Effectiveness and process evaluation in obesity and type 2 diabetes prevention programs in children: a systematic review and meta-analysis

Background: Obesity in children is one of the most severe public health challenges of the current century and Type 2 Diabetes Mellitus (T2DM) frequency is also escalating. More so, the importance of process evaluation (PE) in complex interventions is increasingly recognized. The present review, aims to identify the effectiveness in terms of body composition parameters in a generation of articles to prevent obesity and T2DM in children. We hypothesise that those studies reporting PE applying the latest implementation guidelines suggested by the researchers would potentially show positive changes in body composition compared to those not reporting it. Additionally, we will evaluate the implementation degree of PE in those articles considering it and describe the PE subcomponents. Lastly, we aim to assess the intervention target used and its results. Methods: A literature review was performed in parallel by 2 independent reviewers. A final number of 41 studies were selected for inclusion criteria. Results: Meta-analysis of BMI and zBMI found non-significant effects of the proposed interventions. Sub-group analysis revealed only a significant effect in studies which performed PE. Moreover, PE was reported in 42% effective studies and 57% non-effective studies. Fidelity and satisfaction were the most implemented PE subcomponents, although there was a generally low grade of PE use (7/41). The highest proportion of effectiveness (83%) was shown in interventions of physical activity alone while the intervention most used was 3-arm target (diet, PA and BS). Conclusions: Overall, obesity and T2DM prevention studies included in this review are not effective in terms of BMI and zBMI. Those studies performing PE reported to be effective in terms of BMI, while studies not reporting PE did not have positive results in terms of BMI and zBMI. In addition, none of the intervention studies included all PE indicators and most studies, which included PE in their interventions, did not provide full report of the PE components, according to the guidelines used for the present review. PROSPERO registration number: CRD42018093667

Explanatory factors of preferences for domestically-produced versus American-made fiction series

Fiction series broadcasted by TV channels can be domestically-produced or foreign-made. The former may contribute to the definition of a TV channel’s corporate identity. The latter, usually US-made, series tend to have widely recognized quality standards and offer a reasonable guarantee of high audience ratings in the countries to which they are exported. The definition of viewer preferences for home-produced or American-made fiction series is a key issue in this regard. The purpose of this paper is to explore the effect that certain viewer factors may have on preferences for domestically-produced or American-made fiction series in Spain; in specific terms, the variables taken into consideration here are gender, age, educational level, nationality, preferences for TV genres and the perceived quality of television series.-------------------------------------------------------------------------------Según su origen de producción las series de televisión que emiten las cadenas pueden ser de dos tipos; nacionales o extranjeras. Las primeras ayudan a definir la identidad del canal que las produce. Las de producción ajena, en su mayoría americanas, vienen avaladas por unos altos índices de audiencia y unos reconocidos estándares de calidad. Este trabajo trata de definir las preferencias del público por las series de producción nacional o americana. El objetivo de este artículo es explorar el efecto que ciertos factores tienen sobre la audiencia española a la hora de establecer sus preferencias por las series españolas o americanas. Las variables o factores que se han tenido en cuenta para llevar a cabo el mencionado objetivo han sido: género, edad, nivel de educación, nacionalidad, preferencia por géneros de televisión y la calidad percibida de las series

La percepción sobre la calidad de las series televisivas en España: Contraste entre el público y los profesionales

Este artículo contribuye al debate sobre la calidad de los contenidos televisivos. En la ficción televisiva, los estándares de calidad son difícilmente identificables ya que incluyen talento creativo, índices de audiencia y la compleja ecuación coste-beneficio. La mayoría de es- tudios sobre calidad en televisión se centran en la opinión del público y en los estándares profesionales. Sin embargo, pocos contrastan las percepciones de la audiencia y las de los profesionales. Este trabajo supone una primera aportación en esta línea, analizando el caso de tres series de televisión españolas: "Los Serrano", "Cuéntame cómo pasó" y "La familia Mata". // This article contributes to the ongoing debate about quality in television programmes. Pro- duct quality standards in TV drama are not easily identifiable. Here, values come across with creative talent, audience ratings and the costs-revenues complex equation. Most of studies on quality in TV are either focused on audience’s perception or on professional standards. Nevertheless, few of them try to contrast audiences’ and producers’ perceptions. This article is a first contribution in this regard, focusing on the case of three well-known TV series in Spain: "Los Serrano", "Cuéntame cómo pasó" and "La familia Mata"

Tell me the screen you use, and I will tell you the content you watch: The case of Spanish internet users

En els últims anys s’ha multiplicat el nombre de pantalles disponibles per veure continguts audiovisuals. Les llars han passat de tenir un o més televisors a comptar amb una àmplia varietat de dispositius connectats a internet. Aquest fet ha transformat profundament els hàbits de consum audiovisual a Espanya. Així, per exemple, el temps de visionat s’ha incrementat en totes les pantalles, inclosa la televisió convencional, amb una mitjana de quatre hores al dia. El públic jove sobresurt com el perfil que consumeix cada vegada més continguts en pantalles connectades a internet. L’objectiu d’aquest article és analitzar quins dispositius prefereix l’audiència per veure els diferents tipus de continguts —series de ficció, programes d’entreteniment, pel·lícules, notícies i esports—, així com les raons d’aquesta elecció. Per a això, hem tingut en compte els suports següents: televisió intel·ligent, telèfon mòbil, tauleta, ordinador i videoconsola. Entre les conclusions principals destaca que gairebé la meitat dels internautes espanyols veu la televisió a internet, sobretot per mitjà de l’ordinador. Això no obstant, les dades corroboren que els usuaris trien una pantalla o una altra en funció del tipus de contingut. Els resultats d’aquest estudi, basat en una enquesta pròpia, són especialment rellevants per conèixer els nous hàbits de consum audiovisual de la societat espanyola a internet.In recent years, the number and range of screens used to watch audiovisual contents has risen, from the traditional television set to Internet-enabled devices. This fact has profoundly changed audiovisual consumption habits in Spain. Firstly, viewing-times have increased across every platform. For example, in the case of conventional television, the average Spanish person watches four hours per day. Secondly, at the same time, younger audiences in particular are increasingly likely to use Internetenabled screens. The aim of this article is to analyze which screens are preferred by Spanish Internet users, as well as their reasons for doing so when watching different types of TV contents online, such as fiction series, entertainment shows, films, news and sports. In order to carry out this research, the following screens have been taken into account: smart TV, mobile phones, tablets, computers and video consoles. Of the main findings, two in particular may be highlighted in advance: almost half of Internet users watch TV online, and the most frequently used device to do so is the computer —including laptops and netbooks—. A further clear conclusion is that users choose different program genres depending on the screen. The results of this study, based on an original survey carried out online, may prove especially significant in order to discover new consumption habits of the Spanish population on the Internet

On paraquaternionic submersions between paraquaternionic K\"ahler manifolds

In this paper we deal with some properties of a class of semi-Riemannian submersions between manifolds endowed with paraquaternionic structures, proving a result of non-existence of paraquaternionic submersions between paraquaternionic K\"ahler non locally hyper paraK\"ahler manifolds. Then we examine, as an example, the canonical projection of the tangent bundle, endowed with the Sasaki metric, of an almost paraquaternionic Hermitian manifold.Comment: 13 pages, no figure

Effect of Lifestyle Intervention in the Concentration of Adipoquines and Branched Chain Amino Acids in Subjects with High Risk of Developing Type 2 Diabetes: Feel4Diabetes Study

Introduction: The global prevalence of type 2 diabetes (T2D) is increasing rapidly, especially in low- and middle-income countries and has a high number of associated comorbidities. Plasmatic concentrations of branched chain amino acids (BCAA) and retinol-binding protein 4 (RBP4) have been shown to be elevated in T2D subjects in cross-sectional studies. However, the effect of lifestyle community-based interventions on BCAA and RBP4 concentrations has not yet been analyzed. Material and methods: The Feel4Diabetes study is a school and community-based intervention that identified 360 European families with a high risk of developing T2D according to the FINDRISC questionnaire. Families were randomized in control and intervention groups were followed-up from 2016 to 2018. In the Spanish families, the concentration of BCAA and RBP4 was determined in 266 subjects (115 control and 151 intervention group) that attended the three time-point assessments by colorimetric and ELISA reaction, respectively. Results: Baseline BCAA levels showed positive correlations with the FINDRISC score and glucose impairment (baseline glucose, insulin, and glycated hemoglobin), body mass index, and body weight. The participants receiving the community-based intervention showed a significant decrease in glycated hemoglobin and BCAA levels compared to the control group (p = 0.011 and p < 0.001, respectively). However, baseline RBP4 did not show significant correlations with anthropometric and glycemic parameters, and no significant change was observed in anthropometric parameters and RBP4 concentrations throughout the follow-up. Conclusion: A community-based intervention on lifestyle led to a significant reduction in BCAA levels regardless of weight loss. These findings suggest that this interventional approach could be promising in T2D prevention

Determinants of longitudinal changes in cardiometabolic risk in adolescents with overweight/obesity: the EVASYON study

We investigated which determinants (socioeconomic, early life factors, body composition changes, fitness changes and/or physical activity changes) best predicted longitudinal outcomes in cardiometabolic risk profile (Z-score change) in adolescents with OW/OB who underwent a 13-month multidisciplinary lifestyle intervention. A total of 165 adolescents (13-16 y; 46% boys) from the EVASYON study were included. Socioeconomic variables and early life factors were obtained from the medical records. Body composition was assessed using anthropometry. Fitness and physical activity were measured with field-based tests and questionnaires. Cardiometabolic risk factors (fasting glucose, HDL cholesterol, triglycerides, blood pressure and waist circumference) were derived from standard methods in the hospital. Body weight changes, sex and mother''s education were selected in the stepwise process as the most important determinants of changes in cardiometabolic risk profile (R2 = 0.26, p = 0.002; R2 = 0.14, p = 0.013; and R2 = 0.14, p = 0.017, respectively). Both boys and girls showed a lower cardiometabolic risk score with the reduction in body weight (r = 0.535, p = 0.009 and r = 0.506, p = 0.005, respectively). There was no interaction between sex and body weight change (p = 0.614). In conclusion, the simple measure of changes in body weight should be considered to track changes in cardiometabolic risk profile in adolescents with OW/OB

Dairy consumption at snack meal occasions and the overall quality of diet during childhood. Prospective and cross-sectional analyses from the IDEFICS/I.Family cohort

There is scarce information on the influence of dairy consumption between main meals on the overall diet quality through childhood, constituting the main aim of this research. From the Identification and prevention of Dietary-and lifestyle induced health EFfects In Children and infantS (IDEFICS) study, and based on the data availability in each period due to drop outs, 8807 children aged 2 to 9.9 years from eight European countries at baseline (T0: 2007–2008); 5085 children after two years (T1); and 1991 after four years (T3), were included in these analyses. Dietary intake and the Diet Quality Index (DQI) were assessed by two 24 hours dietary recalls (24-HDR) and food frequency questionnaire. Consumption of milk and yogurt (p = 0.04) and cheese (p < 0.001) at snack meal occasions was associated with higher DQI scores in T0; milk and yogurt (p < 0.001), and cheese (p < 0.001) in T1; and cheese (p = 0.05) in T3. Consumers of milk (p = 0.02), yogurt (p < 0.001), or cheese (p < 0.001) throughout T0 and T1 at all snack moments had significantly higher scores of DQI compared to non-consumers. This was also observed with the consumption of cheese between T1 and T3 (p = 0.03). Consumption of dairy products at snack moments through childhood is associated with a better overall diet quality, being a good strategy to improve it in this period

Graft Risk Index After Liver Transplant: Internal and External Validation of a New Spanish Indicator

OBJECTIVES: Scarcity of liver grafts has led to the use of marginal donors, consequently increasing the number of complications posttransplant. To prevent this situation, several indicators have been developed. However, important differences remain among countries. Here, we compared an early-risk liver transplant indicator based on the Spanish Liver Transplant Registry, called the Graft Risk Index, versus the US donor risk index and the Eurotransplant donor risk index. MATERIALS AND METHODS: The new indicator was based on prospectively collected data from 600 adult liver transplants performed in our center. We considered 2 events to compare the indexes: graft survival and rejection-free graft survival, with Cox proportional regression for analyses. Power to predict graft survival was evaluated by calculating the receiver operating characteristic area under the curve. RESULTS: We found no differences between the US and Eurotransplant donor risk indexes in prediction of patients with and without early graft failure. With regard to early survival, only the Graft Risk Index allowed better survival discrimination, in which survival progressively decreased with values = 3 (with probability of graft survival at 1 month of 68%; 95% confidence interval, 46.2-82.5). This increase in risk was significant compared with the standard group (hazard ratio of 10.15; 95% confidence interval, C 3.91- 26.32; P < .001). We calculated powers of prediction of 0.52 (95% confidence interval, 0.43-0.62), 0.54 (95% confidence interval, 0.45-0.65), and 0.69 (95% confidence interval, 0.61-0.77) for donor risk index, Eurotransplant donor risk index, and early Graft Risk Index, respectively. CONCLUSIONS: Neither the US donor risk index nor the Eurotransplant donor risk index was valid for our Spanish liver donation and transplant program. Therefore, an indicator to predict posttransplant graft survival that is adapted to our environment is necessary. This national Graft Risk Index can be a useful tool to optimize donor-recipient matchin

Associations between insulin resistance and three B-vitamins in european adolescents: The HELENA study

Objective: To assess whether adolescents with high body mass index (BMI), or fat mass index (FMI), in combination with insulin resistance (assessed with the Homeostatic Model Assessment [HOMA] index), had also lower blood vitamin B6, folate and vitamin B12 concentrations. Methods and materials: Six hundred and fifteen adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, with data on B-vitamins (both intakes and status), and BMI, FMI, HOMA, were selected. Intakes were assessed by two non-consecutive 24-h recalls. B-vitamins biomarkers were measured by chromatography and immunoassay. Analysis of covariance was applied to elucidate the differences in B-vitamins between combinations of groups defined according to the median of the z-scores of markers of body composition and insulin sensitivity. Results: When considering energy intakes and education of the mother in the model, in females, vitamin B6 intakes were higher in the high BMI/ high HOMA group than in the high BMI-low HOMA group. Similarly, vitamin B6 intakes were higher in the high FMI/high HOMA group than in the low FMI/low HOMA group. Plasma vitamin B12 was significantly lower in males in the high FMI/high HOMA group than in the low FMI/low HOMA group, keeping also significant their trends throughout the groups, a fact that can be observed also for females (p &lt; 0.05). Conclusion: Adolescents with combined higher adiposity and higher HOMA insulin sensitivity showed lower vitamin B12 plasma concentrations. These differences do not seem to be explained by dietary vitamin B12 intake