Efectos de un programa de danzaterapia en la composición corporal y calidad de vida de mujeres mayores españolas con sobrepeso.

Objetivo: este estudio tuvo como objetivo probar la eficacia de un programa de danzaterapia en la composición corporal y calidad de vida en mujeres mayores de 65 años, que no realizan ejercicio físico de forma habitual. Métodos: cincuenta y dos mujeres sedentarias (edad media de 69,27 ± 3,85 años) fueron asignadas al azar para realizar un programa de danzaterapia (n = 27) o formar parte del grupo control (n = 25). El grupo de danza, participó durante ocho semanas en un programa de danza, tres sesiones semanales de 50 minutos cada una, basado en danza popular española (sevillanas) y ballet. Ambos grupos reciben información sobre la importancia de la alimentación y del ejercicio físico al comienzo y mitad del estudio. La circunferencia de la cintura, la presión arterial, el índice de masa corporal y la calidad de vida se evaluaron al inicio y después del tratamiento en ambos grupos. El análisis estadístico se realizó con un 2 × 2 ANOVA.Resultados: las mujeres del grupo de danza mostraron reducción significativa de la circunferencia de la cintura (p = 0,001) en comparación con las del grupo control. Los cambios en el IMC y la calidad de vida, aunque mejoraron en el grupo de danza, no alcanzaron significación estadística. Conclusión: la danzaterapia española es una forma de ejercicio físico eficaz para reducir la grasa visceral y prevenir comorbilidades en mujeres mayores, contribuyendo a cambiar estilos de vida poco saludables.

Ajustes endocrino-metabólicos durante el ayuno de Ramadán en jóvenes deportistas / Endocrine-metabolic adjustments during Ramadan fasting in young athletes

El precepto islámico del Ramadán (R), implica importantes modificaciones fisiológicas debido a las restricciones hídricas y dietéticas a lo largo del día y durante un mes, lo que tiene una especial repercusión física e intelectual de los musulmanes, particularmente en sociedades occidentales, en las que no se producen reajustes horarios para las actividades cotidianas. Entre las modificaciones impuestas por el R, el ayuno intermitente día/noche, desencadena mecanismos de adaptación para rentabilizar el consumo energético. El objetivo del presente estudio ha sido valorar algunos cambios endocrinometabólicos que acontecen a lo largo de la jornada, durante el mes de ayuno, en jóvenes que tienen que continuar con su actividad y entrenamiento deportivo habitual. Diez jóvenes musulmanes, varones, sanos, sometidos a entrenamiento deportivo, con edades entre 18 y 25 años que realizaron el R. Se analizaron parámetros bioquímicos y hormonales en plasma, una semana previa al R, primera y cuarta del periodo de ayuno (mañana y tarde) y semana posterior. Durante el R, se observa un descenso de los parámetros bioquímicos a lo largo del día, especialmente de la glucemia, siendo estos cambios más evidentes en la primera semana. La concentración de cortisol se encuentran significativamente elevada durante todo el mes, como consecuencia del cambio de ritmo circadiano de secreción. El R obliga al organismo a un ajuste endocrino-metabólico con el fin de preservar la eficiencia energética durante la jornada. Este control se vuelve más eficaz conforme avanza el mes de ayuno y la consecuente adaptación fisiológica.

The Islamic precept of R implies important physiological modifications due to the hydric and dietetic restrictions along a whole month plus a day, all of which have a crucial repercussion over the physical and intellectual performance of Muslims, particularly in occidental societies, in which there is no hour readjustments for daily activities. Among the imposed modifications by Ramadan in daily habits, intermittent fasting along day and night causes adaptation mechanisms to optimize the energy consumption. The objective of this study was to analyze the metabolic-endocrine changes that happen during daily working hours, along the month of fasting in young subjects who have to continue their usual activities and sport training. Ten young muslim subjects, male, healthy, set to sport training, ages in between 18 and 25 who completed Ramadan. Plasma biochemical and hormonal parameters were analyzed in plasma, a week before Ramadan, in the first and fourth of the fasting month and a week after conclusion. During Ramadan, have been observed a drop of biochemical parameters along daytime, especially those related to glycemia, being these changes stronger in the first week. The concentration of cortisol found to be significantly high during the whole month as a consequence of adaptation to the change of circadian secretion rhythms. Ramadan obliges subject´s organisms to readjust their endocrine and metabolic system in order to preserve the energetic efficiency during daytime. This auto control becomes more efficient as long as the month advances due to physiological adaptations.

Can myofascial techniques modify immunological parameters?

OBJECTIVES: The objective was to determine the effect of myofascial techniques on the modulation of immunological variables. DESIGN: Thirty-nine healthy male volunteers were randomly assigned to an experimental or control group. INTERVENTIONS: The experimental group underwent three manual therapy modalities: suboccipital muscle release, so-called fourth intracranial ventricle compression, and deep cervical fascia release. The control group remained in a resting position for the same time period under the same environmental conditions. OUTCOME MEASURES: Changes in counts of CD3, CD4, CD8, CD19, and natural killer (NK) cells (as immunological markers) between baseline and 20 minutes post-intervention. RESULTS: Repeated-measures ANOVA revealed a significant time × groups interaction (F(1,35)=9.33; p=0.004) for CD19. There were no significant time × group interaction effects on CD3, CD4, CD8, or NK cell counts. Intrasubject analyses showed a higher CD19 count in the experimental group post-intervention versus baseline (t=-4.02; p=0.001), with no changes in the control group (t=0.526; p=0.608). CONCLUSION: A major immunological modulation, with an increased B lymphocyte count, was observed at 20 minutes after the application of craniocervical myofascial induction techniques.

Quality assurance of nursing web sites: development and implications of the ALEU method.

This article presents a study that evaluated the physical accessibility, readability, and usability of Spanish nursing Web sites and discusses the quality assurance issues raised, which are relevant to the wider nursing community. The Internet is recognized as an important source of health information for both nurses and the general public. Although it makes health-related information universally available, the wide variation in the overall quality of health Web sites is problematic. This raises many questions for the nursing profession: about what constitutes a good-quality Web site, about the nature of the information that nurses are finding and using to support their professional education, research, and clinical practice, and about the impact that Internet information ultimately has on health interactions and nursing care. The process of completing this small study showed that it is possible to usefully assess dimensions of Web site quality and suggested that it may be feasible to develop tools to help nurses evaluate national and international nursing Web sites. More research is needed to understand how nurses use the Internet to support their everyday professional practices, but the development and application of international Web site quality assurance tools may be important for maintaining professional nursing standards in the Internet age.

[The impact of therapy with TNF-blockers on health-related quality of life in rheumatoid arthritis patients. A pilot study]. / Calidad de vida relacionada con la salud tras terapia anti-factor de necrosis tumoral alfa en pacientes con artritis reumatoide. Un estudio piloto.

INTRODUCTION: The aim of this pilot study was to evaluate the initial response to 16 weeks of treatment with infliximab and etanercept of disease activity and quality of life in a cohort of 37 patients with established rheumatoid arthritis. PATIENTS AND METHOD: Patients were selected from the Unit of Rheumatology in Hospital Clínico San Cecilio from Granada, refractory to conventional treatment with disease modifying antirheumatic drugs. To assess the disease activity, Disease activity score (DAS28) was used and the measurement of quality of life was evaluated with the Spanish version of the SF-36 Health Survey (SF-36) and the RA-specific questionnaire QoL Scale (Quality of Life in Rheumatoid Arthritis). RESULTS: Preliminary results show a significant decrease in inflammatory activity of the disease and consequently in HRQL scores. The comparison with the general reference population shows a deviation well below average, especially in the "physical function" dimension with a rising response pattern in all dimensions. The correlation between specific scores (QoL-RA scale) and generic ones (SF-36) for HQ-treatment also showed significance, especially with the physical aggregate. DISCUSSION: An important limitation of the present study is the number of patients and the duration of the treatment; despite this, improvements in functional parameters and quality of life are evident and remain roughly stable since the first weeks of treatment. This allow us to continue the study and increase the number of patients. CONCLUSIONS: The preliminary results obtained with TNF-blockers after 16 weeks of treatment in RA objectively show the effectiveness of these drugs and also the perception by the patients of the effect on their quality of life.

[Functional level and quality of life in ankylosing spondylitis, pilot study after 16 weeks TNF blocker treatment]. / Nivel funcional y calidad de vida en espondilitis anquilosante. Estudio piloto tras 16 semanas de tratamiento anti-TNF.

BACKGROUND AND OBJECTIVES: The aim of the present study is to assess the impact of infliximab and etanercept, TNF-alpha (tumour necrosis factor-alpha blockers) on functional disability and quality of life in thirteen patients over 65 years-old with ankylosing spondylitis (AS). PATIENTS AND METHODS: We consecutively included patients over 65 years-old, attending our clinic from Rheumatology Service in Hospital Clínico de Granada. These patients were all refractory to conventional therapy with disease-modifying anti-rheumatic drugs (DMARD). Disease activity was assessed using BASDAI index (bath ankylosing spondylitis disease activity index). Functional disability was assessed using BASFI (bath ankylosing spondylitis functional index) and ASQol index (ankylosing spondylitis quality of life index). RESULTS: We present a pilot study with 13 patients over 65 years-old treated with TNF blockers for 16 weeks. A significant decrease in disease activity was observed. Mean values of VAS (visual analogue scale) pain scores and disease decreases significantly after treatment (from 6.72 to 3.67 and 6.15 to 2.79 respectively), less than 4, which is considered an acceptable BASDAI response. Functional ability (BASFI) and health related quality of life (HRQOL) improved significantly from 6.15 to 2.79 and 13.85 to 4.22. CONCLUSIONS: Our results are consistent with the data available in the literature about TNF blockers decreasing clinical signs of the disease. Disease activity had significantly decreased 16 weeks after the onset of TNF blocker therapy. Functionality and quality of life have been also improved in elderly people with AS.

[The emotional impact of a hospital]. / El impacto emotivo del hospital.

In light of the challenge to offer future nurses a quality university education, the authors identify and evaluate the diverse activities which nurses carry out during their clinical stays, which cause a major emotional impact; therefore, these require greater attention, more knowledge and psychological resources which will aid them to successfully comply with this important aspect of their careers. With this goal in mind, the authors complied an inventory of specific stress factors for our context which was applied to a sample of 87 students at the school of nursing in Melilla. The results enabled the authors to establish a hierarchal order among the clinical experiences evaluated as having a greater stress load. These are those experiences, in descending order: terminal phase patients and death, tolerating external suffering, and hospital environment followed by oncology patients, psychiatric patients, tolerating aggressiveness, and infectious diseases. In light of the results, the authors offer some suggestions for the design of an operational program which shall mitigate and prevent as is possible the emotional impact of stress caused by clinical experiences.