Training Characteristics, Performance, and Body Composition of Three U23 Elite Female Triathletes throughout a Season.

(1) Background: There is a lack of data on the long-term training characteristics and performance markers of elite young female endurance athletes. The aim of this study was to present the training load (ECOs), as well as the evolution of the anthropometric values and performance of three elite U23 female triathletes over a season. (2) Methods: General training data and performance data relating to the swimming, cycling, and running legs of the 2021 season were described. The training intensity distribution (TID) was presented using the triphasic model, while the training load was based on the ECO model. An anthropometric analysis was also conducted in accordance with the ISAK standards. (3) Results: Triathletes increased their VO2max in cycling (6.9-10%) and running (7.1-9.1%), as well as their power and speed associated with the VO2max (7.7-8.6% in cycling and 5.1-5.3% in running) and their swimming speed associated with the lactate thresholds (2.6-4.0% in LT2 and 1.2-2.5% in LT1). The triathletes completed more than 10 h of weekly average training time, with peak weeks exceeding 15 h. The average TID of the three triathletes was 82% in phase 1, 6% in phase 2, and 12% in phase 3. A decrease in the sum of skinfolds and fat mass percentage was observed during the season in the three triathletes, although the last measurement revealed a stagnation or slight rise in these parameters. (4) Conclusions: The triathletes performed a combination of two training periodization models (traditional and block periodization) with a polarized TID in most of the weeks of the season. Improvements in performance and physiological parameters were observed after the general preparatory period as well as a positive body composition evolution throughout the season, except at the end, where the last measurement revealed stagnation or a slight decline. This study can be useful as a general guide for endurance coaches to organize a training season with female U23 triathletes.

A Five-Week Periodized Carbohydrate Diet Does Not Improve Maximal Lactate Steady-State Exercise Capacity and Substrate Oxidation in Well-Trained Cyclists compared to a High-Carbohydrate Diet.

There is a growing interest in studies involving carbohydrate (CHO) manipulation and subsequent adaptations to endurance training. This study aimed to analyze whether a periodized carbohydrate feeding strategy based on a daily training session has any advantages compared to a high-carbohydrate diet in well-trained cyclists. Seventeen trained cyclists (VO2peak = 70.8 ± 6.5 mL·kg-1·min-1) were divided into two groups, a periodized (PCHO) group and a high-carbohydrate (HCHO) group. Both groups performed the same training sessions for five weeks. In the PCHO group, 13 training sessions were performed with low carbohydrate availability. In the HCHO group, all sessions were completed following previous carbohydrate intake to ensure high pre-exercise glycogen levels. In both groups, there was an increase in the maximal lactate steady state (MLSS) (PCHO: 244.1 ± 29.9 W to 253.2 ± 28.4 W; p = 0.008; HCHO: 235.8 ± 21.4 W to 246.9 ± 16.7 W; p = 0.012) but not in the time to exhaustion at MLSS intensity. Both groups increased the percentage of muscle mass (PCHO: p = 0.021; HCHO: p = 0.042) and decreased the percent body fat (PCHO: p = 0.021; HCHO: p = 0.012). We found no differences in carbohydrate or lipid oxidation, heart rate, and post-exercise lactate concentration. Periodizing the CHO intake in well-trained cyclists during a 5-week intervention did not elicit superior results to an energy intake-matched high-carbohydrate diet in any of the measured outcomes.

Clinical value of a tool for managing oral anticoagulation in nonvalvular atrial fibrillation in primary health care. Randomized clinical trial.

INTRODUCTION AND OBJECTIVES: The management of atrial fibrillation is complex and requires improvement at strategic points, such as in the control of patients treated with vitamin K antagonists. The aim of this study was to evaluate the impact on health outcomes of a nonvalvular atrial fibrillation decision support tool based on visualization of the time in therapeutic range in primary care. METHODS: The present randomized clinical trial was conducted in 2018 with a 1-year follow-up in 325 primary care centers in Catalonia. In the intervention centers, the decision support tool was installed to control the time in therapeutic range of patients treated with vitamin K antagonists. The tool was not visualized in the control group. This clinical trial was registered with ClinicalTrials.gov (NCT03367325). RESULTS: In total, 44 556 patients were studied. The intervention protected against admission for stroke (adjusted odds ratio [OR], 0.70; 95% confidence interval [95%CI], 0.55-0.88). The number needed to treat was 3502 (95%CI, 3305-3725) while the number of admissions for stroke avoided was 12.63 (95%CI, 11.88-13.38). The intervention also protected against mortality (adjusted OR, 0.78; 95%CI, 0.67-0.90), with a number needed to treat of 13 687 (95%CI, 10 789-18 714) and number of deaths avoided of 3.23 (95%CI, 2.36-4.10). CONCLUSIONS: The decision support tool was associated with slight reductions in the numbers of admissions for ischemic stroke and mortality. Although the follow-up time was short and the effect of the intervention was small, the results are valuable and could improve implementation of the tool.

Does Pool Performance of Elite Triathletes Predict Open-Water Performance?

The capacity of laboratory tests to predict competition performance has been broadly researched across several endurance sports. The aim of the present study was to analyse how pool swimming performance can predict the result of the swimming segment in triathlon competitions and compare predictability differences based on competition level and distance. Eighteen male triathletes participated in the study. Three were ranked world-class, ten elite/international level, and five highly trained/national level. A total of sixty-one graded multi-stage swimming tests were conducted. Blood lactate was measured to calculate the following hypothetical predictor variables: speed at lactate threshold 1 (LT1), speed at lactate threshold 2 (LT2), and speed in the last repetition of the test (SL200). The following data were collected for a total of 75 races: time in the swimming leg (TSL); position after the swimming leg (PSL); time difference with the first triathlete after the swimming leg (DFT); and final race position. The race levels were divided according to participant levels as follows: world series (WS) (n = 22); World Cup (WC) (n = 22); Continental Cup (CC) (n = 19); national championship (N) (n = 5); and local race (L) (n = 5). Based on distance, they were divided into Olympic distance (OD) (n = 37) and sprint distance (SD) (n = 38). A moderate to strong positive association was found between LT1, LT2, SL200 and PSL and TSl at all race levels except for the SD CC, SD WC, and OD CC races, where no or weak-to-moderate correlations were found. The present study demonstrated that performance measured in a graded multi-stage pool lactate test can predict performance in a triathlon swimming segment. This finding is highly useful for coaches as it can help them to obtain a reliable measure of the triathlete's specific capabilities in the swimming leg.

Understanding Prognostic Factors for Human Papillomavirus Vaccination: A Rural Community Case-Control Study.

HPV vaccination coverage rates can vary depending on several factors. The main objective of this study is to identify possible independent prognostic factors that have an impact on HPV vaccination in a rural community, specifically related to sexual and reproductive health. A case-control, retrospective, community-based study was carried out on women aged 15 to 40 in the primary health centers of Southern Catalonia's Terres de l'Ebre region, Spain, from 1 January 2020 to 31 December 2022. A random sample of 520 women with an average age of 29.3 (SD 7.8) years old was included in the study. Independent prognostic factors: age OR 0.680 (95% CI: 0.635-0.729, p < 0.001), immigrant origin OR 0.215 (95% CI: 0.109-0.422, p < 0.001), and HPV PCR OR 7.402 (95% CI: 2.504-21.880, p < 0.001). The variables that showed a barrier effect for HPV vaccination were age (OR 0.680, 95% CI 0.635-0.729, p < 0.001), and immigrant origin (OR 0.215, 95% CI 0.109-0.422, p < 0.001). The variable that showed a facilitating effect for HPV vaccination was HPV PCR (OR 7.402, 95% CI 2.504-21.880, p < 0.001).

Innovative Health and Social Integrated Care Model Effectiveness to Improve Quality Care for Chronic Patients: A Single Group Assignment Clinical Trial.

Background: Patients with chronic disease have become one of the major challenges for health and social protection systems in developed countries. Integrated care models (ICM) have demonstrably improved the quality of care of chronic patients. However, new models of integration need further evaluation of its effectiveness and outcomes. Methods: The ICM studied promoted coordination between the health and social sectors during a 6-month period, through an ad hoc developed application (app) that enabled a constant flow of communication between professionals from both sectors. Patients' quality of life, treatment adherence, chronic patient experience and caregiver overload were assessed by questionnaires at baseline, at the end of the intervention and 6 months post-intervention. Results: The implementation of the new health and social ICM permitted new case detection and medical and social services offered to chronic patients. Furthermore, the quality of life and treatment adherence of patients and caregiver overload were significantly improved. These positive effects lasted at least 6 months after the intervention. Conclusions: Integrated care may facilitate access to care services, increase perceived patient quality of life and treatment adherence. Enhanced access to medical and social services from complex chronic patients may have important implications for caregivers and the care systems who are struggling to adapt to an expanding demand.

Competencias enfermeras y grado de seguridad de estudiantes y profesionales en el cuidado del paciente crítico / Level of nursing skills and confidence among students and professionals regarding critical patient care

Objetivo: describir el nivel competencial y el grado de seguridad percibido en el cuidado al paciente crítico de estudiantes de Enfermería, y de profesionales de Enfermería de nueva contratación; analizar la influencia del sexo sobre ambas capacidades; y analizar las diferencias entre el nivel competencial calculado por los estudiantes/profesionales y sus responsables (tutores/supervisores).Método: estudio descriptivo transversal con estudiantes de cuarto año de Grado Universitario de Enfermería y profesionales de Enfermería con experiencia < 2 años. Se recogieron variables sociodemográficas, el grado de seguridad autopercibido en una escala Likert de 0 a 10, y para la evaluación de competencias se administró el cuestionario validado COM-VA©. Las competencias de cada participante fueron evaluadas por ellos mismos y por sus responsables (tutores/supervisores).Resultados: participaron 54 estudiantes, 22 profesionales y cuatro responsables. La autopercepción del grado de seguridad de los alumnos tutorizados fue superior al de los nuevos profesionales (p= 0,001), el nivel competencial autopercibido fue similar: 22,2% de los estudiantes y 18,2% de los profesionales se autopercibían como competentes. Aunque el nivel competencial fue similar según el cuestionario COM-VA© autocumplimentado (media de 7,2 y 7,8 sobre 10 para estudiantes y profesionales respectivamente), el nivel competencial de los profesionales fue superior según lo valorado por sus supervisores y tutores (p< 0,001). No se dieron diferencias por sexo.Conclusión: los resultados obtenidos muestran que los estudiantes de Enfermería de último año presentan un mayor grado de seguridad que los nuevos profesionales, pero que el nivel competencial de los profesionales es mayor que el de los estudiantes según sus responsables.(AU)

Objective: to describe the level of skills and confidence perceived regarding care for critical patients among Nursing students and newly recruited Nursing professionals; to analyse the influence of gender on both skills, and to analyse the differences between the competence level estimated by students / professionals and their persons in charge (academic tutors / supervisors).Method: a descriptive cross-sectional study with students in the 4th year of their University Nursing Degree and Nursing professionals with <2 years of experience. Sociodemographic variables were collected, as well as the self-perceived confidence level in a Likert scale from 0 to 10; and the COM-VA© validated questionnaire was administered for skill assessment. The skills of each participant were evaluated by themselves and by their academic tutors / supervisors.Results: the study included 54 students, 22 professionals and four persons in charge. The self-perception of the level of confidence by tutored students was higher than that by new professionals (p= 0.001); their self-perceived level of skills was similar: 22.2% of the students and 18.2% of professionals perceived themselves as competent. Even though their competence level was similar according to the self-completed COM-VA© questionnaire (mean of 7.2 and 7.8 out of 10 for students and professionals, respectively), the competence level of professionals was higher according to the evaluation by their supervisors and tutors (p< 0.001). There were no differences by gender.Conclusion: the outcomes obtained showed that Nursing students in their last year presented a higher level of confidence than new professionals, but that the competence level of professionals was higher than that of students according to their tutors / supervisors.(AU)

Ictus isquémico y factores de riesgo vascular en el adulto joven y el adulto mayor. Estudio retrospectivo de base comunitaria (2011-2020) / Ischemic stroke and vascular risk factors in young and older adults. Community-based retrospective study (2011-2020)

Objetivo: Analizar la presencia de factores de riesgo vascular (FRV) entre pacientes adultos jóvenes y adultos mayores con ictus isquémico, con y sin seguimiento en atención primaria tras el alta hospitalaria. Diseño: Estudio observacional, retrospectivo y multicéntrico. Emplazamiento: Centros de salud de atención primaria y hospital Verge de la Cinta, Tortosa, España. Participantes: Pacientes con ictus isquémico de dos grupos de edad (≤55 y ≥65años) distribuidos en dos grupos (grupoA: sin seguimiento en atención primaria; grupoB: con seguimiento en atención primaria), entre 2011 y 2020. Mediciones principales: Datos sociodemográficos, clínicos y de FRV codificados según la Clasificación Internacional de Enfermedades (CIE-10). Estadística descriptiva e inferencial. Resultados: Se analizaron datos de 2.054 participantes. En el grupo de adulto joven, el 94,9% de los participantes del grupoA presentaban entre 1-2FRV, frente al 60% del grupoB. En el adulto mayor, el 84,4% del grupoA presentaban entre 1-2FRV, frente al 43,9% del grupoB. Los FRV más frecuentes entre pacientes adultos jóvenes y mayores con ictus isquémico fueron la hipertensión y la dislipemia en ambos grupos de seguimiento. No había registros sobre obesidad, ni tabaquismo ni consumo de alcohol en el grupoA. Se observó una asociación significativa entre realizar seguimiento en atención primaria tras el ictus y ser adulto joven y presentar entre 3 y 4FRV (p<0,001). Conclusiones: Los resultados refuerzan la necesidad de continuidad asistencial y seguimiento en las personas con ictus agudo en la atención primaria y la mejora de la calidad de los registros.(AU)

Objective: To analyze the presence of vascular risk factors (VRF) among young adult and older adult patients with ischemic stroke, with and without follow-up in primary care after hospital discharge. Design: Observational, retrospective, multicenter study. Setting: Primary care health centers and Hospital Verge de la Cinta, Tortosa, Spain. Participants: Patients with ischemic stroke of two age groups (≤55 and ≥65years) distributed in two groups (GroupA: without follow-up in primary care; and GroupB: with follow-up in primary care), between 2011-2020. Main measurements: Sociodemographic, clinical, and VRF data coded according to the International Classification of Diseases (ICD-10). Descriptive, and inferential statistics. Results: Data from 2054 participants were analyzed. In the young adult group, 94.9% of the participants in groupA had between 1-2VRFs, compared to 60% in groupB. In the older adult group, 84.4% of groupA had between 1-2VRFs, compared to 43,9% of groupB. The most frequent VRFs among younger and older adult patients with ischemic stroke were hypertension and dyslipidemia in both follow-up groups. There were no records of obesity, smoking, or alcohol consumption in groupA. There was a significant association between being followed up in primary care after stroke and being a young adult and presenting between 3-4 VRFs (P<0.001). Conclusions: The results reinforce the need for continuity of care and follow-up in people with acute stroke in primary care and the need to improve the quality of registries.(AU)

Effectiveness and health benefits of a nutritional, chronobiological and physical exercise primary care intervention in fibromyalgia and chronic fatigue syndrome: SYNCHRONIZE + mixed-methods study protocol.

INTRODUCTION: Chronic pain, fatigue and insomnia are classic symptoms of fibromyalgia (FM) and chronic fatigue syndrome (CFS) and seriously affect quality of life. Nutrition and chronobiology are often overlooked in multicomponent approach despite their potential. This study aims to evaluate the effectiveness of a multidisciplinary group intervention based on nutrition, chronobiology, and physical exercise in the improvement of lifestyle and quality of life in FM and CFS. METHODS: Mixed-methods study based on a randomized clinical trial and qualitative analysis with a descriptive phenomenological approach. The study will be conducted in primary care in Catalonia. The control group will follow the usual clinical practice and the intervention group the usual practice plus the studied intervention (12 hours over 4 days). The intervention based on nutrition, chronobiology and physical exercise will be designed considering participants' opinions as collected in 4 focus groups. To evaluate effectiveness, EuroQol-5D, multidimensional fatigue inventory, VAS pain, Pittsburgh Sleep Quality Index, erMEDAS-17, biological rhythms interview of assessment in neuropsychiatry, REGICOR-Short, FIQR and Hospital Anxiety and Depression Scale questionnaires will be collected at baseline, and at 1, 3, 6, and 12 months post-intervention. Food intake, body composition, resistance and, strength will also be evaluated. The effect size will be calculated using Cohen d and logistic regression models will be used to quantify the impact of the intervention by adjusting for different variables. DISCUSSION: It expected that the intervention will improve the patients' quality of life, fatigue, pain and insomnia, as well as food and physical exercise habits, providing effectiveness evidence of a new therapy in addressing these syndromes in Primary Heath Care. Improvements in the quality of life will have a positive socioeconomic impact by reducing health expenditure on recurrent medical consultation, medication, complementary medical tests, etc and favor the maintenance of an active working life and productivity.

[Ischemic stroke and vascular risk factors in young and older adults. Community-based retrospective study (2011-2020)]. / Ictus isquémico y factores de riesgo vascular en el adulto joven y el adulto mayor. Estudio retrospectivo de base comunitaria (2011-2020).

OBJECTIVE: To analyze the presence of vascular risk factors (VRF) among young adult and older adult patients with ischemic stroke, with and without follow-up in primary care after hospital discharge. DESIGN: Observational, retrospective, multicenter study. SETTING: Primary care health centers and Hospital Verge de la Cinta, Tortosa, Spain. PARTICIPANTS: Patients with ischemic stroke of two age groups (≤55 and ≥65years) distributed in two groups (GroupA: without follow-up in primary care; and GroupB: with follow-up in primary care), between 2011-2020. MAIN MEASUREMENTS: Sociodemographic, clinical, and VRF data coded according to the International Classification of Diseases (ICD-10). Descriptive, and inferential statistics. RESULTS: Data from 2054 participants were analyzed. In the young adult group, 94.9% of the participants in groupA had between 1-2VRFs, compared to 60% in groupB. In the older adult group, 84.4% of groupA had between 1-2VRFs, compared to 43,9% of groupB. The most frequent VRFs among younger and older adult patients with ischemic stroke were hypertension and dyslipidemia in both follow-up groups. There were no records of obesity, smoking, or alcohol consumption in groupA. There was a significant association between being followed up in primary care after stroke and being a young adult and presenting between 3-4 VRFs (P<0.001). CONCLUSIONS: The results reinforce the need for continuity of care and follow-up in people with acute stroke in primary care and the need to improve the quality of registries.

[Influence of gender and place of residence differences on the evolution and mortality of ischemic cardiopathy in Catalonia: a population-based study.] / Influencia del género y el lugar de residencia sobre la evolución y mortalidad de la cardiopatía isquémica en Cataluña: un estudio de base poblacional.

OBJECTIVE: Some bibliography supports a diagnostic and therapeutic delay in women with high cardiovascular risk. The objective of this paper was to know the incidence of cardiovascular disease (CVD) and mortality in a cohort with Metabolic Syndrome (MetS); analyze possible differences in gender and place of residence, regarding the performance of primary angioplasties in patients with ischemic heart disease (IHD). METHODS: Population cohort study, with SIDIAP database (Sistema de Información para la Investigación en Atención Primaria), in primary care in Catalonia. We selected people of both sexes, between 35-75 years old, exempt from CVD at the beginning (2009), fulfilling MetS criteria (NCEP-ATPIII-National Cholesterol Education Program-Adult Treatment Panel III- criteria diagnoses). We performed descriptive statistics, and ANOVA and Chi-square test to evaluate differences between variables. RESULTS: 167,673 people met MetS criteria (5.2% of the population), 105,969 men (63.2%). 22% of the population belonged to rural areas. Those urban areas with the most socioeconomic differences (urban-1 and urban-5) exhibited the highest incidences of CVD and IHD. We registered 51,129 CVD (30.7%) of which 8,889 were acute myocardial infarctions (AMI) (5,3%) and 24,284 were IHD (14,5%). 1.758 primary angioplasties procedures were performed, 1,467 in men and 291 in women, representing, respectively, 4.4% and 0.9% (p<0.005). CONCLUSIONS: The incidence of IHD and AMI in subjects with MetS is high in Catalonia. There is a difference in the angioplasties performed, according to sex and place of residence. Probably a practical implication would be to detect IHD in time in women with MetS, so that they can benefit from revascularization therapy in the same way as men.

OBJETIVO: Existe bibliografía que apoya un retraso diagnóstico y terapéutico en mujeres con alto riesgo cardiovascular. El objetivo de este trabajo fue conocer la incidencia de la enfermedad cardiovascular (ECV) y la mortalidad en una cohorte con Síndrome Metabólico (SM), así como analizar posibles diferencias de género y lugar de residencia, respecto a la realización de angioplastias primarias en pacientes con cardiopatía isquémica (CI). METODOS: Se realizó un estudio de cohorte poblacional apoyándonos en la base de datos SIDIAP (Sistema de Información para la Investigación en Atención Primaria), en Atención Primaria de Cataluña. Seleccionamos personas de ambos sexos, entre 35-75 años, exentos de ECV al inicio (2009), cumpliendo criterios de SM (diagnósticos NCEP-ATPIII [National Cholesterol Education Program-Adult Treatment Panel III]). La variable resultado fue la incidencia a 10 años de ECV y la mortalidad global por toda causa. Registramos variables sociodemográficas (edad, sexo, fenotipo SM, índice socioeconómico MEDEA) y reperfusión coronaria. Se realizó estadística descriptiva, ANOVA y prueba de chi-cuadrado para verificar la diferencia entre variables. RESULTADOS: 167.673 personas cumplieron criterios de SM (5,2% de la población), de las cuales había 105.969 hombres (63,2%). El 22% de población pertenecía a áreas rurales. Aquellas áreas urbanas más dispares socioeconómicamente (urbana-1 y urbana-5), exhibieron las mayores incidencias de ECV y CI. Registramos 51.129 ECV (30,7%) de los cuales 8.889 fueron infartos agudos de miocardio (IAM; 5,3%) y 24.284 fueron CI (14,5%). Se realizaron 1.758 procedimientos de angioplastia primaria, 1.467 en hombres y 291 en mujeres, representando respectivamente un 4,4% y un 0,9% (p<0.005). CONCLUSIONES: La incidencia de IAM y CI en sujetos con SM es alta en Cataluña. Existe diferencia estadísticamente significativa en las angioplastias realizadas, según sexo y lugar de residencia. Probablemente una implicación práctica sería detectar a tiempo la CI en mujeres con SM, para que puedan beneficiarse de la terapia revascularizadora igual que los hombres.

Influencia del género y el lugar de residencia sobre la evolución y mortalidad de la cardiopatía isquémica en Cataluña: un estudio de base poblacional / Influence of gender and place of residence differences on the evolution and mortality of ischemic cardiopathy in Catalonia: a population-based study

FUNDAMENTOS: Existe bibliografía que apoya un retraso diagnóstico y terapéutico en mujeres con alto riesgo cardiovascular. El objetivo de este trabajo fue conocer la incidencia de la enfermedad cardiovascular (ECV) y la mortalidad en una cohorte con Síndrome Metabólico (SM), así como analizar posibles diferencias de género y lugar de residencia, respecto a la realización de angioplastias primarias en pacientes con cardiopatía isquémica (CI). MÉTODOS: Información para la Investigación en Atención Primaria), en Atención Primaria de Cataluña. Seleccionamos personas de ambos sexos, entre 35-75 años, exentos de ECV al inicio (2009), cumpliendo criterios de SM (diagnósticos NCEP-ATPIII [National Cholesterol Education Program-Adult Treatment Panel III]). La variable resultado fue la incidencia a 10 años de ECV y la mortalidad global por toda causa. Registramos variables sociodemográficas (edad, sexo, fenotipo SM, índice socioeconómico MEDEA) y reperfusión coronaria. Se realizó estadística descriptiva, ANOVA y prueba de chi-cuadrado para verificar la diferencia entre variables. RESULTADOS: 167.673 personas cumplieron criterios de SM (5,2% de la población), de las cuales había 105.969 hombres (63,2%). El 22% de población pertenecía a áreas rurales. Aquellas áreas urbanas más dispares socioeconómicamente (urbana-1 y urbana-5), exhibieron las mayores incidencias de ECV y CI. Registramos 51.129 ECV (30,7%) de los cuales 8.889 fueron infartos agudos de miocardio (IAM; 5,3%) y 24.284 fueron CI (14,5%). Se realizaron 1.758 procedimientos de angioplastia primaria, 1.467 en hombres y 291 en mujeres, representando respectivamente un 4,4% y un 0,9% (p<0.005). CONCLUSIONES: La incidencia de IAM y CI en sujetos con SM es alta en Cataluña. Existe diferencia estadísticamente significativa en las angioplastias realizadas, según sexo y lugar de residencia...(AU)

BACKGROUND: Some bibliography supports a diagnostic and therapeutic delay in women with high cardiovascular risk. The objective of this paper was to know the incidence of cardiovascular disease (CVD) and mortality in a cohort with Metabolic Syndrome (MetS); analyze possible differences in gender and place of residence, regarding the performance of primary angioplasties in patients with ischemic heart disease (IHD). METHODS: Population cohort study, with SIDIAP database (Sistema de Información para la Investigación en Atención Primaria), in primary care in Catalonia. We selected people of both sexes, between 35-75 years old, exempt from CVD at the beginning (2009), fulfilling MetS criteria (NCEP-ATPIII-National Cholesterol Education Program-Adult Treatment Panel III- criteria diagnoses). We performed descriptive statistics, and ANOVA and Chi-square test to evaluate differences between variables. RESULTS: 167,673 people met MetS criteria (5.2% of the population), 105,969 men (63.2%). 22% of the population belonged to rural areas. Those urban areas with the most socioeconomic differences (urban-1 and urban-5) exhibited the highest incidences of CVD and IHD. We registered 51,129 CVD (30.7%) of which 8,889 were acute myocardial infarctions (AMI) (5,3%) and 24,284 were IHD (14,5%). 1.758 primary angioplasties procedures were performed, 1,467 in men and 291 in women, representing, respectively, 4.4% and 0.9% (p<0.005). CONCLUSIONS: The incidence of IHD and AMI in subjects with MetS is high in Catalonia. There is a difference in the angioplasties performed, according to sex and place of residence. Probably a practical implication would be to detect IHD in time in women with MetS, so that they can benefit from revascularization therapy in the same way as men.

Early Detection of the Start of the Influenza Epidemic Using Surveillance Systems in Catalonia (PREVIGrip Study).

Sentinel physician networks are the method of influenza surveillance recommended by the World Health Organization. Weekly clinical diagnoses based on clinical history are a surveillance method that provides more immediate information. The objective of this study is to evaluate which influenza surveillance system is capable of the earliest detection of the start of the annual influenza epidemic. We carried out an ecological time-series study based on influenza data from the population of Catalonia from the 2010-2011 to the 2018-2019 seasons. Rates of clinical diagnoses and of confirmed cases in Catalonia were used to study the changes in trends in the different surveillance systems, the differences in area and time lag between the curves of the different surveillance systems using Joinpoint regression, Simpson's 1/3 method and cross-correlation, respectively. In general, changes in the trend of the curves were detected before the beginning of the epidemic in most seasons, using the rates for the complete seasons and the pre-epidemic rates. No time lag was observed between clinical diagnoses and the total confirmed cases. Therefore, clinical diagnoses in Primary Care could be a useful tool for early detection of the start of influenza epidemics in Catalonia.

Analysis of Psychosomatic Disorders According to Age and Sex in a Rural Area: A Population-Based Study.

Psychosomatic disorders can develop unevenly depending on certain health determinants; therefore, the aim of this study was to analyze the prevalence of psychosomatic disorders and the differences by age and sex in a rural area. We conducted an observational descriptive retrospective population study to determine the prevalence of 201 diagnoses of psychosomatic nature grouped into 25 diagnostic categories by sex and age groups. A total of 33,680 participants with a diagnosis of psychosomatic disorder were identified (64.6% women, 35.4% men). We found statistically significant differences based on sex in 13 of the 25 diagnostic categories previously defined. When we analyzed these categories by age, we found that women showed a higher probability, between 1.23 and 10.85 times, of suffering from most of these health issues. We also observed that the older the age group, the most often they had a diagnosis. Notably, more women seem to suffer from psychosomatic disorders when compared to men in the same situation. In most of these disorders, being of the female sex was a risk factor, and the older the participants, the greater the probability of developing a disorder.

HPV Vaccination Coverage Rate in a Rural Area: An Observational, Retrospective, and Cohort Study.

In order to reduce the incidence and mortality rate of cervical cancer, the World Health Organization (WHO) declared the Global Strategy Goal for 2030, advocating for reaching a vaccination coverage rate of >90% against human papillomavirus for girls by the age of 15 years. The main objectives of this study were (1) to determine the papillomavirus vaccination coverage among women 15−40 years old and (2) to identify the at-risk subgroups and possible barriers to achieving WHO's 2030 goal. Multicentre, observational, retrospective, and community-based cohort studies were conducted on women from a rural area in southern Catalonia until 31 December 2021. A total of 23,136 women were included, with a mean age of 26.6 (SD = 5.6) years. The average dose number was 1.7 (SD = 0.7). The results showed overall vaccination coverage of 17.4% among the target women. This coverage was unequal across regions (16.6−24.5%, p < 0.001), primary healthcare teams (15.5−24.3%, p < 0.001), and age groups (56.7% (15−19-year-olds) vs. 3.8% (35−40-year-olds), p < 0.001), related to accessibility to vaccination and economic−geographical indicators. Clinical practice guidelines on screening individuals at risk in terms of vaccination access and public vaccination protocols should be implemented in order to improve the vaccination coverage rate.

Concordance Analysis between the Segments and the Overall Performance in Olympic Triathlon in Elite Triathletes.

To date, the performance in triathlon has been measured through time or position. Although this is what defines the medals and the goal of the competition, it can have some limitations. As an alternative, the purpose of this study is to assess the degree of concordance of performance between each of the triathlon disciplines with overall performance through the triathlon performance indicator for the Olympic distance event. The official results from the World Triathlon Series for Olympic distance events from 2000 to 2019 were examined. A total of 11,263 entries were analysed, 6273 corresponding to elite men and 4990 to elite women. Moderate agreement was found between the running performance and overall performance in both elite men ICCa = 0.538 and elite women ICCa = 0.581. Moreover, moderate agreement was found between swimming performance and overall performance in both elite men ICCa = 0.640 and elite women ICCa = 0.613. Finally, good agreement was found between cycling performance and overall performance also in both elite men ICCa = 0.777 and elite women ICCa = 0.816. The main results of the present study show that the cycling performance indicator could be an alternative to anticipate the overall performance in the competition for the Olympic distance event.

Using Musical Feedback Increases Stride Frequency in Recreational Runners.

The number of participants in popular races has increased in recent years, with most of them being amateurs. In addition, it has been observed that there is a high percentage of injuries among them, and some of these injuries may be related to a low stride frequency. The aim of this research was to check if a continuous running training program with a musical base improves the stride frequency of popular runners. For this purpose, the effect of a 6 week continuous running training program with the help of a musical track with a constant rhythm that was 10% higher than the preferred stride frequency of the subjects was analyzed and compared to a control group that performed the continuous running training without sound stimuli. Significant increases were found in the evolution of stride frequency in the experimental group between the pre- and post-test (p = 0.002). No significant changes were observed in the stride frequency of the control group. These results show that training with music feedback helps to improve stride frequency in recreational runners. Future research should study the evolution of the improvement obtained in time as it is unknown if the increase in stride rate has been integrated in the runner's technique, making the improvement obtained permanent. Future research is needed to confirm these results by enlarging the sample and carrying out an exhaustive biomechanical study.

Symptomatology of Fibromyalgia Syndrome in Men: A Mixed-Method Pilot Study.

Fibromyalgia syndrome (FMS) is characterized by generalized chronic musculoskeletal pain, fatigue, and sleep disturbance, as well as cognitive, somatic, and other symptoms. Most people affected by FMS are women, and studies analyzing this condition in men are scarce. In this study, we discuss the physical and psychological symptoms of FMS in men, analyze the possible side effects of pharmacological therapies, and explore the impact of the illness comparing these results between the different classification groups according to sociodemographic variables (marital status, level of education, employment situation and number of people living at home). We used a sequential exploratory mixed method (MM). Qualitative information was obtained from two focus groups (n = 10). Structured questionnaires were administered to 23 men affected by FMS. The mean age of the participants was 51.7 years (SD = 9.64). The most common drugs used were antidepressants and anxiolytics (86.9%), followed by non-steroidal anti-inflammatory drugs (82.6%) and opioids (60.9%). Current level of pain was high (8.2; SD = 1.1), while perceived health and satisfaction with pharmacological treatments were low (4.6; SD = 2.6 and 3.5; SD = 3.2, respectively). The impact of FMS measured using the Fibromyalgia Impact Questionnaire (FIQ) was very high at 88.7 (SD = 8.2). Six categories related with symptoms and side effects of the medication were observed in the qualitative data: (1) main physical symptoms, (2) mood disorders, (3) insomnia and non-restorative sleep, (4) cognitive disturbance, (5) hypersensitivity, and (6) symptoms secondary to opioids. Pain and fatigue were the symptoms most often mentioned by the participants (70% and 80%, respectively). Other important symptoms were anxiety, depression, and memory and sleep disorders. The consumption of opioids causes further unwanted symptoms such as drowsiness and dependence, which makes it difficult for patients to perform basic everyday activities. We believe it is vitally important to continue investigating this symptomatology in order to improve diagnosis and treatment for these patients.

Concordance between the Clinical Diagnosis of Influenza in Primary Care and Epidemiological Surveillance Systems (PREVIGrip Study).

INTRODUCTION: Health authorities use different systems of influenza surveillance. Sentinel networks, which are recommended by the World Health Organization, provide information on weekly influenza incidence in a monitored population, based on laboratory-confirmed cases. In Catalonia there is a public website, DiagnostiCat, that publishes the number of weekly clinical diagnoses at the end of each week of disease registration, while the sentinel network publishes its reports later. The objective of this study was to determine whether there is concordance between the number of cases of clinical diagnoses and the number of confirmed cases of influenza, in order to evaluate the predictive potential of a clinical diagnosis-based system. METHODS: Population-based ecological time series study in Catalonia. The period runs from the 2010-2011 to the 2018-2019 season. The concordance between the clinical diagnostic cases and the confirmed cases was evaluated. The degree of agreement and the concordance were analysed using Bland-Altman graphs and intraclass correlation coefficients. RESULTS: There was greater concordance between the clinical diagnoses and the sum of the cases confirmed outside and within the sentinel network than between the diagnoses and the confirmed sentinel cases. The degree of agreement was higher when influenza rates were low. CONCLUSIONS: There is concordance between the clinical diagnosis and the confirmed cases of influenza. Registered clinical diagnostic cases could provide a good alternative to traditional surveillance, based on case confirmation. Cases of clinical diagnosis of influenza may have the potential to predict the onset of annual influenza epidemics.

Gender Equality and the Global Gender Gap in Life Expectancy: An Exploratory Analysis of 152 Countries.

When looking at life expectancy (LE) by sex, women live longer than men in all countries. Biological factors alone do not explain gender differences in LE, and examining structural differences may help illuminate other explanatory factors. The aim of this research is to analyse the influence of gender inequality on the gender gap in LE globally. We have carried out a regression analysis between the gender gap in relativised LE and the UN Gender Inequality Index (GII), with a sensitivity analysis conducted for its three dimensions, stratified by the six World Health Organization (WHO) regions. We adjusted the model by taking into consideration gross national income (GNI), democratic status and rural population. The results indicated a positive association for the European region (ß=0.184) and the Americas (ß=0.136) in our adjusted model. Conversely, for the African region, the relations between gender equality and the LE gender gap were found to be negative (ß=-0.125). The findings suggest that in the WHO European region and the Americas, greater gender equality leads to a narrowing of the gender LE gap, while it has a contrary relationship in Africa. We suggest that this could be because only higher scores in the GII between men and women show health benefits.