Environmental health knowledge and competences in Basque health workers. A comparison of different professional profiles.

Environmental exposures are responsible for a quarter of morbidity and mortality rates globally. Primary care professionals work in a privileged position to detect and intervene on environmental health matters. Nevertheless, due to lack of specific training, international literature shows that primary care health professionals have limited skills to deal with those. The objectives of this study were to assess the levels of environmental health (EH) knowledge and competence of a sample of 446 health professionals and students in the Basque Country and explore the presence that EH has on their daily practice. Only a very small proportion of participants had received training and took environmental clinical history regularly. Participants were confident to deal, and actually dealt, with tobacco, pollen and sun exposures but less able to address topics like biomarkers, pesticides and endocrine disruptors. Finally, and in accordance to previous works, we found moderate levels of EH knowledge and skills in our sample, and observed that nurses and nursing students reported higher EH skills than other professional profiles but scored lower in knowledge. Despite the manifold impacts of environmental exposures on health, interventions to strengthen health professionals' EH competence are required.

Effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents: Randomized controlled trial.

This study analyzed the effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents. This was a single-blind, multicenter, randomized controlled trial performed in 10 long-term care settings and involved 112 participants. Participants were randomly assigned to a control group or an intervention group. The control group participated in routine activities; the intervention group participated in a six-month individualized and progressive multicomponent exercise program focused on strength, balance, and walking recommendations. The intervention group maintained peak VO2, oxygen saturation, and resting heart rate, while the control group showed a significant decrease in peak VO2 and oxygen saturation and an increase in resting heart rate throughout the six-month period. Individualized and progressive multicomponent exercise programs comprising strength, balance, and walking recommendations appear to be effective in preventing cardiorespiratory fitness decline in older adults living in long-term care settings.

Effectiveness of a multicomponent exercise program in the attenuation of frailty in long-term nursing home residents: study protocol for a randomized clinical controlled trial.

BACKGROUND: There is increasing evidence suggesting that cognition and physical frailty interact within a cycle of decline associated with aging which has been called cognitive frailty. Exercise programs have demonstrated to be an effective tool to prevent functional and cognitive decline during aging, but little is known about their potential to restore or maintain functionality in individuals that require long-term nursing care. Besides, WHO has recently highlighted the importance of introducing systematic musculoskeletal health programs for older people living in residential care, as they represent a particularly vulnerable group for the development of noncommunicable diseases. METHODS: This is a multicentre randomized controlled trial. 114 participants will be randomly allocated to a usual care group or to an intervention group. Inclusion criteria are as follows: ≥ 70 years, ≥ 50 on the Barthel Index, ≥ 20 on MEC-35 who are capable to stand up and walk independently for 10 m. Subjects in the intervention group will add to the activities scheduled for the control group the participation in a 6 months long multicomponent exercise program designed to improve strength, balance and walking retraining. Study assessments will be conducted at baseline and at 3 and 6 months. The primary outcome is change in function assessed by Short Physical Performance Battery and secondary outcomes include other measurements to assess all together the condition of frailty, which includes functionality, sedentary behaviors, cognitive and emotional status and biological markers. The present study has been approved by the Committee on Ethics in Research of the University of the Basque Country (Humans Committee Code M10/2016/105; Biological Samples Committee Code M30/2016/106). DISCUSSION: Results from this research will show if ageing related functional and cognitive deterioration can be effectively prevented by physical exercise in institutionalized elders. It is expected that the results of this research will guide clinical practice in nursing home settings, so that clinicians and policymakers can provide more evidence-based practice for the management of institutionalized elder people. TRIAL REGISTRATION: The protocol has been registered under the Australian and New Zealand Clinical Trials Registry (ANZCTR) with the identifier: ACTRN12616001044415 .

Anthropometric, physiological and maturational characteristics in selected elite and non-elite male adolescent basketball players.

We investigated the anthropometric, physiological and maturation characteristics of young players (13-14 years old) associated with being successful in basketball. Body parameters were measured (stature, total body mass, skinfolds and lengths) and physiological capacities were assessed by endurance, sprint (20 m), jump and dribbling tests. Chronological age (CA) was recorded and maturity estimated using predicted age at peak height velocity (APHV). Anthropometric analysis indicated that elite players were taller, heavier and had a higher percentage of muscle. Further, physiological testing showed that these elite players perform better in jump, endurance, speed and agility tests (especially in the agility and ball tests). In addition, these skills are correlated with point average during the regular season. More basketball players born in the first semester of the year are selected and there is a predominance of early-maturing boys among those selected for the elite team. Those who are more mature have advantages in anthropometric characteristics and physiological test results. In conclusion, around puberty, physical and physiological parameters associated with maturity and CA are important in determining the success of basketball players. These findings should be taken into account by trainers and coaches, to avoid artificial bias in their selection choices.

Effects of a multicomponent physical exercise programme on perceived health-related quality of life and on depressive symptoms in older adults living in long-term nursing homes.

Objectives: This study aimed to investigate the impact of a multicomponent exercise programme on perceived health-related quality of life (HRQoL) and depressive symptomatology in older people living in a long-term nursing home (LTNH). Methods: A quasi-experimental study was conducted. Forty-one older people were conveniently selected from the largest LTNH in the Basque Country. The participants were assigned to either an intervention group (n = 21) or a control group (n = 20). The intervention group participated in 50-min moderate intensity multicomponent physical exercise sessions (strength and balance, three sessions a week for 3 months). The control group participants continued their usual activities in the LTNH. Assessments were completed at baseline and reassessed after the 12-week intervention by the same nurse researchers who filled out the questionnaires: the 36-item Short Form Survey (SF-36) and the Geriatric Depression Scale (GDS). Results: Thirty-eight participants completed the study (19 participants in each group). In the SF-36 parameters, physical functioning increase in the intervention group tends with a mean increase of 11.06 units (a 17.2% increase over the pre). In the role-emotional, the increase in the intervention group is with a mean increase of 5.27 units (a 29.1% increase over the pre) (P < 0.05). In social functioning, the increase in the control group is significant with a mean increase of 13.16 units (a 15.4% increase over the pre) (P < 0.05). There are no significant changes in the rest of the parameters, there are no differences between groups in the evolutionary pattern either. Conclusions: As for the effects of the multicomponent exercise programme on HRQoL and depressive symptomatology, no statistically significant effects were obtained in the outcome data among older adults living in LTNHs. An increase in the sample size could confirm the trends obtained. The results may help inform the design of future studies.

Sex Differences in Frailty Factors and Their Capacity to Identify Frailty in Older Adults Living in Long-Term Nursing Homes.

Frailty is a phenomenon that precedes adverse health events in older people. However, there is currently no consensus for how to best measure frailty. Several studies report that women have a higher prevalence of frailty than men, but there is a gap in studies of the high rates of frailty in older people living in long-term nursing homes (LTNHs) stratified by sex. Therefore, we analyzed health parameters related to frailty and measured their capacity to identify frailty stratified by sex in older people living in LTNHs. According to the Fried Frailty Phenotype (FFP), anxiety increased the risk of frailty in women, while for men functionality protected against the risk of frailty. Regarding the Tilburg Frailty Indicator (TFI), functionality had a protective effect in men, while for women worse dynamic balance indicated a higher risk of frailty. The analyzed parameters had a similar capacity for detecting frailty measured by the TFI in both sexes, while the parameters differed in frailty measured by the FFP. Our study suggests that assessment of frailty in older adults should incorporate a broad definition of frailty that includes not only physical parameters but also psycho-affective aspects as measured by instruments such as the TFI.

The Nutritional Status of Long-Term Institutionalized Older Adults Is Associated with Functional Status, Physical Performance and Activity, and Frailty.

Among older adults living in long-term nursing homes (LTNHs), maintaining an adequate functional status and independence is a challenge. Whilst a poor nutritional status is a potential risk factor for a decreased function in this population, its role is not fully understood. Here, using a transversal multicenter study of 105 older adults living in 13 LTNHs, we analyzed the associations between nutritional status, as measured by the Mini Nutritional Assessment (MNA), and the parameters of functional status, physical performance, physical activity, and frailty as well as comorbidity and body composition. The MNA scores were positively correlated with the Barthel Index, handgrip strength, Short Physical Performance Battery (SPPB) scores, absolute muscle power, and Assessment of Physical Activity in Frail Older People (APAFOP) scores and were negatively correlated with dynamic balance and frailty. In a multiple linear regression model controlling for gender and age, the APAFOP score (ß = 0.386), BMI (ß = 0.301), and Barthel Index (ß = 0.220) explained 31% of the variance in the MNA score. Given the observed close relationship between the MNA score and functional status, physical performance and activity, and frailty, interventions should jointly target improvements in both the nutritional status and functional status of LTNH residents. Strategies designed and implemented by interdisciplinary professional teams may be the most successful in improving these parameters to lead to better health and quality of life.

The impact of physical exercise on cognitive and affective functions and serum levels of brain-derived neurotrophic factor in nursing home residents: A randomized controlled trial.

OBJECTIVES: To determine the effects of a multicomponent physical exercise program on cognitive and affective functioning among nursing home residents and to clarify whether there are any changes in serum levels of brain-derived neurotrophic factor (BDNF) among participants. STUDY DESIGN: This was a single-blind randomized controlled trial in ten nursing homes in Gipuzkoa, Spain. The study included 112 men and women. Participants in the control group engaged in routine activities while those in the intervention group participated in a six-month individualized, progressive, multicomponent physical exercise program focused on strength, balance, and walking. MAIN OUTCOME MEASURES: Cognitive and affective functions were assessed at baseline and at six months. Serum BDNF levels were assessed via ELISA. RESULTS: After six months, a group by time interaction in favor of the intervention group was observed on the Montreal Cognitive Assessment (MOCA), symbol search and De Jong-Gierveld Loneliness Scale (P < 0.05). The control group scored more poorly on the MOCA, WAIS-IV (coding and symbol search), verbal fluency, and semantic fluency tests after six months (P < 0.05) than they did at baseline. The intervention group showed poorer results on the coding test (P < 0.05). Loneliness perception was reduced in the intervention group (P < 0.05). No changes in serum BDNF were observed (group x time and within groups, P > 0.05). CONCLUSION: A six-month individualized, progressive, multicomponent physical exercise intervention is effective at maintaining cognitive function and decreasing perceptions of loneliness among nursing home residents. Blood levels of BDNF were not affected by the intervention.

Associations of Anthropometric Characteristics, Dietary Habits, and Aerobic Capacity With Cardiovascular Risk Factors of Health-Science Students.

The aim of this cross-sectional study was to study the relative importance of dietary habits and aerobic capacity in parameters related to cardiovascular risk in 271 female and 95 male health-science students (mean age = 19.1 ± 1.4 years). In females, fatty-meat consumption predicted triglycerides (ß = .649, p < .001) and high-density lipoprotein (HDL; ß = -.242, p = .001) and low-density lipoprotein (LDL; ß = .373, p < .001) cholesterol levels. Consumption of nuts, legumes, and complex carbohydrates predicted triglyceride (ß = -.099, p = .074), HDL (ß = .231, p = .001), and LDL (ß = -.155, p = .025) levels, respectively. Aerobic capacity (ß = -.245, p < .001) and fatty-meat intake (ß = .230, p < .001) predicted diastolic blood pressure (BP); body mass index (BMI) predicted systolic BP (ß = .340, p < .001). In males, body fat percentage was the strongest predictor of triglycerides (ß = .348, p = .004), cholesterol (ß = .366, p = .006), HDL (ß = -.378, p = .004), and LDL (ß = .271, p = .043) levels. Aerobic capacity (ß = -.263, p = .013) and fatty-meat consumption (ß = .334, p = .005) independently predicted triglyceride levels. Nut (ß = -.286, p = .013) and fatty-meat intake (ß = .361, p = .002) predicted systolic BP, while BMI predicted diastolic BP (ß = .209, p = .045). As health sciences students, these participants are future health professionals; targeting such populations is important for chronic disease prevention.

Longitudinal study: lifestyle and cardiovascular health in health science students.

BACKGROUND: Changing lifestyle habits is considered the principal measure for the control of blood pressure and obesity. The aim of this study was to characterize the eating habits, anthropometric characteristics, physical fitness and blood pressure of students of health science degrees during the first three academic years and to explore the relation between the aforementioned parameters. METHODS: This was a longitudinal study conducted over three years on the eating habits and physical fitness of health science students (n=366) and the influence of these factors on blood pressure and obesity. RESULTS: The mean food group intakes of both female and male participants corresponded to a high consumption of lean and fatty meat, sweets and pastries and a low consumption of cereals, fruits, vegetables, olive oil, fish, nuts and vegetables. Blood pressure and obesity-related parameters were within normal ranges and did not change over the study period. Aerobic capacity values increased in men from the beginning to the end of the study, while V02max decreased in women between the first and second years. CONCLUSION: We note that, in both women and men, blood pressure values were lower when diet was high in vegetables, legumes, nuts, fish and olive oil. In both sexes, we found a negative correlation between aerobic capacity and systolic and diastolic blood pressure and a positive correlation between obesity and blood pressure. The pattern of the eating habits and changes therein were different in young women and men, the former being focused on improving their diet and the latter on improving their physical fitness.

Objetivo: Cambiar los hábitos de vida se considera la principal medida para el control de la presión arterial y la obesidad. El objetivo de este estudio fue caracterizar los hábitos alimentarios, características antropométricas, condición física y la presión arterial de los estudiantes de grados de ciencias de la salud durante los tres primeros años académicos y analizar la relación entre los parámetros antes mencionados. Métodos: El estudio fue un estudio longitudinal llevado a cabo durante los tres primeros años de universidad, donde se midieron los hábitos alimenticios y la condición física de los estudiantes de grados de ciencias de la salud (n = 366) y la influencia de estos factores sobre la presión arterial y la obesidad. Resultados: El consumo de alimentos tanto de mujeres como de hombres, se correspondió con un consumo excesivo de carne magra y grasa, dulces y pasteles; y un bajo consumo de cereales, frutas, verduras, aceite de oliva, pescado, frutos secos y legumbres. Los parámetros de la presión arterial y de la obesidad se sitúan dentro de la normalidad y no varían a lo largo del periodo de estudio. Los valores de la capacidad aeróbica aumentaron en los hombres desde el principio hasta el final del estudio, mientras que V02max disminuyó en las mujeres entre el primer y segundo año. Conclusiones: Observamos que tanto en las mujeres como en los hombres, los valores de presión arterial fueron más bajos cuando la dieta era rica en verduras, legumbres, frutos secos, pescados y aceite de oliva. En ambos sexos, se encontró una correlación negativa entre la capacidad aeróbica y la presión arterial sistólica y diastólica y una correlación positiva entre la obesidad y la presión arterial. El patrón de los hábitos alimentarios y los cambios a lo largo de los tres años, fueron diferentes en las mujeres y los hombres. Las mujeres se centran más en la mejora de su dieta y los hombres en la mejora de su condición física.