/or through scientific associations and activities promoting health education among primary care professionals.