Gender differences in workplace violence against physicians and nurses in Latin America: a survey from the Interamerican Society of Cardiology.

OBJECTIVES: To evaluate gender differences in workplace violence (WPV) against physicians and nurses in Latin America. STUDY DESIGN: Cross-sectional study. METHODS: A cross-sectional electronic survey was conducted between January 11 and February 28, 2022. A prespecified gender analysis was performed. RESULTS: Among the 3056 responses to the electronic survey, 57% were women, 81.6% were physicians, and 18.4% were nurses. At least one act of violence was experienced by 59.2% of respondents, with verbal violence being the most common (97.5%). Women experienced more WPV than men (65.8% vs 50.4%; P < 0.001; odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.63-2.19). Women were more likely to report at least one episode of WPV per week (19.2% vs 11.9%, P < 0.001), to request for psychological help (14.5% vs 9%, P = 0.001) and to experience more psychosomatic symptoms. In addition, women were more likely to report having considered changing their job after an aggression (57.6% vs 51.3%, P = 0.011) and even leaving their job (33% vs 25.7%, P = 0.001). In a multivariate analysis, being a woman (OR: 1.76), working in emergency departments (OR: 1.99), and with COVID-19 patients (OR: 3.3) were independently associated with more aggressive interactions, while older age (OR: 0.95) and working in a private setting (OR: 0.62) implied lower risk. CONCLUSIONS: Women are more likely to experience WPV and to report more psychosomatic symptoms after the event. Preventive measures are urgently needed, with a special focus on high-risk groups such as women.

Childbirth fear in the USA during the COVID-19 pandemic: key predictors and associated birth outcomes.

Background and objectives: Childbirth fear, which has been argued to have an adaptive basis, exists on a spectrum. Pathologically high levels of childbirth fear is a clinical condition called tokophobia. As a chronic stressor in pregnancy, tokophobia could impact birth outcomes. Many factors associated with tokophobia, including inadequate labor support, were exacerbated by the COVID-19 pandemic. Methodology: We used longitudinally collected data from a convenience sample of 1775 pregnant persons in the USA to evaluate the association between general and COVID-19 pandemic-related factors and tokophobia using the fear of birth scale. We also assessed associations between tokophobia, low birth weight and preterm birth when adjusting for cesarean section and other covariates among a subset of participants (N = 993). Results: Tokophobia was highly prevalent (62%). Mothers who self-identified as Black (odds ratio (OR) = 1.90), had lower income (OR = 1.39), had less education (OR = 1.37), had a high-risk pregnancy (OR = 1.65) or had prenatal depression (OR = 4.95) had significantly higher odds of tokophobia. Concerns about how COVID-19 could negatively affect maternal and infant health and birth experience were also associated with tokophobia (ORs from 1.51 to 1.79). Tokophobia was significantly associated with increased odds of giving birth preterm (OR = 1.93). Conclusions and implications: Tokophobia increases the odds of preterm birth and is more prevalent among individuals who are Black, have a lower income, and have less education. Tokophobia may, therefore, be an underappreciated contributor to inequities in US birth outcomes. The COVID-19 pandemic likely compounded these effects.

[Impact of the COVID-19 pandemic: The point of view of patient associations]. / Impacto de la pandemia por COVID-19: El punto de vista de las asociaciones de pacientes.

INTRODUCTION AND OBJECTIVES: The COVID-19 pandemic is causing great social and health impact. We need to involve patients in identifying their new needs in this situation. The aim of this study was to assess the perception of organisations associated with the Spanish Patients' Forum regarding the pandemic. MATERIAL AND METHODS: A descriptive cross-sectional study using an online survey. Organisations associated with the FEP participated over the second half of May 2020. The questionnaire was pre-assessed by professionals and patients. The subject areas were overall effect of the pandemic, impact, the role of patient associations, limitations, and challenges. A descriptive analysis of the quantitative variables and a content analysis of the qualitative information were performed. RESULTS: The participation rate was 88.7%. The respondents highlighted the impact of the pandemic on the quality of life and well-being of patients and their families. They also reported the effect of the baseline disease and delay in treatment and testing. The pandemic has also affected patient associations. CONCLUSIONS: The pandemic has had an impact at the level of healthcare and other spheres of society. Patients' health, quality of life and use of health services have been affected. The need is highlighted to involve patients, their families, and legal representatives in the search for solutions adapted to the current needs of these groups.

Characterization of digital dispersive spectrometers by low coherence interferometry.

We propose a procedure to determine the spectral response of digital dispersive spectrometers without previous knowledge of any parameter of the system. The method consists of applying the Fourier transform spectroscopy technique to each pixel of the detection plane, a CCD camera, to obtain its individual spectral response. From this simple procedure, the system-point spread function and the effect of the finite pixel width are taken into account giving rise to a response matrix that fully characterizes the spectrometer. Using the response matrix information we find the resolving power of a given spectrometer, predict in advance its response to any virtual input spectrum and improve numerically the spectrometer's resolution. We consider that the presented approach could be useful in most spectroscopic branches such as in computational spectroscopy, optical coherence tomography, hyperspectral imaging, spectral interferometry and analytical chemistry, among others.

Función y respaldo a la asociación de pacientes con psoriasis en España según sus miembros: estudio descriptivo transversal / The Spanish psoriasis patients’ association according to its members: cross-sectional descriptive study of members’ opinions of the association’s functions

INTRODUCCIÓN: Las asociaciones de pacientes son un elemento más del sistema sanitario, sin embargo en España se desconoce la funcionalidad y el respaldo que tienen según sus propios asociados. OBJETIVO: Estudiar la funcionalidad de la principal asociación española de pacientes y familiares afectados por la psoriasis según sus propios socios. MATERIAL Y MÉTODOS: Estudio mediante un cuestionario autoadministrado a una muestra de socios y/o simpatizantes (población total = 26.349 personas). Se estudió la credibilidad, confianza y satisfacción y se comparó con otros agentes sanitarios. El cuestionario de funcionalidad se analizó con un modelo de Rasch, y se examinó si había diferencias entre grupos de participantes con la prueba de ANOVA. RESULTADOS: Participaron 746 socios y/o simpatizantes (tasa de respuesta 2,83%). La credibilidad de la asociación se situó tras la de los especialistas que tratan la psoriasis. El respaldo medio a la función de la asociación fue notable (7,53 en una escala de 0 a 10). Según los socios las funciones mejor puntuadas se relacionaban con acciones colectivas para sensibilizar a la sociedad sobre el problema de la psoriasis, en cambio, tuvieron una menor valoración las acciones relacionadas con los servicios de atención personalizada. Solo hubo diferencias significativas (p < 0,05) en el respaldo a la asociación en función del nivel académico de los participantes. CONCLUSIONES: Las asociaciones son unas instituciones que contribuyen a la difusión de información de la enfermedad, que cuidan y representan a los pacientes. Los profesionales de salud e instituciones deberían tenerlas en cuenta para afrontar la psoriasis y diseñar políticas de salud efectivas

INTRODUCTION: Patient associations form part of health care systems, but little is known about how their members' view the functionality of these associations and whether they endorse their goals and activities. OBJECTIVE: To study how the members of the leading Spanish association of patients with psoriasis and their relatives view the group's functioning. MATERIAL AND METHODS: Survey study using a self-administered questionnaire answered by members of the association (total membership, 26 349 persons). The credibility of the association and respondents' confidence in and satisfaction with it were studied and compared with their attitudes toward other agents in the health care system. A Rasch model was used to analyze respondents' ranking of functions. Analysis of variance was used to study between-group differences. RESULTS: A total of 746 members participated (response rate 2.83%). The association's credibility was rated in second place, after that of specialists who treat psoriasis. Support for the association functions was good (7.53 on a scale of 0 to 10). The function the members rated highest was the raising of societal awareness of psoriasis and its problems. Rated lowest were functions related to personal services for members. Educational level was the only participant factor associated with significant differences in evaluations (P < .05). CONCLUSIONS: The psoriasis association contributes by disseminating information about the disease and patient care, and it serves to represent patients. Health professionals and institutions should take the association into account in their efforts to deal with the disease and in designing effective policies

The Spanish Psoriasis Patients' Association According to Its Members: Cross-Sectional Descriptive Study of Members' Opinions of the Association's Functions. / Función y respaldo a la asociación de pacientes con psoriasis en España según sus miembros: estudio descriptivo transversal.

INTRODUCTION: Patient associations form part of health care systems, but little is known about how their members' view the functionality of these associations and whether they endorse their goals and activities. OBJECTIVE: To study how the members of the leading Spanish association of patients with psoriasis and their relatives view the group's functioning. MATERIAL AND METHODS: Survey study using a self-administered questionnaire answered by members of the association (total membership, 26 349 persons). The credibility of the association and respondents' confidence in and satisfaction with it were studied and compared with their attitudes toward other agents in the health care system. A Rasch model was used to analyze respondents' ranking of functions. Analysis of variance was used to study between-group differences. RESULTS: A total of 746 members participated (response rate 2.83%). The association's credibility was rated in second place, after that of specialists who treat psoriasis. Support for the association functions was good (7.53 on a scale of 0 to 10). The function the members rated highest was the raising of societal awareness of psoriasis and its problems. Rated lowest were functions related to personal services for members. Educational level was the only participant factor associated with significant differences in evaluations (P<.05). CONCLUSIONS: The psoriasis association contributes by disseminating information about the disease and patient care, and it serves to represent patients. Health professionals and institutions should take the association into account in their efforts to deal with the disease and in designing effective policies.

Meal timing affects glucose tolerance, substrate oxidation and circadian-related variables: A randomized, crossover trial.

BACKGROUND/OBJECTIVES: Timing of food intake associates with body weight regulation, insulin sensitivity and glucose tolerance. However, the mechanism is unknown. The aim of this study was to investigate the effects of changes in meal timing on energy-expenditure, glucose-tolerance and circadian-related variables. SUBJECTS/METHODS: Thirty-two women (aged 24±4 years and body mass index 22.9±2.6 kg m(-2)) completed two randomized, crossover protocols: one protocol (P1) including assessment of resting-energy expenditure (indirect-calorimetry) and glucose tolerance (mixed-meal test) (n=10), the other (P2) including circadian-related measurements based on profiles in salivary cortisol and wrist temperature (Twrist) (n=22). In each protocol, participants were provided with standardized meals (breakfast, lunch and dinner) during the two meal intervention weeks and were studied under two lunch-eating conditions: Early Eating (EE; lunch at 13:00) and Late Eating (LE; lunch 16:30). RESULTS: LE, as compared with EE, resulted in decreased pre-meal resting-energy expenditure (P=0.048), a lower pre-meal protein-corrected respiratory quotient (CRQ) and a changed post-meal profile of CRQ (P=0.019). These changes reflected a significantly lower pre-meal utilization of carbohydrates in LE versus EE (P=0.006). LE also increased glucose area under curve above baseline by 46%, demonstrating decreased glucose tolerance (P=0.002). Changes in the daily profile of cortisol and Twrist were also found with LE blunting the cortisol profile, with lower morning and afternoon values, and suppressing the postprandial Twrist peak (P<0.05). CONCLUSIONS: Eating late is associated with decreased resting-energy expenditure, decreased fasting carbohydrate oxidation, decreased glucose tolerance, blunted daily profile in free cortisol concentrations and decreased thermal effect of food on Twrist. These results may be implicated in the differential effects of meal timing on metabolic health.

Linfoma no Hodgkin primario de mama: reporte de un caso / Primary non-Hodgkin lymphoma of the breast: a case report

El linfoma no Hodgkin primario de la mama es una patología poco frecuente, constituye menos del 0,5 por ciento de todos los tumores mamarios malignos, debido a que carecen de características propias, tanto clínicas, mamográficas como ultrasonográficas. Es difícil el diagnóstico preoperatorio, la citología mediante BAAF tiene mejor rendimiento que el estudio con material congelado ya que este último tiende a confundirse con el carcinoma. En la actualidad se prefiere el tratamiento con quimioterapia tanto para el tratamiento local como para el regional. Presentamos el caso de un linfoma no Hodgkin primario de la mama en una paciente de 72 años. (AU)

Primary non-Hodgkin lymphoma of the breast is a rare entity. It represents less than 0.5 percent of all breast cancer malignancies. No features at clinical presentation distinguish patients with lymphoma from those with carcinoma of the breast. There are both mammographic and sonographic difficulties to establish the preoperative diagnosis. Contemporary frozen sections can be mistaken with breast carcinoma. In this article we present a case of a primary non-Hodgkin lymphoma of the breast in 72 years old women.(AU)

Molecular mechanisms by which white tea prevents oxidative stress

The flavonoid content of tea (Camellia sinensis) has beneficial properties in the prevention of diseases. However, the mechanisms by which white tea can protect against oxidative stress remain unclear. To shed light on this issue, rats were given distilled water (controls), 0.15 mg/day (dose 1) or 0.45 mg/day (dose 2) of solid tea extract/kg body weight for 12 months. All the animals received an injection of adriamycin (ADR; 10 mg/kg body weight), except half of the control group, which were given an injection of saline solution. The expression of the nuclear factor, E2-related factor 2 (Nrf2), NAD(P)H:quinone oxidoreductase 1 (Nqo1), glutathione S-transferase (Gst), haem oxygenase-1 (Ho1), catalase (Cat), superoxide dismutase (Sod) and glutathione reductase (Gr) in liver was analysed by real-time PCR, and the activity of catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR) was measured spectrophotometrically. ADR significantly increased the expression of Nrf2, Gst, Nqo1, Ho1, Cat, Sod and Gr with respect to the control levels and also increased the activity of CAT, SOD and GR. The intake of white tea increased in a higher degree the expression of Nrf2, Gst, Nqo1 and Ho1 in the tea + ADR group compared with the control group and C + ADR group. In addition, tea + ADR groups decreased the expression and activity of CAT, SOD and GR in a dose-dependent manner

[The opinion of teachers about tutorial problem based learning]. / Aspectos relevantes en el desarrollo del tutorial en aprendizaje basado en problemas desde la perspectiva de los tutores de la Facultad de Medicina de la Universidad de La Frontera.

BACKGROUND: In 2004 the Faculty of Medicine of Universidad de La Frontera in Chile implemented curricular changes, incorporating small group problem based learning in different carriers. AIM: To explore aspects that hamper or facilitate tutorial problem based learning from the perspective of tutors. MATERIAL AND METHODS: Six in depth interviews and a focus group with tutors were carried out in 2010 and 2011. Data were analyzed through constant comparisons using the program ATLAS ti, guaranteeing credibility, reliance, validation and transferability. RESULTS: Five hundred and twenty eight (528) significance units were identified and 25 descriptive categories emerged. The categories of tutor motivation, methodological domain, tutor responsibility, tutor critical capacity, disciplinary domain, student participation and tutor-student interaction were emphasized. Three qualitative domains were generated, namely tutor skills, transformation of student roles and institutional commitment. CONCLUSIONS: Tutorial teaching is favored by teachers when the institutions train them in the subject, when there is administrative support and an adequate infrastructure and coordination.

Molecular mechanisms by which white tea prevents oxidative stress.

The flavonoid content of tea (Camellia sinensis) has beneficial properties in the prevention of diseases. However, the mechanisms by which white tea can protect against oxidative stress remain unclear. To shed light on this issue, rats were given distilled water (controls), 0.15 mg/day (dose 1) or 0.45 mg/day (dose 2) of solid tea extract/kg body weight for 12 months. All the animals received an injection of adriamycin (ADR; 10 mg/kg body weight), except half of the control group, which were given an injection of saline solution. The expression of the nuclear factor, E2-related factor 2 (Nrf2), NAD(P)H:quinone oxidoreductase 1 (Nqo1), glutathione S-transferase (Gst), haem oxygenase-1 (Ho1), catalase (Cat), superoxide dismutase (Sod) and glutathione reductase (Gr) in liver was analysed by real-time PCR, and the activity of catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR) was measured spectrophotometrically. ADR significantly increased the expression of Nrf2, Gst, Nqo1, Ho1, Cat, Sod and Gr with respect to the control levels and also increased the activity of CAT, SOD and GR. The intake of white tea increased in a higher degree the expression of Nrf2, Gst, Nqo1 and Ho1 in the tea + ADR group compared with the control group and C + ADR group. In addition, tea + ADR groups decreased the expression and activity of CAT, SOD and GR in a dose-dependent manner.

Aspectos relevantes en el desarrollo del tutorial en aprendizaje basado en problemas desde la perspectiva de los tutores de la Facultad de Medicina de la Universidad de La Frontera / The opinion of teachers about tutorial problem based learning

Background: In 2004 the Faculty of Medicine of Universidad de La Frontera in Chile implemented curricular changes, incorporating small group problem based learning in different carriers. Aim: To explore aspects that hamper or facilitate tutorial problem based learning from the perspective of tutors. Material and Methods: Six in depth interviews and a focus group with tutors were carried out in 2010 and 2011. Data were analyzed through constant comparisons using the program ATLAS ti, guaranteeing credibility, reliance, validation and transferability. Results: Five hundred and twenty eight (528) significance units were identified and 25 descriptive categories emerged. The categories of tutor motivation, methodological domain, tutor responsibility, tutor critical capacity, disciplinary domain, student participation and tutor-student interaction were emphasized. Three qualitative domains were generated, namely tutor skills, transformation of student roles and institutional commitment. Conclusions: Tutorial teaching is favored by teachers when the institutions train them in the subject, when there is administrative support and an adequate infrastructure and coordination.

Genetic testing of sperm donors for cystic fibrosis and spinal muscular atrophy: evaluation of clinical utility.

OBJECTIVE: To evaluate the clinical utility of genetic testing for cystic fibrosis (CF) and spinal muscular atrophy (SMA) in sperm donors. STUDY DESIGN: We studied the results of the genetic tests for CF and SMA applied to 372 sperm donor candidates. The CF carrier screening test analysed 32 mutations on the CFTR gene. Regarding SMA, the carrier test studied possible deletions of SMN1/2 by Multiplex Ligation-dependent Probe Amplification (MLPA) methodology. RESULTS: The carrier frequency obtained was greater for SMA than for CF. After adjusting the results obtained for the sensitivity of the tests, and taking into account the prevalence of female carriers in our population, the probability of transmission of the disease to the child from a donor with a negative genetic test was about five times lower in the case of SMA than in CF, although this difference was not statistically significant. The number of donors needed to screen (NNS) to avoid the occurrence of a child being affected by CF and SMA in our population was similar in both cases (1591 vs. 1536). CONCLUSIONS: This study demonstrates the need to include SMA among the diseases for which genetic screening is performed in the process of sperm donor selection. We believe that testing donors for SMA is as important and as useful as doing so for CF.

Polyamines in human breast milk for preterm and term infants.

Maternal milk is the first source of exogenous polyamines for the newborn. Polyamines modulate gut maturation in neonates, but no studies are available on polyamine concentration in human milk of preterm babies, even though they could be important for their immature gut. The present study aimed to determine polyamine concentration in human breast milk of mothers with preterm or term infants during the first month of lactation. Human milk samples were obtained during the first month of lactation from twenty-seven mothers with preterm babies and twelve mothers with babies born at term. The polyamine concentration in human milk was quantified by HPLC. During the first month of lactation, the total polyamine concentration was significantly higher in preterm milk than in term milk samples (7590 (SD 4990) v. 4660 (SD 4830) nmol/l, respectively (P » 0·034)), as well as individual polyamine concentrations. Polyamine concentration in mature milk for preterm babies was significantly higher than that in mature milk for babies at term, and a similar trend was observed in colostrum and transition human milk. The spermidine/spermine ratio was higher in transition milk in preterm v. term samples, while in mature milk, the ratio was significantly lower in preterm than in term babies. In conclusion, the polyamine concentration was significantly higher in human milk for preterm than for term infants. This and the different spermidine/spermine ratios could influence the gut development of premature babies.

Evaluación del proceso de desarrollo del folleto educativo de salud Abre los ojos para jóvenes en situación de calle de Medellín / Evaluation of the educational booklet Abre los ojos (Open your eyes) for homeless youth in Medellín

OBJETIVOS: evaluar el proceso de desarrollo del folleto educativo en salud Abre los ojos, diseñado para jóvenes en situación de calle en Medellín. Se evaluaron tanto el proceso de su creación como su percepción posterior entre los jóvenes. METODOLOGIA: la evaluación incluyó el análisis de datos cuantitativos y cualitativos mediante entrevistas individuales y grupos focales con jóvenes en situación de calle de Medellín. De estos jóvenes, 94, con edades entre 14 y 24 años, respondieron una encuesta de percepciones sobre el material. RESULTADOS: los grupos focales fueron efectivos para recoger las ideas y sugerencias del tipo de contenido que ellos querían para el material educativo de salud y la forma de presentarlo. Después de distribuirlo, la respuesta general resultó positiva. Manifestaron que contenía información valiosa y relevante en relación con sus experiencias. Pese a no ser el objeto principal de esta evaluación, las entrevistas individuales proporcionaron resultados preliminares acerca de la posible efectividad del material educativo para incrementar el nivel de conocimiento de los participantes sobre los temas allí incluidos. CONCLUSIONel proceso colaborativo para desarrollar el contenido del material educativo, en asocio con los jóvenes, probó ser muy valioso. Mientras que los investigadores seleccionaron información sobre VIH, los jóvenes seleccionaron información de otros temas como piercing, uso de solventes y lo que significa vivir en la calle. El material educativo resultante fue bien recibido por representantes de los jóvenes en situación de calle de Medellín, diferentes a los que participaron en su diseño.

OBJECTIVE: Conduct a process evaluation of a health education resource (pamphlet), Abre los Ojos, designed for street-involved youth in Medellín. The primary foci of the evaluation were the process of developing the resource and youth's subsequent perception of the resource. METHODOLOGY: Drawing upon both qualitative and quantitative data, a process evaluation was undertaken. Ninety four street-involved youth between the ages of 14-24 years completed surveys about the resource. These semi-structured interviews were key for the information about youth perception of the resource. In addition to individual interviews, prior to resource creation, a series of focus groups were integral for the development of the resource. RESULTS: The process of consulting with the target population through the focus groups was effective in obtaining their ideas and feedback about what type of content they would like to see in a health education resource, and how they wanted that content presented. After distribution, participants described that Abre los Ojos contained information that was valuable and relevant to their experiences. While not a primary focus of this evaluation, the individual interviews were also able to provide some preliminary insight into whether Abre los Ojos was an effective means for participants to increase their knowledge of content included in the resource. CONCLUSION: The collaborative process of jointly developing the resource content in partnership with the youth proved very worthwhile. While our research team chose to include information about HIV, through focus group dialogue, the youth themselves determined the additional content themes (piercings, use of solvents, and description of life on the street). The resulting resource was well-received by members of the street-involved population who had not been involved in its design.

Desarrollo de una versión actualizada de una aplicación informática para investigación y práctica en nutrición humana (GRUNUMUR 2.0) / Development of a current version of a software application for research and practice in human nutrition (GRUNUMUR 2.0)

El objetivo de este trabajo es la descripción de una nueva versión de la aplicación informática GRUNUMUR, herramienta de utilidad en estudios de nutrición humana diseñada por el Grupo de investigación en Nutrición de la Universidad de Murcia. De forma similar a la primera, esta versión ofrece la posibilidad de abordar diferentes tipos de estudios: dietéticos, nutricionales y de hábitos alimentarios, epidemiológicos, así como antropométricos y clínicos. La nueva versión, denominada GRUNUMUR 2.0, compatible con la primera, dispone de un sistema de ayuda en línea para todas las funciones de la aplicación, facilitando las tareas al usuario; permite el almacenamiento seguro de un número prácticamente ilimitado de resultados, de forma ordenada y organizada, que se pueden recuperar en el momento que se precise, gracias a un sistema de copias de seguridad y mantenimiento programado y desatendido (tareas realizadas por un servidor); otra ventaja es su total accesibilidad, tanto desde la intranet universitaria (www.um.es) como desde el internet, por su funcionamiento vía navegador Web (http://senver.inf.um.es/esen); y por último, permite la exportación de los datos a Excel para su posterior tratamiento con otras aplicaciones, así como la edición de informes en PDF, para entregar a los participantes del estudio en caso necesario. La nueva versión ha sido validada por comparación de los resultados extraídos con los obtenidos de otros programas informáticos, no encontrándose diferencias significativas entre ellos para ninguna de las variables analizadas. La aplicación GRUNUMUR 2.0 es una herramienta mejorada, útil y fiable para abordar estudios de nutrición humana (AU)

The aim of this paper is the description of a new version of the software application GRUNUMUR, a useful tool for human nutrition studies designed by the Nutrition Research Group from the Murcia University. Similar to the first, this second version offers the possibility to address different types of study: dietary habits (24 h recall, 7-days dietary record and Food Frequency Questionnaire), epidemiological, anthropometrical and clinical studies. The new version, called GRUNUMUR 2.0, compatible with the first one, has an online help system for all functions of the application, providing the user tasks, allows safe storage of a virtually unlimited number of results, in an orderly and organized way, you can retrieve it when required, through a system of backups and scheduled maintenance and unattended (tasks performed by a server), another advantage is its total accessibility, both from the university intranet (www.um.es) and from the internet, it works via Web Browser (http://senver.inf.um.es/esen), and finally, allows data to be exported to Excel for further processing with other applications as well as publishing reports in PDF, to deliver study participants if necessary. The new version has been validated by comparing the extracted results with those obtained from the other software with no significant differences for any of the variables analyzed. The application GRUNUMUR 2.0 is a tool improved, useful and reliable for addressing human nutrition studies (AU)

Evaluación del gasto energético y actividad física en escolares eutróficos, con sobrepeso u obesidad / Assessment of energy expenditure and physical activity in eutrophic, overweight or obese school students using Actihearts monitors

Physical inactivity has been identified as a major cause of overweight and obesity in children. Objective: To determine and compare the intensity of physical activity and energy expenditure in eutrophic (E) and overweight/obese (OW) children. Patients Method: 37 school children 6 to 9 years old, 15 overweight (OW) and 22 eutrophic (E) were studied with Actihearts™ monitors. Nutritional status was classified according to body mass index (BMI). Resting metabolic rate (RMR), total energy expenditure (TEE) and physical activity level (PAL) was calculated. Actihearts™ monitors were used to record heart rate (HR), physical activity energy expenditure (PAEE), time spent in physical activity (TPA) and accelerometry (AC). Results: OW children reported a RMR = 1,275 kcal/d +/- 164,2; TEE = 2,316 kcal/d +/- 358,7; PAEE = 985 kcal/d +/- 223,1; PAL = 1,82 +/- 0,13; significantly higher (p < 0.05) than those recorded by the eutrophic: RMR = 1066 kcal/d +/- 78,8; TEE = 1821 kcal/d +/- 241,8; PAlEE = 713 kcal/d +/- 168,1; PAlL = 1,70 +/- 0,12. The TPA and the AC did not show significant difference (p < 0.05) between both groups. Conclusions: This study concluded that OW and E children in the early years in elementary school spend, on average, the same time in physical activity and the same PAEE in activities of moderate to vigorous intensity. Both groups present similar physical activity behavior, which suggests that a hypothesis other than physical inactivity might be looked for regarding the origin of obesity, or perhaps look at origins at an earlier age.

La inactividad física ha sido identificada como una causa del sobrepeso y obesidad en niños. Objetivo: Determinar y comparar la intensidad de la actividad física y el gasto energético entre niños eutróficos (E) y con sobrepeso/obesidad (S/O). Pacientes Método: 37 varones de 6 a 9 años, 15 (S/O) y 22 (E) fueron estudiados utilizando monitores Actihearts™ como instrumento de medición. El estado nutricional se clasificó de acuerdo al índice de masa corporal (IMC). Se calculó la tasa metabólica basal (TMB), gasto energético total (GET) y el nivel de actividad física (NAF). El monitor Actihearts™ registró frecuencia cardíaca (FC), gasto energético en actividad física (GEAF), tiempo dedicado a la actividad física (TAF) y la acelerometría (AC). Resultados: Los Escolares S/O registraron: TMB = 1 275 kcal/d +/- 164,2; GET = 2 316 kcal/d +/- 358,7; GEAF = 985 kcal/d +/- 223,1; NAF = 1,82 +/- 0,13; significativamente mayores (p < 0,05) que los registrados por los eutróficos: TMB = 1066 kcal/d +/- 78,8; GET = 1 821 kcal/d +/- 241,8; GEAF = 713 kcal/d +/- 168,1 y NAF = 1,70 +/- 0,12. El TAF y la AC no mostraron diferencia significativa (p < 0,05) entre ambos grupos. Conclusiones: El presente estudio concluyó que los escolares S/O y E del primer ciclo de educación básica dedican en promedio el mismo tiempo a la actividad física y el mismo GEAF en actividades de moderada a vigorosa intensidad, identificando que ambos grupos tuvieron un similar comportamiento en el nivel de actividad física, lo que permite plantear una nueva hipótesis que el S/O es promovido entre otras variables por la inactividad física pero quizá a edades más tempranas.

Nutrition and prevalence of undernutrition assessed by different diagnostic criteria in nursing homes for elderly people.

BACKGROUND: Undernutrition is the state produced by the intake of insufficient energy, macronutrients or micronutrients. The present study aimed to assess the prevalence of undernutrition using 10 different diagnostic criteria described in the literature and to assess its association with energy intake in an institutionalised elderly population. METHODS: The cross-sectional study included 213 subjects, aged 65-96 years (135 women and 78 men), who lived in seven nursing homes in the province of Murcia, on the Mediterranean coast of Spain. Dietary intake and anthropometric and biochemical parameters were assessed, and 10 different diagnostic criteria, taken from studies of elderly subjects similar to our population, were applied. RESULTS: The mean dietary intakes appeared to cover the recommended dietary intake for a Spanish elderly population. However, only 58.2% of the studied subjects consumed 100% of the recommended dietary intake and 15.5% of the subjects had an energy intake below 80% of the recommended dietary intake. Depending on the criteria used for the diagnosis, the proportion of patients with undernutrition varied between 2% and 57%. When the relationship between undernourishment, as defined by the different methods and intake deficiency, was assessed, a statistically significant relationship was only found for five of the 10 diagnostic criteria assessed. CONCLUSIONS: Research needs to focus on the development and evaluation of specific nutritional assessment tools for application to older people aiming to improve the detection of those suffering (or who are at risk of suffering) undernutrition.

[Development of a current version of a software application for research and practice in human nutrition (GRUNUMUR 2.0)]. / Desarrollo de una versión actualizada de una aplicación informática para investigación y práctica en nutrición humana (GRUNUMUR 2.0).

The aim of this paper is the description of a new version of the software application GRUNUMUR, a useful tool for human nutrition studies designed by the Nutrition Research Group from the Murcia University. Similar to the first, this second version offers the possibility to address different types of study: dietary habits (24 h recall, 7-days dietary record and Food Frequency Questionnaire), epidemiological, anthropometrical and clinical studies. The new version, called GRUNUMUR 2.0, compatible with the first one, has an online help system for all functions of the application, providing the user tasks, allows safe storage of a virtually unlimited number of results, in an orderly and organized way, you can retrieve it when required, through a system of backups and scheduled maintenance and unattended (tasks performed by a server), another advantage is its total accessibility, both from the university intranet (www.um.es) and from the internet, it works via Web Browser (http://senver.inf.um.es/esen), and finally, allows data to be exported to Excel for further processing with other applications as well as publishing reports in PDF, to deliver study participants if necessary. The new version has been validated by comparing the extracted results with those obtained from the other software with no significant differences for any of the variables analyzed. The application GRUNUMUR 2.0 is a tool improved, useful and reliable for addressing human nutrition studies.

Dietary self-selection of protein-unbalanced diets supplemented with three essential amino acids in Nile tilapia.

Animals do not eat whatever food item they encounter, but choose different foods that best match their requirements. Fish exhibit such "nutritional wisdom" and adapt their feeding behaviour and food intake according to their needs and the nutritional properties of diets. In this paper, we tested the ability of Nile tilapia to select between diets with a balanced or unbalanced composition of essential amino acids. To this end, three different diets were prepared: a gelatine based diet (D(1)), a gelatine diet supplemented with three essential amino acids (EAA, l-tryptophane, l-methionine, l-threonine) (D(2)), and a diet containing only cellulose and the three crystalline EAA (D(3)). In addition, the putative role of both orosensorial factors (using pellets vs capsules) and social interactions (single vs groups of ten fish) was investigated. To this end, a total of 68 male tilapia of about 141±48 g (mean±S.D.) were challenged, individually or in groups, to select between D(1)vs D(2) using pellets dispensed by self-feeders (exp. 1). In another experiment (exp. 2), 11 individual fish were challenged to select encapsulated diets with non flavour or smell proprieties (D(1)vs D(2)), and in exp. 3 fish were challenged to self-supplementation in EAA (D(1)vs D(3)). The results showed the ability of tilapia to avoid the EAA-deficient diet, choosing 82.2% D(2) in the case of individual fish, and 80.8% D(2) in the case of fish groups. Dietary selection was not directly driven by the orosensorial characteristics of food, since tilapia sustained a higher preference for D(2) when fed with encapsulated diets. Finally, in exp. 3 tilapia self-supplemented the EAA deficiency by selecting a synchronised combination of D(1) and D(3) that matched their nutritional requirements. These findings highlighted the capacity of fish to make dietary selection based on the EAA content, which should be considered when discussing food intake regulation mechanisms, and diet formulation and supplementation with EAA.