Objective The aim of this study was to determine the association between siestas/no siestas and obesity, considering siesta duration (long: >30 minutes, short: ≤30 minutes), and test whether siesta traits and/or lifestyle factors mediate the association of siestas with obesity and metabolic syndrome (MetS). Methods This was a cross‐sectional study of 3275 adults from a Mediterranean population (the Obesity, Nutrigenetics, TIming, and MEditerranean [ONTIME] study) who had the opportunity of taking siestas because it is culturally embedded. Results Thirty‐five percent of participants usually took siestas (16% long siestas). Compared with the no‐siesta group, long siestas were associated with higher values of BMI, waist circumference, fasting glucose, systolic blood pressure, and diastolic blood pressure, as well as with a higher prevalence of MetS (41%; p = 0.015). In contrast, the probability of having elevated SBP was lower in the short‐siesta group (21%; p = 0.044) than in the no‐siesta group. Smoking a higher number of cigarettes per day mediated the association of long siestas with higher BMI (by 12%, percentage of association mediated by smoking; p < 0.05). Similarly, delays in nighttime sleep and eating schedules and higher energy intake at lunch (the meal preceding siestas) mediated the association between higher BMI and long siestas by 8%, 4%, and 5% (all p < 0.05). Napping in bed (vs. sofa/armchair) showed a trend to mediate the association between long siestas and higher SBP (by 6%; p = 0.055). Conclusions Siesta duration is relevant in obesity/MetS. Timing of nighttime sleep and eating, energy intake at lunch, cigarette smoking, and siesta location mediated this association.
To analyze whether there is improvement in adherence to inhaled treatment in patients with COPD and asthma after an educational intervention based on the teach-to-goal method. This is a prospective, non-randomized, single-group study, with intervention and before-after evaluation. The study population included 120 patients (67 females and 53 males) diagnosed with asthma (70.8%) and COPD (29.1%). The level of adherence (low and optimal) and the noncompliance behavior pattern (erratic, deliberate and unwitting) were determined by the Test of the adherence to Inhalers (TAI). This questionnaire allows you to determine the level of adherence and the types of noncompliance. Low Adherence (LowAd) was defined as a score less than 49 points. All patients received individualized educational inhaler technique intervention (IEITI). Before the IEITI, 67.5% of the patients had LowAd. Following IEITI, on week 24, LowAd was 55% (p = 0.024). Each patient can present one or more types of noncompliance. The most frequent type was forgetting to use the inhaler (erratic), 65.8%. The other types were deliberate: 43.3%, and unwitting: 57.5%. All of them had decreased on the final visit: 51.7% (p = 0.009), 25.8% (p = 0.002), 39.2% (p = 0.002). There were no significant differences in adherence between asthma and COPD patients at the start of the study. The only predicting factor of LowAd was the female gender. An individualized educational intervention, in ambulatory patients with COPD and asthma, in real-world clinical practice conditions, improves adherence to the inhaled treatment.
Particulate and gaseous microemboli (GME) are side effects of cardiac surgery that interfere with postoperative recovery by causing endothelial dysfunction and vascular blockages. GME sources during surgery are multiple, and cardiopulmonary bypass (CPB) is contributory to this embolic load. Hematic antegrade repriming (HAR) is a novel procedure that combines the benefits of repriming techniques with additional measures, by following a standardized procedure to provide a reproducible hemodilution of 300 ml. To clarify the safety of HAR in terms of embolic load delivery, a prospective and controlled study was conducted, by applying Doppler probes to the extracorporeal circuit, to determine the number and volume of GME released during CPB. A sample of 115 patients (n = 115) was considered for assessment. Both groups were managed under strict normothermia, and similar clinical conditions and protocols, receiving the same open and minimized circuit. Significant differences in GME volume delivery (control group [CG] = 0.28 ml vs. HAR = 0.08 ml; p = 0.004) and high embolic volume exposure (>1 ml) were found between the groups (CG = 30.36% vs. HAR = 4.26%; p = 0.001). The application of HAR did not represent an additional embolic risk and provided a four-fold reduction in the embolic volume delivered to the patient (coefficient, 0.24; 95% CI, 0.08–0.72; p = 0.01), which appears to enhance GME clearance of the oxygenator before CPB initiation.
RESUMENFundamentos: Las desigualdades de género en salud han sido ampliamente documentadas. El principal objetivo es evaluar si existen diferencias de género en salud percibida y utilización de servicios sanitarios, y su relación con la doble carga de trabajo, en una muestra representativa de población inmigrante y autóctona de la Región de Murcia (RM).Métodos: Se utilizaron datos de la ENS 2006 y el Estudio Salud y Culturas, 1.303 inmigrantes y 1.303 españoles residentes en la RM. La combinación del trabajo reproductivo y remunerado se consideró "doble carga" (DC). Se estimó la razón de prevalencia (RP) de la percepción positiva de salud, morbilidad crónica, limitación de actividad, visitas al médico, hospitalización, visitas a urgencias y consumo de fármacos, en cada grupo de origen, mediante métodos de regresión. Se construyeron dos modelos, añadiendo el ajuste por DC al modelo ajustado por variables sociodemográficas. Se realizó análisis inter e intrasexo.Resultados: Al ajustar por DC no se observaron cambios en las diferencias entre sexos [RP mujeres/hombres de percepción positiva salud: 0,70 (0,54-0,89) europeos Este; 0,87 (0,79-0,95) autóctonos / morbilidad crónica: 1,44 (1,14-1,82) hispanoamericanos; 1,36 (1,19-1,55) autóctonos / limitación actividad: 2,23 (1,29-3,83) hispanoamericanos; 1,45 (1,01-2,10) autóctonos / consulta médico: 1,93 (1,50-2,48) hispanoamericanos; 1,74 (1,06-2,86) marroquíes; 1,32 (1,09-1,59) autóctonos / hospitalización: 1,80 (1,02-3,17) hispanoamericanos], casi los mismos que sin ajustar. Las mujeres consumieron más fármacos que los hombres. Entre sexos, hombres (1,19; 1,06-1,33) y mujeres (1,18; 1,01-1,40) de la RM con DC compartida declararon mayor percepción positiva de salud que aquellos sin DC; hombres hispanoamericanos con DC sin ayuda: 0,67 (0,47-0,94). Conclusiones:Las mujeres presentan peores indicadores de salud y mayor uso de servicios sanitarios independientemente del origen. La doble carga no modifica las desigualdades de género en salud. ABSTRACT Influence of Double Workload in Perceived Health and Health Services Utilization of Immigrants and Murcian Natives, SpainBackground: Gender inequalities in health have been largely documented. The main objective of this study is to assess whether there are gender differences in perceived health and health services utilization, and their relation with double workload in a representative sample of immigrants and Murcian natives. Methods:We used data from the NHS 2006 and Health and Culture Study, 1,303 immigrants and 1,303 Spanish, both residents in the Region of Murcia. With the combination of reproductive work and paid work we built up the variable 'double workload' (DW). We estimated the prevalence ratio (PR) for positive self-perceived health, chronic morbidity, activity limitation, doctor's visits, hospitalization, emergency and drug use, by origin, using regression methods. Two models were constructed by adding double burden to the basic model adjusted by sociodemographic variables. Analyses were performed between and wi...
alumno y profesor sin distinción de género. Es sólo una opción de economía del lenguaje, no lleva implícito ningún juicio de valor. / d.a. manzanaRes -s. maRtínezRÚbRica y evalUación RecípRoca en el tRabajo de gRUpo...
La implantación del título de Grado en Relaciones Laborales y Recursos Humanos en la Universidad de Murcia se hizo en el curso académico 2009-10. En ese mismo año ofertamos un curso de adaptación al Grado a los diplomados que titularon con el plan de estudios anterior. Esta decisión supuso que tuviésemos que organizar, planificar y gestionar la asignatura de Trabajo Fin de Grado (TFG) al tiempo que implantábamos los nuevos estudios. Así, en los últimos cinco cursos académicos, hemos acumulado una valiosa experiencia sobre la materia referida.El TFG es una asignatura más del plan de estudios, pero con características especiales, tales como que no tiene docencia, está tutorizada por un docente a lo largo de un número determinado de sesiones, se defiende una vez cursadas y superadas todas las asignaturas que conforman el plan de estudios, etc. Nuestra comunicación presenta, para su discusión, la experiencia llevada a cabo en la Facultad de Ciencias del Trabajo de la Universidad de Murcia sobre el TFG, desde el punto de vista de la organización, gestión y evaluación de la asignatura y los resultados académicos obtenidos por los alumnos.
The combined use of several histological procedures (i.e. conventional light microscopy, immunohistochemistry and electron microscopy) among 45 unselected pituitary adenomas demonstrated the existence of 9 tumors (20%) containing several identifiable adenohypophyseal cell types. The cellular associations were between 2 or 3 identifiable cell types. Mammosomatotrophic tumors were the most frequent but not the only mixed type (somatomammocorticotrophic, somatocorticotrophic tumors were also found). The cellular components varied in size but the cells appeared randomly distributed in the tumours. In all the adenomas there was an unidentified cell component (no reactivity with antisera used) varying from sparse to numerous elements. On adjacent sections the adenomatous cells reacted with a single specific antiserum, but in two cases the immunohistochemistry on contiguous paraffin embedded sections did not confirm this with certainty. These results confirm those of others and a new term is proposed to designate these tumors: heterogeneous pituitary adenomas. According to the nature and the proportions of the cell components the heterogeneous adenomas were subdivided into two groups: a group A which comprised adenomas formed by a major identifiable cellular type associated with one or two other less frequent cell types, and a group B formed by a predominant unidentifiable (no reactivity with immunochemical stainings) cell type associated with one or two other identified cell types. The present morphofunctional classifications of pituitary adenomas should be modified to include homogeneous adenomas with a single cell type and heterogeneous adenomas with several cell types.
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