Changes in metabolic risk, insulin resistance, leptin and adiponectin following a lifestyle intervention in overweight and obese breast cancer survivors.

Adiposity and physical activity are modifiable factors that could be important determinants of breast cancer (BC) prognosis through their effects on endogenous reproductive hormones, chronic inflammation and metabolic changes. Therefore, it is necessary to evaluate whether offering lifestyle interventions to BC survivors could affect the levels of certain biomarkers involved in these mechanisms. We designed a pre-post intervention study offering diet and exercise sessions over 12 weeks to 42 overweight/obese BC survivors. Before and after the intervention, we obtained dietary information, anthropometry and cardiorespiratory fitness (CRF) measurements and blood samples to measure metabolic risk, insulin resistance and adipokines biomarkers. Wilcoxon signed-rank tests and Spearman partial correlation coefficients were used to compare pre- and post-measurements and assess the correlations between changes in biomarkers and changes in anthropometry and CRF. Breast cancer survivors showed significant improvements in metabolic risk biomarkers and insulin resistance indicators along with a non-significant leptin decrease and a significant adiponectin decrease. The improvements in metabolic risk biomarkers, insulin resistance indicators and leptin were moderately correlated (0.32 ≤ |r| ≤ 0.55) with the decrease in body mass index and the increase in CRF. Diet and exercise interventions implemented in overweight/obese BC survivors may improve metabolic risk, insulin resistance and leptin biomarkers.

Is Quality of Life Related to Cardiorespiratory Fitness in Overweight and Obese Breast Cancer Survivors?

This study assessed changes in quality of life (QoL) and cardiorespiratory fitness (CRF) during a diet and physical activity (PA) intervention in breast cancer (BC) survivors and investigated the relation between these changes. The intervention of this single-arm pre-post study involved supervised, 1-hour weekly, diet sessions and 75-minute bi-weekly PA sessions of moderate-to-high intensity. This 12-week intervention targeted overweight/obese women who had recently completed BC treatment. Pre- and post-CRF and QoL measurements were compared using paired t-tests. Linear regression models, including baseline participants' characteristics and weight change, were used to assess the association between changes in CRF and QoL. The 37 BC survivors who completed the intervention between May 7, 2012 and July 27, 2012 showed significant increases in CRF and QoL. Peak oxygen uptake (mL/kg/min) increased from 19.0 ± 2.8 to 24.0 ± 4.1 while peak workload (watts/kg) increased from 1.3 ± 0.3 to 1.7 ± 0.3. Although statistical significance was not reached, the increase in workload seemed associated with increases in physical, mental, and general health and with a decrease in fatigue. This lifestyle intervention improved BC survivors' QoL and CRF and suggested possible relationships between CRF and QoL. More research needs to confirm these associations and promote lifestyle interventions aiming at improving BC survivors' QoL.

Radiation techniques used in patients with breast cancer: Results of a survey in Spain.

AIM: To evaluate the resources and techniques used in the irradiation of patients with breast cancer after lumpectomy or mastectomy and the status of implementation of new techniques and therapeutic schedules in our country. BACKGROUND: The demand for cancer care has increased among the Spanish population, as long as cancer treatment innovations have proliferated. Radiation therapy in breast cancer has evolved exponentially in recent years with the implementation of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, image guided radiotherapy and hypofractionation. MATERIAL AND METHODS: An original survey questionnaire was sent to institutions participating in the SEOR-Mama group (GEORM). In total, the standards of practice in 969 patients with breast cancer after surgery were evaluated. RESULTS: The response rate was 70% (28/40 centers). In 98.5% of cases 3D conformal treatment was used. All the institutions employed CT-based planning treatment. Boost was performed in 56.4% of patients: electrons in 59.8%, photons in 23.7% and HDR brachytherapy in 8.8%. Fractionation was standard in 93.1% of patients. Supine position was the most frequent. Only 3 centers used prone position. The common organs of risk delimited were: homolateral lung (80.8%) and heart (80.8%). In 84% histograms were used. An 80.8% of the centers used isocentric technique. In 62.5% asymmetric fields were employed. CTV was delimited in 46.2%, PTV in 65% and both in 38.5%. A 65% of the centers checked with portal films. IMRT and hypofractionation were used in 1% and in 5.5% respectively. CONCLUSION: In most of centers, 3D conformal treatment and CT-based planning treatment were used. IMRT and hypofractionation are currently poorly implemented in Spain.

Predictive Variables of Adolescents' Intention to Be Physically Active after Graduation. Is Gender a Conditioning Factor?

The acquisition of physical activity habits during adolescence is fundamental to guarantee its adherence throughout life. However, these levels decrease during this stage, with women experimenting a more significant decrease. This paper aims to analyze if there are significant differences in the variables related to the intention to be physically active between men and women and if there is a moderating effect of gender on the variables that predict this intention. The sample is composed of 256 adolescents, aged between 16 and 19 years, 55.50% of whom are men, and 44.50% women. The results show that there are statistically significant differences (p < 0.05), with boys showing higher scores in the intention, athletic identity, and in the strength, condition, and attractiveness. About the predictive variables of the intention, the gender moderates the relationships between the physical attractiveness, condition and strength with the perceived behavioral control (pcfmale-pcfmale = 0.44; -0.48 p < 0.001; 0.27, p < 0.05, respectively), and between the subjective norm and the intention to be physically active (pcmale-female = 0.33, p < 0.01). These results highlight the importance of considering gender when designing specific policies for the promotion of physical-sports practice among adolescents to reduce the existing gender gap.

Measuring Residents' Perceptions of Corporate Social Responsibility at Small- and Medium-Sized Sports Events.

Due to the increase of sports events in local communities, it has become essential to organize such events in a socially responsible way at the environmental, social, and economic levels. The aim of this research was to develop a measurement tool to help determine the degree of social responsibility perceived by residents at small-medium scale sports events, to guide sports managers towards the design of socially responsible sports events. From the elaboration of a questionnaire developed ad-hoc, the perception of the residents was analyzed (n = 516). The psychometric properties of the tool, composed of 35 items, were analyzed by means of an exploratory and confirmatory factor analysis. As main conclusions, we were able to contrast the validity and reliability of the questionnaire on the perception of corporate social responsibility in small-scale sports events, around the dimensions of Sustainable Sports Activity, Social Cohesion, and Well-Being. As a consequence, it allowed us to identify three strategic management areas towards which the organizers of these events should focus special attention if they want to progress towards the achievement of socially responsible sports events.

Future Intentions of Fitness Center Customers: Effect of Emotions, Perceived Well-Being and Management Variables.

One of the main objectives of fitness center managers is to obtain high levels of loyalty from the customers of these fitness centers. Within the existing literature on fitness center management, previous research has analyzed the importance of the management variables themselves to determine the behavioral intentions of their customers, ignoring other psychological and sociodemographic aspects and focusing on linear relationship models. Therefore, this study, which aims to analyze the impact of different management variables along with psychological (emotions and subjective well-being) and demographic variables (age and sex) on the satisfaction, perceived value (PV) and future intentions (FI) of 398 users (216 men, aged 18-75, Mean = 35.89 ± 14.53) of a fitness center, intends to fill this gap. In this study, two different methodologies are used, i.e., hierarchical regressions models (HRM) and qualitative comparative analysis (QCA). The data were obtained by means of a self-administered questionnaire composed of 69 items that collected different previously validated scales. Considering HRM, the different models proposed explain 52% of the satisfaction variance, 57% of perceived value and 59% of future intentions. In general, it seems that the management variables are better predictors than subjective well-being, emotions and age or gender since their inclusion does not greatly improve the model's predictive capacity. As far as QCA analyses are concerned, it seems that none of the conditions are necessary for high or low levels of satisfaction, perceived value or future intentions. On the other hand, based on sufficiency analyses, there seem to be 8 pathways or combinations of conditions leading to high levels of satisfaction and 13 for low levels, 11 combinations leading to high levels of IF and 10 leading to low levels; however, there are 6 combinations of conditions leading to high levels of PV and 5 leading to low levels. In general, some of the pathways consider only the management variables, although many of them consider the importance not only of the management variables but also of the interactions that these may have with emotional aspects and, to a lesser extent, with age and well-being. When comparing both methodologies, it can be observed that the QCA models are more explanatory than the HRM models and that they take into account aspects that seem unimportant when observing linear models (such as emotions or age). However, both methodologies should be considered complementary and used simultaneously since, by focusing on different aspects, enriched results are obtained. The results obtained will enable managers to make more efficient use of available resources to increase user satisfaction.

Congruence and placement in sponsorship: An eye-tracking application.

Sporting events can be announced using sports posters and by disseminating advertisements on the internet, on the street and in print media. But until now, no prior research has measured the effectiveness of sponsorship in sporting event posters. This study uses eye tracking to measure the effectiveness of sporting event posters and proposes considering the level of the viewer's attention as an indicator. This research involves a factorial experiment based on the following variables: congruence, the number of sponsors, and placement of the sponsor's advertisement in a sporting event poster. The results indicate that sponsors positioned in the poster's area of action receive more attention. However, we were unable to prove that congruent sponsors receive more attention, as claimed in the literature. This result could be due to a situation of blindness towards the sponsor. The conclusion section of this paper discusses theoretical conclusions and potential managerial actions.

Sporting Habits of Urban Runners: Classification According to Their Motivation.

This study analyses the sporting habits of runners participating in short-distance urban running events to identify groups with different motivations towards the practice of endurance running and participation in urban running events. A sample consisting of 937 participants in the Valencia running circuit was interviewed using a questionnaire consisting of a scale of 22 items to analyse their motives for participating in popular races. An exploratory and confirmatory factorial analysis was carried out to check the validity of the instrument, and the analysis identified the following four factors into which the indicators were grouped: psychological and physical motives (3 items), social motives and interest in running events (5 items), occupation of time and social recognition (6 items) and competitive and material motives (3 items). Subsequently, a cluster analysis was performed by combining hierarchical and non-hierarchical methods, and the analysis identified the following three groups of runners with different characteristics: individual hedonists (n = 276), enthusiasts (n = 312) and socializing hedonists (n = 349). Enthusiastic runners consider most motives important when participating in running events, individual hedonists consider individual psychological and physical motives important, and socializing hedonists consider personal and social motives and interest in sport important. Variables related to age, educational level, annual income level, frequency of running, how the individuals went out to run and the level of the runners contributed to differentiating the identified groups. The results confirm the heterogeneous nature of urban runners.

Effect of Match Location, Team Ranking, Match Status and Tactical Dimensions on the Offensive Performance in Spanish 'La Liga' Soccer Matches.

The aim of this paper was to study the combined effects of tactical and contextual dimensions on achieving offensive performance in open play possessions from Spanish "La Liga" soccer matches. 1860 team possessions from 20 random matches were evaluated by means of multidimensional observation. Multilevel regression models were constructed to predict the probability to achieve offensive performance according to the tactical and contextual dimensions registered in each possession. Performing penetrative actions after recovering the ball (OR = 1.497; 95% CI: 1.022-2.192; P < 0.05), and progressing by fast attacks (OR = 3.588; 95% CI: 2.045-6.294; p < 0.001) or counterattacks (OR = 7.097; 95% CI: 3.530-14.269; P < 0.001) was more effective to create scoring opportunities than performing a non-penetrative action and progressing by combinative attack, respectively. Also, progressing by long possessions (OR = 5.057; 95% CI: 2.406-10.627; p < 0.001) was more effective than progressing by short possessions to create scoring opportunities. As for contextual dimensions, multivariate analyses showed how playing at home and against high-ranked opponents registered more likelihood of achieving offensive penetration, although no associations were found in the production of scoring opportunities. Tactical dimensions as initial penetration, type of attack and possession length played an important role on achieving offensive penetration and goal scoring opportunities in Spanish Soccer "La Liga".

Multisource Assessment for Development Purposes: Revisiting the Methodology of Data Analysis.

Multisource assessment (MSA) is based on the belief that assessments are valid inferences about an individual's behavior. When used for performance management purposes, convergence of views among raters is important, and therefore testing factor invariance across raters is critical. However, when MSA is used for development purposes, raters usually come from a greater number of contexts, a fact that requires a different data analysis approach. We revisit the MSA data analysis methodology when MSA is used for development, with the aim of improving its effectiveness. First, we argue that having raters from different contexts is an integral element of the assessment, with the trait-context dyad being the actual latent variable. This leads to the specification of an Aggregate (instead of the usual Latent) multidimensional factor model. Second, since data analysis usually aggregates scores for each rater group into a single mean that is then compared with the self-rating score, we propose that the test for factor invariance must also include scalar invariance, a pre-requisite for mean comparison. To illustrate this methodology we conducted a 360° survey on a sample of over 1100 MBA students enrolled in a leadership development course. Finally, by means of the study we show how the survey can be customized to each rater group to make the MSA process more effective.

Predictive and Prognostic Brain Metastases Assessment in Luminal Breast Cancer Patients: FN14 and GRP94 from Diagnosis to Prophylaxis.

FN14 has been implicated in many intracellular signaling pathways, and GRP94 is a well-known endoplasmic reticulum protein regulated by glucose. Recently, both have been associated with metastasis progression in breast cancer patients. We studied the usefulness of FN14 and GRP94 expression to stratify breast cancer patients according their risk of brain metastasis (BrM) progression. We analyzed FN14 and GRP94 by immunohistochemistry in a retrospective multicenter study using tissue microarrays from 208 patients with breast carcinomas, of whom 52 had developed BrM. Clinical and pathological characteristics and biomarkers expression in Luminal and non-Luminal patients were analyzed using a multivariate logistic regression model adjusted for covariates, and brain metastasis-free survival (BrMFS) was estimated using the Kaplan-Meier method and the Cox proportional hazards model. FN14 expression was associated with BrM progression mainly in Luminal breast cancer patients with a sensitivity (53.85%) and specificity (89.60%) similar to Her2 expression (46.15 and 89.84%, respectively). Moreover, the likelihood to develop BrM in FN14-positive Luminal carcinomas increased 36.70-fold (3.65-368.25, p = 0.002). Furthermore, the worst prognostic factor for BrMFS in patients with Luminal carcinomas was FN14 overexpression (HR = 8.25; 95% CI: 2.77-24.61; p = 0.00015). In these patients, GRP94 overexpression also increased the risk of BrM (HR = 3.58; 95% CI: 0.98-13.11; p = 0.054-Wald test). Therefore, FN14 expression in Luminal breast carcinomas is a predictive/prognostic biomarker of BrM, which combined with GRP94 predicts BrM progression in non-Luminal tumors 4.04-fold (1.19-8.22, p = 0.025), suggesting that both biomarkers are useful to stratify BrM risk at early diagnosis. We propose a new follow-up protocol for the early prevention of clinical BrM of breast cancer patients with BrM risk.

The use of an interstitial boost in the conservative treatment of breast cancer: how to perform it routinely in a radiotherapy department.

PURPOSE: To demonstrate the utility of a boost with interstitial brachytherapy (BT) in breast-conserving therapy (BCT) by doing a thorough review of the literature and describing in detail our technique for delivering this boost. MATERIAL AND METHODS: Our department has been delivering the boost with interstitial BT since 1989, in most cases with rigid needles and a theoretical dosimetry. In the early years, we used low-dose-rate (LDR) with iridium-192 wires. The dose administered was 15 Gy if there were no risk factors for local relapse or 20-25 Gy in the presence of risk factors. The risk factors considered were the presence of a close margin (less than 10 mm) and an extensive intraductal component (more than 25%). After 2002, we switched to high-dose-rate (HDR); using the linear quadratic model we changed the low dose to 3 fractions of 4.5 Gy in the case of no risk factors for local relapse or to 3 fractions of 5 Gy in the presence of risk factors. RESULTS: In 79 consecutive boost patients treated in our department between 2010 and 2011, with a median follow-up of 46 months, the local control rate was 97.47%. With respect to cosmesis, fibrosis occurred in 17 cases (21.5%) and hyperpigmentation in 26 cases (32.9%). Our hospital's results are comparable in terms of local control and cosmesis to those of other authors. CONCLUSIONS: This educational article describes our department's boost technique with rigid needles and comments briefly on our results using this technique in a group of consecutively treated patients in our department. A review of the literature and the published results on local control and cosmesis is also described.

FN14 and GRP94 expression are prognostic/predictive biomarkers of brain metastasis outcome that open up new therapeutic strategies.

Brain metastasis is a devastating problem in patients with breast, lung and melanoma tumors. GRP94 and FN14 are predictive biomarkers over-expressed in primary breast carcinomas that metastasized in brain. To further validate these brain metastasis biomarkers, we performed a multicenter study including 318 patients with breast carcinomas. Among these patients, there were 138 patients with metastasis, of whom 84 had brain metastasis. The likelihood of developing brain metastasis increased by 5.24-fold (95%CI 2.83-9.71) and 2.55- (95%CI 1.52-4.3) in the presence of FN14 and GRP94, respectively. Moreover, FN14 was more sensitive than ErbB2 (38.27 vs. 24.68) with similar specificity (89.43 vs. 89.55) to predict brain metastasis and had identical prognostic value than triple negative patients (p < 0.0001). Furthermore, we used GRP94 and FN14 pathways and GUILD, a network-based disease-gene prioritization program, to pinpoint the genes likely to be therapeutic targets, which resulted in FN14 as the main modulator and thalidomide as the best scored drug. The treatment of mice with brain metastasis improves survival decreasing reactive astrocytes and angiogenesis, and down-regulate FN14 and its ligand TWEAK. In conclusion our results indicate that FN14 and GRP94 are prediction/prognosis markers which open up new possibilities for preventing/treating brain metastasis.

Accelerated hypofractionated breast radiotherapy: FAQs (frequently asked questions) and facts.

The demand for breast cancer care has increased as cancer treatment innovations have proliferated. Adjuvant radiotherapy to the breast is considered to be part of the standard treatment in breast cancer. The role of radiotherapy in terms of reducing loco-regional recurrence and increased survival after conservative surgery, and also after a mastectomy in selected cases, has been previously shown in several randomized trials. Patterns of radiotherapy commonly used for breast cancer comprise a period of approximately five weeks, frequently with the addition of an additional 1-1.5 weeks of a radiation boost to the primary tumour area. In last years, there has been a renewed interest in hypofractionated and accelerated radiotherapy schedules that reduce the overall treatment time to barely three weeks, leading to an improvement in quality of life for patients and also optimizing workload of radiation oncology departments. However, despite the existing evidence supporting the use of hypofractionated treatment regimens, their widespread is still far from complete. Many questions have generated resistance among clinical oncologists for their regular use. The aim of this review is to answer those questions that may arise with the use of moderate hypofractionation in breast cancer.

Brachytherapy for penile cancer: efficacy and impact on sexual function.

PURPOSE: Penis brachytherapy (PB) remains an alternative in the cancer treatment. The objective of this study was to assess the oncologic outcomes, sexual function, and the sexual behavior of men treated by PB for a cancer of the penis. METHODS AND MATERIALS: Between 1992 and 2009, 47 patients with a cancer of the penis were treated by PB ((192)Ir), in the Toulouse, Montpellier, and Barcelona cancer centers. The investigation into their sexuality was obtained by means of questionnaire. A total of 21 French patients were approached, of whom 19 (mean age=73.2 years) agreed to answer the questionnaire (participation rate=90.5%). RESULTS: Oncologic data: The specific survival and the disease-free survival at 5 years was 87.6% (95% confidence interval, 72.4-94.7%) and 84% (95% confidence interval, 57.6-94.7%), respectively. The rate of preservation of the penis was 66% (n=31). Sexual data: Among the 17 patients sexually active before brachytherapy, 10 patients remained sexually active after treatment (58.8%). Of the 18 patients who had erections before PB, 17 still had them after treatment (94.4%). Age was the main predictive factor. CONCLUSION: The PB seems to have a moderated impact on the sexual functions and the sexual behavior of the patients.

Why are you passive? Understanding teen's sports intentions by QCA and LM / ¿Por qué eres pasivo? Comprendiendo las intenciones deportivas de los adolescents mediante QCA y LM

Physical inactivity is one of the most critical issues in our society. Several studies have pointed that during adolescence Physical Activity levels decline the most, becoming a critical period in the acquisition of active lifelong habits. This study aims an understanding of the variables that predict the intention of being physically active (IPA) in high school students after completing their education, comparing two different methodologies: Lineal Models (LM) and Comparative Qualitative Analysis (QCA). No research has combined these methodologies before to see the intention of being physically active in high school. 307 adolescents from 14 to 19 years old (Mean=15.64 ±1.12), 55.5% boys, participated in the research. To get the results, a Hierarchical Regression Model with two steps; 1: Attitude toward the Behaviour (ATB), Perceived Behavioural Control (PBC) and Subjective Norm (SN); 2: Athletic Identity (AI) and Physical Self-concept (PSC) and a Fuzzy-set Qualitative Comparative Analysis (fsQCA) were performed. The first step explain 26% of IPA while the addition on step to explains 65% 2 = .38), AI is the most influential aspect (beta =.74). Considering the fsQCA results, none of the conditions is crucial condition of IPA, although low levels of PBC seem to be the most important condition of not having IPA. Regarding sufficiency, five combinations explain 70% of IPA. The three most important combinations where having high levels of PSC and PBC; high levels of AI and ATB; and high levels PBC and ATB (explaining 45%; 60% and 43% respectively of IPA). In general QCA is more explanatory than LM AU)

La inactividad física es uno de los temas más críticos en nuestra sociedad. Diferentes estudios han señalado que durante la adolescencia los niveles de Actividad Física disminuyen, convirtiéndose en un período crítico en la adquisición de hábitos activos que perduren a lo largo de toda la vida. Es por ello que este estudio tiene como objetivo comprender las variables que predicen la intención de ser físicamente activo (IFA) en estudiantes de secundaria después de completar su educación, comparando dos metodologías diferentes: Modelos Lineales (ML) y Análisis Cualitativo Comparativo (ACC). Ninguna investigación ha combinado anteriormente estas metodologías para conocer la intención de ser físicamente activo en la escuela secundaria. 307 adolescentes de 14 a 19 años (x = 15,64 ± 1,12), 55,5% varones, participaron en la investigación. Para obtener los resultados, se realizó un Modelo de Regresión Jerárquica con dos pasos 1: Actitud hacia el Comportamiento (AHC), Control del Comportamiento Percibido (CCC) y Norma Subjetiva (NS); 2: Se añadió la identidad atlética (IA) y el autoconcepto físico (AF), y un análisis comparativo cualitativo de Fuzzy-set (fsQCA). El primer paso explica el 26% de IFA mientras que la adición en el siguiente paso explica el 65% (TrianguloR2 = .38), siendo IA el aspecto más influyente (beta = .74). Considerando los resultados de la fsQCA, ninguna de las condiciones es condición necesaria de las IFA, aunque los niveles bajos de CCC parecen ser la condición más importante de no tener IFA. En cuanto a la suficiencia, cinco combinaciones explican el 70% de las IFA. Las tres combinaciones más importantes donde tienen altos niveles de AF y CCC; altos niveles de IA y AHC; CCC y AHC (explicando un 45%, 60% y 43%, respectivamente, de IPA). En general, el ACC es más explicativo que el ML (AU)

Physical Education classes, sports motivation and adolescence: study of some moderating variables / Clases de Educación Física, motivación deportiva y adolescencia: Estudio de Algunas variables moderadoras

Adolescence is considered a stage in which there are high rates of sports drop out, and this evidence justifies the need to study those factors that may affect this fact. Importance and Utility of Physical Education Perception (IUPEP) is shown in the literature as a factor to consider when studying this phenomenon, and seems to be affected by the Sport Motivation (SM) of young people. Although the relationship between these two constructs has been studied, it has not been the moderating role that other constructs such as the Professor Learning Climate (PLC) or Student Learning Orientation (SLO) can have in this relationship. The present study analyzes the relationship between IUPEP and SM, as well as the moderating role of PLC and SLO in this relationship. This analyses was performed using the PROCESS macro (Hayes, 2013), designed for testing the moderation by directly assessing the significance of the indirect effect of the independent variable (X; SM) on the dependent variable (Y; IUPEP) through two moderators: PLC (M) and SLO (W). The study was carried out with 267 adolescents from eight classes of public centers in Valencia, aged between 11 and 18 years (mean = 14.04 ± 1.64), 52.8% male. The results suggest that Sports Motivation explains 21% of the Importance and Utility of Physical Education Perception, and, in addition, a moderating role of Professor Learning Climate and Student Learning Orientation in this relationship is observed (AU)

La adolescencia está considerada como una etapa en la que existen altas tasas de abandono deportivo, y esta evidencia justifica la necesidad de estudio de aquellos factores que puedan afectar a este hecho. La Percepción de la importancia y utilidad otorgada a la educación física (IUPEP) se muestra en la literatura como un factor a considerar a la hora de estudiar este fenómeno, y parece estar afectada por la motivación deportiva (SM) de los jóvenes. Aunque la relación entre estos dos constructos ha sido estudiada, no lo ha sido el papel moderador que pueden tener en esta relación otros constructos como el clima de aprendizaje propiciado por el profesor (PLC) o la orientación al aprendizaje del alumno (SLO). El presente estudio analiza la relación entre IUPEP y SM, así como el papel moderador de PLC y SLO en dicha relación. Para el análisis se utiliza la macro PROCESS (Hayes, 2013), diseñada para testear la moderación mediante la evaluación de la importancia del efecto indirecto de la variable independiente (X; SM) sobre la variable dependiente (Y; IUPEP), a través de dos moderadores: PLC (M) y SLO (W). El estudio se llevó a cabo con 267 adolescentes de ocho clases de centros públicos de Valencia, con edades comprendidas entre los 11 y 18 años, (Media=14.04 ± 1.64), 52.8 % varones. Los resultados sugieren que la motivación deportiva explica en 21% de la percepción de la importancia y utilidad de las clases de educación física, además de observarse un papel moderador del clima de aprendizaje propiciado por el profesor y la orientación al aprendizaje del alumno en esta relación (AU)

Percepción de los residentes sobre el legado de la America’s Cup / Percepção dos moradores sobre o legado da Copa América / Residents perceptions about the legacy of America’s Cup

El objetivo de este estudio fue analizar las percepciones de los residentes sobre el legado de un gran evento deportivo como es la America’s Cup (AC) celebrada en Valencia en 2007 y 2010. Se utilizó una encuesta compuesta por una escala de 41 ítems que contemplaban diversos legados positivos y negativos agrupados en seis dimensiones: legado socioeconómico; legado en el desarrollo urbano e infraestructuras; legado en la imagen, política y conocimiento; legado deportivo; legado sociocultural; y legado negativo. Se recogió una muestra de 735 residentes con un error de muestreo ±3.6. Los resultados permitieron identificar tres grupos de residentes con percepciones diferentes hacia el legado de la AC: pesimistas (46.9%), indiferentes (38.4%) y optimistas (14.7%). La mayoría de los ciudadanos entrevistados no se mostraba de acuerdo en que este evento deportivo haya generado legados positivos a nivel socioeconómico, en el desarrollo urbano y las infraestructuras, en el deporte y a nivel sociocultural, mientras que se observaba cierta tendencia al acuerdo en algunos legados negativos. Sólo el legado en la imagen, política y conocimiento adquirido por los residentes mostraba una tendencia positiva para la mayoría de los ciudadanos encuestados (AU)

O objetivo desse estudo foi analisar as percepções sobre dos habitantes de uma cidade sobre o legado de um grande evento esportivo (America’s Cup (AC)) realizado em Valencia (Espanha) nos anos de 2007 e 2010. Foi realizada uma entrevista composta por 41 itens que abordavam diversos legados, tanto positivos como negativos, agrupados em seis dimensões: do legado Socioeconômico, do legado do desenvolvimento urbano e infraestruturas, do legado da imagem, do legado político e conhecimento, do legado esportivo, do legado sociocultural e do legado negativo. Foram avaliados 735 habitantes, com um erro amostral de +3.6. Os resultados permitiram identificar três grupos de habitantes com percepções diferentes do legado do AC: pessimistas (46,9%), indiferentes (38,4%) e otimistas (14,7%). Grande parte dos entrevistados não se mostrou de acordo com que este evento esportivo tenha gerado legados positivos nas questões socioeconômicas, no desenvolvimento urbano e infraestruturas, no esporte e no âmbito sociocultural, enquanto se observou uma tendência concordando com alguns legados negativos. Apenas o legado de imagem, política e conhecimento adquirido pelos habitantes mostrava uma tendência positiva para a maioria dos entrevistados (AU)

The aim of this study was to analyze the residents perception about the legacy of a major sport event like the America’s Cup (AC) held in Valencia in 2007 and 2010 a survey consisting of a scale of 41 items with several positive and negative legacies for six dimensions was used: socioeconomic legacy; legacy in urban development and infrastructure; legacy image, politics and knowledge; sporting legacy; sociocultural legacy; and negative legacy. A sample of 735 residents representing a sampling error of ±3.6 was collected. The results identified three groups of residents with different perceptions of the legacy of AC: pessimists (46.9%), indifferent (38.4%) and optimists (14.7%). Most of those interviewed showed not agree that this sporting event has generated positive socioeconomic legacies, urban development and infrastructure, in sport and sociocultural level, while a tendency was observed to agree on some legacies negative. Only the legacy image, politics and knowledge acquired by residents showed a positive trend for the majority of citizens surveyed (AU)

La irradiación parcial acelerada de la mama: un nuevo paradigma en el tratamiento del carcinoma precoz de mama / Accelerated partial breast irradiation: a new paradigm in the treatment of early breast carcinoma

Objetivo. La recaída local en el carcinoma de mama precoz puede quedar limitada a la zona próxima al tumor, por lo que puede no ser necesario irradiar la mama entera (WBI), que es, actualmente, el tratamiento conservador estándar. Métodos. Se ha revisado la literatura buscando los trabajos aleatorizados de las distintas modalidades de irradiación parcial acelerada para una puesta al día. Resultados. La irradiación intraoperatoria en sesión única ha dado resultados inadecuados con electrones (estudio ELIOT) por una selección inapropiada de los pacientes. El estudio TARGIT con Rx de 50kV en sesión única añadiendo WBI cuando se demuestran factores de riesgo resulta eficaz cuando se administra durante la primera cirugía conservadora, y no en un segundo tiempo. Los sistemas intracavitarios con balón o similar dan buenos resultados a corto plazo, pero se debe tratar de usar múltiples canales para reducir las complicaciones. Las técnicas de irradiación parcial con radioterapia externa 3D pueden aumentar ligeramente las complicaciones locales, no así la radioterapia de intensidad modulada, y en ambos casos resultan eficaces, pero debe esperarse más tiempo y un mayor número de pacientes para confirmarse. La braquiterapia intersticial con multicatéter se ha demostrado igual de eficaz que la WBI y con menos complicaciones. Conclusiones. Hay pacientes con cáncer de mama de bajo riesgo que no requieren WBI. La irradiación parcial acelerada es equivalente, especialmente con técnica intersticial multicatéter, y probablemente con otras técnicas que requieren más seguimiento, con menor dosis de irradiación a pulmón y corazón, por lo que debe ofrecerse como alternativa a la WBI en casos seleccionados (AU)

Objective. Local relapse in early breast carcinoma may be limited to the area around the tumour. Consequently, whole breast irradiation (WBI), which is currently the standard conservative treatment, may not be required. Methods. We reviewed the literature through a search for randomized trials of the different types of accelerated partial breast irradiation in order to provide an update. Results. Intraoperative irradiation with electrons in a single session (ELIOT study) provided suboptimal results due to improper patient selection. The TARGIT trial reported that 50kV x-rays in a single session, with the addition of WBI in patients with risk factors, was effective when administered during the first conservative surgery, rather than in a second intervention. Intracavitary balloon or similar systems offer good short-term results but attempts should be made to use multiple channels to reduce complications. Partial irradiation techniques with 3D-external beam radiation therapy, except for intensity-modulated radiotherapy, may slightly increase local complications. Both are effective, but this finding requires confirmation in studies with a longer follow-up and more patients. Multicatheter interstitial brachytherapy has been demonstrated to be as effective as WBI and has fewer complications. Conclusions. Some patients with low-risk breast cancer do not require WBI. Accelerated partial breast irradiation is equivalent, especially with the multicatheter interstitial technique, and probably with other techniques requiring more follow-up, and delivers a lower radiation dose to the lung and heart. Accelerated partial breast irradiation should be offered as an alternative to WBI in selected patients (AU)