Models Used by Nurse Case Managers in Different Autonomous Communities in Spain: A Scoping Review.

(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing's role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences.

Hidatidosis pulmonar como causa de hemoptisis recidivante / Pulmonary hydatidosis as a cause of recurrent hemoptysis

La hidatidosis es una zoonosis poco frecuente causada por cestodos del género Echinococcus. El órgano afectado con mayor frecuencia es el hígado, seguido del pulmón. La hidatidosis pulmonar se caracteriza por cursar de forma asintomática en la mayoría de los casos, y en muchas ocasiones suele ser un hallazgo casual en estudios realizados con otros fines. El diagnóstico resulta complejo por la diversidad de la presentación clínica, las pruebas serológicas pueden resultar negativas y los hallazgos de laboratorio son inespecíficos, por lo que debería ser un diagnóstico a tener en cuenta sobre todo en zonas con alta prevalencia de esta infestación. (AU)

Hydatidosis is a rare zoonosis caused by cestodes of the genus Echinococcus. The most frequently affected organ is the liver, followed by the lung. Pulmonary hydatidosis is characterized by an asymptomatic course in most cases, and in many cases it is usually an incidental finding in studies performed for other purposes. The diagnosis is complex due to the diversity of the clinical presentation, serological tests can be negative and laboratory findings are nonspecific, so it should be a diagnosis to consider especially in areas with high prevalence of this infestation. (AU)

Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study.

BACKGROUND: The COVID-19 pandemic had a major psychological impact on health care workers (HCWs). This study was embedded in a larger quantitative study on the mental health care of out-of-hospital HCWs in Spain. To better understand this, a qualitative study was conducted to explore the experiences, coping strategies, and influencing factors of out-of-hospital HCWs who scored high (> 25 points) on the Depression Anxiety Stress Scale (DASS-21) in a previous quantitative mental health study. METHODS: A qualitative study was conducted using six in-depth interviews with individuals who scored high on the depression scale and agreed to be contacted by email between May and June 2021, using the phenomenological approach. The data were analysed using Brawn and Clare's method. RESULTS: The main results findings related to four themes. The emotional impact of assuming a professional role with high self-demands and responsibilities; Factors influencing the development of negative emotions such as the cruelty of the pandemic, the helplessness in relation to health management and policy, the changing role of the professional and the relationship with society; Personal protection through coping strategies to manage negative emotions such as support from colleagues and family; Good practices for the future looking for different management strategies that can influence individuals and their personal, professional, and social relationships. CONCLUSION: The strong impact of the circumstances experienced points to the need to develop psychological support programmes that can protect people's mental health from depression during a crisis and improve the relationship between workers and their managers.

RESUMEN: ANTECEDENTES: La pandemia de COVID-19 tuvo un gran impacto psicológico en el personal sanitario. Este estudio forma parte de un estudio cuantitativo más amplio sobre la atención a la salud mental de los trabajadores sanitarios extrahospitalarios en España. Para comprenderlo mejor, se llevó a cabo un estudio cualitativo para explorar las experiencias, estrategias de afrontamiento y factores de influencia de los trabajadores extrahospitalarios que obtuvieron puntuaciones altas (> 25 puntos) en la Escala de Depresión, Ansiedad y Estrés (DASS-21) en un estudio cuantitativo previo sobre salud mental. MéTODOS: Se realizó un estudio cualitativo mediante seis entrevistas en profundidad con individuos que puntuaron alto en la escala de depresión y aceptaron ser contactados por correo electrónico entre mayo y junio de 2021, utilizando el enfoque fenomenológico. Los datos se analizaron utilizando el método de Brawn y Clare. RESULTADOS: Los principales hallazgos de los resultados se relacionaron con cuatro temas. El impacto emocional de asumir un rol profesional con altas autoexigencias y responsabilidades; Factores que influyen en el desarrollo de emociones negativas como la crueldad de la pandemia, la impotencia en relación con la gestión y la política sanitaria, el papel cambiante del profesional y la relación con la sociedad; Protección personal a través de estrategias de afrontamiento para gestionar las emociones negativas como el apoyo de los compañeros y la familia; Buenas prácticas para el futuro buscando diferentes estrategias de gestión que puedan influir en los individuos y en sus relaciones personales, profesionales y sociales. CONCLUSIóN: El fuerte impacto de las circunstancias vividas apunta a la necesidad de desarrollar programas de apoyo psicológico que puedan proteger la salud mental de las personas durante una crisis y mejorar la relación entre los trabajadores y sus jefes.

[Nutritional problems of vegetarian and vegan children]. / Problemática nutricional de los niños vegetarianos y veganos.

Introduction: The number of people following plant-based diets to a greater or lesser degree is increasing, but the more restrictive a diet, the greater the risk of nutritional deficiencies. The childhood stage is a stage of great physical and maturational growth, therefore, nutritional deficiencies at this stage can have serious and sometimes permanent consequences. People who follow restrictive diets of any kind, such as plant-based diets, should receive support from specialized staff to ensure that their diets are varied and balanced, as is desirable in any case.

Introducción: Está aumentando el número de personas que siguen dietas basadas en vegetales en mayor o menor grado, pero cuanto más restrictiva es una dieta, más riesgos existen de presentar deficiencias nutricionales. La etapa infantil es una etapa de gran crecimiento físico y madurativo, por ello, las deficiencias nutricionales en esta etapa pueden acarrear consecuencias graves y, en ocasiones, permanentes. Las personas que siguen dietas restrictivas de cualquier tipo, como son las dietas basadas en vegetales, deben recibir apoyo de personal especializado para conseguir que sus dietas sean variadas y equilibradas, como es deseable en cualquier caso.

[Properties of milk in sleep induction]. / Propiedades de la leche en la inducción del sueño.

Introduction: Sleep induction and its quality are issues of growing concern because its deterioration affects a large number of people and poses a risk to their well-being and quality of life and long-term health. There are several factors involved in the problem, but nutrition is one of them and in particular milk consumption has often been linked to sleep habits, sometimes as a promoter and sometimes as an inhibitor. The purpose of this review is to examine the matter further. On reaching the brain, tryptophan is the basis for the synthesis of serotonin and melatonin, which improve the induction and quality of sleep. But there is competition between tryptophan and other long-chain neutral amino acids (LNAA) (valine, leucine, isoleucine, tyrosine and phenylalanine) to cross the blood-brain barrier and reach the brain. In this sense, milk proteins with a high tryptophan content and the highest ratio between tryptophan and LNAA are very useful in promoting sleep. Moreover, milk also provides various micronutrients that help in the transformation of tryptophan into serotonin and melatonin, as well as antioxidant components, anti-inflammatory and bioactive peptides, and recent studies indicate that it favorably modulates the composition of the intestinal microbiota. Studies show that increasing milk consumption, up to the recommended intake and within a correct diet, favors the achievement and maintenance of quality sleep.

Introducción: La inducción del sueño y su calidad son temas de preocupación creciente porque su deterioro afecta a un número elevado de personas y supone un riesgo en su bienestar y calidad de vida y en la salud a largo plazo. Hay diversos factores implicados en el problema, pero la nutrición es uno de ellos y, en concreto, el consumo de leche se ha relacionado frecuentemente con los hábitos de sueño, a veces como factor promotor y otras como inhibidor. Profundizar en el tema es el objeto de la presente revisión. El triptófano, al llegar al cerebro, es la base para la síntesis de serotonina y melatonina, que mejoran la inducción y la calidad del sueño. Pero hay una competencia entre el triptófano y otros aminoácidos neutros de cadena larga (ANCL) (valina, leucina, isoleucina, tirosina y fenilalanina) para cruzar la barrera hematoencefálica y llegar al cerebro. En este sentido, las proteínas de la leche, con elevado contenido en triptófano y la relación más elevada entre triptófano y ANCL, son muy útiles en la promoción del sueño. Por otra parte, la leche también aporta diversos micronutrientes que ayudan en la transformación del triptófano en serotonina y melatonina, así como componentes antioxidantes, antiinflamatorios y péptidos bioactivos, y estudios recientes indican que modula favorablemente la composición de la microbiota intestinal. Los estudios realizados ponen de relieve que aumentar el consumo de leche, hasta el aporte aconsejado y dentro de una alimentación correcta, favorece el conseguir y mantener un sueño de calidad.

Effects of Gestational Intermittent Hypoxia on Placental Morphology and Fetal Development in a Murine Model of Sleep Apnea.

Obstructive sleep apnea (OSA) during pregnancy is characterized by episodes of intermittent hypoxia (IH) during sleep, resulting in adverse health outcomes for mother and offspring. Despite a prevalence of 8-20% in pregnant women, this disorder is often underdiagnosed.We have developed a murine model of gestational OSA to study IH effects on pregnant mothers, placentas, fetuses, and offspring. One group of pregnant rats was exposed to IH during the last 2 weeks of gestation (GIH). One day before the delivery date, a cesarean section was performed. Other group of pregnant rats was allowed to give birth at term to study offspring's evolution.Preliminary results showed no significant weight differences in mothers and fetuses. However, the weight of GIH male offspring was significantly lower than the controls at 14 days (p < 0.01). The morphological study of the placentas showed an increase in fetal capillary branching, expansion of maternal blood spaces, and number of cells of the external trophectoderm in the tissues from GIH-exposed mothers. Additionally, the placentas from the experimental males were enlarged (p < 0.05). Further studies are needed to follow the long-term evolution of these changes to relate the histological findings of the placentas with functional development of the offspring in adulthood.

Influence of Previous Mental State on Psychological Outcomes of Spanish Out-of-Hospital Professionals during the COVID-19 Pandemic.

This study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student's t-test for independent samples, one-way ANOVA, Pearson's correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority.

Acquisition of fertilization competence in guinea pig spermatozoa under different capacitation protocols.

Guinea pig in vitro fertilization (IVF) are poorly developed due to the limited accessibility to oocytes and the lack of an efficient method of sperm capacitation. Thus, we aimed to evaluate different capacitation protocols that we validated through sperm analysis and using heterologous (He) IVF with zona-intact bovine oocytes. Spermatozoa of guinea pigs were collected and processed separately by 4 different protocols: A) Spermatozoa were obtained by flushing the lumen of one cauda epididymis and incubated in a minimal culture medium (MCM); B) One epididymis was placed in a prewarmed of M2 medium and gently minced with fine scissors. Spermatozoa were incubated in a modified human tubal fluid medium (HTF). In both protocols, the spermatozoa were capacitated at 37 °C under an atmosphere of 5% CO2 for 2 h. In the protocols C and D, the spermatozoa were collected by flushing the lumen of the cauda epididymis and selected by commercial density gradient Bovipure® (Nidacon Laboratories AB, Göthenborg, Sweden), according to the manufacturer's instructions. Then for Protocol C) spermatozoa were incubated in MCM medium supplemented with 10 mg/mL heparin (MCM-Hep); while for Protocol D) spermatozoa were incubated in FERT medium supplemented 10 mg/mL heparin (FERT-Hep). Incubation of C and D protocols were performed at 38.5 °C under an atmosphere of 5% CO2 for 2 h. Capacitation protocols C and D showed a higher percentage of viability, total and hyperactive-like motility, and acrosome reaction compared to protocols A and B. For this reason, protocols C and D were used for further He-IVF analysis. Guinea pig sperm and matured zona-intact bovine oocytes were co-incubated at 5% CO2 and 38.5 °C. Sperm-oocyte interaction was assessed at 2.5 h post-insemination (hpi) and pronuclear formation (PrF) were evaluated at 18, 20, 22, 24 and 26 hpi, while the cleavage rate was evaluated at 48 hpi. In protocol D, PrF was significantly higher than in protocol C (P ≤ 0.05) at every time point evaluated. Also, the cleavage rate at 48 hpi was higher (P ≤ 0.05) in He-IVF protocol D (69.8 ± 1.7%) compared to He-IVF protocol C (49.1 ± 1.1%). In conclusion, we determined the most adequate sperm capacitation conditions for guinea pig that allow zona-intact bovine oocyte penetration and lead to hybrid embryo formation, suggesting that these conditions could be optimal to develop IVF in guinea pigs.

Propiedades de la leche en la inducción del sueño / Properties of milk in sleep induction

La inducción del sueño y su calidad son temas de preocupación creciente porque su deterioro afecta a un número elevado de personas y suponeun riesgo en su bienestar y calidad de vida y en la salud a largo plazo. Hay diversos factores implicados en el problema, pero la nutrición es unode ellos y, en concreto, el consumo de leche se ha relacionado frecuentemente con los hábitos de sueño, a veces como factor promotor y otrascomo inhibidor. Profundizar en el tema es el objeto de la presente revisión.El triptófano, al llegar al cerebro, es la base para la síntesis de serotonina y melatonina, que mejoran la inducción y la calidad del sueño. Pero hayuna competencia entre el triptófano y otros aminoácidos neutros de cadena larga (ANCL) (valina, leucina, isoleucina, tirosina y fenilalanina) paracruzar la barrera hematoencefálica y llegar al cerebro. En este sentido, las proteínas de la leche, con elevado contenido en triptófano y la relaciónmás elevada entre triptófano y ANCL, son muy útiles en la promoción del sueño. Por otra parte, la leche también aporta diversos micronutrientesque ayudan en la transformación del triptófano en serotonina y melatonina, así como componentes antioxidantes, antiinflamatorios y péptidosbioactivos, y estudios recientes indican que modula favorablemente la composición de la microbiota intestinal.Los estudios realizados ponen de relieve que aumentar el consumo de leche, hasta el aporte aconsejado y dentro de una alimentación correcta,favorece el conseguir y mantener un sueño de calidad. (AU)

Sleep induction and its quality are issues of growing concern because its deterioration affects a large number of people and poses a risk to theirwell-being and quality of life and long-term health. There are several factors involved in the problem, but nutrition is one of them and in particularmilk consumption has often been linked to sleep habits, sometimes as a promoter and sometimes as an inhibitor. The purpose of this review isto examine the matter further.On reaching the brain, tryptophan is the basis for the synthesis of serotonin and melatonin, which improve the induction and quality of sleep. Butthere is competition between tryptophan and other long-chain neutral amino acids (LNAA) (valine, leucine, isoleucine, tyrosine and phenylalanine)to cross the blood-brain barrier and reach the brain. In this sense, milk proteins with a high tryptophan content and the highest ratio betweentryptophan and LNAA are very useful in promoting sleep.Moreover, milk also provides various micronutrients that help in the transformation of tryptophan into serotonin and melatonin, as well as antioxidantcomponents, anti-inflammatory and bioactive peptides, and recent studies indicate that it favorably modulates the composition of the intestinalmicrobiota. Studies show that increasing milk consumption, up to the recommended intake and within a correct diet, favors the achievementand maintenance of quality sleep. (AU)

Problemática nutricional de los niños vegetarianos y veganos / Nutritional problems of vegetarian and vegan children

Está aumentando el número de personas que siguen dietas basadas en vegetales en mayor o menor grado, pero cuanto más restrictiva es unadieta, más riesgos existen de presentar deficiencias nutricionales.La etapa infantil es una etapa de gran crecimiento físico y madurativo, por ello, las deficiencias nutricionales en esta etapa pueden acarrearconsecuencias graves y, en ocasiones, permanentes.Las personas que siguen dietas restrictivas de cualquier tipo, como son las dietas basadas en vegetales, deben recibir apoyo de personal especializado para conseguir que sus dietas sean variadas y equilibradas, como es deseable en cualquier caso. (AU)

The number of people following plant-based diets to a greater or lesser degree is increasing, but the more restrictive a diet, the greater the riskof nutritional deficiencies.The childhood stage is a stage of great physical and maturational growth, therefore, nutritional deficiencies at this stage can have serious andsometimes permanent consequences.People who follow restrictive diets of any kind, such as plant-based diets, should receive support from specialized staff to ensure that their dietsare varied and balanced, as is desirable in any case. (AU)

Female reproduction and the microbiota in mammals: Where are we?

While it is generally accepted that the mammalian vagina contains a site-specific microbiota that plays relevant roles in genital and reproductive health, the existence of an extra-vaginal microbiota in the female reproductive tract (i.e. follicular fluid, oviduct, endometrium, and placenta) is, at least, a matter of controversy. Many conclusions in this field have failed to consider the technical limitations, biases, and confounding factors inherent to next-generation sequencing (NGS) approaches. While this creates uncertainty in the field, there is no doubt this subject is set to be the focus of new research efforts because of its scientific and practical connotations in female reproductive health. The current art state, its limitations, and gaps in our knowledge about the female reproductive tract's microbiota and, particularly, about the microbes of the extra-vaginal environment are presented in this review. Also are discussed possible relationships between the gut and oral microbiota and reproductive events.

Flare-Ups in Crohn's Disease: Influence of Stress and the External Locus of Control.

(1) Background: The aim of this study was to explore the role of perceived stress and the health locus of control in Crohn's disease and their influence upon the development of flare-ups of this disease. (2) Methods: Stress and the external locus of control were evaluated in a sample of 64 Crohn's patients (flare-up phase versus latency phase). The perceived stress scale (PSS-14) and the multidimensional health locus of control scale were the measurement instruments used. (3) Results: The results indicate that the patients have high stress levels during a flare-up (26.13; 27.44; 28.79; 29.67); high stress levels (28.07; 29.67; 27.44; 28.07) if they have a high external locus of control; and that the external locus of control and stress levels have a significant influence upon the existence of flare-ups in those patients with low external locus of control levels (χ2 = 11.127; df = 1: p < 0.001). (4) Conclusions: Actions aimed at reducing stress and external locus of control levels are necessary in Crohn's disease.

[Importance of hydration in cardiovascular health and cognitive function]. / Importancia de la hidratación en la salud cardiovascular y en la función cognitiva.

Introduction: Water is an essential nutrient for health. Inadequate water intake induces states of dehydration and hypovolemia,causing an increase in plasma osmolality proportional to the decrease in body water. Restricting water intake can have harmful effects on cardiovascular health by affecting endothelial function and increasing the viscosity of blood, haematocrit and fibrinogen. Adequate hydration is associated with lower risk of deadly coronary heart disease. Obesity and diabetes are risk factors for cardiovascular disease. Hypohydration is linked to weight gain and obesity. An association between adequate water intake and healthier body composition has been evidenced, there is an inverse relationship between water consumption and weight, body fat and waist circumference. In addition, water consumption decreases the risk of hyperglycemia and typ 2 diabetes. Regarding the composition of water, a positive association between the level of calcium and magnesium and cardiovascular health has been observed. On the other hand, hydration also affects cognitive ability. Decreased fluid intake and dehydration have a negative impact on cognitive performance (attention, memory, learning and executive functions), improving cognitive function with rehydration.

Introducción: El agua es un nutriente esencial para la salud. La ingesta inadecuada de agua induce estados de deshidratación e hipovolemia, lo que causa un aumento de la osmolalidad plasmática proporcional a la disminución del agua corporal. La restricción de la ingesta hídrica puede tener efectos nocivos sobre la salud cardiovascular al verse afectada la función endotelial y al aumentar la viscosidad de la sangre, el hematocrito y el fibrinógeno. Una hidratación adecuada se asocia con menor riesgo de enfermedad coronaria mortal. La obesidad y la diabetes son factores de riesgo de la enfermedad cardiovascular. La hipohidratación se relaciona con aumento de peso y de obesidad. Se ha evidenciado una asociación entre la ingesta adecuada de agua y una composición corporal más saludable. Existe una relación inversa entre el consumo de agua y el peso, la grasa corporal y la circunferencia de la cintura. Asimismo, el consumo de agua disminuye el riesgo de hiperglucemia y de diabetes tipo 2. Respecto a la composición del agua, se ha observado una asociación positiva entre el nivel de calcio y de magnesio y la salud cardiovascular. Por otra parte, la hidratación afecta a la capacidad cognitiva. Una disminución de la ingesta líquida y la deshidratación tienen un impacto negativo en el rendimiento cognitivo (atención, memoria, aprendizaje y funciones ejecutivas), mejorando la función cognitiva con la rehidratación.

[Childhood obesity as a health priority. Guidelines for improving weight control]. / La obesidad infantil como prioridad sanitaria. Pautas en la mejora del control de peso.

Introduction: Childhood obesity is a growing concern, because the problem affects a high percentage of children and is the source of many diseases in the present and in the future, which can lead to a decrease in life expectancy and quality of life. In order to combat the problem, it is necessary to analyze the factors associated with excess weight in childhood in order to act on them and try to curb the trend observed in recent years. Various socio-demographic aspects, as well as inactivity and sedentary lifestyle in children are factors that are associated with an increased risk of obesity and central adiposity. With great prominence in this issue, we have to highlight that the consumption of food is improvable: decrease the consumption of sugar, fat and sodium, and above all increase the consumption of fruits, vegetables, whole grains, fish, dairy is associated with lower obesity and central obesity in children. There is no single responsible for the problem and the interaction between healthy behaviors increases the chances of success in the fight against childhood obesity, which should be considered when planning nutritional education campaigns. Many aspects of the diet and lifestyle of the child population must be improved, perhaps now more emphasis is being placed on restrictive guidelines. Of course, it is desirable to reduce the consumption of sweets and snacks, but messages aimed at increasing the consumption of vegetables, fruits, whole grains and approximating the diet to the theoretical ideal can be prioritized. Constructive guidelines should stand out from restrictive ones.

Introducción: La obesidad infantil es objeto de preocupación creciente, porque el problema afecta a un elevado porcentaje de niños y es el origen de numerosas enfermedades en el presente y en el futuro, pudiendo condicionar un descenso en la esperanza y calidad de vida. Para combatir el problema es necesario analizar los factores que se asocian con el exceso de peso en la infancia para actuar sobre ellos e intentar frenar la tendencia observada en los últimos años. Diversos aspectos sociodemográficos, así como la inactividad y el sedentarismo de los niños son factores que se asocian con mayor riesgo de padecimiento de obesidad y adiposidad central. Con gran protagonismo en este tema debe destacarse que el consumo de alimentos es mejorable: disminuir el consumo de azúcar, grasa y sodio, y sobre todo aumentar el consumo de frutas, verduras, cereales integrales, pescado, lácteos se asocia con menor padecimiento de obesidad y obesidad central en los niños. Pero no hay un único responsable del problema y la interacción entre conductas saludables aumenta las posibilidades de éxito en la lucha contra la obesidad infantil, lo que debe ser considerado al planificar campañas de educación nutricional. Se deben mejorar numerosos aspectos de la alimentación y estilo de vida de la población infantil, quizá en este momento se hace más hincapié en pautas restrictivas, aunque es muy conveniente reducir el consumo de dulces y snacks, resulta muy deseable y quizá prioritario el aumentar el consumo de verduras, hortalizas, frutas, cereales integrales y aproximar la dieta al ideal teórico. Las pautas constructivas deberían destacar respecto a las restrictivas.

[Nutritional problems in celiac patients. Difficulties in achieving an adequate nutritional status]. / Problemática nutricional en pacientes celíacos. Dificultades para conseguir una situación nutricional adecuada.

Introduction: Celiac disease is the most common chronic intestinal disease. It affects approximately 1 % of the world population, affects all age groups and has symptoms both digestive and extra-digestive. The treatment of celiac disease is based on the strict withdrawal of gluten from the diet. This treatment supposes the improvement of symptoms and histology and the reduction of long-term comorbidities. People with celiac disease often follow diets that are far from the theoretical ideal, so they must be supervised and guided to achieve gluten-free diets that are also varied and balanced. In these patients it is important to avoid gluten consumption, but also to achieve an adequate supply of nutrients. However, their health problems, together with the limitations they must introduce in the diet make it more difficult to achieve a correct diet, so the group deserves special nutritional monitoring and surveillance.

Introducción: La enfermedad celíaca es la enfermedad crónica intestinal más frecuente que existe. Afecta aproximadamente al 1 % de la población mundial, a todos los grupos de edad y tiene síntomas de presentación tanto digestivos como extradigestivos. El tratamiento de la enfermedad celíaca se basa en la retirada estricta del gluten de la dieta. Este tratamiento supone la mejora de los síntomas y de la histología y la disminución de comorbilidades a largo plazo. Las personas con enfermedad celíaca realizan con frecuencia dietas alejadas del ideal teórico, por lo que deben ser supervisadas y orientadas para lograr dietas sin gluten y también variadas y equilibradas. En estos pacientes es importante evitar el consumo de gluten, pero también lograr un aporte adecuado de nutrientes y su problemática sanitaria, junto con las limitaciones que deben introducir en la dieta, hacen más difícil lograr una alimentación correcta, por lo que el colectivo merece una vigilancia y un control nutricional especiales.

Nurse Intervention: Attitudes and Knowledge About Organ Donation and Transplantation in Adolescents.

BACKGROUND: The problems involved in obtaining authorization in favor of organ donation have led us to evaluate the level of knowledge and attitudes of a group of Spanish adolescents (14-16 years) regarding organ donation, transplantation, and brain death. The evaluation was carried out before and after a health education intervention by nursing personnel. METHODS: Experimental, prospective and quantitative study. The educational intervention was carried out at Las Salinas high school (Laguna de Duero, Spain). We collected 86 preworkshop questionnaires and 88 post-workshop questionnaires. RESULTS: The composition of the groups did not differ significantly in sex (P = .653), age (P = .266), or in the desire to be a donor (P = .099). We found significant postworkshop improvements in knowledge about brain death (P < .001) and which organs can be donated (P < .001), as well as in the total score (18.29 ± 2.45 before vs 21.47 ± 2.70 after) (P < .001). We discovered a vast lack of knowledge about the organs that cannot be transplanted, which included the penis (38.4%), uterus (31.4%), prostate (41.9%), or bladder (37.2%); these beliefs decreased significantly after the intervention (P < .01). The increase in knowledge of the organs that can be donated, including eye (P = .024), lung (P = .025), stomach (P < .001), intestine (P = .001), and skin (P < .001), was also significant. CONCLUSIONS: The good results reflected the importance of conducting educational programs taught by health personnel on donation and organ transplantation in adolescents.

Adapting Agriculture to Climate Change: A Synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across Five Continents.

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges.

What Do We Know Today about Long COVID? Nursing Care for a New Clinical Syndrome.

Persistent COVID, long COVID, long-effects, long-term effects or chronic COVID are all names of a new syndrome caused by a set of multi-organ symptoms that appear after having been infected with SARS-CoV-2 [...].