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1.
Emergencias (Sant Vicenç dels Horts) ; 32(1): 33-39, feb. 2020. tab, graf
Artigo em Espanhol | IBECS-Express | ID: ibc-ET2-3434

RESUMO

Objetivo. Identificar los factores asociados con una respuesta inicial inmediata a los síntomas en los pacientes que han padecido un ictus isquémico. Método. Estudio observacional transversal en el que se incluyeron a todos los pacientes con ictus isquémico ingresados de forma consecutiva en el Hospital Universitario de Burgos (España) durante 1 año. Se recogieron parámetros sociodemográficos, clínicos, conductuales, cognitivos y contextuales, y se estudió su posible relación con el tiempo de reacción del paciente (TR) mediante análisis univariante y multivariante. Resultados. Se incluyeron 425 pacientes (mediana del TR de 140 minutos). El TR supuso un 72,6% del tiempo prehospitalario total (TPH), con una respuesta inmediata si el paciente se encontraba acompañado (OR 9,57; IC95% 3,89-23,52), si los síntomas se iniciaban durante el día (OR 8,77; 3,40-22,63), si el paciente sabía cómo actuar ante un posible ictus (OR 3,84; 2,77-7,09), si el primer contacto médico era con el servicio de emergencias médicas (SEM) (OR 3,03; 1,62-5,68), si el paciente percibía la situación como grave o muy grave (OR 2,38; 1,17-4,83) o si el ictus ocurría en el ámbito urbano (OR 2,17; 1,16-4,06). Conclusión. El intervalo de tiempo entre el inicio de los síntomas y la respuesta inicial del paciente se relaciona con factores conductuales, cognitivos y contextuales, los cuales deberían ser considerados en la planificación de futuras campañas educacionales


Objective. To identify factors related to a rapid response to the onset of symptoms and a call for help for patients with ischemic stroke. Methods. Observational cross-sectional study of all patients with ischemic stroke admitted consecutively to Hospital Universitario de Burgos in Spain during 1 year. We collected sociodemographic, clinical, behavioral, cognitive, and contextual data for all patients and applied uni- and multivariate analysis to explore possible associations with the patient's response time. Results. A total of 425 patients were included. The mean patient response time was 140.00 minutes. Patient delay accounted for 72.6% of the total prehospital response time. Factors associated with a rapid call for help were the presence of an accompanying person (OR, 9.57; 95% CI, 3.89–23.52), daytime onset of symptoms (OR, 8.77; 3.40-22.63), patient knowledge of how to act in case of stroke symptoms (OR, 3.84; 2.77-7.09), first medical contact through the public health system's emergency medical service (OR, 3.03; 1.62-5.68), patient perception of symptoms as severe or very severe (OR, 2.38; 1.17-4.83), and stroke onset in an urban area (OR, 2.17; 1.16-4.06). Conclusions. The patient's response time between onset of symptoms is related to behavioral, cognitive and contextual factors that should be taken into account when planning future patient education campaigns

2.
Nutrients ; 12(1)2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31963374

RESUMO

Physical activity and a healthy, balanced diet are remaining unresolved issues among young people. According to the World Health Organization, young people do not get enough exercise during the week, and physical education classes are the best way to promote healthy habits. This study aims to analyze how the role of the teacher influences the frustration of psychological needs, coping strategies, motivation, and the adoption of healthy eating habits through the Mediterranean diet and the regular practice of physical activity. The study involved 1031 boys and 910 girls between the ages of 13 and 18. To explain the relationships between the different variables included in this study, a model of structural equations has been developed. The results showed that autonomy support negatively predicted the frustration of four psychological needs. The failure to meet four psychological needs negatively predicted resilience. Likewise, resilience positively predicted autonomous motivation, and this positively predicted the Mediterranean diet and the practice of physical activity. Thus, the results obtained in the present study are in line with those of various studies wherein physical education classes were seen to help consolidate healthy living habits.

3.
Artigo em Inglês | MEDLINE | ID: mdl-31671532

RESUMO

The objective of the present study is to analyze the influence of coaches on emotional intelligence and on levels of anxiety, motivation, self-esteem, and resilience among athletes. Five-hundred forty-seven semi-professional athletes between the ages of 16 and 19 participated in this study. Various statistical analyses were conducted which explain the causal relationships between the variables. The results, obtained using a structural equations model, find that while autonomy support positively predicts emotional intelligence, perceived control predicts it negatively. Moreover, emotional intelligence positively predicts self-esteem and self-determined motivation, but negatively predicts anxiety. Other results show that self-esteem positively predicts self-determined motivation, whereas anxiety predicts it negatively. Finally, self-determined motivation positively predicts resilience. Indeed, the study demonstrates the influence and the importance of coaches in relation to the emotional intelligence, psychological well-being, and motivational processes of adolescent athletes when the latter engage in their respective sports. These results help to better understand how different behavioral, emotional, and social aspects belonging to the athlete interrelate with one another during competition.

4.
Nutrients ; 11(11)2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31671742

RESUMO

According to various WHO reports in 2018, a large number of adolescents worldwide are either overweight or obese. This situation is the result of not following a healthy and balanced diet, combined with a lack of practice of physical activity. In this sense, Physical Education classes could help to solve the problem. The present study seeks to analyze the relationship between the role of the teacher in relation to the structural dimensions of the PE teaching environment and the basic psychological needs and self-motivation of adolescents as determinants of their behaviors related to eating habits and the practice of physical activity. A total of 1127 secondary school adolescents between the ages of 13 and 18 participated in this study. Questionnaires were used: Perceived Autonomy Support Scale, Psychologically Controlling Teaching Scale, Basic Psychological Needs in Physical Education, Frustration of Psychological Needs in PE context, Physical Activity Class Satisfaction Questionnaire, Perceived Locus of Causality Revised, and WHO's Global school-based student health survey. A structural equations model was elaborated to explain the causal relationships between the variables. The results showed that autonomy support positively predicted the three structural dimensions of PE classes, while, in contrast, they were negatively predicted by psychological control. The three structural dimensions positively predicted the satisfaction of psychological needs and negatively predicted the thwarting of psychological needs. Self-determined motivation was positively predicted by the satisfaction of psychological needs and negatively predicted by the thwarting of psychological needs. Finally, self-determined motivation positively predicted healthy eating habits and the practice of physical activity and negatively predicted unhealthy eating habits. Certainly, the results obtained in this study support the postulates of the self-determination theory, demonstrating the predictability of PE class context towards the adoption of healthy lifestyle habits, such as a proper diet and the regular practice of physical activity.

5.
J Clin Med ; 8(10)2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31627368

RESUMO

BACKGROUND: Despite recent advances in acute stroke care, only 1-8% of patients can receive reperfusion therapies, mainly because of prehospital delay (PHD). OBJECTIVE: This study aimed to identify factors associated with PHD from the onset of acute stroke symptoms until arrival at the hospital. METHODS: A cross-sectional study was conducted including all patients consecutively admitted with stroke symptoms to Burgos University Hospital (Burgos, Spain). Socio-demographic, clinical, behavioral, cognitive, and contextualized characteristics were recorded, and their possible associations with PHD were studied using univariate and multivariable regression analyses. RESULTS: The median PHD of 322 patients was 138.50 min. The following factors decreased the PHD and time until reperfusion treatment where applicable: asking for help immediately after the onset of symptoms (OR 10.36; 95% confidence interval (CI) 4.47-23.99), onset of stroke during the daytime (OR 7.73; 95% CI 3.09-19.34) and the weekend (OR 2.64; 95% CI 1.19-5.85), occurrence of stroke outside the home (OR 7.09; 95% CI 1.97-25.55), using a prenotification system (OR 6.46; 95% CI 1.71-8.39), patient's perception of being unable to control symptoms without assistance (OR 5.14; 95% CI 2.60-10.16), previous knowledge of stroke as a medical emergency (OR 3.20; 95% CI 1.38-7.40), call to emergency medical services as the first medical contact (OR 2.77; 95% CI 1.32-5.88), speech/language difficulties experienced by the patient (OR 2.21; 95% CI 1.16-4.36), and the identification of stroke symptoms by the patient (OR 1.98; 95% CI 1.03-3.82). CONCLUSIONS: The interval between the onset of symptoms and arrival at the hospital depends on certain contextual, cognitive, and behavioral factors, all of which should be considered when planning future public awareness campaigns.

6.
PLoS One ; 14(4): e0215569, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30998744

RESUMO

Numerous interventions propose mindfulness training as a means of improving empathy. Our aim is to analyse the relationship between mindfulness practice and empathy through the mediating process of trait mindfulness. This sample comprised 264 undergraduate students ([Formula: see text], SD = 11,39). The instruments used were Five Facet Mindfulness Questionnaire and Toronto Empathy Questionnaire. The indirect effect was calculated using 10.000 bootstrap samples for the bootstrap confidence intervals corrected for bias. Empathy improvement is mediated by changes in the cognitions derived from mindfulness (B = .346, p<.01). The direct effect of mindfulness practice on empathy disappears in presence of this mediator (B = .133, p>.05). Mindfulness interventions that aim to improve empathy should focus on three of its components; observing, describing and nonreactivity to inner experience. Given the significance of the results, the research must be extended to larger samples.

7.
Emergencias ; 31(2): 86-90, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30963735

RESUMO

OBJECTIVES: To identify factors associated with activation of emergency medical services (EMS) in stroke. MATERIAL AND METHODS: Cross-sectional study of all patients admitted with stroke to Hospital Universitario de Burgos in Spain between September 1, 2015, and August 31, 2016. We recorded sociodemographic, clinical, behavioral, cognitive, and context information and explored possible associations with calls for EMS units. RESULTS: Three hundred eleven patients were included. EMS units were activated in 171 cases (55%) associated with an assessment that the patient was unable to manage the health situation from the onset of symptoms (adjusted odds ratio [OR], 6.95; 95% CI, 3.64-13.26), a witness's call for help (rather than the patient's) (OR, 5.68; 95% CI, 2.99-10.83), serious neurological deficit defined by a score over 16 on the National Institute of Health Stroke Scale (OR, 4.51; 95% CI, 1.10-18.46), a patient's awareness of serious symptoms leading to a call for help (OR, 4.03; 95% CI, 1.42-11.42), and a patient's history of high blood pressure (OR, 2.38; 95% CI, 1.25-4.54). CONCLUSION: Calls for EMS attendance from either a patient or a witness are associated with objective signs of severe stroke and subjective perception of severity.

8.
Emergencias (Sant Vicenç dels Horts) ; 31(2): 86-90, abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182524

RESUMO

Objetivo: Identificar los factores asociados con la activación del servicio de emergencias médicas (SEM) en pacientes que han padecido un ictus. Método: Estudio transversal en el que se incluyeron a todos los pacientes con ictus ingresados en el Hospital Universitario de Burgos (España) entre el 01/09/2015 y el 31/08/2016. Se recogieron datos sociodemográficos, clínicos, conductuales, cognitivos y contextuales, y se estudió su posible relación con el uso del SEM. Resultados: Se incluyeron 311 pacientes. El uso del SEM (n = 171; 55%) se asoció con el pensamiento del paciente de no ser capaz de manejar la situación en el momento de inicio de los síntomas con OR (ajustada) 6,95 (IC 95%: 3,64-13,26), con ser los testigos y no el paciente quienes solicitaran ayuda con OR 5,68 (IC 95%: 2,99-10,83), con presentar un déficit neurológico grave (NIHSS > 16) con OR 4,51 (IC 95%: 1,10-18,46), cuando el paciente solicitó ayuda atendiendo a la gravedad de los síntomas con OR 4,03 (IC 95%: 1,42-11,42) o cuando tenía antecedentes personales de hipertensión arterial OR 2,38 (IC 95%: 1,25-4,54). Conclusión: La solicitud de asistencia al SEM por parte del paciente o testigos se relaciona con factores objetivos de gravedad del ictus y con la percepción subjetiva de gravedad


Objective: To identify factors associated with activation of emergency medical services (EMS) in stroke. Methods: Cross-sectional study of all patients admitted with stroke to Hospital Universitario de Burgos in Spain between September 1, 2015, and August 31, 2016. We recorded sociodemographic, clinical, behavioral, cognitive, and context information and explored possible associations with calls for EMS units. Results: Three hundred eleven patients were included. EMS units were activated in 171 cases (55%) associated with an assessment that the patient was unable to manage the health situation from the onset of symptoms (adjusted odds ratio [OR], 6.95; 95% CI, 3.64-13.26), a witness's call for help (rather than the patient's) (OR, 5.68; 95% CI, 2.99-10.83), serious neurological deficit defined by a score over 16 on the National Institute of Health Stroke Scale (OR, 4.51; 95% CI, 1.10-18.46), a patient's awareness of serious symptoms leading to a call for help (OR, 4.03; 95% CI, 1.42-11.42), and a patient's history of high blood pressure (OR, 2.38; 95% CI, 1.25-4.54). Conclusion: Calls for EMS attendance from either a patient or a witness are associated with objective signs of severe stroke and subjective perception of severity


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Acidente Vascular Cerebral/diagnóstico , Fatores de Tempo , Serviço Hospitalar de Emergência , Estudos Transversais , Cuidados Críticos , Ambulâncias , Transferência de Pacientes , Epidemiologia Descritiva
9.
Rev. neurol. (Ed. impr.) ; 65(5): 209-215, 1 sept., 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-166956

RESUMO

Objetivo. El ictus es la condición médica más importante que origina discapacidad permanente en el adulto. El objetivo es valorar la eficacia de ortesis dinámicas en la rehabilitación del miembro superior en pacientes que han presentado un ictus. Pacientes y métodos. Estudio longitudinal de casos y controles. Se incluyó una muestra de pacientes procedentes de centros de rehabilitación que presentaban hemiparesia secundaria a ictus isquémico o hemorrágico. De forma aleatoria, los pacientes fueron distribuidos en un grupo de estudio, cuyos miembros recibieron una ortesis dinámica en el miembro superior durante seis meses, y un grupo control. Se realizaron valoraciones pre y postratamiento con la ortesis con la Fugl-Meyer Assessment Scale y con la Wolf Motor Function para medir los dominios de las funciones y actividades corporales. Se compararon las diferencias entre pre y postest usando ANCOVA y t de Student. Resultados. Se incluyó a 40 pacientes (65% hombres) que presentaban una hemiparesia crónica secundaria a ictus isquémico (n = 28) o hemorrágico (n = 12), con una edad media de 58,43 ± 8,67 años. Tras el seguimiento de seis meses, se observó una mejoría en ambos grupos en la función motora según ambas escalas. El uso de la ortesis dinámica se asoció a una tendencia hacia la mejoría en la fuerza de la extremidad superior. Conclusiones. La rehabilitación tras el ictus mejora la fuerza y las actividades corporales en el miembro superior. El uso de una ortesis dinámica puede adicionalmente mejorar la fuerza en este miembro, pero se necesitan más estudios para confirmar nuestros resultados (AU)


Aims. Stroke is the most important medical condition leading to permanent disability in adults. The aim of this study is to evaluate the efficacy of dynamic orthoses in the rehabilitation of the upper limbs in patients who have had a stroke. Patients and methods. We conducted a longitudinal case-control study. The sample used in the study consisted of patients from rehabilitation centres who presented hemiparesis secondary to an ischaemic or haemorrhagic stroke. The patients were randomly distributed into a study group, whose members received a dynamic orthosis on an upper limb for a sixmonth period, and a control group. Appraisals were performed pre- and post-treatment with the orthosis with Fugl-Meyer Assessment Scale and with Wolf Motor Function to measure their command over body functions and activities. Differences between pre- and post-test were compared using ANCOVA and Student’s t. Results. The sample included 40 patients (65% males) who presented chronic hemiparesis secondary to ischaemic (n = 28) or haemorrhagic stroke (n = 12), with a mean age of 58.43 ± 8.67 years. After the six-month follow-up, improved motor function was observed in both groups, according to both scales. The use of a dynamic orthosis was associated with a tendency towards improved strength in the upper limb. Conclusions. Rehabilitation following a stroke improves strength and body activities in the upper limb. the use of a dynamic orthosis can further improve the strength in this limb, but additional research is needed to confirm our results (AU)


Assuntos
Humanos , Acidente Vascular Cerebral/complicações , Aparelhos Ortopédicos , Extremidade Superior/lesões , Pessoas com Deficiência/reabilitação , Acidente Vascular Cerebral/reabilitação , Dano Encefálico Crônico/reabilitação , Estudos Longitudinais
10.
Alzheimer Dis Assoc Disord ; 25(3): 213-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21346517

RESUMO

OBJECTIVE: To determine the usefulness of a formal, structured, nonpharmacological treatment for apathetic dementia patients. PATIENTS AND METHODS: A controlled, cross-over, randomized, simple-blind, multicentre clinical trial. A total of 146 institutionalized or day care dementia patients with a stage 1 or 2 Clinical Dementia Rating, with no significant motor or sensory problems, or with rapidly evolving dementia and in a clinically stable state were recruited. A cognitive mini examination, and functional, depression, and potential toxicity scales, Neuropsychiatric Inventory Questionnaire (NPI-Q), and Dementia Apathy Interview and Rating (DAIR) scales were applied at baseline. Patients were randomized to initial intervention (music and art therapy and psychomotor activity) or initial control (free activities in the day room) and changed over at 4 weeks. NPI-Q and DAIR scales were administered at the end of weeks 4 and 8. RESULTS: A significant difference between intervention and control periods, as measured using the DAIR scale, was observed, with a difference of 0.21 (95% confidence interval: 0.07-0.34, P<0.005). The difference was very important in the patients with moderated apathy. However, differences were not so important in the patients with severe apathy and there were no differences at all in the non-apathetic patients. No significant differences were found with the NPI-Q scale, although there was a clear improvement trend in the "apathy" question on this scale. This effect seems to extend beyond the therapeutic intervention period. CONCLUSIONS: A structured, nonpharmacological, short-term occupational therapy intervention is more useful than activities of the patients' own choice for improving apathy in patients with mild or moderate dementia.


Assuntos
Apatia , Demência/reabilitação , Idoso , Idoso de 80 Anos ou mais , Estudos Cross-Over , Demência/complicações , Demência/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Terapia Ocupacional , Método Simples-Cego
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