Satisfacción laboral del fisioterapeuta en la sanidad pública de Castilla y León / Job satisfaction of the physiotherapist in the public health care system of Castilla y León

Objetivo: El grado de satisfacción laboral es uno de los indicadores más relevantes respecto de la forma en la que los profesionales sanitarios perciben su entorno laboral. Valorado a través de dimensiones, facilita conocer las fortalezas y las debilidades de cada entidad sanitaria y específicamente de cada gremio profesional. El objetivo de este estudio es medir mediante 13 dimensiones, relacionadas con todos los aspectos del desempeño laboral, la satisfacción de los fisioterapeutas que trabajan en la sanidad pública de la comunidad de Castilla y León, y comparar su valoración con las prioridades reales que ellos estiman más importantes en su trabajo diario. Material y métodos Este estudio se centra en los fisioterapeutas asistenciales públicos de la comunidad de Castilla y León. Para la recogida de datos se ha utilizado un cuestionario basado en el Modelo EFQM. Resultados Los resultados de la matriz de posicionamiento indican que son dimensiones a consolidar las «Condiciones de trabajo», la «Identificación con el trabajo y desarrollo profesional» y el «Clima y ambiente de trabajo». Sin embargo, la «Formación» y el «Reconocimiento en el trabajo» realizado son dimensiones que están en el polo opuesto ya que se encuentran en el área de prioridad de mejora. Conclusiones Creemos que las organizaciones sanitarias deberían implicarse en la formación continuada de los fisioterapeutas; crear indicadores de buen desempeño laboral promoviendo acciones que sirvan de reconocimiento hacia sus trabajadores; establecer las infraestructuras necesarias para implementar los procesos de comunicación y construir patrones de gestión avalados por su efectividad (AU)

Objective: Degree of job satisfaction is one of the most relevant indicators of how health care professionals perceive their work environment. Job satisfaction assessed through dimensions facilitates knowledge about the strengths and weaknesses of each entity and specific to each health care professional association. This study has aimed to measure the satisfaction of physiotherapists working in the public health services in the community of Castilla y León and to compare their assessment with the real priorities that they regard as most important in their daily work using thirteen dimensions related to all aspects of job performance. Material and methods: This study focuses on public care physiotherapists in the community of Castilla y León. Data were collected using a questionnaire based on the EFQM Model. Results: The positioning matrix results indicate that dimensions to consolidate are: ‘‘Working conditions’’, ‘‘Identification with work and professional development’’ and ‘‘Climate and working environment’’. However, ‘‘Professional education’’ and ‘‘Recognition at work’’ are dimensions located at the opposite pole, since they are found in the priority area for improvement. Conclusions: We believe that health care organizations should be involved in continuing education for physiotherapists, creating job performance indicators that promote actions that serve as recognition for their employees; establishing the necessary infrastructures to implement communication processes and building management patterns endorsed by their effectiveness (AU)

[Performance of nutritional education programmes to prevent obesity in children through a pilot study in Soria]. / Utilidad de los programas de educación nutricional para prevenir la obesidad infantil a través de un estudio piloto en Soria.

BACKGROUND: Spain has one of the highest rates of childhood obesity in Europe. The Spanish authorities of health have launched some strategies, which among others, includes activities to develop healthier dietary habits in children. OBJECTIVE: The aim of the present study has been to assess the effectiveness of the nutritional education programmes undertaken to prevent obesity in children through a pilot study in Soria. This has been evaluated through the comparative study of adherence to the Mediterranean Diet and anthropometric parameters between two samples of same age schoolchildren at an interval of 10 years. SUBJECTS AND METHODS: Adherence to the Mediterranean diet and BMI was evaluated in two occasional samples of pupils aged between 6 and 9 years, who were attended to 5 public Schools in Soria, during two academic years 1998/ 99 (n=119) and 2008/09 (n=231). Adherence to the Mediterranean diet was evaluated by the KidMed index. RESULTS: There were no differences in KidMed score between sexes within the same sample. However, there were a significant differences (p<0.0001) in total KidMed socore between the 2008/09 and 1998/99 schoolchildren. The mean BMIs were similar for the boys and girls of the same course, while it was significantly lower (p<0.05) in 2008/09 school children. The Kidmed score was negatively associated with BMI (r=-0.133, p<0.05). CONCLUSIONS: The proportion of childhood that showed an upper-middle degree of adherence to the Mediterranean diet patterns was higher among 2008-09 pupils. These results suggests that activities coordinated from different agencies in Spain, may be a useful tool for promotion of healthy eating habits in children.

Utilidad de los programas de educación nutricional para prevenir la obesidad infantil a través de un estudio piloto en Soria / Performance of nutritional education programmes to prevent obesity in children through a pilot study in Soria

Introducción: España tiene una de las mayores tasas de obesidad infantil de Europa, por ello las autoridades sanitarias han puesto en marcha actividades para desarrollar hábitos de alimentación saludables entre los escolares. Objetivo: Evaluar la utilidad de los programas de educación nutricional para prevenir la obesidad infantil a través de un estudio piloto en Soria, comparando la adhesión a los patrones de la Dieta Mediterránea y los parámetros antropométricos entre dos muestras de escolares de la misma edad, en un intervalo de 10 años. Sujetos y métodos: Se ha valorado la adhesión a la Dieta Mediterránea, mediante el test KidMed y el IMC en dos muestras de escolares de entre 6 y 9 años que acudían al comedor escolar en 5 Colegios Públicos de Soria, durante los cursos escolares 1998/99 (n = 119) y 2008/09 (n = 231). Resultados: En el índice KidMed no se han encontrado diferencias entre sexos dentro de la misma muestra, pero se ha observado una mejora significativa entre los niños escolarizados en 2008/09 respecto a los encuestados en 1998/99 (p < 0,0001). Los valores del IMC son similares entre niños y niñas del mismo curso, aunque el valor medio es significativamente inferior en los escolarizados en 2008/09 (p < 0,05). El análisis de correlación muestra una asociación negativa entre el índice KidMed y el IMC (r = -0,133, p < 0,05) de todos los encuestados. Conclusiones: La proporción de escolares que presentaba una adhesión media-alta a los patrones de de la Dieta Mediterránea fue superior entre los encuestados en 2008/09 lo que sugiere que las actividades coordinadas por las distintas administraciones sanitarias son una herramienta útil para promocionar buenos hábitos alimentarios entre los escolares (AU)

Background: Spain has one of the highest rates of childhood obesity in Europe. The Spanish authorities of health have launched some strategies, which among others, includes activities to develop healthier dietary habits in children. Objective: The aim of the present study has been to assess the effectiveness of the nutritional education programmes undertaken to prevent obesity in children through a pilot study in Soria. This has been evaluated through the comparative study of adherence to the Mediterranean Diet and anthropometric parameters between two samples of same age schoolchildren at an interval of 10 years. Subjects and methods: Adherence to the Mediterranean diet and BMI was evaluated in two occasional samples of pupils aged between 6 and 9 years, who were attended to 5 public Schools in Soria, during two academic years 1998/ 99 (n = 119) and 2008/09 (n = 231). Adherence to the Mediterranean diet was evaluated by the KidMed index. Results: There were no differences in KidMed score between sexes within the same sample. However, there were a significant differences (p < 0.0001) in total KidMed socore between the 2008/09 and 1998/99 schoolchildren. The mean BMIs were similar for the boys and girls of the same course, while it was significantly lower (p < 0.05) in 2008/09 school children. The Kidmed score was negatively associated with BMI (r= -0.133, p < 0.05). Conclusions: The proportion of childhood that showed an upper-middle degree of adherence to the Mediterranean diet patterns was higher among 2008-09 pupils. These results suggests that activities coordinated from different agencies in Spain, may be a useful tool for promotion of healthy eating habits in children (AU)

[Macronutrients intake in school teenagers in Soria capital]. / Ingesta de macronutrientes en adolescentes escolarizados en Soria capital.

OBJECTIVES: To study the macronutrients intake in Soria teenagers from 10 to 19 years, as well as their body mass index (BMI). METHODS: A seven-day diet questionnaire filled in by an accidental sample of teenagers (54 boys and 56 girls) from public schools in the capital. Working out the average daily intake of energy, carbohydrates, lipids and proteins by the software of "Alimentación y Salud" which also gives values of individual recommended dietary allowances (RDAs) related to each individual's particular characteristics. Use of Student's t-test to compare the average values of the estimated intakes of different nutrients and their RDAs. RESULTS: In general, the intakes of energy, proteins and lipids are statistically significant over the RDAs, while the carbohydrates intake is under the recommendations. With reference to the type of lipids, the intake is over the RDAs for cholesterol, monounsaturated fatty acids, and saturated fatty acids, but not for polyunsaturated fatty acids. Among girls from 13 years of age more than 12% have a higher BMI than 26 kg/m2, but between 10 and 12 years of age more than 20% of the students have this parameter under 16 kg/m2. CONCLUSIONS: According to the results, it would be useful to implement some nutritional intervention among the adolescents in Soria capital to promote a healthy feeding in order to avoid possible disorders (obesity, anorexia, etc.).

Ingesta de macronutrientes en adolescentes escolarizados en Soria capital / Macronutrients intake in school teenagers in Soria capital

Objetivos: Estudiar la ingesta de macronutrientes en adolescentes sorianos de 10-19 años, así como su índice de masa corporal (IMC). Metodología: Encuesta sobre el consumo de alimentos durante siete días en una muestra accidental de adolescentes (54 varones y 56 mujeres) de escuelas públicas de Soria capital. Valoración del aporte medio diario de energía, glúcidos, lípidos y proteínas mediante el programa "Alimentación y Salud" que también da valores de ingesta diaria recomendada (IDR) para cada individuo en función de sus características particulares. Utilización del test de la t de Student para comparar los valores medios de la ingesta estimada para los distintos nutrientes y sus ingestas diarias recomendadas. Resultados: En general, el aporte de energía, proteínas y lípidos supera de forma estadísticamente significativa las ingestas diarias recomendadas, mientras que el de glúcidos es inferior a las recomendaciones. En cuanto al tipo de lípidos ingerido, la ingesta es superior a la recomendada para colesterol, ácidos grasos monoinsaturados y ácidos grasos saturados, pero no para los ácidos grasos poliinsaturados. En chicas, a partir de los 13 años, más del 12% tiene un valor de índice de masa corporal superior a 26 kg/m2, sin embargo, entre los 10-12 años el 20% de la población estudiada tiene este parámetro por debajo de 16 kg/m2. Conclusiones: En función de los resultados obtenidos, parece conveniente realizar algún tipo de intervención nutricional entre los adolescentes de la capital soriana para promover una alimentación saludable que permita prevenir posibles trastornos (obesidad, anorexia, etc.) (AU)

Objectives: To study the macronutrients intake in Soria teenagers from 10 to 19 years, as well as their body mass index (BMI). Methods: A seven-day diet questionnaire filled in by an accidental sample of teenagers (54 boys and 56 girls) from public schools in the capital. Working out the average daily intake of energy, carbohydrates, lipids and proteins by the software of "Alimentación y Salud" which also gives values of individual recommended dietary allowances (RDAs) related to each individual's particular characteristics. Use of Student's t-test to compare the average values of the estimated intakes of different nutrients and their RDAs. Results: In general, the intakes of energy, proteins and lipids are statistically significant over the RDAs, while the carbohydrates intake is under the recommendations. With reference to the type of lipids, the intake is over the RDAs for cholesterol, monounsaturated fatty acids, and saturated fatty acids, but not for polyunsaturated fatty acids. Among girls from 13 years of age more than 12% have a higher BMI than 26 kg/m2, but between 10 and 12 years of age more than 20% of the students have this parameter under 16 kg/m2. Conclusions: According to the results, it would be useful to implement some nutritional intervention among the adolescents in Soria capital to promote a healthy feeding in order to avoid possible disorders (obesity, anorexia, etc.) (AU)

Ingesta de micronutrientes en adolescentes de comedores escolares de Soria / Micronutrients intake in adolescents who attend the school dining halls in Soria

En este trabajo se examina la ingesta de ciertos micronutrientes en adolescentes de entre 10 y 19 años, habitantes de una ciudad española. Un grupo de 111 adolescentes (49,5 por ciento varones, 50,5 por ciento mujeres) escolarizados en escuelas públicas de Soria fueron encuestados sobre el consumo de alimentos durante 7 días para medir la ingesta de minerales, calcio, hierro, magnesio y cinc y vitaminas, A, E, C y ácido fólico. Utilizando la prueba de Student entre los resultados obtenidos de ingesta y la ingesta individual recomendada se observó una ingesta excesiva de vitaminas A, E, C y ácido fólico en todos los grupos a excepción del grupo de mujeres entre 16 y 19 años en el que la diferencia no fue estadísticamente significativa. La ingestión de calcio y cinc fue superior a las recomendaciones en todos los grupos, aunque no significativa para calcio en el grupo de mujeres de entre 16 y 19 años y para cinc en el grupo de mujeres de 10 a 12 años. La ingesta diaria de magnesio fue claramente insuficiente para ambos sexos entre los adolescentes encuestados y finalmente el consumo estimado de hierro en mujeres fue inadecuado para todos los grupos de edad y suficiente en todos los grupos de varones. A la vista de los resultados obtenidos en este estudio y sobre todo en lo que concierne a lo inadecuado del consumo de hierro y magnesio, especialmente en mujeres, sería conveniente realizar algún tipo de intervención nutricional entre los adolescentes de centros públicos de la provincia de Soria (AU)

In vitro effect of Cl2Ca and Cl2Mg on warfarin-human serum albumin (HSA) binding.

The binding of warfarin to 10 mumol/L human serum albumin (HSA) was studied in vitro by equilibrium dialysis in presence of two different calcium concentrations. At 2.3 and 23 mmol/L calcium concentrations, the percentage binding decreased. The number of saturable sites of warfarin-HSA at these two calcium concentrations were 1.02 and 1.23 respectively; the number of saturables sites observed with warfarin alone was higher (n1 = 1.32). The association constant for saturable sites (K1 = 0.187 mumol-1) and the affinity coefficient for the nonsaturable sites (n2K2 = 0.0955) remained unchanged. The binding to HSA was 98 per cent at therapeutic levels, that is a physiological concentrations of protein and therapeutic levels of warfarin, in the presence of several concentrations of calcium (2.5; 5; 25; 50 and 100 mmol/L) or magnesium (1;2;10;50 and 100 mmol/L) as chloride compounds, the free fraction of warfarin remained constant until calcium or magnesium reached concentrations of 50 mmol/L, in which cases the percentage binding fell to 92 per cent. In conclusion a displacement of bound warfarin can be expected only if the plasma concentrations of calcium or magnesium and as well chloride concentration are raised by much.

Effect of iron and estrogen on melatonin secretion by the chicken pineal gland.

Estrogen effects on pineal secretion of melatonin are controversial. Some feel that estrogen inhibits melatonin output in vitro but not in vivo. Melatonin levels vary with the age in chickens where circulating estrogen levels also vary. Laying hens have minimal melatonin levels and maximal serum iron concentrations. Thus, we reasoned that iron released by estrogen may inhibit melatonin secretion from the chick pineal gland. The present study shows that perifusion of estrogen-treated chick pineal glands with several concentrations of iron greatly inhibited melatonin secretion.

Displacement of rifampicin bound to serum proteins by addition of levamisole.

We have studied, by ultrafiltration, the interactions between rifampicin (15 and 30 microM) and levamisole (7 microM) since both drugs may be associated for the treatment of brucellosis. We can observe a statistically significant increase in the free plasmatic fraction of rifampicin at the studied concentration of levamisole, which indicated that levamisole reduced rifampicin bound to proteins (290 and 250%, respectively).

[Effect of strontium and magnesium on blood calcium]. / Influencia del estroncio y del magnesio sobre el calcio sérico.

Twenty four male Wistar rats weighing 250 +/- 10 g, in three groups of 8 rats each, were used. Group A was used as control and the content of its drinking water was 6.5 mg/l Ca; 2.4 mg/l Mg. The drinking water of groups B and C was supplemented with 20 mM (SrCl2) and 20 mM (MgCl2), respectively. Once the 20 days of mineral supplementation had passed, arterial blood was extracted by puncture in the abdominal aorta. In the serum obtained after centrifugation, Ca, Mg, Sr and the total proteins (TP) were determined. Afterwards the serum was subjected to ultrafiltration. Concentrations of Ca, Mg and TP were measured in the obtained ultrafiltrates (u), with the above described techniques. The pH was measured before and after the ultrafiltration. The TP decreased significantly both in group B (supplemented with Sr), and in group C (supplement with Mg). Increases in Ca were found in group B and in Mg in group C. The Mg/Ca ratio increased 10% after the supplementation with Mg. At the ultrafiltrate a significant increase in Cau after supplementation with Sr and with Mg was observed. The Mgu/Cau ratio decreased 14% in the group supplemented with Sr and 38% after the supplementation with Mg. In conclusion, the supplementation with Sr (20 mM) in rats increases the Cau and could have the effect of reducing protein synthesis. These facts should be borne in mind when Sr is used for therapeutical purposes.

Effects of calcium, magnesium, tobramycin and theophylline on phenobarbitone binding to serum proteins.

Binding of phenobarbitone to human serum proteins was determined in vitro using ultrafiltration. At therapeutic concentrations of 10-600 microM, 63.51 +/- 2.5% of the phenobarbitone was bound to total serum proteins. The binding kinetics were non-saturable and the plasma apparent affinity coefficient (NKa) was 0.791 +/- 0.09 for normal serum and 0.664 +/- 0.06 for chromatographed serum. Tobramycin and theophylline at therapeutic concentrations of 10 and 15 micrograms/ml, respectively, reduced NKa compared with the values found in normal serum. Calcium and especially magnesium at physiological concentrations of 2.5 and 5 mM, respectively, increased NKa compared with values obtained in chromatographed serum, whereas at supraphysiological concentrations of magnesium of 15 mM NKa was reduced. It is concluded that free phenobarbitone concentrations in serum can be modified by calcium, magnesium, tobramycin and theophylline, and this fact must be considered when studying enzyme induction and other properties of phenobarbitone.