Relationship between nutritional status, consumption of non nutritive foods and stress perception in perimenopausal women

La perimenopausia puede afectar el peso corporal, la ingesta alimentaria y el estado anímico de las mujeres. El objetivo de este trabajo fue describir la relación entre estado nutricional, consumo de alimentos no nutritivos y percepción de estrés en mujeres adultas (40-65años) habitantes de Vedia, Provincia de Bs. As (Argentina). Estudio descriptivo transversal, muestra no probabilística a las mujeres, se las clasificó según etapa biológica en pre y postmenopáusicas y se controló el consumo de ansiolíticos. Se evaluó estado nutricional mediante índice de masa corporal (IMC) y riesgo cardio-metabólico (RCM) según circunferencia de cintura (CC). La percepción de estrés (PS) se valoró por escala de estrés percibido (PSS-10). Se estimó el consumo de alimentos no nutritivos, bebidas azucaradas y alimentos ricos en grasas. Se incluyeron 91 mujeres, edad media de 52,1 años (DS= 7,7) (40% premenopáusicas; 60% posmenopáusicas). El 62,6% presentó sobrepeso u obesidad y 70,3% RCM. La media de PS fue 15 puntos (DS= 6,0), siendo mayor en las postmenopáusicas (p= 0,03) y en las que consumían ansiolíticos (p< 0,001). La PS no se asoció al IMC (p= 0,83) ni a la distribución adiposa (p= 0,95). El consumo de alimentos no nutritivos fue similar en ambos grupos, sólo se registró un consumo mayor de chocolates en posmenopáusicas (p= 0,03). Así, el climaterio y la menopausia se deberían abordar por un equipo interdisciplinario, capacitados desde una perspectiva biopsicosocial y no solo desde la óptica clínica.Perimenopause is a critical period that can affect body weight, food intake and mood. Our objective was to describe the relationship between nutritional status, nonnutritive food consumption and perception of psychological stress in adult women (40-65 years old) from Vedia, Province of Buenos Aires (Argentina). A cross-sectional descriptive study was carried out using a non-probabilistic sample. Women were classified according to the biological stage in pre-and postmenopausal and anxiolytic consumption was controlled. Nutritional status was measured by body mass index (BMI) and cardiometabolic risk (CMR) by waist circumference (WC). The perception of stress (PS) was assessed using the PSS-10 scale. Consumption of non-nutritive foods, sugary drinks and high-fat foods was estimated. Ninety-one women were included with a mean age of 52,1 years (SD= 7,7) (40% premenopausal; 60% postmenopause); 62,6% were overweight or obese” and 70,3% had CMR according to WC. The mean of PS for the sample was 15 points (SD= 6,0), which was higher in postmenopausal women (p= 0,03) and in those who consumed anxiolytics (p<0,001). PS was not associated with BMI (p= 0,83) nor with adipose distribution (p= 0,95). The consumption of non-nutritive foods was similar among women in both biological stages, except the consumption of chocolate that was higher in the postmenopausal (p= 0,03). Thus, the climacteric and menopause should be addressed by an interdisciplinary team, trained from a biopsychosocial perspective and not only from a clinical perspective.Fil: Rossi, María Laura. Universidad de Buenos Aires. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Janjetic, Mariana Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Ferreyra, Marina Alexandra. Universidad de Buenos Aires. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Ciccarelli, Maria Albertina. Universidad de Buenos Aires. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Matioli, María. Universidad de Buenos Aires. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Vásquez, Felisa. Universidad de Buenos Aires. Facultad de Medicina. Escuela de Nutrición; ArgentinaFil: Torresani, María Elena. Universidad de Buenos Aires. Facultad de Medicina. Escuela de Nutrición; Argentin

Relación TG/HDL-C y resistencia a la insulina en mujeres adultas argentinas según su estado nutricional

Introduction: The ratio assessment TG/HDL-C is an indicator of LDL size, facilitating the detection of individuals with increased atherogenic risk. Estimating the size of the LDL becomes important, especially in patients with TG values near the upper limit of normal values of reference and HDL-C. The objective of the study is to estimate the association between TG/HDL-C and insulin resistance (IR) by nutritional status in adult women attending the Foundation for Endocrine Metabolic Diseases Research and Applied Clinical Research (FIEEM).Material and methods: Design Cross-sectional, non-pregnant adult women, apparently healthy, older than 30 years old, attending FIEEM in the Autonomous City of Buenos Aires. Dependent variable: TG/HDL-C ≥ 3.0 considered high value. Independent variables: IR by homeostatic model index HOMA-IR ≥ 2.5 categorizing the sample into two groups: with and without IR, and controlled by nutritional status using body mass index (BMI) and waist circumference (CC). SPSS Statistics 15.0, calculating X2 or Fisher exact test, OR with confidence intervals of 95% and establishing logistic regression p value &lt; 0.05.Results: We evaluated a purposive sample of 104 women (31.4% and 26% IR with TG/HDL-C high). 84.6% were overweight or obese and 88.5% increased CC. Women with BMI had significantly increased 0.15-fold increased risk (95% CI = 0.01 to 1.26) for TG/HDL-C high (p = 0.04) than the control women. There was no significance with increased CC. The ratio TG/HDL-C high IR was significantly correlated (r = 0.30 p = 0.002).Conclusions: Body weight was significantly associated with IR and the ratio TG/HDL-C increased. This ratio correlated significantly with IR in apparently healthy women.Introducción: la valoración del índice TG/HDL-C resulta un indicador del tamaño de las LDL, facilitando la detección de individuos con riesgo aterogénico aumentado. El objetivo del estudio fue estimar la asociación entre TG/HDL-C y resistencia a la insulina (RI) según el estado nutricional en mujeres adultas.Material y métodos: diseño descriptivo transversal, de mujeres adultas no embarazadas, y aparentemente sanas, mayores de 30 años de edad, concurrentes a la Fundación para Investigación de Enfermedades Endócrino Metabólicas e Investigación Clínica Aplicada (FIEEM) en la Ciudad Autónoma de Buenos Aires. Variable dependiente: relación TG/HDL-C considerando valor elevado ≥ 3,0. Variables independientes: RI por Índice modelo  homeostático HOMA-IR ≥ 2,5 categorizando a la muestra en dos grupos: con y sin RI, y controladas según el estado nutricional mediante índice de masa corporal (IMC) y circunferencia de la cintura (CC). Estadística con SPSS 15,0, calculando X2 o prueba exacta de Fisher, OR con intervalos de confianza del 95% y regresión logística estableciendo valor p &lt; 0,05.Resultados: se evaluó una muestra intencional de 104 mujeres (31,4% con RI y 26% con TG/HDL-C elevada). El 84,6% presentó sobrepeso u obesidad y el 88,5% CC aumentada. Las mujeres con IMC aumentado presentaron significativamente 0,15 veces (IC 95% = 0,01-1,26; p = 0,04) más riesgo de TG/HDL-C elevada que las mujeres normopeso. No hubo significación con la CC aumentada. La relación TG/HDL-C elevada se correlacionó significativamente con RI (r = 0,30 p= 0,002).Conclusiones: el peso corporal se asoció significativamente con RI y la relación TG/HDL-C aumentada. Esta relación se correlacionó con la RI en mujeres aparentemente sanas

Prevalencia de hipotiroidismo y su asociación con factores de riesgo cardiometabólicos en mujeres adultas argentinas

Introduction: It is known that hypothyroidism is associated with cardiometabolic risk factors (CRF) as well as age, female gender. The main objective was determine the prevalence of hypothyroidism and its association with cardiometabolic risk factors in adult women attending the Foundation for Endocrine Metabolic Diseases Research of the Autonomous City of Buenos Aires, Argentina.Material and Methods: Cross-sectional and observational design. Probabilistic sample of 316 adult women (40-65 years), randomized into two groups: hypothyroid controlled with pharmacological treatment and euthyroid. Variable: the following were studied CRF: body mass index (BMI), normal &lt;25kg/m2 and increased ≥25.0kg/m2; waist circumference (WC) normal ≤88cm and increased &gt;88cm; biological stage (premenopausal and postmenopausal), smoking, sedentary lifestyle; altered lipid profile (TC&gt;200mg/dl; LDL&gt;130mg/dl; Tg&gt;150mg/dl; HDL-c&lt;40mg/dl); HT≥120/80mmHg and increased fasting glucose &gt;100mg/dl. Statistics with SPSS 15.0 establishing measures of central tendency, ANOVA and OR with 95% confidence intervals (CI) and difference of proportions with p&lt;0.05.Results: The 46.2% of the sample were women controlled hypothyroid and euthyroid 53.8%. The 64.2% were postmenopausal, 68% overweight or obese and 45.2% with WC increased. Age was similar in both groups: 53.3 (SD=6.4) years the hypothyroid and 53.9 (SD=6.6) years theeuthyroid. The inactivity was the CFR more prevalent in both groups. The hypothyroid women had a significantly higher risk for BMI increased (OR=0.36; 95%CI=0.21-0.59; p=0.0001) and WC altered (OR=0.53; 95%CI=0.34-0.84; p=0.006) with respect to the euthyroid women.Conclusions: Found a prevalence of hypothyroidism in approximately half of the sample. The altered nutritional status CRF was the only significantly associated with hypothyroidism.Introducción: El hipotiroidismo se asocia con factores de riesgo cardiometabólicos (FRC) además de la edad y del sexo femenino. El principal objetivo fue conocer la prevalencia de hipotiroidismo y su asociación con FRC en mujeres adultas concurrentes a un Centro de Endocrinología de la Ciudad Autónoma de Buenos Aires, Argentina.Material y Métodos: Diseño transversal y observacional en muestra no probabilística de 316 mujeres adultas (40 a 65 años), categorizadas en hipotiroideas controladas con tratamiento farmacológico y eutiroideas. Variables: Se estudiaron los siguientes FRC: Índice Masa Corporal (IMC), &lt;25kg/m2 y ≥25,0Kg/m2; circunferencia cintura (CC) ≤88cm y &gt;88cm; etapa biológica (premenopausia y posmenopausia), tabaquismo, sedentarismo; perfil lipídico alterado (ColT&gt;200mg/dl; LDL-c&gt;130mg/dl; Tg&gt;150mg/dl; HDL-c&lt;40mg/dl); HTA≥120/80mmHg y glucemia basal aumentada &gt;100mg/dl. Estadística con SPSS 15.0 estableciendo medidas de tendencia central, ANOVA y OR con intervalos de confianza 95% (IC) y diferencia de proporciones con valor p&lt;0,05.Resultados: 46,2% hipotiroideas controladas y 53,8% eutiroideas; 64,2% posmenopáusicas; 68% con sobrepeso u obesidad y 45,2% con CC aumentada. La edad fue similar en ambos grupos: 53,3 (DS=6,4) años hipotiroideas y 53,9 (DS=6,6) años eutiroideas. Sedentarismo fue el FRC más prevalente en ambos grupos. Las hipotiroideas presentaron más riesgo de IMC aumentado (OR=0,36 IC95%=0,21-0,59; p=0,0001) y CC alterada (OR=0,53 IC95%=0,34-0,84; p=0,006) que las eutiroideas.Conclusiones: La prevalencia de hipotiroidismo se presentó aproximadamente en la mitad de la muestra. El estado nutricional alterado fue el único FRC asociado significativamente con el hipotiroidismo

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Background Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in \u2018real-world\u2019 services. Methods/Design The Psychosis early Intervention and Assessment of Needs and Outcome (PIANO) trial is part of a larger research program (Genetics, Endophenotypes and Treatment: Understanding early Psychosis - GET UP) which aims to compare, at 9\u2009months, the effectiveness of a multi-component psychosocial intervention versus treatment as usual (TAU) in a large epidemiologically based cohort of patients with FEP and their family members recruited from all public community mental health centers (CMHCs) located in two entire regions of Italy (Veneto and Emilia Romagna), and in the cities of Florence, Milan and Bolzano. The GET UP PIANO trial has a pragmatic cluster randomized controlled design. The randomized units (clusters) are the CMHCs, and the units of observation are the centers\u2019 patients and their family members. Patients in the experimental group will receive TAU plus: 1) cognitive behavioral therapy sessions, 2) psycho-educational sessions for family members, and 3) case management. Patient enrolment will take place over a 1-year period. Several psychopathological, psychological, functioning, and service use variables will be assessed at baseline and follow-up. The primary outcomes are: 1) change from baseline to follow-up in positive and negative symptoms\u2019 severity and subjective appraisal; 2) relapse occurrences between baseline and follow-up, that is, episodes resulting in admission and/or any case-note records of re-emergence of positive psychotic symptoms. The expected number of recruited patients is about 400, and that of relatives about 300. Owing to the implementation of the intervention at the CMHC level, the blinding of patients, clinicians, and raters is not possible, but every effort will be made to preserve the independency of the raters. We expect that this study will generate evidence on the best treatments for FEP, and will identify barriers that may hinder its feasibility in \u2018real-world\u2019 clinical settings, patient/family conditions that may render this intervention ineffective or inappropriate, and clinical, psychological, environmental, and service organization predictors of treatment effectiveness, compliance, and service satisfactio

Tracking the progressive spread of the SARS-CoV-2 Omicron variant in Italy, December 2021 to January 2022

The SARS-CoV-2 variant of concern Omicron was first detected in Italy in November 2021.AimTo comprehensively describe Omicron spread in Italy in the 2 subsequent months and its impact on the overall SARS-CoV-2 circulation at population level.MethodsWe analyse data from four genomic surveys conducted across the country between December 2021 and January 2022. Combining genomic sequencing results with epidemiological records collated by the National Integrated Surveillance System, the Omicron reproductive number and exponential growth rate are estimated, as well as SARS-CoV-2 transmissibility.ResultsOmicron became dominant in Italy less than 1 month after its first detection, representing on 3 January 76.9-80.2% of notified SARS-CoV-2 infections, with a doubling time of 2.7-3.3 days. As of 17 January 2022, Delta variant represented &lt; 6% of cases. During the Omicron expansion in December 2021, the estimated mean net reproduction numbers respectively rose from 1.15 to a maximum of 1.83 for symptomatic cases and from 1.14 to 1.36 for hospitalised cases, while remaining relatively stable, between 0.93 and 1.21, for cases needing intensive care. Despite a reduction in relative proportion, Delta infections increased in absolute terms throughout December contributing to an increase in hospitalisations. A significant reproduction numbers' decline was found after mid-January, with average estimates dropping below 1 between 10 and 16 January 2022.ConclusionEstimates suggest a marked growth advantage of Omicron compared with Delta variant, but lower disease severity at population level possibly due to residual immunity against severe outcomes acquired from vaccination and prior infection

Energy content and carbon emission audit of building materials

The main thesis examined in this research is that "the embedded energy of construction is much more significant than the operational energy for buildings in a tropical country such as Sri Lanka". All building elements (e.g. brickwall), materials (e.g. bricks) and "primitive" raw materials (e.g. clay) are placed in an aggregation-decomposition hierarchy. The process analysis carried out here basically captures most of the energy inputs associated with levels 1 and 2 in the IFIAS (1974) scheme, and accounts for around 90% of the embedded energy in a product. These calculations are based on Tonnes of Oil Equivalent (TOE). The data required to estimate these embedded energies were collected from building materials manufacturers. A computerised database was implemented using a relational database management system. This can be used to represent and calculate the embedded energies and carbon coefficients of building materials and elements that are hierarchically arranged. It can also handle multiple sources of data and perform calculations to give the average, maximum and minimum embedded energies, which are also classified according to fuel type and process stage. Though the analysis was done assuming that the final building is located in the City of Colombo, these database values can be used, with some caution, for buildings even outside the Colombo City or District. The embedded energy requirements were also calculated on the basis of the lowest quality energy (bio-equivalent energy), in addition to the more conventional basis of TOE. According to energy quality calculations carried out (based on efficiency considerations), 1GJ of energy from electricity is equivalent to 5 GJ of biomass energy, 1 GJ of fossil fuel energy is equivalent to 1.8 GJ of biomass energy and 1 GJ of electrical energy is equivalent to 2.78 GJ of fossil fuel energy. It is seen that the price per unit of biomass energy based on the actual prices of products is around one third of the actual price per unit of biomass energy. For fossil fuel and electricity on the other hand, the actual prices of products are much higher than the actual prices of the energy sources used for their production. In order to minimise adverse energy effects and to give a beneficial effect to halting global warming, policy measures to promote timber products are desirable. It is also seen that though materials which use timber fuels (e.g. bricks and tiles) consume more energy, the use of timber fuels is more competitive when compared on a bio-equivalent unit basis. Furthermore, with respect to carbon emissions, wood fuels are considered to be self sustaining. The use of timber, whether as a construction material or a fuel, will require properly planned re-forestation strategies. The energy contribution from walls for a typical two storey house is from 10 - 44%; for a single storey house it is from 29 - 49%. The contribution from roofs for the two storey house is from 4 - 7%, whereas it is 8 - 16% for the single storey house. The contribution from windows is 0.6 - 3% for the single storey house and 0.2 - 4.5% for the two storey. house. The contribution from the floor slab for the two storey house is 6 - 7%. The above ranges are a result of the difference of the between the use of low and high energy materials. The ratio between total embedded energy and annual operational energy for the buildings selected lies between 14 to 35 for the houses while for an office building with air conditioning loading it is 5. Though air conditioning has a large contribution towards the annual operational energy of a building, the total number of air conditioned buildings are small for a developing country such as Sri Lanka. Nevertheless, the results of the analysis show that the focus of energy efficient designs for buildings with air conditioning has to be on the operational energy. On the other hand, for houses, which are largely not air conditioned, the way to promote efficiency is by reducing the embedded energy through the appropriate choice of building materials. This is borne out not only by the high ratio of construction to operational energy ratio obtained, but also by the fact that the ratios for houses with low energy materials is almost half those for the houses with high energy materials. Key Words : Embedded Energy, Process Analysis, Building Materials, Carbon Emissions, Energy Databas

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services