A qualitative study

Aim To explore the barriers and facilitators perceived by home caregivers regarding their involvement in the home care of people with pressure injuries. Background Although home caregivers are key in the process of caring for people with pressure injuries, little is known about their perceptions regarding their involvement in the same. Methods A qualitative study based on grounded theory involving a theoretical sample of 15 home caregivers of people with pressure injuries within the health district of Puertollano, Spain. Results This study identified three barriers (feminization of care, necessary life adaptations as a home caregiver, and the organization of health services) and three facilitators (the perceived family duty for caring, willingness to provide care, and satisfaction with the care received on behalf of primary care services) associated with caregiver involvement in the home care of pressure injuries. Conclusions The care of a person with pressure injuries is perceived as a duty and requires important adaptations affecting the home caregiver’s personal, social and work life. The emotional closeness and trust that develops between a patient and the primary care staff equals an involvement which, in turn, also has positive results for both the home caregiver and the patient

Stability of the factorial structure of metabolic syndrome from childhood to adolescence: a 6-year follow-up study

Background Metabolic syndrome (MS) is a clustering of cardiometabolic risk factors that is considered a predictor of cardiovascular disease, type 2 diabetes and mortality. There is no consistent evidence on whether the MS construct works in the same way in different populations and at different stages in life. Methods We used confirmatory factor analysis to examine if a single-factor-model including waist circumference, triglycerides/HDL-c, insulin and mean arterial pressure underlies metabolic syndrome from the childhood to adolescence in a 6-years follow-up study in 174 Swedish and 460 Estonian children aged 9 years at baseline. Indeed, we analyze the tracking of a previously validated MS index over this 6-years period. Results The estimates of goodness-of-fit for the single-factor-model underlying MS were acceptable both in children and adolescents. The construct stability of a new model including the differences from baseline to the end of the follow-up in the components of the proposed model displayed good fit indexes for the change, supporting the hypothesis of a single factor underlying MS component trends. Conclusions A single-factor-model underlying MS is stable across the puberty in both Estonian and Swedish young people. The MS index tracks acceptably from childhood to adolescence.This study was supported by grants from the Estonian Ministry of Education and Science (No 0180027 and 0942706) and the Estonian Science Foundation (No 6932 and 6788). The study was also supported by grants from the Stockholm County Council, the Spanish Ministry of Education (EX-2008-0641), the Spanish Ministry of Science and Innovation (RYC-2010-05957), and the Swedish Council for Working Life and Social Research, the Swedish Heart-Lung Foundation (20090635)

Estudio longitudinal de calidad de vida en ancianos de Cuenca. Validez predictiva del cuestionario CVA.

Título. Validez predictiva del cuestionario CVA de calidad de vida en ancianos.Objetivo. Evaluar la validez predictiva del cuestionario CVA y analizar cuál/es de sus 5 dimensiones predice/n mejor los resultados adversos en salud.Diseño. Estudio observacional longitudinal prospectivo.Emplazamiento. Tres zonas básicas de salud de la provincia de Cuenca.Participantes. Quinientos diecinueve individuos mayores de 64 años seleccionados aleatoriamente tomando como marco muestral los domicilios en los que residía al menos una persona mayor de 64 años. Mediciones y resultados principales. A partir del cuestionario CVA se evaluó la calidad de vida de los individuos en 1994 y 2002. En esos 8 años de seguimiento, fallecieron 130 individuos (25%). Se ajustó un modelo de Regresión de Cox en el que se incluyeron como covariables aquellas que en el análisis bivariante mostraron asociación estadística. Se observó que se comportaban como predictores independientes de mortalidad: el índice global del cuestionario (Hazard ratio o HR= 1,07; IC95%= 1,009-1,14); el deterioro en las actividades de la vida diaria (HR= 2,77 IC95%= 1,45-5,31); la edad elevada (HR= 2,94 IC95%= 1,93-4,48); el sexo masculino (HR= 1,7 IC95%= 1,19-2,44) y el deterioro cognitivo (HR= 2 IC95%= 1,26-3,16).Conclusiones. El cuestionario CVA tiene capacidad para predecir mortalidad, siendo las actividades de la vida diaria, la dimensión del cuestionario que mejor la predice.<br /

Self-reported and measured cardiorespiratory fitness similarly predict cardiovascular disease risk in young adults

We aimed to (a) examine the validity and reliability of the International FItness Scale (IFIS) in Spanish young adults and (b) compare the capacity of self-reported vs measured fitness to predict cardiovascular disease (CVD) risk. The study comprised 276 participants (18–30 years). Fitness level (overall and specific components) was both self-reported (IFIS) and measured using standard fitness tests. Total and trunk fat was assessed by dual-energy X-ray absorptiometry. We computed a previously validated metabolic syndrome score. A separate sample of 181 of same age and characteristics fulfilled IFIS twice for reliability purposes. The results of the present study support the validity and reliability of self-reported fitness, as measured by IFIS, in Spanish young adults. Our data also suggest that not only measured cardiorespiratory fitness but also self-reported cardiorespiratory fitness predicts CVD risk, as assessed by adiposity and metabolic syndrome indicators. The associations for muscular fitness (both reported and measured) differed depending on how it was expressed (i.e., absolute vs relative terms). Self-reported fitness, as assessed by IFIS, can be a good alternative when physical fitness cannot be measured in large surveys.Nuestro objetivo fue (a) examinar la validez y confiabilidad de la Escala Internacional de Fitness (IFIS) en adultos jóvenes españoles y (b) comparar la capacidad del fitness autoinformado frente al medido para predecir el riesgo de enfermedad cardiovascular (ECV). El estudio comprendió a 276 participantes (18-30 años). El nivel de condición física (componentes generales y específicos) fue autoinformado (IFIS) y medido mediante pruebas de condición física estándar. La grasa total y del tronco se evaluó mediante absorciometría de rayos X de energía dual. Calculamos una puntuación de síndrome metabólico previamente validada. Una muestra separada de 181 de la misma edad y características cumplió IFIS dos veces para propósitos de confiabilidad. Los resultados del presente estudio respaldan la validez y la fiabilidad del estado físico autoinformado, medido por IFIS, en adultos jóvenes españoles. Nuestros datos también sugieren que no solo la aptitud cardiorrespiratoria medida sino también la aptitud cardiorrespiratoria autoinformada predicen el riesgo de ECV, según lo evaluado por los indicadores de adiposidad y síndrome metabólico. Las asociaciones para la condición física muscular (tanto informadas como medidas) diferían dependiendo de cómo se expresara (es decir, términos absolutos versus relativos). El estado físico autoinformado, según lo evaluado por IFIS, puede ser una buena alternativa cuando el estado físico no se puede medir en encuestas grandes

EVIDENT smartphone app, a new method for the dietary record: comparison with a food frequency questionnaire

Background: More alternatives are needed for recording people’s normal diet in different populations, especially adults or the elderly, as part of the investigation into the effects of nutrition on health. Objective: The aim of this study was to compare the estimated values of energy intake, macro- and micronutrient, and alcohol consumption gathered using the EVIDENT II smartphone app against the data estimated with a food frequency questionnaire (FFQ) in an adult population aged 18 to 70 years. Methods: We included 362 individuals (mean age 52 years, SD 12; 214/362, 59.1% women) who were part of the EVIDENT II study. The participants registered their food intake using the EVIDENT app during a period of 3 months and through an FFQ. Both methods estimate the average nutritional composition, including energy intake, macro- and micronutrients, and alcohol. Through the app, the values of the first week of food recording, the first month, and the entire 3-month period were estimated. The FFQ gathers data regarding the food intake of the year before the moment of interview. Results: The intraclass correlation for the estimation of energy intake with the FFQ and the app shows significant results, with the highest values returned when analyzing the app’s data for the full 3-month period (.304, 95% CI 0.144-0.434; P<.001). For this period, the correlation coefficient for energy intake is .233 (P<.001). The highest value corresponds to alcohol consumption and the lowest to the intake of polyunsaturated fatty acids (r=.676 and r=.155; P<.001), respectively. The estimation of daily intake of energy, macronutrients, and alcohol presents higher values in the FFQ compared with the EVIDENT app data. Considering the values recorded during the 3-month period, the FFQ for energy intake estimation (Kcal) was higher than that of the app (a difference of 408.7, 95% CI 322.7-494.8; P<.001). The same is true for the other macronutrients, with the exception g/day of saturated fatty acids (.4, 95% CI −1.2 to 2.0; P=.62). Conclusions: The EVIDENT app is significantly correlated to FFQ in the estimation of energy intake, macro- and micronutrients, and alcohol consumption. This correlation increases with longer app recording periods. The EVIDENT app can be a good alternative for recording food intake in the context of longitudinal or intervention studies. Trial Registration: ClinicalTrials.gov NCT02016014; http://clinicaltrials.gov/ct2/show/NCT02016014 (Archived by WebCite at http://www.webcitation.org/760i8EL8Q).Spanish Ministry of Science and Innovation and Carlos III Health Institute/European Regional Development Fund (FIS: PI13/00618, PI13/01526, PI13/00058, PI13/01635, PI13/02528, PI12/01474; RETICS: RD12/0005, RD16/0007), Regional Health Management of Castilla and León (GRS 1191/B/15, GRS 909/B/14, GRS 770/B/13), and the Infosalud Foundatio

Role of Physical Activity and Fitness in the Characterization and Prognosis of the Metabolically Healthy Obesity Phenotype: a Systematic Review and Meta-Analysis

The aims of the present article are to systematically review and meta-analyze the existing evidence on: 1) differences in physical activity (PA), sedentary behavior (SB), cardiorespiratory fitness (CRF) and muscular strength (MST) between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO); and 2) the prognosis of all-cause mortality and cardiovascular disease (CVD) mortality/morbidity in MHO individuals, compared with the best scenario possible, i.e., metabolically healthy normal-weight (MHNW), after adjusting for PA, SB, CRF or MST. Our systematic review identified 67 cross-sectional studies to address aim 1, and 11 longitudinal studies to address aim 2. The major findings and conclusions from the current meta-analysis are: 1) MHO individuals are more active, spend less time in SB, and have a higher level of CRF (yet no differences in MST) than MUO individuals, suggesting that their healthier metabolic profile could be at least partially due to these healthier lifestyle factors and attributes. 2) The meta-analysis of cohort studies which accounted for PA (N = 10 unique cohorts, 100% scored as high-quality) support the notion that MHO individuals have a 24-33% higher risk of all-cause mortality and CVD mortality/morbidity compared to MHNW individuals. This risk was borderline significant/non-significant, independent of the length of the follow-up and lower than that reported in previous meta-analyses in this topic including all type of studies, which could be indicating a modest reduction in the risk estimates as a consequence of accounting for PA. 3) Only one study has examined the role of CRF in the prognosis of MHO individuals. This study suggests that the differences in the risk of all-cause mortality and CVD mortality/morbidity between MHO and MHNW are largely explained by differences in CRF between these two phenotypes

Milk and dairy product consumption and cardiovascular diseases: An overview of systematic reviews and meta-analyses

Milk and dairy products containing milk fat are major food sources of saturated fatty acids, which have been linked to increased risk of cardiovascular-related clinical outcomes such as cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Therefore, current recommendations by health authorities advise consumption of low-fat or fat-free milk. Today, these recommendations are seriously questioned by meta-analyses of both prospective cohort studies and randomized controlled trials (RCTs) reporting inconsistent results. The present study includes an overview of systematic reviews and meta-analyses of follow-up studies, an overview of meta-analyses involving RCTs, and an update on meta-analyses of RCTs (2013–2018) aiming to synthesize the evidence regarding the influence of dairy product consumption on the risk of major cardiovascular-related outcomes and how various doses of different dairy products affect the responses, as well as on selected biomarkers of cardiovascular disease risk, i.e., blood pressure and blood lipids. The search strategies for both designs were conducted in the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases from their inception to April 2018. From the 31 full-text articles retrieved for cohort studies, 17 met the eligibility criteria. The pooled risk ratio estimated for the association between the consumption of different dairy products at different dose-responses and cardiovascular outcomes (CVD, CHD, and stroke) showed a statistically significant negative association with RR values <1, or did not find evidence of significant association. The overview of 12 meta-analyses involving RCTs as well as the updated meta-analyses of RCTs did not result in significant changes on risk biomarkers such as systolic and diastolic blood pressure and total cholesterol and LDL cholesterol. Therefore, the present study states that the consumption of total dairy products, with either regular or low fat content, does not adversely affect the risk of CVD.This study was partially funded by the University of Granada Plan Propio de Investigación 2016, Excellence actions: Unit of Excellence on Exercise and Health (UCEES), Plan Propio de Investigación 2018, Programa Contratos-Puente, the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, and European Regional Development Funds (ref. SOMM17/6107/UGR).Peer reviewe

Sleep patterns and sleep problems in a sample of Spanish schoolchildren

Sleep in children is essential for growth, emotional health and cognitive function. Although it has been described that poor sleep can seriously affect learning capacity, this relationship remains unclear. The purposes were to: (1) describe sleep patterns and sleep problems in schoolchildren; and (2) analyze the relationship between sleep quality and quantity and academic achievement. This study included 330 children aged 8–11 years and who had complete sleep data from 20 primary schools in 20 towns from the Cuenca province, Spain. The Spanish version of the Children’s Sleep Habits Questionnaire was used, and parents’ educational level, and academic achievement (final grades) were measured. Analysis of covariance models was used to assess differences in academic achievement by sleep problems and sleep duration categories, controlling for age and parents’ educational level. This study found that 6.1% of the children who participated in our study slept < 9 h/day, and 9.1% of them had sleep problems. Our results showed an inverse trend between sleeping < 9 h/day and having sleep problems with academic achievement, although these differences did not reach statistical significance (p > 0.05). In this study, a considerable proportion of the schoolchildren sleep less than recommended and have sleep problems. Sleep intervention may be important to prevent sleep problems and insufficient sleep in schoolchildren. Further research is needed to clarify the association of sleep insufficiency and problems with academic performance in schoolchildren