Comparisons of assessment pathways after abnormal mammography screening in Denmark, Norway, and Spain.

PURPOSE: To ensure high-quality screening programmes and effective utilization of resources, it is important to monitor how cancer detection is affected by different strategies performed at recall assessment. This study aimed to describe procedures performed at recall assessment and compare and evaluate the performance of the assessment in Denmark, Norway, and Spain in terms of screen-detected cancer (SDC) and interval cancer (IC) rates. METHODS: We included women aged 50-69 years from Denmark, Norway, and Spain, who were recalled for assessment after screening mammography, and recorded all procedures performed during six months after diagnosis, and the timing of the procedures. Women were followed for two years and screen-detected and interval cancer, and sensitivity of recall was calculated and compared. RESULTS: In total, data from 24,645 Danish, 30,050 Norwegian, and 41,809 Spanish women were included in the study. Most of the women had some assessment within 2 months in all three countries. SDC rates were higher in Denmark (0.57) and Norway (0.60) compared to Spain (0.38), as were the IC rates, i.e. 0.25 and 0.18 vs. 0.12, respectively. The sensitivity of the diagnostic follow-up was somewhat higher in Denmark (98.3%) and Norway (98.2%), compared to Spain (95.4%), but when excluding non-invasive assessment pathways, the sensitivities were comparable. CONCLUSION: This comparison study showed variation in the assessment procedures used in the three countries as well as the SDC and IC rates and the sensitivity of recall.

The promoting physical activity in regional and remote cancer survivors (PPARCS) trial: Physical activity maintenance.

INTRODUCTION: The study examined whether increased physical activity (PA) in nonmetropolitan cancer survivors was maintained 12 weeks following the PPARCS intervention. METHODS: PA outcomes were assessed using an accelerometer at baseline, end of the intervention, and at 24 weeks. Linear mixed models were used to examine between-group changes in PA outcomes. RESULTS: The increased moderate-to-vigorous PA (MVPA) following intervention was maintained with significantly higher MVPA in the intervention group at 24 weeks (vs. controls) compared to baseline nett change of 52.5 min/week (95% CI 11.0-94.0.4). CONCLUSIONS: Distance-based interventions using wearables and health coaching may produce MVPA maintenance amongst nonmetropolitan cancer survivors.

Breast Delineation in Full-Field Digital Mammography Using the Segment Anything Model.

Breast cancer is a major health concern worldwide. Mammography, a cost-effective and accurate tool, is crucial in combating this issue. However, low contrast, noise, and artifacts can limit the diagnostic capabilities of radiologists. Computer-Aided Diagnosis (CAD) systems have been developed to overcome these challenges, with the accurate outlining of the breast being a critical step for further analysis. This study introduces the SAM-breast model, an adaptation of the Segment Anything Model (SAM) for segmenting the breast region in mammograms. This method enhances the delineation of the breast and the exclusion of the pectoral muscle in both medio lateral-oblique (MLO) and cranio-caudal (CC) views. We trained the models using a large, multi-center proprietary dataset of 2492 mammograms. The proposed SAM-breast model achieved the highest overall Dice Similarity Coefficient (DSC) of 99.22% ± 1.13 and Intersection over Union (IoU) 98.48% ± 2.10 over independent test images from five different datasets (two proprietary and three publicly available). The results are consistent across the different datasets, regardless of the vendor or image resolution. Compared with other baseline and deep learning-based methods, the proposed method exhibits enhanced performance. The SAM-breast model demonstrates the power of the SAM to adapt when it is tailored to specific tasks, in this case, the delineation of the breast in mammograms. Comprehensive evaluations across diverse datasets-both private and public-attest to the method's robustness, flexibility, and generalization capabilities.

"For and against" factors influencing participation in personalized breast cancer screening programs: a qualitative systematic review until March 2022.

BACKGROUND: Personalized breast cancer screening is a novel strategy that estimates individual risk based on age, breast density, family history of breast cancer, personal history of benign breast lesions, and polygenic risk. Its goal is to propose personalized early detection recommendations for women in the target population based on their individual risk. Our aim was to synthesize the factors that influence women's decision to participate in personalized breast cancer screening, from the perspective of women and health care professionals. METHODS: Systematic review of qualitative evidence on factors influencing participation in personalized Breast Cancer Screening. We searched in Medline, Web of science, Scopus, EMBASE, CINAHL and PsycINFO for qualitative and mixed methods studies published up to March 2022. Two reviewers conducted study selection and extracted main findings. We applied the best-fit framework synthesis and adopted the Multilevel influences on the cancer care continuum model for analysis. After organizing initial codes into the seven levels of the selected model, we followed thematic analysis and developed descriptive and analytical themes. We assessed the methodological quality with the Critical Appraisal Skills Program tool. RESULTS: We identified 18 studies published between 2017 and 2022, conducted in developed countries. Nine studies were focused on women (n = 478) and in four studies women had participated in a personalized screening program. Nine studies focused in health care professionals (n = 162) and were conducted in primary care and breast cancer screening program settings. Factors influencing women's decision to participate relate to the women themselves, the type of program (personalized breast cancer screening) and perspective of health care professionals. Factors that determined women participation included persistent beliefs and insufficient knowledge about breast cancer and personalized screening, variable psychological reactions, and negative attitudes towards breast cancer risk estimates. Other factors against participation were insufficient health care professionals knowledge on genetics related to breast cancer and personalized screening process. The factors that were favourable included the women's perceived benefits for themselves and the positive impact on health systems. CONCLUSION: We identified the main factors influencing women's decisions to participate in personalized breast cancer screening. Factors related to women, were the most relevant negative factors. A future implementation requires improving health literacy for women and health care professionals, as well as raising awareness of the strategy in society.

European validation of an image-derived AI-based short-term risk model for individualized breast cancer screening-a nested case-control study.

Background: Image-derived artificial intelligence (AI)-based risk models for breast cancer have shown high discriminatory performances compared with clinical risk models based on family history and lifestyle factors. However, little is known about their generalizability across European screening settings. We therefore investigated the discriminatory performances of an AI-based risk model in European screening settings. Methods: Using four European screening populations in three countries (Italy, Spain, Germany) screened between 2009 and 2020 for women aged 45-69, we performed a nested case-control study to assess the predictive performance of an AI-based risk model. In total, 739 women with incident breast cancers were included together with 7812 controls matched on year of study-entry. Mammographic features (density, microcalcifications, masses, left-right breast asymmetries of these features) were extracted using AI from negative digital mammograms at study-entry. Two-year absolute risks of breast cancer were predicted and assessed after two years of follow-up. Adjusted risk stratification performance metrics were reported per clinical guidelines. Findings: The overall adjusted Area Under the receiver operating characteristic Curve (aAUC) of the AI risk model was 0.72 (95% CI 0.70-0.75) for breast cancers developed in four screening populations. In the 6.2% [529/8551] of women at high risk using the National Institute of Health and Care Excellence (NICE) guidelines thresholds, cancers were more likely diagnosed after 2 years follow-up, risk-ratio (RR) 6.7 (95% CI 5.6-8.0), compared with the 69% [5907/8551] of women classified at general risk by the model. Similar risk-ratios were observed across levels of mammographic density. Interpretation: The AI risk model showed generalizable discriminatory performances across European populations and, predicted ∼30% of clinically relevant stage 2 and higher breast cancers in ∼6% of high-risk women who were sent home with a negative mammogram. Similar results were seen in women with fatty and dense breasts. Funding: Swedish Research Council.

Análisis diferencial de variables psicológicas relacionadas con el compromiso para la práctica deportiva en universitarios durante el confinamiento por la COVID-19 / Differential Analysis of Psychological Variables Related to the Commitment to Sport Practice in University Students During Confinement by COVID-19

En la actualidad los componentes psicológicos han alcanzado una importancia muy notable en la adquisición de comportamientos saludables. Por lo tanto, este estudio analiza las diferencias entre variables psicológicas que se relacionan con la práctica deportiva en estudiantes universitarios durante el confinamiento causado por la COVID-19. El estudio tuvo una muestra de 1239 participantes (765 varones y 474 mujeres), de edades comprendidas entre los 16 y 45 años (M = 21,44; DT = 3,94). Se utilizó un cuestionario que incluyó la Behavioral Regulation in Sport Questionnaire (BRSQ), la Escala de las Necesidades Psicológicas Básicas en el Ejercicio; la Escala de Autoeficacia para la Actividad Física; y la Escala de Grado de Compromiso Deportivo. Los resultados más relevantes muestran diferencias significativas (p<0,01) en favor del género masculino en casi todas las variables psicológicas excepto en la desmotivación, así mismo en lo que respecta a la motivación controlada y desmotivación, se encontraron diferencias significativas entre las localidades pequeñas y grandes, siendo los valores más altos en las primeras (p<0,05 y <0,01). Se discuten los resultados con objeto de determinar las diferencias en cuanto a qué componentes psicológicos permitirían plantear intervenciones que sean más efectivas para lograr la práctica regular de actividades deportivas así como su compromiso y adherencia, mediante el uso de estrategias que vayan encaminadas a fomentar la motivación autónoma de los universitarios y contrarrestar los efectos de la motivación controlada y la desmotivación. (AU)

Nowadays, psychological components have attained a very notable importance in the acquisition of healthy behaviours. Therefore, this study analyses the differences between psychological variables that are related to sports practice in university students during the confinement caused by COVID-19. The study had a sample of 1239 participants (765 males and 474 females), aged 16-45 years (M = 21.44, SD = 3.94). A questionnaire, which included the Behavioural Regulation in Sport Questionnaire (BRSQ), the Basic Psychological Needs in Exercise Scale; the Physical Activity Self-Efficacy Scale; and the Degree of Sport Commitment Scale, was used. The most relevant results show significant differences (p<0.01) in favour of the male gender in almost all psychological variables except demotivation. Likewise, with regard to controlled motivation and demotivation, significant differences were found between small and large localities, with higher values in the former (p<0.05 and <0.01). The results are discussed in order to determine the differences in terms of which psychological components would allow for interventions that might be more effective in achieving regular sport practice, commitment, and adherence through the use of strategies aimed at fostering autonomous motivation in university students and counteracting the effects of controlled motivation and demotivation. (AU)

Validation of the Spanish Healthy Lifestyle Questionnaire / Validación española del Cuestionario de Estilos de Vida Saludables

Background/Objective: It is essential to carry out a diagnosis of people’s healthy lifestyles, in order to apply strategies to improve them. The aim of the study was to validate the Healthy Lifestyles Questionnaire (CEVS-II), collecting all factors that make up the concept of a healthy lifestyle, such as a balanced diet, respect for mealtimes, tobacco consumption, rest habits, alcohol consumption, other drug use and physical activity. Method: The questionnaire was completed by 1,132 people between 18 and 89 (M = 42.43; SD = 18.69) years from different parts of Spain. Results: The seven-factor model proposed by the Confirmatory Factor Analysis, according to the goodness indices, presented an acceptable fit (SRMR = .059; CFI = .973; RMSEA = .049; 90% CI [.046, .052]; χ2/df = 3.76), also presented good reliability indices and was endowed with concurrent validity. Conclusions: The results of the present study proved the validity and reliability of the Healthy Lifestyles Questionnaire in a Spanish population, which is an adequate instrument for the diagnosis of a healthy lifestyles in the Spanish population. (AU)

Antecedentes/Objetivo: Resulta primordial realizar un diagnóstico de los estilos de vida saludables de las personas, con el fin de aplicar estrategias para la mejora de estos. El objetivo del estudio fue validar el Cuestionario de Estilos de Vida Saludables (CEVS-II), recogiendo todos los factores que componen el concepto de estilo de vida saludable como son la alimentación equilibrada, el respeto al horario de las comidas, el consumo de tabaco, los hábitos de descanso, el consumo de alcohol, el consumo de otras drogas y la práctica de actividad física. Método: El cuestionario fue cumplimentado por 1.132 personas de 18-89 (M = 42,43; DT = 18,69) años de diferentes partes de España. Resultados: El modelo de siete factores propuesto por el Análisis Factorial Confirmatorio presentó un ajuste aceptable (SRMR = 0,059; CFI = 0,973; RMSEA = 0,049; 90% CI [0,046 - 0,052]; χ2/df = 3,76), buenos índices de fiabilidad y de validez concurrente. Conclusiones: Los resultados del presente estudio probaron la validez y fiabilidad del Cuestionario de Estilos de Vida Saludables en una muestra española, dando lugar a un instrumento adecuado para la medición de estilos de vida saludables en la población española. (AU)

Comorbidities and Mortality in Patients With COVID-19 Aged 60 Years and Older in a University Hospital in Spain / Comorbilidades y mortalidad en pacientes con COVID-19 de 60 años o mayores en un hospital universitario en España

No disponible

Lesión de Dieulafoy en divertículo duodenal. Una causa infrecuente de HDA / A Dieulafoy's lesion in a duodenal diverticulum. An infrequent cause of UGIB

No disponible

Adherencia al seguimiento de las personas con adenoma de alto riesgo diagnosticadas y excluidas del Programa de detección precoz de cáncer de colon y recto de Barcelona / Adherence to follow-up in high-risk adenoma patients diagnosed by, and excluded from the Barcelona colorectal cancer screening programme

INTRODUCCIÓN: Los programas de detección precoz de cáncer colorrectal han demostrado reducir la mortalidad y la incidencia de este cáncer. Del conjunto de lesiones diagnosticadas en los programas, los adenomas de alto riesgo (AAR) son las más frecuentes. Los AAR son derivados al especialista pero son escasos los estudios que han evaluado la adherencia al seguimiento endoscópico recomendado. OBJETIVOS: Analizar la adherencia y el intervalo de seguimiento de personas diagnosticadas de AAR en un programa de cribado. MÉTODOS: Estudio de cohorte retrospectivo, de personas diagnosticadas de AAR en uno de los centros hospitalarios del Programa de detección precoz de cáncer colorrectal en Barcelona durante la primera ronda (2010-2011). El periodo de observación fue de 75,5 meses. Se realizaron análisis descriptivos y modelos de regresión logística y de supervivencia. RESULTADOS: La población de estudio fue de 602 personas, el 66,6% hombres. La tasa de adherencia fue del 83,7% (n = 504). El 57,7% realizaron la colonoscopia de seguimiento en el intervalo de tiempo recomendado (36 ± 6 meses), con una media de 34 meses. En la regresión de Cox solo se observaron diferencias según el índice socioeconómico, con menor adherencia en el quintil de mayor privación (HR 0,70; IC 95%: 0,53-0,93). CONCLUSIONES: La adherencia al seguimiento se consideró aceptable al compararla con estudios previos, si bien en un alto porcentaje no se realizó en el tiempo recomendado. Es necesario explorar los motivos de la menor adherencia del grupo de mayor privación para diseñar estrategias que mejoren la equidad del Programa más allá de la participación

INTRODUCTION: Colorectal cancer screening programmes have been shown to reduce incidence and mortality. High-risk adenomas (HRA) are the most frequently diagnosed lesions in these programmes, and these patients are referred to a specialist. However, few studies have evaluated the adherence of HRA patients to the recommended endoscopic follow-up. OBJECTIVES: To analyse follow-up adherence and duration in patients diagnosed with HRA in a screening programme. METHODS: Retrospective cohort study of patients diagnosed with HRA within one of the participating hospitals of the colorectal cancer screening programme of Barcelona, during the first round of the programme (2010-2011). The follow-up period was 75.5 months. Descriptive analyses, logistic regression and survival models were performed. RESULTS: 602 patients were included in the study, 66.6% of which were men. The adherence rate was 83.7% (n= 504). Follow-up colonoscopy was performed within the recommended time (36±6 months) in 57.7%, with a mean follow-up of 34 months. The Cox regression only showed differences at the socioeconomic level, with a lower adherence rate in the most deprived quintile (HR 0.70; 95% CI, 0.53-0.93). CONCLUSIONS: Compared to previous studies, the follow-up adherence rate is considered to be acceptable. However, follow-up was not performed within the recommended time frame in a high proportion of cases. There is a need to further explore the reasons leading to lower follow-up adherence in the most deprived socioeconomic group and to increase the equity of the programme beyond participation

Hematoma gástrico intramural en el contexto de una pancreatitis aguda / Intramural gastric hematoma in the context of an acute pancreatitis

No disponible

Ultrasonografía endoscópica versus tomografía computarizada en la estadificación preoperatoria del cáncer gástrico / Endoscopic ultrasound versus multidetector computed tomography in preoperative gastric cancer staging

Introducción: la ultrasonografía endoscópica (USE) es la técnica de elección para la estadificación loco-regional del adenocarcinoma gástrico (ACG). Sin embargo, la introducción de la tomografía computarizada multidetector (TCMD) permite obtener estudios de muy alta calidad diagnóstica. Objetivo: nuestro objetivo fue comparar la rentabilidad diagnóstica de la USE frente a la TCMD en la estadificación loco-regional preoperatoria de los pacientes con ACG. Material y métodos: se realizó un estudio retrospectivo y comparativo entre pacientes intervenidos de ACG con estadificación preoperatoria mediante USE y TCMD de 64 filas, comparando en cada caso los resultados con el informe anatomopatológico final. Resultados: se analizaron 77 pacientes intervenidos de ACG, incluyéndose finalmente 42 que disponían de estadificación completa. Para la estadificación "T", la precisión diagnóstica (PD) global de USE fue superior a la de TCMD (62% vs. 50%). En un subanálisis entre estadios precoces (T1-2) y avanzados (T3-T4), la PD y sensibilidad (S) de la USE resultaron ser superiores a las de la TCMD (83,3% vs. 64,29% y 84,4% vs. 59,5% respectivamente), aunque sin alcanzarse niveles de significación estadística. Respecto al estadio N, la PD y S de la USE resultaron inferiores a las de la TCMD, aunque tampoco se alcanzaron diferencias estadísticamente significativas (57% vs. 64% y 29% vs. 55%). Conclusiones: en nuestra experiencia, la rentabilidad diagnóstica de la ecoendoscopia es similar a la de los nuevos TCMD en la estadificación preoperatoria T y N en pacientes con ACG. Sin embargo, ambas técnicas deberían considerarse complementarias hasta que estudios más extensos y aleatorizados puedan confirmar estos resultados (AU)

Introduction: Endoscopic ultrasonography (EUS) is the gold standard technique in loco-regional staging of gastric adenocarcinoma (GAC). Nevertheless, the introduction of multidetector-row computed tomography (MDCT) allows accurate studies to be performed. Objective: To compare the diagnostic yield of EUS and MDCT in loco-regional preoperative staging of gastric adenocarcinoma. Material and methods: This was a retrospective and comparative study of all surgical patients with GAC and preoperative staging by EUS and 64-row MDCT. The results for each case were compared with the histological data. Results: Seventy seven surgical patients with GAC were identified and forty two had a complete preoperative staging and were finally included in the study. With regard to overall accuracy of T staging, EUS was superior to MDCT (62% vs 50%). In a subanalysis of early stages (T1-T2) and advanced stages (T3-T4), accuracy and sensitivity (S) were higher for EUS than for MDTC (83.3% vs 64.29% and 84.4% vs 59.5% respectively), although this did not reach statistical significance. The overall accuracy and sensitivity of EUS for N staging was lower than that for MDCT, although neither comparison reached statistical significance (57% vs 64% and 29% vs 55%). Conclusion: EUS diagnostic yield is similar to new MDCT with regard to T and N preoperative staging of GAC. Nevertheless, both techniques should be considered as complementary until more extensive and randomized studies can confirm these results (AU)

Motivación y estadios de cambio para el ejercicio físico en adolescentes / Motivation and stages of change for physical exercise in adolescents

Resulta primordial que los adolescentes adquieran un estilo de vida activo; por ello, el objetivo de este estudio fue averiguar qué variables de la Teoría de Metas de Logro y del Modelo Jerárquico de la Motivación predecían los estadios de cambio para el ejercicio físico del Modelo Transteórico. Para ello, se empleó un diseño de investigación descriptivo transversal, con una muestra de 359 estudiantes de segundo ciclo de ESO y primero de Bachillerato, que respondieron el Cuestionario de Orientación al Aprendizaje y al Rendimiento en las Clases de Educación Física (LAPOPECQ), la Escala de Motivación Educativa (EME), la Escala de medición de las Necesidades Psicológicas Básicas (BPNES) y el Cuestionario de Estadios de Cambio para el ejercicio físico - Medida continua (URICA-E2), y se realizaron los análisis factorial exploratorio, confirmatorio, de fiabilidad, descriptivo y de regresión. Los resultados más relevantes mostraron que el estadio de precontemplación fue predicho negativamente por la competencia y positivamente por la desmotivación y la percepción del clima motivacional que implica al ego; el estadio de contemplación-preparación fue predicho positivamente por la competencia y la motivación intrínseca-perfección, la motivación extrínseca-introyectada, y negativamente por la autonomía; y el estadio de acción-mantenimiento fue predicho positivamente por la competencia. Estos resultados sugieren que la necesidad psicológica básica de competencia es la variable más relevante para adherirse a los estadios de práctica de ejercicio físico más activos.

It is essential for adolescents to acquire an active lifestyle. Therefore, the purpose of this study was to determine which variables of Achievement Goal Theory and the Hierarchical Model of Motivation predicted the change stages for exercise in the Transtheoretical Model. To this effect, a descriptive and cross-section study was carried out with 359 secondary school and undergraduate students. The Learning and Performance Orientations in Physical Education Classes Questionnaire (LAPOPECQ), Academic Motivation Scale (AMS), Basic Psychological Needs Scale (BPNES), and Stages of Change in Exercise - Continuous Measure (URICA-E2) were applied. Exploratory and confirmatory factorial, reliability, descriptive and regression analyses were subsequently conducted. The most relevant results showed that the Pre-contemplation Stage was predicted negatively by Competence, and positively by Amotivation and perception of ego-involving environment. The Contemplation-Preparation Stage was predicted positively by competence and Perfection Intrinsic Motivation - Introjected Extrinsic Motivation and negatively by autonomy. The Action-Maintenance Stage was positively predicted by competence. These results suggesting that basic psychological need of competence is the most relevant variable for the engagement to the more active stages of physical activity.

Spanish adaptation of Yamagishi General Trust Scale / Adaptación al castellano de la Escala de Confianza General de Yamagishi

The significance that trust has in social exchange relationships has led to a growing amount of literature dealing with this phenomenon at a theoretical and an applied level. With the aim of conducting trust research by means of an instrument with established reliability and validity, the General Trust Scale (Yamagishi & Yamagishi, 1994) was translated into Spanish. The sample comprised 626 participants. Results indicate that the Spanish adaptation has satisfactory psychometric properties: test's reliability (α =.862) and items' discrimination (a ≥ 1.58). There was no differential item functioning regarding the participants’ gender, but differences aroused as regards to their age. The relationship with several dispositional and behavioral variables was assessed, being significant its correlation with agreeableness (r =.376) and, for the women, also with Openness to Experience (r =.135)

La confianza es, por su importancia en las relaciones sociales, un fenómeno de gran interés tanto a nivel teórico como aplicado. En este articulo presentamos la adaptación al castellano de uno de los instrumentos más utilizados en el investigación sobre confianza: la Escala de Confianza General de Yamagishi & Yamagishi (1994). Un total de 626 participantes respondieron al cuestionario. Los resultados indican que las propiedades psicométricas de la versión en castellano son satisfactorias tanto a nivel de escala (α =.862) como a nivel de items (a ≥ 1.58). No se observo funcionamiento diferencial de los items respecto al sexo, si respecto a la edad. En cuanto a la relación entre la medida de Confianza y otras variables disposicionales y conductuales, se obtuvieron correlaciones significativas con Cordialidad (r = .376), y en mujeres también con Apertura a la Experiencia (r = .135)

Reflexiones sobre el modelo de mediación estadística de Baron y Kenny / Reflections on the Baron and Kenny model of statistical mediation

En los 25 años que han transcurrido desde que Baron y Kenny (1986) publicaran sus ideas acerca de cómo proceder para analizar e interpretar la mediación estadística, pocos trabajos han sido tan citados como éste y, probablemente, ningún otro ha influido de una forma tan decisiva sobre la forma en que los investigadores aplicados entienden y analizan la mediación en el ámbito de las ciencias sociales y de la salud. Pero la utilización masiva de un procedimiento no lo convierte, por sí sola, en una estrategia fiable o segura. De hecho, en estos 25 años no pocos investigadores han puesto de manifiesto las limitaciones de la propuesta de Baron y Kenny para demostrar mediación. El objetivo de este trabajo es (1) realizar una revisión de las limitaciones del método de Baron y Kenny prestando especial atención a la debilidad de la lógica confirmatoria en la que se basa y (2) ofrecer una demostración empírica de que, aplicando la estrategia de Baron y Kenny, los datos obtenidos en el marco de un mismo escenario teórico (sea o no de mediación) pueden ser compatibles tanto con la hipótesis de mediación como con la hipótesis de no mediación (AU)

In the 25 years since Baron and Kenny (1986) published their ideas on how to analyze and interpret statistical mediation, few works have been more cited, and perhaps, so decisively influenced the way applied researchers understand and analyze mediation in social and health sciences. However, the widespread use of a procedure does not necessarily make it a safe or reliable strategy. In fact, during these years, many researchers have pointed out the limitations of the procedure Baron and Kenny proposed for demonstrating mediation. The twofold aim of this paper is to (1) carry out a review of the limitations of the method by Baron and Kenny, with particular attention to the weakness in the confirmatory logic of the procedure, and (2) provide an empirical example that, in applying the method, data obtained from the same theoretical scenario (i.e., with or without the presence of mediation) can be compatible with both the mediation and no-mediation hypotheses (AU)

Aplicación de un programa motivacional para promocionar la actividad física en adultos y mayores / Application of a motivational program to promote physical activity among adults and older adults

La actividad física es esencial para desarrollar un estilo de vida saludable. Desde la investigación aplicada al campo de la actividad física y el deporte, la calidad de vida y su relación con la práctica deportiva, es una línea de trabajo que despierta gran interés, por consiguiente, el objetivo de nuestro estudio fue mejorar el estilo de vida de las personas adultas y mayores a través de un programa de ejercicio físico y fomento de la motivación intrínseca, empleando como marco teórico la Teoría de la Autodeterminación y el Modelo Transteórico del cambio en ejercicio físico. Para ello, se utilizó una muestra de 90 mujeres con edades comprendidas entre los 40 y 88 años (59.66±10.76). Se realizó un estudio cuasi-experimental de manera que los sujetos fueron comparados en diferentes momentos del proyecto para evaluar el impacto de las variables independientes (programa de ejercicio físico con fomento de la motivación intrínseca) sobre las variables dependientes (motivación, necesidades psicológicas básicas, estadio de ejercicio físico, intención de ser físicamente activo y condición física funcional). Los resultados mostraron en la última medición, después de la aplicación del programa de ejercicio físico con fomento de la motivación intrínseca al grupo experimental, que existen diferencias significativas entre el grupo control y el grupo experimental en las variables intención de ser físicamente activo (F1,89= 5.95; p<.05), motivación intrínseca (F1,89=15.70; p<.01), regulación identificada (F1,89= 17.53; p<.051), regulación introyectada (F1,89= 33.41; p<.01), desmotivación (F1,89=7.54; p<.05), autonomía (F1,89= 19.54; p<.01), competencia (F1,89= 21.00; p<.01), relaciones sociales (F1,89= 27.43; p<.01), estadio de contemplación (F1,89= 7.11; p<.05), y en la variable estadio de mantenimiento (F1,89= 4.721; p<.05). Se concluye que el programa de intervención ha tenido éxito en los participantes de nuestro proyecto (AU)

Physical activity is essential to develop a healthy lifestyle in subjects. From the viewpoint of the investigation applied to the field of physical activity and sports, the quality of life and its relation with sports practice is a line of work that arouses great interest, and therefore, the aim of this investigation was to improve the lifestyle of adults and older people through an exercise and foment of intrinsic motivation program, using as a theoretical framework the Self-Determination Theory and the Transtheoretical Model of change for exercise. For it, we used a sample of 90 women aged between 40 and 88 years (59.66±10.76). The investigation was a quasi-experimental study. In this way, the subjects were compared in different moments of the project to evaluate the impact of independent variables (program of physical exercise with foment of intrinsic motivation) on the dependent variables (motivation, basic psychological needs, stage of change for physical exercise, and functional physical condition). The results showed in the last measurement, after applying the physical exercise program based on intrinsic motivation to the experimental group, that there are significant differences between the control group and the experimental group on the variables: intention to be physically active (F1,89= 5.95; p<.05); intrinsic motivation (F1,89=15.70; p<.01); regulation through identification (F1,89= 17.53; p<.051); introjected regulation (F1,89= 33.41; p<.01); demotivation (F1,89= 7.54; p<.05); autonomy (F1,89= 19.54; p<.01); competence (F1,89= 21.00; p<.01); social relationships (F1,89= 27.43; p<.01);contemplation state (F1,89= 7.11; p<.05); and in the variable of maintenance stage (F1,89= 4.721; p<.05). The study concluded that application programs have been successful in the participants of our project (AU)