The present study examined the effects of mindfulness on depression and anxiety, both direct and indirect through the mediation of four mechanisms of emotional regulation: worry, rumination, ...reappraisal and suppression. Path analysis was applied to data collected from an international and non-clinical sample of 1151 adults, including both meditators and non-meditators, who completed an online questionnaire battery. Our results show that mindfulness are related to lower levels of depression and anxiety both directly and indirectly. Suppression, reappraisal, worry and rumination all acted as significant mediators of the relationship between mindfulness and depression. A similar picture emerged for the relationship between mindfulness and anxiety, with the difference that suppression was not a mediator. Our data also revealed that the estimated number of hours of mindfulness meditation practice did not affect depression or anxiety directly but did reduce these indirectly by increasing mindfulness. Worry and rumination proved to be the most potent mediating variables. Altogether, our results confirm that emotional regulation plays a significant mediating role between mindfulness and symptoms of depression and anxiety in the general population and suggest that meditation focusing on reducing worry and rumination may be especially useful in reducing the risk of developing clinical depression.
Malnutrition is prevalent among hospitalized patients in developed countries, contributing to negative health outcomes and increased healthcare costs. Timely identification and management of ...malnutrition are crucial. The lack of a universally accepted definition and standardized diagnostic criteria for malnutrition has led to the development of various screening tools, each with varying validity. This complicates early identification of malnutrition, hindering effective intervention strategies. This systematic review and meta-analysis aimed to identify the most valid and reliable nutritional screening tool for assessing the risk of malnutrition in hospitalized adults.
A systematic literature search was conducted to identify validation studies published from inception to November 2023, in the Pubmed/MEDLINE, Embase, and CINAHL databases. This systematic review was registered in INPLASY (INPLASY202090028). The risk of bias and quality of included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). Meta-analyses were performed for screening tools accuracy using the symmetric hierarchical summary receiver operative characteristics models.
Of the 1646 articles retrieved, 60 met the inclusion criteria and were included in the systematic review, and 21 were included in the meta-analysis. A total of 51 malnutrition risk screening tools and 9 reference standards were identified. The meta-analyses assessed four common malnutrition risk screening tools against two reference standards (Subjective Global Assessment SGA and European Society for Clinical Nutrition and Metabolism ESPEN criteria). The Malnutrition Universal Screening Tool (MUST) vs SGA had a sensitivity (95% Confidence Interval) of 0.84 (0.73–0.91), and specificity of 0.85 (0.75–0.91). The MUST vs ESPEN had a sensitivity of 0.97 (0.53–0.99) and specificity of 0.80 (0.50–0.94). The Malnutrition Screening Tool (MST) vs SGA had a sensitivity of 0.81 (0.67–0.90) and specificity of 0.79 (0.72–0.74). The Mini Nutritional Assessment-Short Form (MNA-SF) vs ESPEN had a sensitivity of 0.99 (0.41–0.99) and specificity of 0.60 (0.45–0.73). The Nutrition Universal Screening Tool-2002 (NRS-2002) vs SGA had a sensitivity of 0.76 (0.58–0.87) and specificity of 0.86 (0.76–0.93).
The MUST demonstrated high accuracy in detecting malnutrition risk in hospitalized adults. However, the quality of the studies included varied greatly, possibly introducing bias in the results. Future research should compare tools within a specific patient population using a valid and universal gold standard to ensure improved patient care and outcomes.
Several studies have shown a relation between the adipose tissue accumulation and a higher risk for developing metabolic and cardiovascular diseases. Thus, body fat content and, mainly, the fat ...distribution or adiposity could be considered as important indicators of health risk. In spite of presenting several limitations, BMI is the most widely used and accepted index for classifying overweight and obesity. The aim of the study was to evaluate the correlations between Body Adiposity Index (BAI), BMI and other adiposity indexes such as WC, WHR and WHtR with cardiovascular and metabolic risk factors. Furthermore, the behavior of BAI and BMI regarding the ability to discriminate overweight or obese individuals was also analyzed.
A cross-sectional study was conducted in Spanish Caucasian adult workers. Participants in the study (29.214 men and 21.040 women, aged 20-68 years) were systematically selected during their work health periodic examinations. BAI, BMI, WHR, WHtR, body weight, hip and waist circumference (WC) as well as systolic and diastolic blood pressure were measured. Serum levels of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and glucose were also determined. Results of the study indicated that BAI was less correlated with cardiovascular risk factors and metabolic risk factors than other adiposity indexes (BMI, WC and WHtR). The best correlations were found for WHtR. In addition, the BAI presented lower discriminatory capacity than BMI for diagnosing metabolic syndrome (MS) using both IDF and ATP III criteria. A different behavior of the BAI in men and women when considering the ability to discriminate overweight or obese individuals was also observed.
The adiposity indexes that include the waist circumference (WHtR and WC) may be better candidates than BAI and BMI to evaluate metabolic and cardiovascular risk in both clinical practice and research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: In higher education, there is a lack of knowledge about how individual factors influence personal preferences for teaching methodology and academic outcomes in biostatistics among nursing ...students. This study sought to evaluate the associations between personality traits and preferences for the flipped classroom or traditional lessons, satisfaction, and achievement in a biostatistics course in nursing education. Methods: The cross-sectional study included data collection at two time points. During the 2018–2019 academic course, the flipped classroom approach was implemented into a biostatistics course of the nursing degree at the University of the Balearic Islands (Spain). Students responded to an online questionnaire including sociodemographic data, personality traits, locus of control, satisfaction, teaching quality, student involvement, and effort. After the final examination, students’ achievements were collected. Results: A total of 137/161 (85.1%) students were included in the study. Most students preferred a flipped classroom to traditional lectures. Students who scored high in neuroticism preferred the traditional class (p < 0.001). Furthermore, personality was associated with satisfaction: high levels of responsibility and internal locus of control were significantly associated with higher satisfaction (p < 0.05). The percentage of students who did not pass the biostatistics exam was reduced by 50% with the flipped classroom methodology (33% vs. 15%; p < 0.001). Conclusions: A flipped classroom is adequate for the biostatistics course. Teachers should reconsider possible reservations about new teaching methods, which can be related to student personality.
Interatrial blocks are considered a new important risk factor for atrial fibrillation and cerebrovascular events. Their prevalence and clinical implications have been reported in general population ...and several subgroups of patients but no data from HIV-infected populations, with a non-negligible prevalence of atrial fibrillation, has been previously reported.
We conducted a cross-sectional study in a previously enrolled cohort of randomly selected middle-aged HIV-infected patients who attended our hospital and were clinically stable. Patients underwent both a 12-lead rest electrocardiogram and clinical questionnaires while epidemiological, clinical and HIV-related variables were obtained from electronic medical records and interviews with the patients. Electrocardiograms were then analyzed and codified using a standardized form by two trained members of the research team who were blinded to clinical variables.
We obtained electrocardiograms from 204 patients with a mean age of 55.22 years, 39 patients (19.12%) presented an interatrial block, 9 (4.41%) advanced and 30 (14.71%) partial. Patients with interatrial block had a lower nadir lymphocyte CD4 count (124 vs 198 cells, p = 0.02) while advanced interatrial blocks were associated to older age (62.16 vs. 54.95 years, p = 0.046) and hypertension (77.8% vs. 32.3%, p = 0.009). We did not find differences regarding baseline CD4 lymphocyte count or CD4/CD8 lymphocyte ratio. Clinical variables and functional capacity among patients with or without interatrial block were similar.
In a cohort of clinically stable HIV infected patients the prevalence of interatrial blocks, specially advanced, is high and associated to previously known factors (age, hypertension) and novel ones (nadir CD4 lymphocyte count).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Fatty Liver Index (FLI) is strongly associated with changes in glycemic status and incident Type 2 Diabetes (T2D). The probability of reverting to normoglycemia from a state prediabetes could be ...determined by FLI, however such relationship remains poorly understood.
To determine the clinical interest of using FLI to estimate prediabetes reversion at 5 years in patients with impaired fasting plasma glucose at baseline, and identify those factors associated with changes in FLI, that could contribute to the reversion of prediabetes.
This 5-year cohort study included 16,648 Spanish working adults with prediabetes. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dl according to the ADA criteria, while prediabetes reversion was defined as a FPG <100 mg/dL. The population was classified as: FLI <30 (no hepatic steatosis), FLI 30-59 (intermediate status), and FLI ≥60 (hepatic steatosis).
At 5 years follow-up, 33.7% of subjects reverted to normoglycemia (annual rate of 6.7%). The adjusted binomial logistic regression model showed that scoring FLI <30 (OR 1.544; 95% CI 1.355-1.759), performing at least 150 min/week of physical activity (OR 4.600; 95% CI 4.088-5.177) and consuming fruits and vegetables daily (OR 1.682; 95% CI 1.526-1.855) were associated with the probability of reverting form prediabetes to normoglycemia. The ROC curve for prediction of reversion showed that FLI (AUC 0.774;95% CI 0.767-0.781) was a better predictor than FPG (AUC 0.656; 95% CI 0.648-0.664).
Regular physical activity, healthy dietary habits and absence of hepatic steatosis are independently associated with the probability of reversion to normoglycemia in adult workers with prediabetes at baseline. Low FLI values (especially FLI< 30) may be useful to predict the probability of prediabetes reversion, especially in active subjects with healthy eating habits, and thus identify those who might benefit from early lifestyle intervention.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To evaluate the effectiveness of a nurse‐led personalized telephone lifestyle intervention versus automated SMSs in the reduction of fasting plasma glucose in adults with prediabetes.
Design
The ...PREDIPHONE is a randomized controlled, parallel, two arms, superiority trial with 15 months of follow‐up. Participants will be randomized to either the intervention group (teleconsultations) or the active control group (SMSs).
Methods
A total of 428 participants will be randomized in a 1:1 ratio to one of the two arms and followed up during 9 months. The teleconsultations group will receive nurse‐led personalized advice, while the SMSs group will receive 4–5 brief SMSs a week. Participants in both groups will receive evidence‐based recommendations for diet and physical activity (PA). Outcome measures will be collected at baseline, months 4 and 9 and at month 15, to evaluate post‐intervention effects.
Discussion
Prevention of diabetes through the implementation of lifestyle interventions remains an important priority. The current pandemic situation has magnified its urgency as it heavily affected the functionality of the healthcare system. Moreover, it created the need of remotely delivering preventative interventions. This study will provide insights on the effectiveness and feasibility of a telephone‐based intervention led by nurses in the amelioration of risk factors associated with diabetes.
Impact
Findings from this study will offer health services decision‐makers sound evidence regarding an alternative method to face‐to‐face consultations that could be practical, acceptable and inexpensive, and that concretely answers the need for easily implementable prevention strategies.
Trial Registration
NCT04735640 (ClinicalTrials.gov identifier).
Protocol version
V1.0, 18/02/2021.
Because the accurate measure of body fat (BF) is difficult, several prediction equations have been proposed. The aim of this study was to compare different multiple regression models to predict BF, ...including the recently reported CUN-BAE equation.
Multi regression models using body mass index (BMI) and body adiposity index (BAI) as predictors of BF will be compared. These models will be also compared with the CUN-BAE equation. For all the analysis a sample including all the participants and another one including only the overweight and obese subjects will be considered. The BF reference measure was made using Bioelectrical Impedance Analysis.
The simplest models including only BMI or BAI as independent variables showed that BAI is a better predictor of BF. However, adding the variable sex to both models made BMI a better predictor than the BAI. For both the whole group of participants and the group of overweight and obese participants, using simple models (BMI, age and sex as variables) allowed obtaining similar correlations with BF as when the more complex CUN-BAE was used (ρ = 0:87 vs. ρ = 0:86 for the whole sample and ρ = 0:88 vs. ρ = 0:89 for overweight and obese subjects, being the second value the one for CUN-BAE).
There are simpler models than CUN-BAE equation that fits BF as well as CUN-BAE does. Therefore, it could be considered that CUN-BAE overfits. Using a simple linear regression model, the BAI, as the only variable, predicts BF better than BMI. However, when the sex variable is introduced, BMI becomes the indicator of choice to predict BF.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Several studies have shown an association between personality and health status. The aim of this study was to evaluate the association between personality traits, parental education and ...health-related lifestyles in a cohort of Spanish adolescents. This is a longitudinal study with a source population of 1,123 third-year students (aged 14-15) in secondary schools in Spain. At the baseline evaluation sociodemographic variables, parental education and personality (Big Five Questionnaire for Children) were collected. At 18 months of follow-up health related lifestyles, including adherence to a healthy diet (KidMed index), tobacco and alcohol consumption, physical exercise, sleep problems and recreative screen and social network time were collected. A total of 824 adolescents (73.4%) completed the 18 months assessment and 695 (84.3%) presented valid data. Higher conscientiousness was associated to a lower risk for non-adherence to Mediterranean diet (OR = 0.7, 95% CIs=0.5-0.9), tobacco (OR = 0.5, 95% CIs=0.3-0.7) and alcohol consumption (OR = 0.6, 95% CIs=0.5-0.8), excessive use of screens (OR = 0.7, 95% CIs=0.5-0.9) and social network sites (OR = 0.7, 95% CIs=0.5-0.8). Higher levels of extraversion was significantly related to a lower risk of physical inactivity (OR = 0.7, 95% CIs=0.6-0.9), but they are at a higher risk of low adherence to Mediterranean diet (OR = 1.3, 95% CIs=1.0-1.7), tobacco (OR = 2.7, 95% CIs=1.7-4.3) and alcohol consumption (OR = 1.9, 95% CIs=1.5-2.4) and excessive use of social network sites (OR = 1.6, 95% CIs=1.3-1.9). High levels of emotional instability were associated with tobacco consumption (OR = 1.5, 95% CIs=1.0-2.2) and sleep problems (OR = 2.0, 95% CIs=1.5-2.7). Finally, we found an association with lower parental education and adolescents' low adherence to Mediterranean diet (OR = 1.6, 95% CIs=1.0-2.4) and sleep problems (OR = 1.8, 95% CIs=1.0-3.0). Cluster analysis of health-related behaviours indicated the presence of two different clusters (unhealthy and healthy adolescents) that were associated with personality traits. Conscientiousness, extraversion, emotional instability and parental education are independent factors associated with the acquisition of adolescent healthy lifestyles.
Objective
There is some controversy about the beneficial effects of occupational physical activity (OPA) on cardiovascular risk (CVR). The main aim of this study was to explore the effect of the ...combination of different frequencies of leisure-time physical activity (LTPA) and two types of OPA on CVR and body composition, and whether the association between physical activity (PA) and CVR was mediated by visceral adipose tissue (VAT).
Methods
This cross-sectional study included data from 2516 couriers living in Spain, delivering either by motorbike or foot, and practicing LTPA never, occasionally, or regularly. Couriers were classified into six categories according to LTPA and OPA; body composition was assessed by Bioelectrical Impedance, and CVR by the Framingham equation. General linear models were performed to explore the association between different categories with each outcome (CVR and body composition) and the possible role of VAT as a mediator between PA and CVR.
Results
Compared with the most sedentary group (motorbike couriers that never practice PA), walking couriers who practice regular PA presented the lowest CVR β −1.58 (95% CI −2.31; −0.85) and the lowest VAT β −2.86 (95% CI −3.74; −1.98) followed by the motorbike couriers who practiced regular PA β −0.51 (95% CI −1.00; −0.03) for CVR and β −2.33 (95% CI −2.91; −1.75) for VAT. The association between PA and CVR was partially mediated by VAT.
Conclusion
The present results indicated that both OPA and LTPA are protective factors for CVR and play an important role on VAT accumulation.
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