Mejora de la calidad de vida en cuidadores informales de personas dependientes mediante talleres educacionales

Introduction: The ageing of the population is associated with an increase in the number of dependent people, with an estimate of 15% living with a disability. The provision of care to family members entails an added responsibility associated with care-related problems, which can have a negative impact on caregivers. Therefore, we propose to design and evaluate a caregiving programme based on caregiver education, measuring knowledge, pain perception, emotional burden and health-related quality of life. Objective: The main objective is to improve the quality of life of informal caregivers through training interventions, in order to decrease the disability caused by caregiving tasks.Method: 99 caregivers belonging to the Aljarafe-Northern Seville Primary Care Health District participated, divided into control and intervention groups. We designed two educational workshops on care programmes for informal caregivers. They completed a knowledge questionnaire, and different validated scales related to pain, health states and quality of life.Results: Most of the caregivers presented back problems, for which they received pharmaceutical treatment. The implemented intervention was associated with a decrease in pain during basic activities of daily living, care and rest, as well as a reduction in strain index in both groups.Conclusions: Intervention programmes for informal carers of dependent patients are effective in improving the state of health and quality of life of this group, and their implementation should therefore be encouraged in primary care. Introducción: El envejecimiento de la población está asociado a un incremento de personas dependientes, estimándose que el 15% vive con alguna discapacidad. La prestación de cuidados a familiares supone una responsabilidad añadida asociada a problemas relacionados con el cuidado, que pueden repercutir negativamente en los cuidadores. Por ello, planteamos diseñar y evaluar un programa de cuidados, basado en la educación de los cuidadores, midiendo los conocimientos, la percepción del dolor, la carga emocional y la calidad de vida relacionada con la salud. Objetivo: El objetivo principal es mejorar la calidad de vida de los cuidadores informales mediante intervenciones formativas, con el fin de disminuir la incapacidad causada por las tareas del cuidado.Método: Participaron 99 cuidadores pertenecientes al Distrito Sanitario Aljarafe-Sevilla Norte de Atención Primaria, divididos en grupo control e intervención. Diseñamos dos talleres educacionales sobre programas de atención a cuidadores informales. Cumplimentaron un cuestionario de conocimientos, y diferentes escalas validadas relacionadas con el dolor, los estados de salud y la calidad de vida.Resultados: La mayor parte de los cuidadores presentaban problemas de espalda tomando medicación para ello. La intervención implementada se asoció a un descenso del dolor durante actividades básicas de la vida diaria, los cuidados y el descanso, y disminución del índice de esfuerzo en ambos grupos.Conclusiones: Los programas de intervención en cuidadores informales de pacientes dependientes resultan eficaces para mejorar el estado de salud y la calidad de vida de este colectivo por lo que se debe fomentar su realización desde la Atención Primaria.

Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training

While competitive training is usually associated with the prevalence of back pain and injuries in athletes, little attention is being paid to the positive effects of sport-specific exercises on core musculature in the prevention of back problems. This scoping review aims (i) to map the literature that addresses the effects on reduction of back problems following athlete training with differing demands on the core musculature and (ii) to identify gaps in the existing literature and propose future research on this topic. The main literature search was conducted on the MEDLINE, PubMed, Web of Science, Scopus, and Cochrane Library databases and was completed on Elsevier, SpringerLink, and Google Scholar. A total of 21 research articles met the inclusion criteria. The findings of 17 studies identified that core strengthening and core stabilization exercises, alone or in combination with athlete training, contribute to the reduction of back pain in athletes, whereas only four studies revealed no significant association of core muscle strength and/or endurance with back problems. Nevertheless, more research is warranted to elucidate the pros and cons of purely sport-specific training with differing demands on the core musculature on back health in athletes. This could help us to design prevention strategies specifically tailored to individual athletes.

Changing patterns of sickness absence among healthcare workers in England during the COVID-19 pandemic.

Objective To explore impacts of the COVID-19 pandemic on patterns of sickness absence among staff employed by the National Health Service (NHS) in England. Methods We analysed prospectively collected, pseudonymised data on 959,356 employees who were continuously employed by NHS trusts during 1 January 2019 to 31 July 2020, comparing the frequency of new sickness absence in 2020 with that at corresponding times in 2019. Results After exclusion of episodes directly related to COVID-19, the overall incidence of sickness absence during the initial 10 weeks of the pandemic (March-May 2020) was more than 20% lower than in corresponding weeks of 2019, but trends for specific categories of illness varied. Marked increases were observed for asthma (122%), infectious diseases (283%) and mental illness (42.3%), while reductions were apparent for gastrointestinal problems (48.4%), genitourinary/gynaecological disorders (33.8%), eye problems (42.7%), injury and fracture (27.7%), back problems (19.6%), other musculoskeletal disorders (29.3%), disorders of ear, nose and throat (32.7%), cough/flu (24.5%) and cancer (24.1%). A doubling of new absences for pregnancy-related disorders during 18 May to 19 July of 2020 was limited to women with earlier COVID-19 sickness absence. Conclusions Various factors will have contributed to the large and divergent changes that were observed. The findings add to concerns regarding delays in diagnosis and treatment of cancers, and support a need to plan for a large backlog of treatment for many other diseases. Further research should explore the rise in absence for pregnancy-related disorders among women with earlier COVID-19 sickness absence.

A novel approach to thermographic images analysis of equine thoracolumbar region: the effect of effort and rider’s body weight on structural image complexity

Background The horses’ backs are particularly exposed to overload and injuries due to direct contact with the saddle and the influence of e.g. the rider’s body weight. The maximal load for a horse’s back during riding has been suggested not to exceed 20% of the horses’ body weight. The common prevalence of back problems in riding horses prompted the popularization of thermography of the thoracolumbar region. However, the analysis methods of thermographic images used so far do not distinguish loaded horses with body weight varying between 10 and 20%. Results The superficial body temperature (SBT) of the thoracolumbar region of the horse’s back was imaged using a non-contact thermographic camera before and after riding under riders with LBW (low body weight, 10%) and HBW (high body weight, 15%). Images were analyzed using six methods: five recent SBT analyses and the novel approach based on Gray Level Co-Occurrence Matrix (GLCM) and Gray Level Run Length Matrix (GLRLM). Temperatures of the horse’s thoracolumbar region were higher (p < 0.0001) after then before the training, and did not differ depending on the rider’s body weight (p > 0.05), regardless of used SBT analysis method. Effort-dependent differences (p < 0.05) were noted for six features of GLCM and GLRLM analysis. The values of selected GLCM and GLRLM features also differed (p < 0.05) between the LBW and HBW groups. Conclusion The GLCM and GLRLM analyses allowed the differentiation of horses subjected to a load of 10 and 15% of their body weights while horseback riding in contrast to the previously used SBT analysis methods. Both types of analyzing methods allow to differentiation thermal images obtained before and after riding. The textural analysis, including selected features of GLCM or GLRLM, seems to be promising tools in considering the quantitative assessment of thermographic images of horses’ thoracolumbar region.

Physical Health Symptoms and Hurricane Katrina: Individual Trajectories of Development and Recovery More Than a Decade After the Storm

Objectives. To examine how physical health symptoms developed and resolved in response to Hurricane Katrina. Methods. We used data from a 2003 to 2018 study of young, low-income mothers who were living in New Orleans, Louisiana, when Hurricane Katrina struck in 2005 (n = 276). We fit logistic regressions to model the odds of first reporting or “developing” headaches or migraines, back problems, and digestive problems, and of experiencing remission or “recovery” from previously reported symptoms, across surveys. Results. The prevalence of each symptom increased after Hurricane Katrina, but the odds of developing symptoms shortly before versus after the storm were comparable. The number of traumatic experiences endured during Hurricane Katrina increased the odds of developing back and digestive problems just after the hurricane. Headaches or migraines and back problems that developed shortly after Hurricane Katrina were more likely to resolve than those that developed just before the storm. Conclusions. While traumatic experiences endured in disasters such as Hurricane Katrina appear to prompt the development of new physical symptoms, disaster-induced symptoms may be less likely to persist or become chronic than those emerging for other reasons.

Advanced spinal movements (ASM) as manipulative treatment in back pain and promotion of spinal column

The human back is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around. The segments of the spine are cushioned with cartilage-like pads called disks. Problems with any of these components can lead to back pain. In some cases of back pain, its cause remains unclear. Low back problems affect the spines flexibility, stability, and strength, which can cause pain, discomfort and stiffness. Approximately 80% of individuals will experience an episode of lower back pain at some time during their life. Lower back pain is the fifth leading reason for patients visiting a doctor and the leading cause of work related disability. However, the underlying cause is usually not serious and may not even be identified by the doctor. Lower back pain is most common in patients between the ages of 20 and 40 years, but can be more severe and disabling in elderly patients. The ASM technique was implemented in private clinic with aims to increases the strength, stability & flexibility of spine & prevent the different kinds of back problems. As the pain was relieved almost and the patients will be encouraged to practice the ASM technique regularly, even after the pain has gone, to prevent back pain/problems recurrence and promotion of spinal column.

Factors related to adherence to drug treatment in public university workers

Objective: to analyze factors associated with medication adherence among public university workers who reported use of continuous medication. Methods: cross-sectional study carried out with 629 workers from a public university. Data were collected through interviews using forms adapted from the Brazilian Ministry of Health and analyzed using the chi-square test. Results: three hundred thirty-one (52.6%) participants were users of continuous medication, of these, 175 (52.9%) had a partially satisfactory adherence pattern and 156 (47.1%) a totally satisfactory pattern. Workers with chronic back problems, depression, weakness/tiredness, dyspnea, and chest pain had significantly less adherence to drug treatment (p≤0.050). Sociodemographic and labor characteristics, polypharmacy, and type of medication were not associated with medication adherence (p>0.050). Conclusion: satisfactory drug adherence was observed among the participants in relation to drug treatment, and the presence of some symptoms and specific chronic diseases was associated with partially satisfactory drug adherence.