Physical activity (PA) promotes cardiovascular health and health related quality of life (HRQoL), although the effect of that on blood pressure (BP) control has rarely been studied in hypertensive ...subjects. Our aim was to evaluate the effectiveness of a PA intervention programme on cardiovascular disease (CVD) risk, HRQoL and BP control in hypertensive subjects.
A randomized clinical trial, with a PA intervention programme of 9 months duration, comprising a walking group of 120 min/week, supervised, and with socio-cultural activities. Participants were 207 hypertensive subjects (68.2 years, 76.8% women). PA (IPAQ-s), diet, CVD risk, BP, BMI, smoking, and HRQoL (SF-36) were assessed at baseline and at the end of the intervention. Changes in CVD risk and in HRQoL during the intervention was calculated (end-baseline score). Multivariate models were applied.
In multivariate models, the PA intervention programme, with no modification of the diet, decreased CVD risk (- 1.19 points) and the systolic BP (- 8.68 mmHg), and increased some areas of HRQoL (4.45 to 14.62 points). An increase in the percentage of subjects with controlled BP was observed by the PA programme itself (OR 5.395 to 5.785 according to multivariate models), and by the changes during the intervention in the decrease in CVD risk (OR 0.609) and in the increase in the HRQoL in physical component summary (OR 1.041), role physical (OR 1.010), and bodily pain (OR 1.014), independently of controlled BP at baseline.
This PA intervention programme improved cardiovascular health and HRQoL, and favoured BP control in primary care users with hypertension.
Clinicaltrials.gov ID NCT02767739 ; Trial registered on May 5th, 2016. Retrospectively registered.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To develop a quantitative predictive scoring model for the early recognition and assessment of paediatric sepsis.
Methods
Prospective observational study including emergency department and ...in‐hospital febrile patients under 18 years. Sepsis diagnose (Goldstein 2005 definitions) was the main outcome. Variables associated with the outcome were included in a multivariable analysis. Cut‐off points, odds ratio and coefficients for the variables kept after the multivariable analysis were identified. The score was obtained from the coefficients, The AUC was obtained from ROC‐analysis, and internal validation was performed using k‐fold cross‐validation.
Results
The analysis included 210 patients. 45 variables were evaluated and the bivariate analysis identified 24 variables associated with the outcome. After the multivariable regression, 11 variables were kept and the score was obtained. The model yielded an excellent AUC of 0.886 (95% CI 0.845–0.927), p < 0.001 for sepsis recognition. With a cut‐off value of 5 for the score, we obtained a sensitivity of 98%, specificity of 76.7%, positive predictive value of 87.9% and negative predictive value of 93.3%.
Conclusion
The proposed scoring model for paediatric sepsis showed adequate discriminatory capacity and sufficient accuracy, which is of great clinical significance in detecting sepsis early and predicting its severity. Nevertheless external validation is needed before clinical use.
Introducción: La alimentación y la actividad física son los principales factores de riesgo modificables para la prevención y/o control del sobrepeso y la obesidad en etapas pediátricas. Los objetivos ...de este estudio fueron evaluar los estilos de vida (dietéticos y actividad física), y su asociación con el Índice de Masa Corporal (IMC) en adolescentes.Material y métodos: Se realizó un estudio de tipo transversal sobre estilos de vida en adolescentes escolares. Se recogieron características sociodemográficas, datos clínicos, medidas antropométricas, hábitos dietéticos y de actividad física. Se utilizó una Regresión Lineal Múltiple para valorar la asociación entre los estilos de vida y el IMC, ajustados a posibles factores de confusión: sexo, edad, horas de sueño y tabaquismo.Resultados: Se analizaron 129 adolescentes (51,94% chicos) con una media de edad de 14,88 años. La prevalencia de exceso de peso fue del 32,80%, siendo mayor en los chicos comparados con las chicas. Un 59,70% de los adolescentes presentaron una dieta adecuada, y un 71,10% cumplen con las recomendaciones de actividad física de la OMS, siendo los chicos los que realizan mayor actividad física comparado con las chicas. Los adolescentes con exceso de peso obtuvieron menor puntuación de la calidad de la dieta y realizan menor actividad física que los normopeso. Además, el incremento en la puntuación de la calidad de la dieta (p-valor 0,013), horas de sueño al día (p-valor 0,032) y ser chica (p-valor <0,001), disminuyen el IMC.Conclusión: Observamos una prevalencia amplia de adolescentes con exceso de peso; y una menor calidad de la dieta y actividad física en este grupo. Además, existe una asociación entre los estilos de vida y el IMC en los adolescentes.
Physical activity is a major, modifiable, risk factor for cardiovascular disease (CVD) that contributes to the prevention and management of CVD. The aim of this study was to assess the short- and ...medium-term effectiveness of 9 months of a supervised physical activity program, including sociocultural activities, on CVD risk in adults.
Multicentered, randomized, controlled community intervention involving 364 patients in four primary care centers. The participants were randomly assigned to a Control Group (CG = 104) or Intervention Group (IG = 260); mean age 65.19 years; 76.8% women. The intervention consisted of 120 min/week walking (396 METs/min/week) and sociocultural gathering once a month. Clinical history, physical activity, dietary intake, CVD risk factors (smoking, systolic and diastolic blood pressure, weight, waist circumference, BMI, total cholesterol, LDL- and HDL-cholesterol, triglycerides, glycosylated hemoglobin and glucose) and global CVD risk were assessed at baseline and at the end of the intervention and multivariate models were applied to the data. Incidence of adverse cardiovascular events and continued adherence to the physical activity were assessed 2 years after intervention.
At the end of the intervention period, in the IG relative to the CG group, there was a significant increase in physical activity (774.81 METs/min/week), a significant change during the intervention period in systolic blood pressure (-6.63 mmHg), total cholesterol (-10.12 mg/dL) and LDL-cholesterol (-9.05 mg/dL) even after adjustment for potential confounders. At 2 years after the intervention, in the IG, compared with the CG, tthe incidence of adverse cardiovascular events was significantly lower (2.5% vs. 10.5%) and the adherence to regular physical activity was higher (72.8% vs 27.2%) in IG compared to CG.
This community-based physical activity program improved cardiovascular health in the short- as well as medium-term, and promoted regular physical activity in the medium-term in older Spanish adults.
Clinicaltrials.gov ID NCT02767739 . Trial registered on May 5th, 2016. Retrospectively registered.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A seasonal study of the lipid composition of a primary sludge (dry and dewatered base) obtained from an urban wastewater treatment plant located in Aguascalientes (Mexico) is reported. This study ...assessed the variability in sludge composition to establish its potential as a raw material for biodiesel production. Lipid recovery was achieved by extraction using two solvents. Hexane was employed for lipid extraction from dry sludge, whereas hexane and ethyl butyrate were used for comparison with dewatered sludge. The formation (%) of fatty acid methyl esters (biodiesel) was determined using extracted lipids. The extraction results from the dry sludge showed 14 and 6% of recovered lipids and their conversion to biodiesel, respectively. For the dewatered sludge, the lipid recovery and biodiesel formation were 17.4 and 60% using hexane, and 23 and 77% for ethyl butyrate, respectively, on a dry basis. Statistical data indicated that lipid recovery depended on the physicochemical characteristics of sewage sludge, which were related to seasonal changes, population activities, and changes in plant configuration, among other factors. These variables must be considered in the design of large-scale extraction equipment for the application and commercial exploitation of biomass waste in biofuel production.
En el presente artículo se describe el proceso de elaboración y contenido del documento normativo de protocolos sectoriales para la reactivación de los sectores productivos en el caso de Costa Rica. ...Tiene como principal objetivo presentar la forma en que las medidas gubernamentales evolucionan para dar respuesta a situaciones de emergencia sanitaria por medio de protocolos sectoriales para la continuidad de los servicios y de los sectores productivos. Se argumenta que la continuidad de las operaciones en las organizaciones públicas y privadas, es aún más relevante y prioritario en el contexto actual ante la pre-sencia de múltiples amenazas que influyen en la estabilidad del sistema económico, social y político. La metodología empleada para el desarrollo de los protocolos sectoriales se basó en la revisión bibliográfica y en las buenas prácticas de otros países en su elaboración, así como las recomendaciones de las autoridades sobre lineamientos sanitarios para la COVID-19. En conclusión, se reconoce la importancia de los instrumentos de política pública emitidos ante una situación de emergencia y desastres en salud. JEL: I1 Política pública, regulación, sanidad pública.
In recent years there has been a surge in the development of new small scale offshore facilities, including minimum facility structures for oil and gas developments as well as offshore renewable ...energy devices such as offshore wind turbines. In these cases the loading applied to the structure and foundation is significantly different to that applied to more typical larger offshore structures. The weight of the structure is much lower, and the horizontal load and moment applied to the foundation is much higher as a proportion of the vertical load. Design guidance for the combined loading response of shallow foundations under low vertical loads is sparse, and in particular much guidance is drawn from work where the vertical load applied to the foundation is close to the vertical bearing capacity. This paper addresses this lack of data by presenting results of combined loading experiments at low vertical loads on novel shallow foundations known as suction caissons. The experiments are carried out on dry sand at a low relative density to explore the drained response of the foundation. The experiments are successfully interpreted within the framework of work hardening plasticity, and information on the shape of the yield surface and the post-yield behaviour of the foundation is deduced. One of the key results is that the foundation can sustain moments and horizontal loads even when a tension is applied to the foundation.
Previous studies have shown that adherence to the Mediterranean Diet (MeDi) has a positive impact on lung function in subjects with lung disease. In subjects free of respiratory diseases, but at ...risk, this association is not yet well established.
Based on the reference data from the MEDISTAR clinical trial (Mediterranean Diet and Smoking in Tarragona and Reus; ISRCTN 03.362.372), an observational study was conducted with 403 middle-aged smokers without lung disease, treated at 20 centres of primary care in Tarragona (Catalonia, Spain). The degree of MeDi adherence was evaluated according to a 14-item questionnaire, and adherence was defined in three groups (low, medium, and high). Lung function were assessed by forced spirometry. Logistic regression and linear regression models were used to analyse the association between adherence to the MeDi and the presence of ventilatory defects.
Globally, the pulmonary alteration prevalence (impaired FEV1 and/or FVC) was 28.8%, although it was lower in participants with medium and high adherence to the MeDi, compared to those with a low score (24.2% and 27.4% vs. 38.5%,
= 0.004). Logistic regression models showed a significant and independent association between medium and high adherence to the MeDi and the presence of altered lung patterns (OR 0.467 95%CI 0.266, 0.820 and 0.552 95%CI 0.313, 0.973, respectively).
MeDi adherence is inversely associated with the risk impaired lung function. These results indicate that healthy diet behaviours can be modifiable risk factors to protect lung function and reinforce the possibility of a nutritional intervention to increase adherence to MeDi, in addition to promoting smoking cessation.
This baseline cross-sectional analysis from data acquired in a sub-sample of the PREDIMED-Plus study participants aimed to evaluate the relation between the Composite Socioeconomic Index (CSI) and ...lifestyle (diet and physical activity). This study involved 1512 participants (759 (52.2%) women) between 55 and 80 years with overweight/obesity and metabolic syndrome assigned to 137 primary healthcare centers in Catalonia, Spain. CSI and lifestyle (diet and physical activity) were assessed. Multiple linear regression or multinomial regression were applied to the data. Cluster analysis was performed to identify dietary patterns. The multiple linear regression model showed that a high deprivation index was related to a higher consumption of refined cereals (11.98 g/d, p-value = 0.001) and potatoes (6.68 g/d, p-value = 0.001), and to a lower consumption of fruits (−17.52 g/d, p-value = 0.036), and coffee and tea (−8.03 g/d, p-value = 0.013). Two a posteriori dietary patterns were identified by cluster analysis and labeled as “healthy” and “unhealthy”. In addition, the multinomial regression model showed that a high deprivation index was related to an unhealthy dietary pattern and low physical activity (OR 1.42 95% CI 1.06–1.89; p-value < 0.05). In conclusion, a high deprivation index was related to an unhealthy lifestyle (diet and physical activity) in PREDIMED-Plus study participants.
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