Analysis of Madrid Primary Health-Care staff for the implementation of exercise prescription.

OBJECTIVE: To assess the self-perception of nurses and general practitioners (GPs) toward Physical Activity on Prescription (PAP) in Madrid Primary Health-Care (PHC). DESIGN: A survey-cohort study. SITE: Nurses and GPs of Madrid PHC System. PARTICIPANTS: A total of 319 GPs and 285 nurses' responders. MEASUREMENTS: Data were analyzed under a classification tree analysis by four predictor variables: (i) Health professional (Nurses/GPs); (ii) Exercise prescription collaboration with all health professionals: physicians, nurses, psychologists, physical therapists, sports medicine physicians, sports scientists, nutritionists, and teachers (Yes/No); (iii) PA promotion collaboration with Sports Scientists (Yes/No); and (iv) The stage of change of PHC staff to PA promotion (0-4 Likert scale). RESULTS: Regarding the predictor variable (i), responders without PA guidelines knowledge and positive attitude to collaborate with nurses in PA promotion are more GPs of female sex (nurses n=33 and GPs n=175) than male sex (nurses n=3 and GPs n=59) (p<.001). For the predictor variable (ii) only 9.30% of PHC staff with a positive attitude to collaborate with all health professionals in PA promotion and exercise prescription. For the predictor variable (iii) was shown low collaboration with sports physicians and sports scientists under a multidisciplinary PAP approach (26.50% responders). Finally, in the predictor variable (iv) Staff maintaining PAP for at least 6 months, self-considered active, and with PAP knowledge want to collaborate with Sports scientists (Yes=233; No=133). CONCLUSIONS: Nurses and GPs are conscious of health-related PA benefits despite the lack of PAP knowledge and lack of willingness to collaborate with other health personnel, exercise professionals, and community resources available.

Psychosocial factors related to physical activity in frail and prefrail elderly people.

BACKGROUND: Increased physical activity (PA) is a very important factor in a healthy aging lifestyle. Psychosocial factors have also a main role in the initiation and maintenance of this behavior, but nowadays its implications for frailty elderly people are unknown, therefore, the aim of this study was to identify the psychosociological variables of behavior change that influence the practice of (PA) in frail and prefrail elderly. METHODS: A total of 103 frail and pre-frail elderly people (72 females) participated in this cross-sectional study, on the framework of the EXERNET-Elder3.0 project. Age ranged from 68-94 years (mean = 80.4 ± 5.9 years). Individualized face-to-face interviews according to the constructs of the Transtheoretical Model of Change (TTM) [(decisional balance (DB) and self-efficacy (SE)], social support (SS) (family and friends) and outcome expectations (OE) were administered to all participants. RESULTS: Significant differences were found in DB, perceived benefits (PBn), SE, family-related SS and OE as a function of stages of change (SoC) (p < 0.005), but no significant were found in perceived barriers (PBrr) (p = 0.259) and friends-related SS (p = 0.068). According to the Scheffé post-hoc test, those in advanced SoC (Action-Maintenance), scored higher than those in lower SoC (Precontemplation-Contemplation and Preparation). CONCLUSION: The scores obtained from the study variables differed according to the SoC, supporting the external validity for the use of the TTM in frailty elderly. Further research is needed to determine the impact of PBrr and friends-related SS on this people, as well as to identify the validity of this model in the long-term in this population.

Standardized spectral and radiometric calibration of consumer cameras.

Consumer cameras, particularly onboard smartphones and UAVs, are now commonly used as scientific instruments. However, their data processing pipelines are not optimized for quantitative radiometry and their calibration is more complex than that of scientific cameras. The lack of a standardized calibration methodology limits the interoperability between devices and, in the ever-changing market, ultimately the lifespan of projects using them. We present a standardized methodology and database (SPECTACLE) for spectral and radiometric calibrations of consumer cameras, including linearity, bias variations, read-out noise, dark current, ISO speed and gain, flat-field, and RGB spectral response. This includes golden standard ground-truth methods and do-it-yourself methods suitable for non-experts. Applying this methodology to seven popular cameras, we found high linearity in RAW but not JPEG data, inter-pixel gain variations >400% correlated with large-scale bias and read-out noise patterns, non-trivial ISO speed normalization functions, flat-field correction factors varying by up to 2.79 over the field of view, and both similarities and differences in spectral response. Moreover, these results differed wildly between camera models, highlighting the importance of standardization and a centralized database.

Synthesis of a Crushed Fullerene C60H24 through Sixfold Palladium-Catalyzed Arylation.

The synthesis of a new C3v -symmetric crushed fullerene C60H24 (5) has been accomplished in three steps from truxene through sixfold palladium-catalyzed intramolecular arylation of a syn-trialkylated truxene precursor. Laser irradiation of 5 induces cyclodehydrogenation processes that result in the formation of C60, as detected by LDI-MS.

Design and validity of the Spanish version of two questionnaires related to adverse reactions to foodstuffs.

Introduction: Introduction: there is an emerging current necessity of valid questionnaires, encompassing most of food, beverages, diseases, signs and symptoms currently related to the pathogenesis of adverse reactions to foodstuffs (ARFS) in the Spanish population. Objectives: this study aimed to design and validate two questionnaires to assess ARFS in the Spanish population, Food and Beverages Frequency Consumption Questionnaire to Identify Adverse Reactions to Foodstuffs (FBFC-ARFSQ-18); and Pathologies and Symptomatology Questionnaire associated with Adverse Reactions to Foodstuffs (PSIMP-ARFSQ-10). Methods: both questionnaires were designed adapting questionnaires from the literature; and validated, using the expert judgment method, in five phases: questionnaires development, pilot test and reliability, content validity, face validity, and ethical considerations. Questionnaires were developed using the REDCap™ tool hosted at the Universidad Politécnica de Madrid. A total of 20 Spanish experts evaluated the questionnaires. Cronbach's alpha reliability coefficients were calculated using SPSS version 25.0 (IBM Corp., Armonk, NY-USA) and Aiken's V coefficient values were calculated using ICaiken.exe (Visual Basic 6.0, Lima-Perú). Results: a final construct of questions was designed, ensuring no overlap, for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10. Cronbach's alpha reliability coefficients were 0.93 and 0.94; and Aiken's V coefficient values were 0.90 (0.78-0.96 CI) and 0.93 (0.81-0.98 CI) for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10, respectively. Conclusions: both validated questionnaires could be used to analyze the association between certain food and beverages consumption with ARFS, such as food allergies and food intolerances; also, to investigate the link between some specific diseases, signs and symptoms with ARFS.

Introducción: Introducción: actualmente, existe una necesidad emergente de cuestionarios validados que abarquen la mayor parte de los alimentos, bebidas, enfermedades, signos y síntomas relacionados con la patogénesis de las reacciones adversas a los alimentos (RAA). Objetivos: diseñar y validar dos cuestionarios para evaluar las RAA en población española, el Cuestionario de Frecuencia de Consumo de Alimentos y Bebidas para Identificar Reacciones Adversas de Origen Alimentario (CFCAB-RAA-18); y el Cuestionario de Patologías y Sintomatología Asociadas a Reacciones Adversas a Alimentos (PSIMP-RAA-10). Métodos: ambos cuestionarios se diseñaron adaptando cuestionarios de la literatura y se validaron, utilizando el método de juicio de expertos, en cinco fases: desarrollo de cuestionarios, prueba piloto y confiabilidad, validez de contenido, validez aparente y consideraciones éticas. Los cuestionarios se desarrollaron utilizando la herramienta REDCap™. Un total de 20 expertos evaluaron los cuestionarios. Se calcularon coeficientes de confiabilidad alfa de Cronbach con SPSS versión 25.0 (IBM Corp., Armonk, NY-Estados Unidos) y valores del coeficiente V de Aiken con ICaiken.exe (Visual Basic 6.0, Lima-Perú). Resultados: se diseñó una construcción final de preguntas, evitando solapamiento entre ambas herramientas. Los coeficientes de confiabilidad alfa de Cronbach fueron 0,93 y 0,94, y los valores del coeficiente V de Aiken fueron 0,90 (IC: 0,78-0,96) y 0,93 (IC: 0,81-0,98) (CFCAB-RAA-18 y PSIMP-RAA-10, respectivamente). Conclusiones: ambos cuestionarios fueron validados y podrían utilizarse para analizar la asociación entre el consumo de determinados alimentos y bebidas con las RAA, como alergias e intolerancias alimentarias, así como para investigar el vínculo entre algunas enfermedades, signos y síntomas específicos con las RAA.

Adherence Factors Related to Exercise Prescriptions in Healthcare Settings: A Review of the Scientific Literature.

Purpose: Physical activity on prescription (PAP) is being introduced in healthcare systems around the world. To apply a successful treatment is as important as to know if the patient is able to follow-up. In order to contribute to the development of effective PAP strategies, we have analyzed PAP-related adherence factors with a multi-dimensional approach. Methods PAP adherence factors in studies published in the WoS, Pubmed, and PsycInfo were reviewed, according to the WHO five dimensions adherence model. In a setting of prediction or adherence analysis of adults with high-risk factors or chronic diseases, the methods used to measure physical activity (PA), PAP treatments, PAP adherence, and mentioned theories related to human behavior change were analyzed. Results A total of 32 studies fulfilled our inclusion criteria. According to the WHO five dimensions adherence model, these total clustered adherence variables were observed: social/economic (n = 100), healthcare system/healthcare team (n = 18), condition-related (n = 61), therapy-related (n = 20), and patient-related (n = 47). PAP adherence has mainly been measured by adherence to measurement methods and by calculating attended versus total sessions scheduled. PA level was measured mainly by questionnaires and exercise referrals were the most frequent PAP resource in analyzed studies. Transtheoretical model of behavior change was the theory most referenced. Conclusion A lack of considering health system/healthcare-team factors and therapy-related factors has been identified, as most studies only analyze social/economic factors in non-pharmacological PAP adherence studies in healthcare settings. A multidimensional approach should be adopted to analyze PAP adherence in healthcare settings.

Physical exercise training in the syllabus of Bachelor of Science in nursing degrees: an environmental scan.

Background: Scientific evidence regarding the effectiveness of physical activity (PA) in the prevention and treatment of chronic diseases is increasing. Healthcare systems are trying to increase exercise prescription treatments. However, it is not clear if health professionals are sufficiently trained. Aim: to analyze the contents related to PA and exercise in the prevention and treatment of chronic diseases in the syllabus of the Bachelor of Science in Nursing at all Spanish universities. Methods: A systematic environmental scan that included a web page search of curricular guide programs of all Spanish universities offering the Bachelor of Science in Nursing was undertaken for the 2017-2018 academic course. The assessment of the European Credit Transfer System (ECTS) about physical activity and/or exercise health-related benefits in the prevention or treatment of chronic diseases was performed by two experts in a peer-review process. ECTS of Practicum and Bachelor thesis were not included in the analysis. Results: In the mean, the Bachelor of Science in Nursing dedicated 5.82% (5.01% mandatory and 0.82% voluntary) of a total of 240 ECTS (ranging from 0 to 45 ECTS). The majority of contents were related to PA promotion; in contrast, contents related to exercise prescription are neglectable. Five Spanish universities do not offer any academic teaching to physical activity on prescription. Conclusions: A great disparity between universities was identified. In general, acquired knowledge seems scarce for PA promotion and exercise prescription in primary healthcare staff. Nurses would need additional physical activity on prescription training to improve PA promotion and exercise prescription knowledge as a coadjutant non-pharmacological treatment for non-communicable chronic diseases in Primary Healthcare settings.

Holistic nursing care for people diagnosed with an eating disorder: A qualitative study based on patients and nursing professionals' experience.

PURPOSE: To analyze eating disorder patients and nursing professionals' views and experience of the relationship-based care established. DESIGN AND METHODS: A qualitative study that employs an interpretative phenomenological analysis. Nineteen patients and 19 nurses participated in the research through interviews and narrations. FINDINGS: Nurses' help is both unexpected and relevant during the patients' recovery process. They provide care not focusing just on nutritional aspects, other factors such as mutual help, the psychological, emotional, social, and personal aspects are highlighted. PRACTICE IMPLICATIONS: This study provides a deep understanding of the relationship-based care established that makes it possible to expand knowledge and to individualize the care provided.

Synthesis of fluoranthenes by hydroarylation of alkynes catalyzed by gold(I) or gallium trichloride.

Electrophilic gold(I) catalyst 6 competes with GaCl(3) as the catalyst of choice in the synthesis of fluoranthenes by intramolecular hydroarylation of alkynes. The potential of this catalyst for the preparation of polyarenes is illustrated by a synthesis of two functionalized decacyclenes in a one-pot transformation in which three C-C bonds are formed with high efficiency.

Retention of Point-of-Care Ultrasound Skills Among Practicing Physicians: Findings of the VA National POCUS Training Program.

BACKGROUND: Point-of-care ultrasound (POCUS) use continues to increase in many specialties, but lack of POCUS training is a known barrier among practicing physicians. Many physicians are obtaining POCUS training through postgraduate courses, but the impact of these courses on skill retention and frequency of POCUS use post-course is unknown. The purpose of this study was to assess the change in POCUS knowledge, skills, and frequency of use after 6-9 months of participating in a brief training course. METHODS: Course participants' POCUS knowledge and hands-on technical skills were tested pre-course using an online, 30-question knowledge test and a directly observed skills test, respectively. The same knowledge and skills tests were repeated immediately post-course and after 6-9 months using remote tele-ultrasound software. Course participants completed a survey on their POCUS use pre-course and after 6-9 months post-course. RESULTS: There were 127 providers who completed the POCUS training course from October 2016 to November 2017. Knowledge test scores increased from a median of 60% to 90% immediately post-course followed by a slight decrease to 87% after 8 months post-course. Median skills test scores for 4 common POCUS applications (heart, lung, abdomen, vascular access) increased 36-74 points from pre-course to immediately post-course with a 2-7-point decrease after 8 months. Providers reported more frequent POCUS use post-course, which suggests application of their POCUS knowledge and skills in clinical practice. More frequent use of cardiac POCUS applications was associated with significantly greater retention of cardiac skills at 8 months. CONCLUSIONS: Practicing physicians can retain POCUS knowledge and hands-on skills 8 months after participating in a 2.5-day POCUS training course, regardless of frequency of POCUS use post-course.

Is Energy Expenditure or Physical Activity Considered When Energy Intake Is Measured? A Scoping Review 1975-2015.

The health-transitions humans have delivered during the 20th Century associated with the nutrition is that from undernutrition to obesity, which perseveres in the current years of the 21st Century. Energy intake (EI) is a contributing factor and therefore a fascination in nutritional sciences. However, energy expenditure (EE) has not been usually considered as a conjoint factor. Thus, this study aimed to review if studies on adults consider data on dietary intake, specifically EI, and included data on EE and physical activity (PA). A search of MEDLINE from 1975 to December 2015 was managed. Our scoping review consisted of keywords related to EI, dietary allowances, and nutritional requirements. From 2229 acknowledged articles, 698 articles were finally taken fulfilling inclusion and quality criteria. A total of 2,081,824 adults (53.7% females) were involved, and most studies had been conducted in EEUU (241), Canada (42), Australia (30), Japan (32), and Brazil (14). In Europe, apart from UK (64), the Netherlands (31) and France (26) led the classification, followed by Sweden (18), Denmark (17), and France (26). Mediterranean countries are represented with 27 studies. A total of 76.4% did not include EE and 93.1% did not include PA. Only 23.6% of the studies contained both EI and EE. A large methodological diversity was perceived, with more than 14 different methods regarding EI, and more than 10 for EE. PA was only analyzed in scarce articles, and scarcely considered for interpretation of data and conclusions. Moreover, PA was often measured by subjective questionnaires. Dietary surveys show a large diversity regarding methodology, which makes comparability of studies difficult. EE and PA are missing in around 80% of studies or are not included in the interpretation of results. Conclusions regarding EI or diet adequacy in adults should not be taken without analyzing EE and PA.

Design and Validity of a Choice-Modeling Questionnaire to Analyze the Feasibility of Implementing Physical Activity on Prescription at Primary Health-Care Settings.

Worldwide health policies are trying to implement physical activity on prescription (PAP) at healthcare settings. However, there is not a proper methodology to analyze PHC organizational staff factors. This study aims to validate two questionnaires to assess the self-perception of nurses and general practitioners to implement PAP at primary healthcare (PHC) settings. The designed choice-modeling Google-form questionnaire was sent to 11 expert nurses and 11 expert sports medicine physicians. Experts evaluated each question on a 1-5 points Likert-type scale according to their expertise. Aiken's V coefficient values ≥0.75 were used to validate separately each question using the Visual Basic-6.0 software. A total of 10 sports medicine physicians and 10 nurses with 28.4 ± 5.1 y and 16.3 ± 11.8 y of PAP experience, respectively, validated the questionnaire. One expert in each group was not considered for offering 3 ± SD answers in ≥2 questions respect to the mean of the rest of experts. Final Aiken's V coefficient values were 0.89 (0.77-1.00) for the nurses' questionnaire and 0.84 (0.77-0.95) for the physicians' one. The questionnaires designed to assess the PAP self-perception of PHC nurses and physicians were validated. This methodology could be used to analyze PHC organizational staff factors in order to achieve an efficient PAP implementation in other PHC contexts.

Effects of Ground Cover Management on Insect Predators and Pests in a Mediterranean Vineyard.

Conservative techniques, such as ground cover management, could help promote viticulture sustainability, which is a goal of conservation biological control, by providing shelter and food sources for predatory insects. A field experiment was conducted in a Mediterranean vineyard to evaluate ground cover management impacts on predatory insect and potential grapevine pest abundance and diversity, both on the ground and in the grapevine canopy. Three different ground cover management techniques (tillage, spontaneous cover and flower-driven cover) were tested for two years (2016 and 2017). Overall, the ground cover management significantly affected the abundance of important epigeal predators, of which carabids, forficulids and staphylinids were the most captured. The carabid abundances under both the cover crop treatments were found to be approximately three times higher compared with that under the tillage treatment. In contrast, the canopy insect abundance in the vineyard was similar among the treatments for both the predators and the potential grapevine pest species. These results indicate that cover crop vegetation can be used in vineyards to enhance predatory insect abundance and may improve agroecosystem resilience.

Oxo-4-methylpentanoic acid directs the metabolism of GABA into the Krebs cycle in rat pancreatic islets.

OMP (oxo-4-methylpentanoic acid) stimulates by itself a biphasic secretion of insulin whereas L-leucine requires the presence of L-glutamine. L-Glutamine is predominantly converted into GABA (gamma-aminobutyric acid) in rat islets and L-leucine seems to promote its metabolism in the 'GABA shunt' [Fernández-Pascual, Mukala-Nsengu-Tshibangu, Martín del Río and Tamarit-Rodríguez (2004) Biochem. J. 379, 721-729]. In the present study, we have investigated how 10 mM OMP affects L-glutamine metabolism to uncover possible differences with L-leucine that might help to elucidate whether they share a common mechanism of stimulation of insulin secretion. In contrast with L-leucine, OMP alone stimulated a biphasic insulin secretion in rat perifused islets and decreased the islet content of GABA without modifying its extracellular release irrespective of the concentration of L-glutamine in the medium. GABA was transaminated to L-leucine whose intracellular concentration did not change because it was efficiently transported out of the islet cells. The L-[U-14C]-Glutamine (at 0.5 and 10.0 mM) conversion to 14CO2 was enhanced by 10 mM OMP within 30% and 70% respectively. Gabaculine (250 microM), a GABA transaminase inhibitor, suppressed OMP-induced oxygen consumption but not L-leucine- or glucose-stimulated respiration. It also suppressed the OMP-induced decrease in islet GABA content and the OMP-induced increase in insulin release. These results support the view that OMP promotes islet metabolism in the 'GABA shunt' generating 2-oxo-glutarate, in the branched-chain alpha-amino acid transaminase reaction, which would in turn trigger GABA deamination by GABA transaminase. OMP, but not L-leucine, suppressed islet semialdehyde succinic acid reductase activity and this might shift the metabolic flux of the 'GABA shunt' from gamma-hydroxybutyrate to succinic acid production.

[Physical activity as prevention and treatment resource of chronic diseases in the syllabus of Medicine and Sport Sciences at Spanish universities]. / La actividad física en el currículo universitario español de los grados de Medicina y Ciencias de la Actividad Física y del Deporte como recurso en la prevención y tratamiento de las enfermedades crónicas.

INTRODUCTION: Currently, there is scientific evidence about the benefits of physical exercise over human health. The aim of this study was to review the curricula of Medicine and Sport Sciences at Spanish universities, specifically regarding the contents related to physical exercise in the promotion, prevention and treatment of non-communicable chronic diseases (NCDs). MATERIAL AND METHODS: In a systematic way, all syllabus, programs and contents of the different subjects were reviewed for all Spanish universities which offer the Bachelors of Medicine and Sport Sciences. Total, compulsory and optional European Credit Transfer System (ECTS) were analyzed and added for each university. Practicum and Bachelor thesis were not considered. RESULTS: In the mean, Medicine studies dedicate 3.62% (2.38% mandatory and 1.20% optional) of the total 360 ECTS to these contents. In Sport Sciences studies, of the total 240 ECTS, 17.78% (9.87% mandatory and 7.92% optional) were identified as related to these areas of knowledge. Contents ranged from 36 to 4.5 ECTS in Medicine and from 48 to 28 ECTS in Sport Sciences. CONCLUSION: There is a great disparity between universities for both degrees among Spanish universities. Contents related to the efficient use of physical exercise for the prevention and treatment of non-communicable chronic diseases are scarce, especially in Medicine. Results indicate the need of increasing these contents in undergraduate studies and/or include them in Master or other programs.

INTRODUCCIÓN: la evidencia científica ha acreditado los beneficios que posee la actividad física sobre la salud. El objetivo de esta revisión fue analizar la formación curricular de los estudiantes de Medicina y de Ciencias de la Actividad Física y del Deporte (CAFYD) en las universidades españolas, en relación a la prevención y el tratamiento de enfermedades crónicas a través de la actividad y el ejercicio físico. MATERIAL Y MÉTODOS: de manera sistemática, se han revisado los planes de estudio de todas las universidades españolas que tienen capacidad legal para impartir de forma presencial los grados de Medicina y CAFYD, contabilizando el promedio de créditos ECTS (European Credit Transfer System) totales, obligatorios y optativos de las asignaturas que abordan la promoción, la prevención y el tratamiento de las enfermedades crónicas a través del ejercicio físico, excluyendo practicum y trabajos fin de grado (TGF). RESULTADOS: el grado de Medicina dedica un promedio del 3,62% (2,38% y 1,20% créditos obligatorios y optativos, respectivamente) (360 ECTS) y el grado de CAFYD un 17,78% (9,87% y 7,92%) (240 ECTS) a contenidos relacionados con la actividad física como herramienta en la prevención y tratamiento de las enfermedades crónicas no trasmisibles. El rango va de 36 a 4,5 ECTS en Medicina y de 48 a 28 ECTS en CAFYD. CONCLUSIÓN: se observa cierta disparidad entre los planes de estudio de las universidades españolas para los dos grados. Los créditos ECTS relacionados con actividad física y salud resultan escasos en el currículo de ambos grados, especialmente en Medicina. Los resultados indican la necesidad de aumentar estos contenidos en los estudios de grado y/o incluirlos en programas de postgrado.

Cuidados de enfermería desde la experiencia de personas que padecen trastornos alimentarios: un estudio cualitativo / Nursing care experiences of people with eating disordes: a qualitative study from patients' perspective

Resumen Los Trastornos de la Conducta Alimentaria suponen uno de los problemas más prevalentes en la sociedad, siendo los cuidados prestados por las enfermeras fundamentales para su recuperación. Es por ello necesario comprender la experiencia que tienen los pacientes de los cuidados que reciben, para poder adaptarse a sus necesidades. Este estudio cualitativo propone aproximarse a la vivencia de cuidados de pacientes que padecen trastornos alimentarios desde un enfoque fenomenológico hermenéutico. Diecinueve pacientes de Alcalá de Henares (Madrid) colaboraron en la investigación a través de entrevistas y relatos, que fueron grabados, transcritos y analizados temáticamente. Los resultados se agruparon en cuatro categorías: 1. Una ayuda inesperada, 2. Buscar raíces: encontrar el origen, 3. Derribar barreras y construir contrafuertes, 4. Entender el significado del Trastorno Conducta Alimentaria. Para los pacientes, las enfermeras son una figura tanto inesperada como relevante, mostrando la importancia de los aspectos psicológicos y emocionales, sociales y personales como reguladores de su relación con la comida, la imagen y la vivencia de la corporeidad. A través del estudio, se profundiza en la relación de cuidados entre enfermera y paciente, obteniendo una perspectiva de cuidados desconocida, que posibilita ampliar el conocimiento e individualizar los cuidados prestados.

Abstract Eating Disorders are one of the most prevalent problems in our society being nursing care essential for recovery. It is therefore necessary to understand patients' experience in order to adapt their actions to patients' needs. This qualitative study offers an approach to nursing care experience of people with eating disorders from an hermeneutical phenomenological approach. Nineteen patients from Alcalá de Henares (Madrid) collaborated in the research through in-depth interviews and stories, which were thematically recorded, transcribed and analyzed. The results were grouped in four categories: 1. Unexpected help, 2. In search for roots: discovering the origin, 3. To break down barriers and build buttresses, 4. To understand the meaning of the eating disorder. Patients emphasize that nurses are as unexpected as relevant in their lives, showing the importance of psychological, emotional, social and personal aspects, as regulators of their food relationship, their body image and their corporeality experience. This investigation allows getting a deeper view of care relationship between nurses and patients, previously unknown, which makes it possible to widen the knowledge and to individualize the care provided.

Conversion into GABA (gamma-aminobutyric acid) may reduce the capacity of L-glutamine as an insulin secretagogue.

We have carried out a detailed examination of L-glutamine metabolism in rat islets in order to elucidate the paradoxical failure of L-glutamine to stimulate insulin secretion. L-Glutamine was converted by isolated islets into GABA (gamma-aminobutyric acid), L-aspartate and L-glutamate. Saturation of the intracellular concentrations of all of these amino acids occurred at approx. 10 mmol/l L-glutamine, and their half-maximal values were attained at progressively increasing concentrations of L-glutamine (0.3 mmol/l for GABA; 0.5 and 1.0 mmol/l for Asp and Glu respectively). GABA accumulation accounted for most of the 14CO2 produced at various L-[U-14C]glutamine concentrations. Potentiation by L-glutamine of L-leucine-induced insulin secretion in perifused islets was suppressed by malonic acid dimethyl ester, was accompanied by a significant decrease in islet GABA accumulation, and was not modified in the presence of GABA receptor antagonists [50 micromol/l saclofen or 10 micromol/l (+)-bicuculline]. L-Leucine activated islet glutamate dehydrogenase activity, but had no effect on either glutamate decarboxylase or GABA transaminase activity, in islet homogenates. We conclude that (i) L-glutamine is metabolized preferentially to GABA and L-aspartate, which accumulate in islets, thus preventing its complete oxidation in the Krebs cycle, which accounts for its failure to stimulate insulin secretion; (ii) potentiation by L-glutamine of L-leucine-induced insulin secretion involves increased metabolism of L-glutamate and GABA via the Krebs cycle (glutamate dehydrogenase activation) and the GABA shunt (2-oxoglutarate availability for GABA transaminase) respectively, and (iii) islet release of GABA does not seem to play an important role in the modulation of the islet secretory response to the combination of L-leucine and L-glutamine.

Similar effects of succinic acid dimethyl ester and glucose on islet calcium oscillations and insulin release.

UNLABELLED: The relative contribution of glycolysis vs. oxidative metabolism to the stimulus secretion coupling mechanism of beta-cells was investigated in isolated islets. For that purpose, the secretory and intracellular calcium responses of islets to both glucose and succinic acid dimethyl ester (SAD) were compared. After 45 min of rat islet perifusion in the absence of substrates, the maximum secretory responses to glucose (20 mmol/L) and SAD (10 mmol/L) were qualitatively and quantitatively indistinguishable. Malonic acid dimethyl ester (a permeable citric acid cycle inhibitor) suppressed the insulin secretory response to both 20 mmol/L glucose and 10 mmol/L SAD (-70% on average). The inhibitor decreased within 70% the rate of 14CO2-production from 10 mmol/L [2-(14)C]pyruvate without affecting the rate of 20 mmol/L D-[5-(3)H]glucose utilization. Both, 11.1 mmol/L glucose and 10 mmol/L SAD, elevated the intracellular calcium concentration and induced a similar pattern of oscillations that were rapidly ablated by 20 mmol/L malonic acid dimethyl ester. However, the intracellular concentration of calcium declined to basal values several minutes after the introduction of the inhibitor in the presence of SAD whereas it remained elevated in the case of glucose. IN CONCLUSION: (1) An exclusive increase of mitochondrial metabolism in pancreatic islets was sufficient to mimic the effects of glucose on intracellular calcium and insulin secretion. (2) Islet glycolysis and/or the re-oxidation of cytoplasmic NADH allowed the maintenance of an elevated, though non-oscillating, intracellular calcium concentration, but a reduced response to glucose.

Fluoroalkyl alpha,beta-unsaturated imines. Valuable synthetic intermediates from primary fluorinated enamine phosphonates.

[reaction: see text] A simple method for the preparation of fluoroalkyl allylamines or alpha,beta-unsaturated ketones by an olefination reaction of primary enamine phosphonates and aldehydes, followed by selective reduction with hydrides or hydrolysis, is reported. Fluorinated beta-amino nitriles are also obtained by an olefination reaction of primary enamine phosphonates with aldehydes and subsequent addition of metalated acetonitrile.