ENFERMERÍA

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Educación terapéutica en insuficiencia cardiaca mediante e-Salud: revisión sistemática.
(Atención Primaria, 2023) Camino Ortega, Emma; Baroja Gil de Gómez, Ana; González Gamarra, Amelia; Cuevas-Budhart, Miguel Angel; García Klepzig, Jose Luis; Gómez del Pulgar García-Madrida, Mercedes
Objetivo Aportar la mejor evidencia científica disponible sobre la efectividad de los programas de educación terapéutica mediante salud digital en pacientes con insuficiencia cardiaca. Diseño Revisión sistemática de ensayos clínicos aleatorizados. Bases de datos Se incluyeron 6 bases de datos por su relevancia en Ciencias de la Salud: PubMed, EMBASE, Scielo, Cochraine, CINAHL y Web of Science. Selección de los estudios Se seleccionaron estudios realizados entre el año 2018 y 2023, en idioma inglés y español, tras evaluar la calidad metodológica de los estudios; se utilizó la herramienta Jadad para discriminar aquellos que no cumplían con dicha calidad. En total se incluyeron 8 artículos de 6 países diferentes. Extracción de datos La revisión y análisis de los documentos se realizó por pares de manera independiente. Para evaluar el riesgo de sesgo se utilizó la herramienta Cochrane para ensayos clínicos aleatorizados RoB 2. Resultados Todas las aplicaciones contaban con educación terapéutica; también se valoró que contasen con monitorización, evaluación de signos y síntomas, titulación de fármacos y seguimiento de profesionales a través de la aplicación. Conclusión Esta revisión revela el impacto significativo de la educación terapéutica en el aumento de conocimiento del paciente, la reducción de reingresos hospitalarios y la mejora del estado funcional y el autocuidado. Esto convierte a la salud digital en una herramienta válida para complementar la atención enfermera en pacientes con insuficiencia cardiaca.
Consenso Ibero-americano sobre Habilidades Comunicacionais para Estudantes de Graduação em Enfermagem.
(Revista latino-americana de enfermagem, 2022) Pérez Martín, Ana; Gómez del Pulgar, Mercedes; Ruiz Moral, Roger; Crespo Cañizares, Almudena; García de Leonardo Mena, Cristina; Caballero Martínez, Fernando
Objective: as a health care profession focused on caring for people, Nursing requires sound communication skills. Based on an international expert consensus, a proposal on learning outcomes in clinical communication for undergraduate Nursing education curricula in Spanish speaking countries is presented. Method: a steering committee, consisting of 5 nurses and experts in communication in health care sciences, drew up the first list of communication skills specific to the Nursing degree. Their proposal was reviewed and improved by a committee of 7 international scientific advisers. 70 experts from 14 countries were selected using a snowball sampling procedure and invited to participate in a distance modified Delphi consensus process in two survey rounds. Statistical analysis was carried out to establish the final consensus level for each item. Results: a questionnaire with 68 learning outcomes in clinical communications was submitted for panel assessment. In the first Delphi round, the panel reached a statistical consensus on all the items assessed. There was no need for a second round to reconcile positions. Conclusion: an academic proposal, approved by a high level of international consensus, is presented to guide and unify the learning outcomes on the clinical communication curriculum for undergraduate Nursing studies in Spanish speaking countries.
"Comprehensive Care" Concept in Nursing: Systematic Review.
(Investigación Y Educación En Enfermería, 2022) Renghea, Alina Mariana; Cuevas Budhart, Miguel Ángel; Yébenes Revuelto, Hugo; Gómez del Pulgar, Mercedes; Iglesias López, María Teresa
Introduction. Integrated health care is a concept widely used in the planning and organisation of nursing care. It is a highly topical concept, but at the same time it is deeply rooted in the theory and models of Nursing right from its inception as a science. There is no clear, agreed definition that describes it. Objective. To systematise the knowledge available on the concept of "comprehensive care" in Nursing from the point of view of nursing care, its domains and characteristics. Methods. A literature search has been carried out in several languages (Spanish, Portuguese, English and Romanian) in the databases Web of Science, Scopus, Medline, PubMed, Cochrane and Dialnet, covering the period between 2013 and 2019. The search terms used were: comprehensive health care, health and nursing. Prospero register 170327. Results. Sixteen documents were identified, which grouped 8 countries, mainly Brazil, being the country with the highest output on this context– 10 documents were found within the qualitative paradigm and 6 quantitative ones. The concept "Comprehensive" ; is commonly used to refer to comprehensive nursing care techniques, protocols, programmes and plans, covering care in all aspects of the individual as a complement to or independent of the clinical needs arising from health care. Conclusion. The definition of features pertaining to the concept "Comprehensive Care" ; encourages the use and standardisation of nursing care plans, improving patient follow-up, the detection of new risk factors, complications and new health problems not related to the reason for admission. This increases the capacity for prevention and improves the patient’s quality of life, and their primary and/or family caregivers, which translates into lower costs in the health system.
Best Nursing Intervention Practices to Prevent Non-Communicable Disease: A Systematic Review.
(Public Health Reviews, 2022) Gómez del Pulgar, Mercedes; Cuevas Budhart, Miguel Ángel; Hernández Iglesias, Sonsoles; Kappes, Maria; Riquelme Contreras, Veronica Andrea; Rodriguez-Lopez, Esther; De Almeida Souza7, Alina Maria; Gonzalez Jurado, Maximo A.; Crespo Cañizares, Almudena
Objectives: To explore nursing health education interventions for non-communicable disease patients. Methods: The design was a systematic review of research work published between 2008 and 2018. The data sources included the Web of Science, PubMed, Scopus, COCHRANE, and LILACS. The studies that met the inclusion were assessed, and the analysis for methodological quality through the recommended tools CASPe, and JADAD. Results: Fifteen original studies from eight counties were included in the review; Findings revealed 13 studies with randomized samples and six used power analysis. Nurses’ interventions included house calls, home care, and individual and group health education. Conclusion: Nursing interventions showed 76.4% the effectiveness of results in patient outcomes to promote and improve healthier lifestyles and quality of life of noncommunicable disease patients. This review discloses the significant impact of nursing health education interventions. Nursing leadership and political decision-makers should consider providing programs to enhance health education knowledge and abilities. All of this can favor the sustainability of the global economy by changing the life style of thousands of people worldwide.
Response Facilitation Induced by Insulin-like Growth Factor-I in the Primary Somatosensory Cortex of MiceWas Reduced in Aging.
(Cells, 2022) García Magro, Nuria; Zegarra-Valdivia, Jonathan A.; Troyas-Martinez, Sara; Torres-Aleman, Ignacio; Nuñez, Angel
Aging is accompanied by a decline in cognition that can be due to a lower IGF-I level. We studied response facilitation induced in primary somatosensory (S1) cortical neurons by repetitive stimulation of whiskers in young and old mice. Layer 2/3 and 5/6 neurons were extracellularly recorded in young ( 6 months of age) and old ( 20 month of age) anesthetized mice. IGF-I injection in S1 cortex (10 nM; 0.2 L) increased whisker responses in young and old animals. A stimulation train at 8 Hz induced a long-lasting response facilitation in only layer 2/3 neurons of young animals. However, all cortical neurons from young and old animals showed long-lasting response facilitation when IGF-I was applied in the S1 cortex. The reduction in response facilitation in old animals can be due to a reduction in the IGF-I receptors as was indicated by the immunohistochemistry study. Furthermore, a reduction in the performance of a whisker discrimination task was observed in old animals. In conclusion, our findings indicate that there is a reduction in the synaptic plasticity of S1 neurons during aging that can be recovered by IGF-I. Therefore, it opens the possibility of use IGF-I as a therapeutic tool to ameliorate the effects of heathy aging.
Pain management and coping strategies for primary dysmenorrhea: A qualitative study among female nursing students.
(Nursing Open, 2021) Fernández Martínez, Elia; Pérez Corrales, Jorge; Palacios Ceña, Domingo; Abreu Sánchez, Ana; Iglesias López, María Teresa; Carrasco Garrido, Pilar; Velarde García, Juan Francisco
Aim Primary dysmenorrhea is a problem that affects both young and adult women, with a significant impact on their daily lives. This pain is primarily managed through the consumption of non-steroidal anti-inflammatories and non-pharmacological approaches such as exercise, acupressure and heat. The present study aimed to describe how Spanish university students manage dysmenorrhea. Design Qualitative case study. Methods Nursing students (N = 33) from the region of Andalusia (Spain) participated in focus groups. A purposive sampling method was used, and the data were collected through videoconferencing and subsequently analysed thematically. The guidelines for conducting qualitative studies established by the consolidated criteria for reporting qualitative research (COREQ) and the standards for reporting qualitative research (SRQR) were followed. Results Four principal themes were identified: (a) Strategies for pain management; (b) using painkillers; (c) choosing the ideal treatment; (d) non-pharmacological interventions. Conclusions The nursing students experienced difficulties in managing primary dysmenorrhea, they self-medicated, expressed reluctance to seek professional medical advice, used non-pharmacological strategies and seeked advice from other women within their family/social circle.
Implication of type 4 NADPH oxidase (NOX4) in tauopathy.
(Redox Biology, 2022) Luengo, Enrique; Trigo Alonso, Paula; Fernández Mendívil, Cristina; Núñez, Ángel; Del Campo, Marta; Porrero, César; García Magro, Nuria; Negredo, Pilar; Senar, Sergio; Sánchez Ramos, Cristina; Bernal, Juan A.; Rábano, Alberto; Hoozemans, Jeroen; Casas, Ana I.; Schmidt, Harald H. H. W.; G. López, Manuela
Aggregates of the microtubule-associated protein tau are a common marker of neurodegenerative diseases collectively termed as tauopathies, such as Alzheimer’s disease (AD) and frontotemporal dementia. Therapeutic strategies based on tau have failed in late stage clinical trials, suggesting that tauopathy may be the consequence of upstream causal mechanisms. As increasing levels of reactive oxygen species (ROS) may trigger protein aggregation or modulate protein degradation and, we had previously shown that the ROS producing enzyme NADPH oxidase 4 (NOX4) is a major contributor to cellular autotoxicity, this study was designed to evaluate if NOX4 is implicated in tauopathy. Our results show that NOX4 is upregulated in patients with frontotemporal lobar degeneration and AD patients and, in a humanized mouse model of tauopathy induced by AVV-TauP301L brain delivery. Both, global knockout and neuronal knockdown of the Nox4 gene in mice, diminished the accumulation of pathological tau and positively modified established tauopathy by a mechanism that implicates modulation of the autophagy-lysosomal pathway (ALP) and, consequently, improving the macroautophagy flux. Moreover, neuronal-targeted NOX4 knockdown was sufficient to reduce neurotoxicity and prevent cognitive decline, even after induction of tauopathy, suggesting a direct and causal role for neuronal NOX4 in tauopathy. Thus, NOX4 is a previously unrecognized causative, mechanism-based target in tauopathies and blood-brain barrier permeable specific NOX4 inhibitors could have therapeutic potential even in established disease.
The Implementation of Nursing Specialties in Spain, 2005-2018: A Documental Study
(Clinical Nurse Specialist, 2020) De Almeida Souza, Alina Maria; Cuevas-Budhart, Miguel Ángel; Pérez Raya, Florentino; González Jurado, Máximo A.; Gómez del Pulgar, Mercedes
Nursing specialization is considered a significant professional requirement to meet the challenges and needs of the health systems under evolving epidemiological patterns and scientific, technological, and social advances. In Spain, experiences in the training of specialist nurses have followed the same pattern and have been consolidated through legislation. This study aimed to analyze the implementation of the Spanish Nursing Specialty process according to the Royal Decree 450/2005. It used the documentary and systematic analysis method: a systematic review of official regulation documents published in the State Official Bulletin of Spain, Spanish legislative and historical nursing inventories, and other nursing-specific literature. This study shows an extensive account of nursing specialties' development process through a rather long period in Spain. It evidences the complexity involved to ensure legislative legality. The study also points to the need for homogeneity within the programs across the national territory and legal definition for specialty practice. This study could be an illustration to stimulate other nurse leaders in the world working in regulation and nursing specialty development to empower nurses' development and enhance the nurse specialists' contribution to archive the needs of the health system and healthcare of the population. HIGHLIGHTS:.
Menstrual Migraine Among Spanish University Students.
(Journal of Pediatric Nursing, 2020) Fernández-Martínez, Elia; Onieva-Zafra, María Dolores; Abreu-Sánchez, Ana; González-Sanz, Juan Diego; Iglesias López, María Teresa; Fernández-Muñoz, Juan José; Parra-Fernández, María Laura
Purpose:This study sought to determine the prevalence of menstrual migraine among female university studentsat the Nursing Faculty of Ciudad Real and to determine possible risk factors.Design and methods:A cross-sectional observational study was performed using a self-report questionnaire. Twohundred and ninety-nine femaleuniversity students participated inthestudy;all were enrolledin the2017/2018academic year at the Faculty of Nursing. Participants were over the age of 18 years and without any diagnosedgynecological pathology. The main measurement tools were menstrual migraine between days−2 and +3 ofthe menstrual cycle, over the previous six cycles.Results:The prevalence of menstrual migraine was 45.15%, identifying the following possible risk factors: dys-menorrhea (OR 9.19; 1.62–6.28% CI), use of hormonal contraceptive methods (OR 2.60; 95% CI 1.30–5.20), men-strual irritability (OR 2.34; 95% CI 1.25–4.40), menstrual dizziness (OR 2.05; 95% CI % 1.12–3.75) and dailyconsumption of cola beverages (OR 1.85; 95% CI % 1.04–3.32).Conclusions:The prevalence of this problem is high among our population and the approach is complex.Practice implications: It is necessary to continue to research the pharmacological measures and methods of phar-macological pain relief as well as interventions directed at lifestyle modifications considering the potential riskfactors involved in menstrual migraine
Efectividad de la terapia compresiva de doble capa frente al vendaje de crepé en la cicatrización de úlceras venosas en atención primaria. Ensayo clínico aleatorizado
(Atención primaria, 2020) Folguera-Álvarez, Carmen; Garrido-Elustondo, Sofía; Rico-Blázquez, Mili Milagros; Esparza-Garrido, Miren Iranzu; Verdú Soriano, José
Objetivo Evaluar si el vendaje de 2 capas es más efectivo que el vendaje de crepé en la cicatrización de úlceras venosas tras 12 semanas de seguimiento. Diseño Ensayo clínico aleatorizado multicéntrico. Emplazamiento 22 Centros de Salud de Madrid. Participantes Mayores de 18 años, con diagnóstico de úlceras venosas. Se aleatorizaron 93 pacientes, 56 en el grupo de doble capa y 37 en crepé. Retiradas: 16 en el grupo de doble capa y 7 en el de crepé. Intervenciones Grupo control: práctica clínica habitual: tratamiento de la herida y vendaje con crepé. Grupo experimental: misma práctica habitual para tratamiento de la herida y vendaje con doble capa. Mediciones principales Variable respuesta principal: cicatrización completa a las 12 semanas. Variables secundarias: severidad de las lesiones, calidad de vida, reacciones adversas. Evaluación ciega de la variable respuesta. Resultados Cicatrización completa: 25 (67%) en el grupo crepé (IC al 95% 50,2-81,9) y 32 (57,1%) en doble capa (IC al 95% 43,2-70,3). Sin diferencias en ambos grupos, RR = 1,10 (IC al 95% 0,864-1,424). La severidad de las úlceras basales se asocia al tiempo de cicatrización, HR = 0,86 (IC al 95% 0,78-0,94). Se objetiva mejora significativa en la calidad de vida total y en las dimensiones cosmesis y estado emocional. No se encuentran diferencias según el vendaje utilizado. Sin reacciones adversas graves en ninguno de los grupos. Conclusiones No encontramos diferencias significativas en la cicatrización entre los 2 tipos de vendaje. Ambos son apropiados para la cicatrización de las úlceras y para mejorar la calidad de vida.
Efectividad de la estrategia educativa para la prevención de la violencia y el maltrato infantil en el currículo del Grado de Enfermería.
(Educación Médica, 2020) Soy Andrade, Mayte; Cuevas-Budhart, Miguel Ángel; Hernández Iglesias, Sonsoles; Crespo Cañizares, Almudena; Renghea, Alina Mariana; Gómez del Pulgar, Mercedes
Objetivo: Determinar la efectividad de la estrategia educativa «libro fórum» para la prevención de la violencia y el maltrato infantil dentro del itinerario curricular del alumno de Grado de Enfermería, en la Universidad Francisco de Vitoria, durante el curso académico 2018-2019. Método: Estudio cuasiexperimental, longitudinal y prospectivo. Se realizaron dos mediciones, una previa a la intervención educativa y otra posterior. La variable dependiente fue el resultado cuantitativo posterior a esta. La variable de intervención elegida fue una estrategia educativa basada en el «libro fórum» titulado La mirada de Sara Nosly. Relatos para prevenir el maltrato infantil. Para la captación de información se realizó una base de datos en el programa SPSS v24. En el análisis inferencial se utilizó la t de Student para muestras relacionadas y ANOVA para conocer la diferencia entre grupos. Resultados: La evaluación global pretest (promedio ± desviación estándar) fue 7,82 ± 1,02; posteriormente a la intervención el promedio fue 9,16 ± 0,80. De acuerdo con el análisis estadístico, se observó una significación estadística positiva tras la intervención ([t = 14,44] p < 0,001). Conclusión: La estrategia educativa «libro fórum» es efectiva para el desarrollo de competencias sobre maltrato infantil en la formación de los alumnos, lo que favorece la prevención de este fenómeno de gran impacto social.
Análisis de la definición de la matrona, acceso a la formación y programa formativo de este profesional de la salud a nivel internacional, europeo y español.
(Educación médica, 2018) Fernández Martínez, Elia; Gómez del Pulgar, Mercedes; Pérez Martín, Ana; Onieva Zafra, María Dolores; Parra Fernández, María Laura; Beneit Montesinos, J. Vicente
La matrona es el profesional sanitario de referencia en relación con el cuidado de la mujer, y su acceso y formación viene regulada a nivel internacional, europeo y español. Debido a que en la actualidad una matrona formada en otros países puede ejercer en España su profesión surge la necesidad de analizar la definición de este profesional en los diferentes contextos, así como las normativas de acceso a la formación y la estructura del programa formativo de la matrona. Para lo cual se llevó a cabo un análisis documental y se analizó la coherencia entre los documentos normativos vigentes en relación con la definición de la matrona, acceso y programa formativo a nivel internacional, europeo y nacional. En este estudio se detectan ligeras diferencias en la definición de este profesional, así como se identifican dos modelos de acceso a la formación que condicionan un itinerario formativo más o menos extenso. Se contempla una modalidad de formación específica independiente y otra modalidad como especialidad enfermera tras la formación como enfermero generalista. Así mismo, se detecta que la matrona tiene reconocidas más competencias de las que actualmente ejerce en el sistema nacional de salud español.
Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea.
(International Journal of Environmental Research and Public health, 2020) Fernández Martínez, Elia; Abreu Sánchez, Ana; Velarde García, Juan Francisco; Iglesias López, María Teresa; Pérez Corrales, Jorge; Palacios Ceña, Domingo
Primary dysmenorrhea (PD) affects a large number of female university students, diminishing their quality of life and hindering academic performance, representing a significant cause of absenteeism. The purpose of our study was to determine how nursing students experienced restrictions as a result of primary dysmenorrhea. A qualitative exploratory study was conducted among 33 nursing students with primary dysmenorrhea. A purposeful sampling strategy was applied. Data were collected from five focus groups (two sessions each) and the field notes of 10 researchers. A video meeting platform was used to conduct the focus groups. A thematic inductive analysis was performed. Thirty-three female nursing students participated in the study with a mean age of 22.72 (SD 3.46) years. Three broad themes emerged: (a) restrictions on daily activities and sports; (b) academic restrictions, and (c) restrictions on social and sexual relationships. The students described restrictions in performing everyday activities, such as carrying weight, and shopping. Some students even gave up the practice of sports and were absent from classes at the university, and from clinical practices at the hospital. The pain affected their ability to maintain and create new social relationships. Primary dysmenorrhea caused restrictions in the personal, social and academic life of the nursing students.
Why Do Some Spanish Nursing Students with Menstrual Pain Fail to Consult Healthcare Professionals?.
(International Journal of Environmental Research and Public health, 2020) Ramos Pichardo, Juan Diego; Ortega Galán, Ángela María; Iglesias López, María Teresa; Abreu Sánchez, Ana; Fernández Martínez, Elia
Dysmenorrhea is a problem that affects a large percentage of young women worldwide. Alarmingly, the majority of these women choose to self-medicate rather than consult a healthcare professional, despite the risks involved. The present study aimed to explore the reasons why undergraduate nursing students do not consult health care professionals regarding their menstrual pain. A qualitative study was conducted using an open question: “Why didn’t you consult a healthcare professional?” within the context of a research project on primary dysmenorrhea among nursing students at the University of Huelva, Spain. The responses of 202 women were analyzed using content analysis. Three categories were identified: assessment of the pain experienced, expectations, and experiences of professional care and selfcare. We found a striking normalization of the problem; notably, students downplayed the importance of the problem, considering that it was not worth consulting a physician. Furthermore, there was a notable degree of self-medication using non-steroidal anti-inflammatories (NSAIDs). These results may be useful for orienting policies to raise social awareness of this problem and for designing health education strategies aimed at women with primary dysmenorrhea.
Management of Primary Dysmenorrhea among University Students in the South of Spain and Family Influence.
(International Journal of Environmental Research and Public health, 2020) Parra-Fernández, María Laura; Onieva-Zafra, María Dolores; Abreu-Sánchez, Ana; Ramos-Pichardo, Juan Diego; Iglesias López, María Teresa; Fernández-Martínez, Elia
The present study analyses the management of primary dysmenorrhea by university students in the south of Spain. In this cross-sectional observational study, 224 women participated, using an ad hoc self-report questionnaire about menstrual pain and self-care and including sociodemographic and gynecological variables. Some 76.8% of participants consumed analgesics and the majority self-medicated with non-steroidal anti-inflammatory drugs (NSAIDs) without consulting a health professional, with a correlation between pain intensity and the number of pills ingested during menstruation (r = 0.151, p < 0.05). The higher proportion of women who found their analgesia effective were those who took medication after being prescribed by a health care provider (60.8%) compared to those who self-medicated (40%; p < 0.01). Only 43.8% employed non-pharmaceutical methods, most commonly antalgic positions, massages and local heat. These choices were not related to the intensity of menstrual pain nor with the severity of the dysmenorrhea, nor did these most common methods prove to be the most effective. However, a higher percentage of women using non-pharmacological methods was identified in women with family members suffering from dysmenorrhea (73.2%) compared to those without (60%; p = 0.040), which may indicate that the choice of remedies is more related to learning self-care in the family context. This study identifies the need for education on self-care and management of menstrual pain.
Fiabilidad de una escala para la evaluación de competencias enfermeras: estudio de concordancia.
(Educación médica, 2019) Gómez del Pulgar, Mercedes; Hernández Iglesias, Sonsoles; Crespo Cañizares, Almudena; Pérez Martín, Ana; González Jurado, Máximo A.; Beneit Montesinos, Juan Vicente
Introducción Evaluar las competencias es una cuestión de importancia que ocupa un lugar primordial en el contexto de la educación superior. Para ello, es necesario disponer de instrumentos que reúnan criterios de validez y fiabilidad, y que puedan ser utilizados en escenarios de desempeño, capacidad y actuación profesional. Por esta razón, nos planteamos el siguiente objetivo: determinar la concordancia intra e interobservador de una escala para la evaluación de competencias enfermeras (ECOEnf) en España. Material y método Estudio observacional, descriptivo y transversal para evaluar la fiabilidad mediante el análisis de concordancia intra e interobservadores de la escala «ECOEnf». Se utilizó la prueba no paramétrica Tau-b de Kendall para establecer la correlación, aplicada a la misma población, en el mismo tiempo, por 2 observadores diferentes. Resultado La concordancia intraobservador se obtuvo una excelente consistencia interna (r = 0,98). Respecto a la concordancia entre observadores se mostraron escasos ítems con una correlación menor de 0,5; sin embargo, todos los ítems cumplen con una buena fiabilidad, estadísticamente significativa, p valor < 0,05. Conclusión En general, al realizar la correlación entre los resultados de la herramienta medido 2 veces por diferentes observadores en el mismo momento se encontró estadísticamente una buena concordancia, por lo cual se considera un instrumento fiable para ser utilizado en la evaluación de las competencias enfermeras en España.
Enfermería, calidad asistencial y deontología. Análisis de un caso
(2011-10-20) Noriega Matanza, Concepción; Agejas Esteban, José Ángel
Curso (2010/2011)
Estudio descriptivo de hábitos en estudiantes madrileños respecto a su IMC, ejercicio físico, horas de sueño y consumo de alcohol.
(2011-01-26T13:37:38Z) Iglesias López, María Teresa; Sáez Crespo, Antonio; Cuesta Álvaro, Pedro
Curso 2010-2011
Relación entre consumo de tabaco y alcohol, número de horas de sueño y ejercicio físico en jóvenes en Madrid
(2011-01-26T13:37:30Z) Iglesias López, María Teresa; Sáez Crespo, Antonio; Cuesta Álvaro, Pedro
Curso 2010-2011

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