Aims
To analyse the degree of susceptibility to smoking according to gender in students between 12 and 16 years of age and study the role of factors associated with gender and the extended index of ...susceptibility to smoking.
Design
Cross‐sectional study.
Methods
Between November 2019 and March 2020, 12‐ to 16‐year‐old students were recruited from three educational centres in western Spain. Sociodemographic, environmental, social and personal variables were analysed. The value of the extended index of susceptibility to smoking was calculated, and the associations between the students' genders and smoking susceptibility were studied. Multinomial logistic regression was used to study associations between the independent variables and Expanded Susceptibility Index (ESSI) results. The roles of factors in this association were explored through mediation analysis.
Results
A total of 364 students participated in the study (53% females). A total of 79.3% of females and 61.4% of males presented a medium‐high level of the extended index of susceptibility. Females reported greater cigarette use (28% vs. 12.3%), hookah (19.9% vs 9.9%) and alcohol consumption (20.7% risk alcohol consumption). They obtained higher scores on the impulsivity scale in the urgency domain and the negative affect scale. Regardless of other factors, females showed more than double the smoking susceptibility (aOR: 2.05, 95% CI: 1.03–4.07, p = .041). Mediation analysis showed that gender had a total effect on the extended susceptibility index β = .023 (95% CI: 0.07–0.38, p = .01). The effect appeared to be mediated only by having smoking friends (0.08; 95% CI: 0.03–0.15, p = .001).
Conclusions
The greater susceptibility to smoking found in females may be related to a greater influence of smoking among friends.
Impact
These results show that smoking friends have a strong influence among adolescent females; therefore, developing preventive programmes with gender approaches aimed at reducing the influence of these environmental factors would be of interest.
Aims
To evaluate the effectiveness of a brief motivational intervention to increase the breastfeeding duration in the first 6 months postpartum in mothers who began breastfeeding in the first hour ...after birth and to explore the role of general and breastfeeding self‐efficacy in this relationship.
Design
A multi‐centre randomized controlled clinical trial.
Methods
Data were collected from February 2018 ‐ March 2019. Women were randomly assigned to an intervention group that received a brief motivational intervention (N = 44) or a control group that was offered standard education on breastfeeding (N = 44). Survival analysis techniques were carried out with a follow‐up of 6 months. In addition, the roles of breastfeeding and general self‐efficacy in the association between BMI and breastfeeding duration were explored through mediation/moderation analysis.
Results
Among 88 randomized patients (mean age, 32.82 years), 81 (92.04%) completed the trial. The survival analyses of exclusive breastfeeding and breastfeeding (exclusive and non‐exclusive) showed reductions in the risk of abandonment in the intervention group of 63% (aHR: 0.37 0.22–0.60 p < .001) and 61% (aHR: 0.39 0.20–0.78 p = .008), respectively. We found that self‐efficacy acted as a moderator of the effect of brief motivational intervention on breastfeeding self‐efficacy. A discrete indirect effect of brief motivational intervention through increased breastfeeding self‐efficacy was found on breastfeeding duration, with an index of moderated mediation of 0.08 (95% CI: 0.02–0.19). Greater positive variations in the breastfeeding self‐efficacy scores during follow‐up predicted exclusive and non‐exclusive breastfeeding duration.
Conclusion
A brief motivational intervention conducted in the immediate postpartum period increases breastfeeding and exclusive breastfeeding duration in the first 6 months. Although breastfeeding self‐efficacy seems to moderate the effect of brief motivational intervention on the increase in breastfeeding duration, other factors may influence its effectiveness. Further studies could focus on exploring how brief motivational intervention works and whether it also works for pregnant mothers who have not yet decided whether to breastfeed.
Impact
Brief motivational intervention could be introduced as part of routine care of women who begin breastfeeding to improve the low rates of exclusive breastfeeding at 6 months postpartum.
Trial registration
Unique Protocol ID: Moti003; https://ClinicalTrials.gov ID: NCT03357549.
目的
评价对产后1小时开始母乳喂养的产妇在产后前6个月进行短期激励性干预以延长母乳喂养时间的有效性,并探讨一般自我效能感和母乳喂养自我效能感在这一关系中的作用。
设计
多中心随机对照临床试验。
方法
收集了2018年2月至2019年3月期间的数据资料。经随机分配,将产妇分为两组,一组为接受短期激励性干预的干预组(N = 44),另一组为接受母乳喂养标准教育的对照组(N=44)。随访时间6个月,并进行生存分析。此外,通过调解/适度性分析,还探讨了母乳喂养自我效能感和一般自我效能感在体重指数与母乳喂养持续时间二者关系中的作用。
结果
88名随机患者中(平均年龄32.82岁)中有81例(92.04%)完成了试验。纯母乳喂养和母乳喂养(纯母乳喂养和非纯母乳喂养)的生存分析表明,干预组的放弃风险分别降低了63%(aHR: 0.37 【0.22–0.60】 p < .001)和61%(aHR: 0.39【0.20–0.78】 p = .008)。我们发现,自我效能感可调节短期励性干预对母乳喂养自我效能感的影响。通过提高母乳喂养自我效能感,短期励性干预对母乳喂养持续时间具有离散的间接影响,且适度调解指数为0.08(95% CI: 0.02–0.19)。在随访期间,母乳喂养自我效能感评分的正向变化较大,因此可用于预测纯母乳喂养和非纯母乳喂养的持续时间。
结论
产后立即进行短期激励性干预,可延长产后前6个月的母乳喂养和纯母乳喂养时间。虽然母乳喂养自我效能感似乎可调解短期激励性干预措施对增加母乳喂养持续时间的效果,但其他因素也可能会对其有效性产生影响。未来研究可侧重于探讨短期激励性干预的作用方式,以及其是否对尚未决定进行母乳喂养的孕妇有所影响。
影响
可实施短期激励性干预措施,作为开始进行母乳喂养的产妇的日常护理的一部分,以提高产后6个月的纯母乳喂养率。
试验注册
唯一协议编号:Moti003;北美临床试验中心编号:NCT 03357549。
Brief motivational intervention (bMI) is a therapeutic approach that encourages self‐efficacy and may have a positive effect on breastfeeding self‐efficacy (BSE). The purpose of this study was to ...analyze the effectiveness of a bMI in increasing BSE in women who started breastfeeding in the immediate postpartum period and to explore the roles of general self‐efficacy and other baseline variables in this relationship. A randomized, parallel‐group clinical trial was carried out. A bMI was compared with an educational session on breastfeeding. Changes in BSE and its dimensions and the interaction and mediation/moderation of general self‐efficacy and other variables were analyzed. BSE increased in the bMI group from a mean baseline score of 59.14 (±9.35) to 64.62 (±7.91) at 1st month (p < 0.001). An interaction was found in that only women with higher education had an improvement in BSE during the follow‐up period that was attributable to the bMI (mean difference between the bMI and the attention control group: 18.25 (95% confidence interval: 5.86–30.19; p = 0.006). This interaction was not found for the changes produced in the intrapersonal thoughts dimension of BSE, whose scores were higher in the bMI group at 3 and 6 months. General self‐efficacy exerted a moderating effect on the association of bMI with BSE change. The effect of bMI was no longer significant when the general self‐efficacy score was above 84. Thus, bMI is effective in increasing BSE. This effectiveness was limited by the mother's educational level and moderated by baseline general self‐efficacy.
Introduction: The body roundness index (BRI) and a body shape index (ABSI) are novel anthropometric indices established to determine both the amount visceral adipose tissue and body fat. Objective: ...to investigate whether BRI and ABSI are better predictors of hypertension than body mass index (BMI), waist circumference (WC) or waist-to-height ratio (WHtR). Methods: A systematic search was conducted in the Scopus, PubMed and Web of Science databases up until 31 December 2020. Results: The estimated pooled area under curve AUC (95% CI) for BRI 0.67 (0.65–0.70) for the prediction of hypertension were superior to that of ABSI (0.58 (0.56–0.60)), similar to that of BMI 0.67 (0.64–0.69), and lower than those WC 0.68 (0.66–0.70) and WHtR 0.68 (0.66–0.71). Nevertheless, the difference of BRI compared to WC and WHtR in the context of predicting hypertension was non-significant. ABSI was significantly lower (p < 0.05) than BRI, BMI, WC and WHtR. Similar findings were observed with the summary receiver operating characteristic curve (AUC-SROC). There were no significant differences between subgroups according to type of population or diagnostic criteria of hypertension. The diagnostic odds ratio (dORs) proved that increased BRI and ABSI were related with an elevated hypertension risk. Conclusions: BRI and ABSI have discriminatory power for hypertension in adult women and men from different populations. Although, WHtR and WC provided the best performance when assessing hypertension, no significant differences were found for BRI. Finally, BRI was significantly better predictor of hypertension than ABSI.
The relationship between benzodiazepines, opioids and tricyclic antidepressants and trauma is of great importance because of increased consumption and the growing evidence of a positive association ...among older adults. The objective of this study was to determine the effect size of the association between the consumption of psychotropic medications /opioids and falls in patients who have suffered trauma by studying the role of other variables in this relationship.
From 2011 to 2016, the presence of benzodiazepines, opioids and tricyclic antidepressants and other drugs in 1060 patients admitted for trauma at a level I trauma hospital was analysed. Multivariate models were used to measure the adjusted effect size of the association between consumption of benzodiazepines, opioids and tricyclic antidepressants and falls, and the effect of age on this association was studied.
A total of 192 patients tested positive for benzodiazepines, opioids and tricyclic antidepressants, with same-level falls being the most frequent mechanism of injury in this group (40.1%), with an odds ratio of 1.96 (1.40-2.75), p < 0.001. Once other covariates were introduced, this association was not observed, leaving only age, gender (woman) and, to a lesser extent, sensory conditions as variables associated with falls. Age acted as an effect modifier between benzodiazepines, opioids and tricyclic antidepressants and falls, with significant effect sizes starting at 51.9 years of age.
The association between the consumption of benzodiazepines, opioids and tricyclic antidepressants and falls in patients admitted for trauma is conditioned by other confounding variables, with age being the most influential confounding variable.
The use of electronic cigarettes (ECs) is a major problem globally. Susceptibility and curiosity are important factors that develop prior to the onset of substance use, such as ECs, and are therefore ...considered as predictors. Both factors are used to obtain an extended index of susceptibility (ESIe-c), which allows the identification of adolescents who are at risk of starting to use these devices. The aim of this study was to determine the prevalence of EC consumption and to assess the association of possible predictors with susceptibility to use and experimentation with ECs among adolescents. A cross-sectional study was carried out in 377 adolescents (53.0% female). Participants were compared according to their experimentation with ECs. A total of 45.9% had already used electronic cigarettes, and 20.8% were current users. Among those who had not tried electronic cigarettes, 43.3% had a medium-high susceptibility to EC initiation. Consumption among close friends, receiving offers of consumption and alcohol consumption were associated with initiation. There was an inverse association between a medium susceptibility index electronic cigarette score and the consumption of cigarettes and positive affect; on the other hand, the lack of premeditation was associated with a higher susceptibility index score. Intrapersonal factors and social factors seem to influence the ESIe-c and onset of EC use, respectively. The main conclusion in this study is that susceptibility is influenced by intrapersonal factors such as affectivity and impulsivity through the lack of premeditation, and by social factors such as EC consumption by best friends.
Introduction: New anthropometric indices have been developed as an alternative to body mass index (BMI) and waist circumference (WC) to assess body mass and visceral fat. Asymptomatic hyperuricemia ...is considered an independent cardiovascular risk factor. Currently, little is known about the relationship between asymptomatic hyperuricemia and several new anthropometric indices. This study aimed to assess the association between the presence of asymptomatic hyperuricemia and anthropometric indices, both novel and traditional. Methods: This study analyzed 1094 Spanish subjects who consecutively visited the cardiovascular risk consultation of the University Hospital San Pedro de Alcántara of Cáceres, Spain, between June 2021 and September 2022. Anthropometric measures, including traditional and novel indices, were determined. The asymptomatic hyperuricemia group was defined according to serum uric acid levels. Results: All the anthropometric indices studied, including new and traditional, were significantly greater among patients with asymptomatic hyperuricemia, except for WWI. In multiple linear regression analysis, serum uric acid levels were significantly correlated with BMI, WHR, WHtR, AVI, BAI, BRI, CUN-BAE, and WWI but not ABSI or CI. In the univariate analysis, all indices were associated with asymptomatic hyperuricemia (p < 0.05); however, only WHtR (adjusted OR: 2.93; 95% CI: 1.03–8.37; p = 0.044), AVI (adjusted OR: 1.46; 95% CI: 1.04–2.04; p = 0.026), and BRI (adjusted OR: 1.66; 95% CI: 1.19–2.32; p = 0.003) were significantly associated in multivariate analysis. Finally, WHtR, AVI, and BRI provided the largest AUCs. Conclusions: Our findings showed that WHtR, AVI, and BRI were independently positively associated with asymptomatic hyperuricemia and could be good predictors.
Over the last few years, novel anthropometric indices have been developed as an alternative to body mass index (BMI) and other traditional anthropometric measurements to enhance the estimate of fat ...proportion and its relationship to a future cardiovascular event. The purpose of this study was to investigate the association of carotid intima-media thickness (c-IMT) estimated by Doppler ultrasound with current anthropometric indices (traditional and novel).
A cross-sectional study was conducted on a total of 789 Spanish patients. Traditional (BMI, WHR, and WHtR) and new (WWI, AVI, ABSI, BRI, BAI, CUN-BAE, and CI) anthropometric indices were determined, and carotid Doppler ultrasound was performed to evaluate c-IMT (≥0.90 mm).
Most of the anthropometric indices analyzed were significantly higher among patients with pathological c-IMT, except for BMI, BAI, and CUN-BAE. In multiple linear regression analysis, c-IMT was positively related to ABSI, AVI, BRI, CI, and WWI but not to CUN-BAE, BAI, or traditional anthropometric indices. Similarly, in univariate analysis, all indices were associated with a c-IMT of ≥0.90 mm (
< 0.05), except BMI, BAI, and CUN-BAE; however, only ABSI (adjusted OR: 1.61; 95% CI: 1.08-2.40;
= 0.017), CI (adjusted OR: 1.73; 95% CI: 1.15-2.60;
= 0.008), and WWI (adjusted OR: 1.74; 95% CI: 1.14-2.64;
= 0.009) were significantly associated in multivariate analysis. Finally, CI, ABSI, and WWI provided the largest AUC, and BMI and CUN-BAE showed the lowest AUC.
ABSI, CI, and WWI were positively associated with pathological c-IMT (≥0.90 mm), independent of other confounders.
Schooling of children between 0 and 3 years old involves a process of adaptation and increases their exposure to infectious diseases, which leads to school absenteeism. Breastfeeding facilitates the ...development of secure attachment and protects the infant against infections. This study aimed to determine whether breastfeeding facilitates the adaptation of infants between 0 and 3 years old to early childhood center and decreases school absenteeism. A cross-sectional study was carried out by collecting data through a questionnaire, which was filled out by the parents and the childcare professionals. 160 infants participated. 40% of the infants who received infant formula from birth showed dependency behaviors (inconsolable crying or do not leave the caregiver for a long time) at the time of pick-up from the center, compared with 10%, 2.7%, and 2.6% of children breastfed between 0 and 6 months, and more than 6 and 12 months, respectively (
= 0.001). The interquartile range of absenteeism days per episode was 2-3 days for infants fed infant formula versus 1-2 days for those who were breastfed for more than 12 months (
= 0.041). Breastfeeding seems to be associated with fewer dependency behaviors at the time of collection and with fewer days of absence.
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