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
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.
Background
Numerous studies have shown the beneficial effects of exercise on glycemic control in people with prediabetes. However, the most effective exercise modality for improving glycemic control ...remains unclear. We aimed to assess which exercise training modality is most effective in improving glycemic control in a population with prediabetes.
Methods
We conducted searches in Pubmed/MEDLINE, EMBASE, SPORTDiscus, Web of Science, PEDro, BVS, and the Cochrane Library from inception to June 2022. Included studies reported fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and 2-hour postprandial (2hPP) levels and implemented an exercise program lasting at least 12 weeks in adults with prediabetes. We performed a direct meta-analysis using a random-effects model and a network meta-analysis. Cochran’s Q statistic and the inconsistency I
2
test were used to assess the heterogenicity between studies.
Results
Twenty trials were included, with 15 trials (comprising 775 participants with prediabetes) combined in the meta-analysis, and 13 in the network meta-analysis. The meta-analysis results did not show a statistically significant reduction in fasting plasma glucose (FPG) after aerobic training (AT) intervention compared to a control group (mean (95%CI) difference = -5.18 (-13.48; 3.12) mg/dL, Z=1.22, p=0.22). However, a difference of -7.25 (-13.79; -0.71) mg/dL, p=0.03, in FPG after interval training (IT) intervention was detected compared to a control group. After resistance training (RT) intervention, FPG was significantly lower -6.71 (-12.65,-0.77) mg/dL, Z=2.21, p=0.03, and HbA1c by -0.13 (-0.55, 0.29), p=0.54, compared to the control group. The impact of RT compared to no intervention on 2hPP was not statistically significant (p=0.26). The network meta-analysis did not show statistical significance. Most of the studies presented an unclear risk of bias, and a low and very low-quality of evidence. According to the GRADE criteria, the strength of the body of evidence was low.
Conclusion
Resistance training and IT had demonstrated benefits on glycemic indices, especially on FPG, in a population with prediabetes. Further studies with larger sample sizes and a more robust methodology that compare different types of exercise modalities, frequencies, and durations, are needed to establish a beneficial exercise intervention.
Systematic review registration
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=370688
, identifier CRD42022370688.
Cyberbullying among children and adolescents is a major public health concern. However, research has not yet definitively identified the risk factors associated with cybervictimization. The purpose ...of this study was to determine the association of cybervictimization with use of social networks, personality traits and parental education in secondary students.
The study population consisted of 765 secondary students (56.5% girls) from Majorca (Spain) who were aged 15.99 years (grade 4). The data were from the 16 secondary school centers that participated in the ITACA Project, a multi-center, cluster randomized controlled trial. Cybervictimization was measured by the Garaigordobil Cybervictimization Scale, and the Big Five Questionnaire for Children was used to assess personality traits.
Results showed that 39.9% of the students were cybervictims. Univariate analysis indicated that more girls than boys were cybervictimized (43.1% vs 35.7%). Cybervictims spent more time in social networking sites than non-victims (6 h 30 min vs. 5 h 16 min) and had greater emotional instability (0.16 vs. -0.23) and extraversion (0.11 vs. -0.09) and were less conscientious (- 0.001 vs. 0.20). Multivariable analysis indicated that social networking time was not significantly associated with cybervictimization after controlling for personality traits, but the same personality traits remained significantly associated.
Our findings indicate that cyberbullying is a frequent and relevant problem in adolescents. Big Five personality traits are related with cybervictimization. Possible ways to design interventions include promoting social leisure activities, encourage responsible attitudes and provide stress coping tools.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To evaluate the impact of a psychoeducational, mobile health intervention based on cognitive behavioural therapy and mindfulness‐based approaches on the mental health of healthcare workers at the ...frontline against COVID‐19 in Spain.
Design
We will carry out a two‐week, individually randomized, parallel group, controlled trial. Participants will be individually randomized to receive the PsyCovidApp intervention or control App intervention.
Methods
The PsyCovidApp intervention will include five modules: emotional skills, lifestyle behaviour, work stress and burnout, social support, and practical tools. Healthcare workers having attended patients with COVID‐19 will be randomized to receive the PsyCovidApp intervention (intervention group) or a control App intervention (control group). A total of 440 healthcare workers will be necessary to assure statistical power. Measures will be collected telephonically by a team of psychologists at baseline and immediately after the 2 weeks intervention period. Measures will include stress, depression and anxiety (DASS‐21 questionnaire—primary endpoint), insomnia (ISI), burnout (MBI‐HSS), post‐traumatic stress disorder (DTS), and self‐efficacy (GSE). The study was funded in May 2020, and was ethically approved in June 2020. Trial participants, outcome assessors and data analysts will be blinded to group allocation.
Discussion
Despite the increasing use of mobile health interventions to deliver mental health care, this area of research is still on its infancy. This study will help increase the scientific evidence about the effectiveness of this type of intervention on this specific population and context.
Impact
Despite the lack of solid evidence about their effectiveness, mobile‐based health interventions are already being widely implemented because of their low cost and high scalability. The findings from this study will help health services and organizations to make informed decisions in relation to the development and implementation of this type of interventions, allowing them pondering not only their attractive implementability features, but also empirical data about its benefits.
Clinical trial registration
NCT04393818 (ClinicalTrials.gov identifier).
Approved funding
May 2020.
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.
Health-related lifestyles in young adults are a public health concern because they affect the risk for developing noncommunicable diseases. Although unhealthy lifestyles tend to cluster together, ...most studies have analyzed their effects as independent factors. This study assessed the prevalence, association, and clustering of health-related lifestyles (smoking, alcohol consumption, physical activity, and quality of diet) among university students. This cross-sectional study examined a sample of student participants from the University of the Balearic Islands (n = 444; 67.8% females; mean age: 23.1 years). A self-reported questionnaire was used to assess health-related lifestyles. Men that consumed more alcohol, had less healthy diets, were more likely to be overweight, and performed more physical activity. Women had a higher prevalence of low weight and performed less physical activity. Physical activity had a negative association with time using a computer (OR: 0.85; 95% CI: 0.76, 0.95) and a positive association with adherence to the Mediterranean diet (OR: 1.16; 95% CI: 1.02, 1.32). Adherence to the Mediterranean diet had a negative association with tobacco consumption (OR: 0.52; 95% CI: 0.30, 0.91), and positive associations with having breakfast every day (OR: 1.70; 95% CI: 1.05, 2.76) and consuming more daily meals (OR: 1.43; 95% CI: 1.10, 1.87). Cluster analysis indicated the presence of three distinct groups: Unhealthy lifestyles with moderate risk; unhealthy lifestyles with high risk; and healthy lifestyles with low risk. Health promotion interventions in the university environment that focus on multiple lifestyles could have a greater effect than interventions that target any single lifestyle.
To assess the prevalence of malnutrition in hospitalised adult patients, and to evaluate the accuracy of the most commonly used nutritional screening tools for identifying individuals at risk of ...malnutrition.
A prospective cross-sectional study was conducted on a total of 248 hospitalised patients in internal medicine wards (mean age: 75.2 years; 39.5% females). Nutritional screening was performed within 48 h of admission using the following tools: Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening Tool (NRS-2002), Malnutrition Screening Tool (MST), Short Nutritional Assessment Questionnaire (SNAQ), and Mini Nutritional Assessment Short Form (MNA-SF). The criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were used as the gold standard for defining malnutrition. Patients were also evaluated using the Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Accuracy was determined by examining sensitivity, specificity, and positive and negative predictive values, and diagnostic agreement was determined by calculation of Cohen's kappa (κ). The study is reported as per the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
The ESPEN criteria classified 20.2% of the hospitalised patients as malnourished. Overall, the MUST had the highest sensitivity (80.0%), specificity (74.7%) and positive predictive value (44.4%). For the subgroup of patients aged >65 years, the MNA-SF had high sensitivity (94.4%) but low specificity (39.0%). Based on Cohen's κ, the SGA and GLIM criteria showed low agreement with the ESPEN criteria.
The MUST was the most accurate nutritional screening tool, through the MST is more easily applied in many clinical settings. A comprehensive assessment of malnutrition that considers muscle mass is crucial for the reliable diagnosis of malnutrition.
The present findings underscore the importance of accurate assessment of the malnutrition status of hospitalised patients and the need for a reliable screening tool. No patient or public contribution.
We examined whether personality traits and parental education are associated with smoking initiation in a sample of Spanish secondary school students. Participants, taken from the ITACA study (842 ...adolescents aged 14-15 years), completed a questionnaire assessing personality traits of the Five Factor Model, smoking behaviours and parental education. Multinomial logistic regression models controlling for age and sex were used to determine the independent associations and interactions of personality traits and parental education with risk of ever trying smoking, as well as with being a regular smoker in adolescence. Higher conscientiousness was related to a lower chance of trying smoking at least once (OR = 0.57, 95% CIs = 0.46, 0.71) as well as being a regular smoker (OR = 0.39, 95% CIs = 0.27, 0.55). Higher emotional instability (neuroticism) was associated with higher risk of being in either smoking category (OR = 1.33, 95% CIs = 1.10, 1.60 and OR = 1.76, 95% CIs = 1.31, 2.35, respectively). Higher extraversion was also associated with a higher risk of both types of smoking behaviour (OR = 1.38, 95% CIs = 1.12, 1.70 and OR = 2.43 (1.67, 3.55, respectively). Higher parental education was significantly related to lower risk of being a regular smoker (OR = 0.70, 95% CIs = 0.54, 0.89), but not with trying smoking in the past. Finally, we found no evidence of the interactions between adolescents' personality and parental education in predicting adolescent smoking behaviours. We conclude that personality factors and parental education are important and independent factors associated with smoking behaviour in adolescents.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background Respiratory frequency increases during exacerbations of COPD (ECOPD). We hypothesized that this increase can be detected at home before ECOPD hospitalization. Methods To test this ...hypothesis, respiratory frequency was monitored at home daily for 3 months in 89 patients with COPD (FEV1 , 42.3% ± 14.0%; reference) who were receiving domiciliary oxygen therapy (9.6 ± 4.0 h/d). Results During follow-up, 30 patients (33.7%) required hospitalization because of ECOPD. In 21 of them (70%), mean respiratory frequency increased (vs baseline) during the 5 days that preceded it (from 15.2 ± 4.3/min to 19.1 ± 5.9/min, P < .05). This was not the case in patients without ECOPD (16.1 ± 4.8/min vs 15.9 ± 4.9/min). Receiver operating characteristic analysis showed that 24 h before hospitalization, a mean increase of 4.4/min (30% from baseline) provided the best combination of sensitivity (66%) and specificity (93%) (area under the curve AUC = 0.79, P < .05). Two days before hospitalization, a mean increase of 2.3/min (15% change from baseline) was associated with a sensitivity of 72% and a specificity of 77% (AUC = 0.76, P < .05). Conclusions Respiratory frequency can be monitored daily at home in patients with COPD receiving domiciliary oxygen therapy. In these patients, breathing rate increases significantly days before they require hospitalization because of ECOPD. This may offer a window of opportunity for early intervention.
PDF
