Short term effectiveness of Pressure Release and Kinesiotaping in Cervical Myofascial Pain caused by sternocleidomastoid muscle: A randomized clinical trial / Efectividad a corto plazo de la liberación por presión y del kinesiotaping en el dolor miofascial cervical causado por el músculo esternocleidomastoideo. Ensayo clínico aleatorizado

Objective: The aim of this study is to evaluate the effectiveness of 2 different therapies, pressure release (PR) and kinesiotaping (KT) for myofascial pain syndrome in the sternocleidomastoid muscle. Methods: Experimental, randomized, controlled, single-blind study. KT was applied for group C, PR to treat group B and placebo to treat group A. The used variables were: Algometry, Numerical Pain Scale (NPS), Questionnaire of Quality of Life SF-12, and Goniometry of cervical complex. Participants were assisted in public hospitals of the Balearic Health Service (Spain), from March 2012 to March 2013. The study includes a sample of 75 patients with cervical myofascial pain syndrome of the sternocleidomastoid muscle. Each patient received three appointments. Each appointment lasted 20 minutes approximately. Results: Questionnaire SF-12 shows that the improvement of the quality of life with KT was 10.32 points (P < 0.001), with PR was 5.0 points (P < 0.05) and the group A with placebo treatment scored 2.20 points (P < 0.05). NPS for KT shows a reduction of pain of 24.00% (P < 0.001), for PR a reduction of 11.20% (P < 0.001), and in group A no significant outcome was found. Algometry shows that the pain is reduced with the KT and the PR significantly. Goniometry of cervical complex improved significantly with KT for all range of mobility. Conclusions: KT and PR are two therapeutic techniques which help to reduce pain, show increased levels in Goniometry (cervical movements) and contribute to improve quality of life. It seems that KT could be more effective than PR

Objetivo: Este trabajo evalúa la eficacia de 2 terapias, la liberación por presión (LP) y el kinesiotaping (KT) para el síndrome de dolor miofascial en el músculo esternocleidomastoideo. Métodos: Estudio experimental, aleatorizado, controlado a simple ciego, en el que se aplicó KT (grupo C), LP (grupo B) y placebo (grupo A). Las variables utilizadas fueron: algometría, escala numérica del dolor, cuestionario de calidad de vida SF-12 y goniometría del complejo cervical. Los participantes fueron atendidos en hospitales públicos del Servicio de Salud de las Islas Baleares (España), desde marzo de 2012 hasta marzo de 2013. El estudio recoge una muestra de 75 pacientes a los que se realizaron 3 visitas de 20 min cada una. Resultados: El SF-12 muestra la mejora de la calidad de vida de 10,32 puntos (p < 0,001) con el KT, de 5,0 puntos (p < 0,05) con la LP y de 2,20 puntos (p < 0,05) con el Grupo A. La escala numérica del dolor señala una reducción del dolor del 24% (p < 0,001) con el KT, del 11,20% (p < 0,001) con la LP, y con el grupo A no se obtienen resultados significativos. La algometría muestra una reducción significativa del dolor con el KT y la LP. La goniometría mejoró significativamente con el KT para todos los rangos. Conclusiones: El KT y la LP son 2 técnicas terapéuticas que ayudan a reducir el dolor, aumentan los rangos de movilidad cervical y contribuyen a mejorar la calidad de vida. Parece ser que el KT podría ser más eficaz que la LP

Using knowledge as the basis for evidence-based practice in primary care nurses.

AIM: The aim of this study was to explore the perception of primary care nurses regarding the need and use of knowledge from research, as a basis for evidence-based practice in their workplace. Additionally, the study aimed to determine which factors might hinder or enable implementation into daily practice. BACKGROUND: Evidence-based practice involves integrating best results in research with clinical experience, which enables us to provide a higher quality of care, as well as to optimize the care given. International studies show that nurses feel that there are still many barriers that hinder their doing research and incorporating new findings into clinical practice; although in the field of primary care, few studies have been carried out. METHODS: This descriptive qualitative study design used focus groups to collect data. This study was carried out in Spanish primary care centres. Forty-six registered nurses took part in this study and were divided into five focus groups. RESULTS: Three significant themes emerged: awareness of the need to use research, nurses as knowledge-generation agents and motivation to use research despite barriers. LIMITATIONS: A limited number of participants and a convenience sample were used. CONCLUSION: Nurses recognize that professional health care must be based on evidence obtained from daily work - both originated by their colleagues and by themselves - and they are willing to work on it although they perceive a lack of competence for this purpose and demand support from their institutions. IMPLICATIONS FOR NURSING POLICY: Primary care institutions should empower nursing coordinators as leaders of evidence-based practice and implicate clinical nurses from the beginning on the implementation of guidelines.

Obesity, metabolic syndrome and Mediterranean diet: Impact on depression outcome.

OBJECTIVE: Obesity, metabolic syndrome (MetS) and low adherence to Mediterranean diet are frequent in major depression patients and have been separately related with prognosis. The aim of this study is to analyse their predictive power on major depression outcome, at 6 and 12 months. METHODS: 273 Major depressive patients completed the Beck Depression Inventory for depressive symptoms and the 14-item Mediterranean diet adherence score. MetS was diagnosed according to the International Diabetes Federation (IDF). RESULTS: At the baseline Mediterranean diet adherence was inversely associated with depressive symptoms (p=0.007). Depression response was more likely in those patients with normal weight (p=0.006) and not MetS (p=0.013) but it was not associated with Mediterranean diet adherence (p=0.625). Those patients with MetS and obesity were less likely to improve symptoms of depression than patients with obesity but not MetS. CONCLUSIONS: Obesity and MetS, but not low adherence to the Mediterranean diet at baseline, predicted a poor outcome of depression at 12 months. Our study suggests that MetS is the key factor that impacts negatively in depression prognosis, rather than obesity or diet. If this finding is confirmed, clinicians should be aware about MetS diagnosis and treatment in overweight depressed patients, especially if outcome is not being satisfactory enough.

Bayesian network modeling: A case study of an epidemiologic system analysis of cardiovascular risk.

An extensive, in-depth study of cardiovascular risk factors (CVRF) seems to be of crucial importance in the research of cardiovascular disease (CVD) in order to prevent (or reduce) the chance of developing or dying from CVD. The main focus of data analysis is on the use of models able to discover and understand the relationships between different CVRF. In this paper a report on applying Bayesian network (BN) modeling to discover the relationships among thirteen relevant epidemiological features of heart age domain in order to analyze cardiovascular lost years (CVLY), cardiovascular risk score (CVRS), and metabolic syndrome (MetS) is presented. Furthermore, the induced BN was used to make inference taking into account three reasoning patterns: causal reasoning, evidential reasoning, and intercausal reasoning. Application of BN tools has led to discovery of several direct and indirect relationships between different CVRF. The BN analysis showed several interesting results, among them: CVLY was highly influenced by smoking being the group of men the one with highest risk in CVLY; MetS was highly influence by physical activity (PA) being again the group of men the one with highest risk in MetS, and smoking did not show any influence. BNs produce an intuitive, transparent, graphical representation of the relationships between different CVRF. The ability of BNs to predict new scenarios when hypothetical information is introduced makes BN modeling an Artificial Intelligence (AI) tool of special interest in epidemiological studies. As CVD is multifactorial the use of BNs seems to be an adequate modeling tool.

Competency frameworks for advanced practice nursing: a literature review.

AIM: This paper describes a literature review that identified common traits in advanced practice nursing that are specific to competency development worldwide. BACKGROUND: There is a lack of international agreement on the definition of advanced practice nursing and its core competencies. Despite the lack of consensus, there is an ongoing process worldwide to establish and outline the standards and competencies for advanced practice nursing roles. INTRODUCTION: International agencies, such as the International Council of Nurses, have provided general definitions for advanced practice nursing. Additionally, a set of competency standards for this aim has been developed. METHODS: A literature review and a directed search of institutional websites were performed to identify specific developments in advanced practice nursing competencies and standards of practice. To determine a competency map specific to international advanced practice nursing, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents and countries. RESULTS: The review process identified 119 relevant journal articles related to advanced practice nursing competencies. Additionally, 97 documents from grey literature that were related to advanced practice nursing competency mapping were identified. From the text analysis, 17 worldwide transversal competency domains emerged. CONCLUSIONS: Despite the variety of patterns in international advanced practice nursing development, essential competency domains can be found in most national frameworks for the role development of international advanced practice nursing. These 17 core competencies can be used to further develop instruments that assess the perceived competency of advanced practice nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes.

Perception of Spanish primary healthcare nurses about evidence-based clinical practice: a qualitative study.

BACKGROUND: Although evidence-based clinical practice constitutes a priority for healthcare services in many countries within the last few years, there is a general lack of implementation of evidence-based clinical practice in nursing care, especially in primary health care. Few qualitative studies concerning the influencing factors on evidence-based clinical practice for community nurses have been carried out. AIM: This study examined the perception of nurses in Spanish primary health care with regard to the knowledge, advantages and barriers within the application process with evidence-based clinical practice. METHODS: We used a descriptive qualitative study with focus groups to collect data. Forty-six primary care nurses took part in this study and they were distributed into five focus groups. RESULTS: Five main topics arose from the results achieved: knowledge and development of evidence-based clinical practice, evidence searching, evidence dissemination, advantages of use of evidence-based clinical practice, and barriers for its application and implementation. Participants had a positive attitude towards evidence-based practice, although they used this infrequently because of lack of competence and organizational support for its application. CONCLUSION: Our participants are increasingly determined to take into account evidence within the decision-making processes in their usual clinical practice. We consider it advisable to develop specialized training strategies as well as provide necessary resources for the implementation of evidence-based clinical practice duly adapted to the field of primary health care. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study highlights the existing gap in translating knowledge to practice and its potential implications in the effectiveness of nursing interventions and decision making in primary health care, and thus its implications for education policy.

Caracterización del hábito tabáquico en una consulta de enfermería de Atención Primaria / Characterization of smoking habit in the Primary Care nursing consultation

Introducción: En 1999, la OMS (Salud para Todos en el Siglo XXI) identifica a la enfermera de Atención Primaria como uno de los pilares básicos de la promoción de la salud en la población y declara que «El tabaquismo es la mayor amenaza para la salud en la Región Europea». Objetivo: Caracterizar el hábito tabáquico de la población sometida a estudio con el fin de desarrollar estrategias adecuadas y específicas que rentabilicen los recursos y esfuerzos en la ayuda a nuestros pacientes. Pacientes y métodos: Estudio descriptivo transversal mediante cuestionario cumplimentado por los autores a partir de la información voluntariamente transmitida por 205 pacientes, seleccionados a medida que iban accediendo a una consulta programada de enfermería del centro de atención primaria Trencadors. Resultados: El 19,0% son exfumadores, el 28,3% fumadores y el 52,7% no han fumado nunca. Existen diferencias significativas entre géneros en cuanto a exfumadores, fumadores y nunca fumadores. La totalidad de exfumadores no ha usado ningún método para intentar dejar de fumar y el 71,8% lo ha dejado con un solo intento. Conclusiones: Nuestra población asistencial desarrolla una conducta báquica similar al resto de la población de las Islas Baleares, Cataluña o España. los pacientes que deciden dejar de fumar y no pueden, infrautilizan los medios de ayuda de que disponen. El consejo breve oportunista durante las crisis o molestias del paciente o su familia se muestra como la herramienta más eficaz en la lucha antitabáquica (AU)

Introduction: In 1999 the WHO (Health for All) signalled out primary care infirmaries as the milestones in the promotion of public health and declared that «Tobacco use is the greatest health threat to the European Region». Objective: Define the smoking habits of the population with the objective that their study would allow the development of adequate and specific strategies that take advantage of the abilities and efforts of the nursing professionals in helping our patients give-up tobacco use. Patients and Methods: A descriptive, cross-sectional study of the information gathered in the form of questionnaire was developed by the authors. Data was obtained from information voluntarily given by 205 patients, selected when entering for a programmed visit at the «Trencadors». Primary Health Care Centre. Results: Of the population studied, 19.0% were former smokers, 28.3% were smokers, and 52.7% had never smoked. Significant gender related differences were found between former smokers, smokers and patients that had never smoked. Former smokers as a whole did not use any type of method to give up smoking and of these, 71.8% had stopped at the first attempt to abandon the habit. Conclusions: The population that visit the health care centres have smoking habits that are similar to the rest of the populations in the Balearic Islands, Catalonia and Spain. Patients that decided to stop smoking and could not were under-utilising the help available to them. The opportunistic advice during an abstention crisis or the nuisance caused to the patients or their families proved to be the best weapons in the fight to stop smoking (AU)