Clinical trial: a nutritional supplement Viusid, in combination with diet and exercise, in patients with nonalcoholic fatty liver disease

Background  Nonalcoholic fatty liver disease (NAFLD) is a significant health problem for which there is no universally accepted pharmacological treatment. The combination of weight loss and antioxidant drugs to ameliorate insulin resistance and improve steatosis, inflammation and fibrosis provides the rational for therapeutic trials.
Aim  To evaluate the efficacy and safety of a nutritional supplement Viusid in association with diet and exercise for NAFLD.
Methods  A randomized, controlled and parallel-group trial was conducted at a tertiary care academic centre (National Institute of Gastroenterology, Havana, Cuba). We randomly assigned 60 patients with liver biopsy-proven NAFLD to 6 months of treatment with a hypocaloric diet plus aerobic exercise daily and three Viusid sachets daily or a hypocaloric diet and exercise. Endpoints were improvement in the NAFLD activity score (NAS), fibrosis and normalization of serum aminotransferase levels.
Results  A significant improvement in steatosis, necroinflammation and fibrosis was seen in each group of treatment ( P  < 0.01 for each feature). The Viusid group, as compared with the control group, significantly reduced the mean of NAS [from 4.18 to 0.54 points in the Viusid group vs. 4.45 to 2.2 points in the control group ( P  < 0.001)]. On between-group comparison, Viusid was found to be associated with a significantly greater improvement in steatosis ( P  < 0.001), ballooning ( P  = 0.002) and lobular inflammation ( P  = 0.025), but not in fibrosis ( P  = 0.07). Viusid was well tolerated.
Conclusions  Our results indicate that treatment with diet and exercise leads to a notable improvement in the histological features of NAFLD; however, the administration of Viusid intensifies the improvements of histological findings, especially of steatosis and inflammation.     

Coaches’ Perceptions of Competence and Acknowledgement of Training Needs Related to Professional Competences

The purpose of the present study was to examine coaches’ perceptions of competence and acknowledgement of training needs related to professional competences according to the professional experience and academic education. The participants were 343 coaches from several sports, who answered to a questionnaire that includes a scale focused on perceptions of competence and another scale on acknowledgment of training needs. An exploratory factor analysis with Maximum Likelihood Factoring was used with Oblimin rotation for the identification of emergent factors. Comparison on coaches’ perceptions in function of coaching experience and coaches’ academic background were made applying One-way ANOVA and Tukey’s post hoc multiple comparisons. Factor analysis on coaches’ perceptions of competence and acknowledgement of training needs made apparent three main areas of competences, i.e. competences related to annual and multi-annual planning; competences related to orientation towards practice and competition; and personal and coaching education competences. Coaches’ perceptions were influenced by their experience, as low experienced coaches rated themselves at lower levels of competence and with more training needs; also coaches with high education, in Physical Education or others, perceived themselves as more competent than coaches with no higher education. Finally, the majority of the coaches perceived themselves to be competent but, nevertheless, they indicated to have training needs, which brings an important feedback to coach education. This suggests that coaches are interested in increasing their knowledge and competence in a broad range of areas which should be considered in future coach education programs.

Key points

• Coaches’ perceptions of competence and acknowledgement of training needs resulted in three main areas: competences related to annual and multi-annual planning, competences related to practice and competition orientation and, finally, personal and coaching education competences.
• The professional tasks that coaches had the most need in performing were related to the training orientation.
• Coaches with higher education degrees (P.E. or others) perceive themselves as more competent than coaches with no higher education.
• Low experienced coaches perceived themselves less competent than high experienced coaches. Also, they pointed out more training needs in issues related to practice and competition orientation, and annual and multi-annual planning.

Key words: Coaching education, perceptions of competence, professional competences, science of coaching, training needs