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Marcilla-Toribio I, Moratalla-Cebrián ML, Notario-Pacheco B, Escudero-Lopez MA, Morales-Cuenca N, Martinez-Andres M. Gender differences in symptomatology, socio-demographic information and quality of life in Spanish population with long COVID condition: a cross-sectional study. Front Public Health 2024; 12:1355973. [PMID: 38577278 PMCID: PMC10991816 DOI: 10.3389/fpubh.2024.1355973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/26/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Long COVID patients experience a decrease in their quality of life due to the symptomatology produced by the disease. It is also important to understand how long COVID affects both men and women. The objective of this study is to examine the impact of long COVID symptomatology on the quality of life of Spanish adults from a gender perspective. Methods An observational and cross-sectional study was carried out. Participants were able to complete an online questionnaire using an online platform. A sample of 206 people participated in the study. Results The 80.6% of the sample were women with a mean age of 46.51 (±8.28) and the 19.4% were men with a mean age of 48.03 (±9.50). The medium score in the PAC19-QoL test was 141.47 (±24.96) and segmented by gender, 141.65 (±23.95) for women and 140.82 (±28.66) for men. The most common symptoms in women were muscle and joint pain (94.6%), fatigue (94.0%), discomfort (92.2%), difficulty concentrating (91.0%), and memory loss (88.6%). For men the symptoms included muscle and joint pain (97.5%) and fatigue (97.5%) both occupying first position, discomfort (92.0%), difficulty concentrating (90.0%), mood disturbances (90.0%), and memory loss (87.5%). The chi-square test showed statistical significance (p < 0.005) for socio-demographic information, quality of life scores, and long COVID symptoms by intensities. Conclusion This study shows that there are gender differences in the way that long COVID is experienced.
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Affiliation(s)
- Irene Marcilla-Toribio
- Universidad de Castilla-La Mancha, Centro de Estudios Sociosanitarios, Cuenca, Spain
- Universidad de Castilla-La Mancha, Grupo de Investigación Health, Gender, Social Determinants, Cuenca, Spain
- Universidad de Castilla- La Mancha, Facultad de Enfermería de Albacete, Albacete, Spain
| | - Maria Leopolda Moratalla-Cebrián
- Universidad de Castilla-La Mancha, Grupo de Investigación Health, Gender, Social Determinants, Cuenca, Spain
- Universidad de Castilla- La Mancha, Facultad de Enfermería de Albacete, Albacete, Spain
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Centro de Estudios Sociosanitarios, Cuenca, Spain
- Universidad de Castilla-La Mancha, Grupo de Investigación Health, Gender, Social Determinants, Cuenca, Spain
- Universidad de Castilla-La Mancha, Facultad de Enfermería de Cuenca, Cuenca, Spain
| | - Miguel Angel Escudero-Lopez
- Universidad de Castilla-La Mancha, Grupo de Investigación Health, Gender, Social Determinants, Cuenca, Spain
| | - Nagore Morales-Cuenca
- Universidad de Castilla-La Mancha, Grupo de Investigación Health, Gender, Social Determinants, Cuenca, Spain
- Universidad de Castilla-La Mancha, Facultad de Enfermería de Cuenca, Cuenca, Spain
| | - Maria Martinez-Andres
- Universidad de Castilla-La Mancha, Centro de Estudios Sociosanitarios, Cuenca, Spain
- Universidad de Castilla-La Mancha, Grupo de Investigación Health, Gender, Social Determinants, Cuenca, Spain
- Universidad de Castilla- La Mancha, Facultad de Enfermería de Albacete, Albacete, Spain
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Martí-Lluch R, Bolíbar B, Llobera J, Maderuelo-Fernández JA, Magallón-Botaya R, Sánchez-Pérez Á, Fernández-Domínguez MJ, Motrico E, Vicens-Pons E, Notario-Pacheco B, Alves-Cabratosa L, Ramos R. Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of health services, and mortality (DESVELA cohort): quantitative study protocol for a prospective cohort study in a hybrid analysis. Front Public Health 2023; 11:1067249. [PMID: 37427254 PMCID: PMC10325828 DOI: 10.3389/fpubh.2023.1067249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/26/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals' approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up. Methods This protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC. Discussion The analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
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Affiliation(s)
- Ruth Martí-Lluch
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Parc Hospitalari Martí Julià, Institut d'Investigació Biomèdica de Girona (IDIBGI), Salt, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Bonaventura Bolíbar
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Joan Llobera
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Balearic Islands Health Service (Ib-Salut), Primary Care Research Unit of Mallorca, Palma, Spain
- Hospital Universitari Son Espases, GrAPP-caIB—Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - José A Maderuelo-Fernández
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Salamanca, Spain
- Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Gerencia Regional de salud de Castilla y León (SACyL), Gerencia de Atención Primaria de Salamanca, Salamanca, Spain
| | - Rosa Magallón-Botaya
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Primary Health Care Research Group of Aragón (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Álvaro Sánchez-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Unidad de Investigación Atención Primaria de Bizkaia. Subdirección para la Coordinación de la Atención Primaria, Dirección General Osakiadetza, Vitoria, Spain
- Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios Sanitarios Instituto Investigación Biocruces, Baracaldo, Bizkaia, Spain
| | - Ma José Fernández-Domínguez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Ourense Health Area, SERGAS, Ourense, Spain
- Centro de Saúde de Leiro, SERGAS, Leiro, Spain
- I-Saúde Group, Hospital Álvaro Cunqueiro Bloque Técnico, South Galicia Health Research Institute, Vigo, Spain
| | - Emma Motrico
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Departamento de Psicología, Universidad Loyola Andalucía, Sevilla, Spain
| | - Enric Vicens-Pons
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Parc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu, St Boi de Llobregat, Catalunya, Spain
| | - Blanca Notario-Pacheco
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
- Social and Health Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Lia Alves-Cabratosa
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Rafel Ramos
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Parc Hospitalari Martí Julià, Institut d'Investigació Biomèdica de Girona (IDIBGI), Salt, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Department of Medical Sciences, School of Medicine, Campus Salut, Universitat de Girona, Girona, Spain
- Atenció Primària, Institut Català de la Salut, Girona, Catalonia, Spain
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Saz-Lara A, Lucerón-Lucas-Torres M, Mesas AE, Notario-Pacheco B, López-Gil JF, Cavero-Redondo I. Association between sleep duration and sleep quality with arterial stiffness: A systematic review and meta-analysis. Sleep Health 2022; 8:663-670. [PMID: 36055936 DOI: 10.1016/j.sleh.2022.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/26/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Altered sleep parameters, such as duration and quality, play an important role in the pathogenesis and progression of cardiovascular diseases, as well as in all-cause morbidity and mortality. It has been suggested that the specific mechanisms underlying this association could be through the influence of sleep parameters on vascular markers, such as arterial stiffness (AS), although this remains unclear. Thus, in this meta-analysis, we aimed to assess the association between sleep duration and sleep quality with AS in adults. METHODS PubMed, Scopus, Web of Science and Cochrane Library databases were searched from inception to July 30, 2021. The DerSimonian and Laird method was used to compute pooled effect size estimates and their respective 95% confidence intervals (95% CIs) of the association of sleep duration and sleep quality with AS. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the United States National Institute of Health National Heart, Lung, and Blood Institute was used to assess the risk of bias. RESULTS Finally, 14 studies (8 cross-sectional studies and baseline data from 6 prospective longitudinal studies) involving 97,837 individuals between 18 and 92 years of age were included. Our results showed that increased sleep duration, as continuous values, does not influence AS (effect size [ES]: 0.00; 95% CIs: -0.15, 0.15) in the general population. However, when sleep duration was longer than 8 hours (ES: 0.21; 95% CIs: 0.06, 0.36), according to sleep categories, a significant increase in pulse wave velocity was shown. Poor sleep quality was associated with increased AS (ES: 0.13; 95% CIs: 0.04, 0.21) in the general population. The overall risk of bias for studies examining sleep duration was fair in 77.8% of the included studies and the overall risk of bias for studies examining sleep quality was fair in 55.6%. CONCLUSIONS Our findings showed that both long sleep duration and poor sleep quality were associated with AS in adults. These findings underscore the influence of sleep on vascular health markers, specifically AS, as a possible pathway to explain the increased cardiovascular morbidity and mortality associated with sleep disorders.
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Affiliation(s)
- Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | - Arthur E Mesas
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | | | | | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Talca, Chile
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Fernández-Rodríguez R, Martínez-Vizcaíno V, Mesas AE, Notario-Pacheco B, Medrano M, Heilbronn LK. Does intermittent fasting impact mental disorders? A systematic review with meta-analysis. Crit Rev Food Sci Nutr 2022; 63:11169-11184. [PMID: 35713641 DOI: 10.1080/10408398.2022.2088687] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Accumulating evidence supports the benefits of intermittent fasting (IF) as a dietary strategy for cardiometabolic health and weight control. However, little is known about the potential implications of IF on mental disorders. The aim of this review was to synthesize evidence regarding the effects of IF on mental disorders (depression, anxiety, and mood state) in the general population. We conducted a systematic search in five databases from inception to January 2022. Randomized and nonrandomized clinical trials (RCTs/nonRCTs) were included. A random effects method was used to pool standardized mean differences (SMDs) and 95% CIs. A total of 14 studies involving 562 individuals were included, of which 8 were RCTs and 6 were nonRCTs. IF showed a moderate and positive effect on depression scores when compared to control groups (SMD: 0.41; 95%CI: 0.05 to 0.76; I2=45%; n = 4). Conversely, within-group analyses did not show any significant effect of IF on anxiety (SMD: 0.10; 95%CI: -0.09 to 0.30; I2=0%; n = 5) or mood state (SMD: 0.14; 95%CI: -0.09 to 0.37; I2=59%; n = 7). IF modalities did not negatively impact mental disorders in the general population. In fact, IF showed a positive influence on diminishing depression scores, and did not modify anxiety or mood.
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Affiliation(s)
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla La-Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Arthur E Mesas
- Health and Social Research Center, Universidad de Castilla La-Mancha, Cuenca, Spain
- Health Science Centre, Universidade Estadual de Londrina, Londrina, Brazil
| | | | - María Medrano
- Health and Social Research Center, Universidad de Castilla La-Mancha, Cuenca, Spain
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Leonie K Heilbronn
- Adelaide Medical School, Faculty of Health and Medical Sciences, Adelaide, Australia
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Fernández-Rodríguez R, Álvarez-Bueno C, Martínez-Ortega IA, Martínez-Vizcaíno V, Mesas AE, Notario-Pacheco B. Immediate effect of high-intensity exercise on brain-derived neurotrophic factor in healthy young adults: A systematic review and meta-analysis. J Sport Health Sci 2022; 11:367-375. [PMID: 34481089 PMCID: PMC9189701 DOI: 10.1016/j.jshs.2021.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/09/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although brain-derived neurotrophic factor (BDNF) has been identified as a molecular biomarker of the neurophysiological effects induced by exercise, the acute effects of high-intensity exercise (HIE) on BDNF levels are inconclusive. This study aims to estimate the immediate effects of HIE on BDNF levels in healthy young adults. METHODS A systematic search was conducted in the MEDLINE, Scopus, Cochrane CENTRAL, and SPORTDiscuss databases up to December 2020. Randomized controlled trials (RCTs) and non-RCTs reporting pre-post changes in serum or plasma BDNF after an acute intervention of HIE compared to a control condition were included. Pooled effect sizes (p-ESs) and 95% confidence intervals (95%CIs) were calculated for RCTs using a random effects model with Stata/SE (Version 15.0; StataCorp., College Station, TX, USA). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. PROPERO registration number: CRD42020221047. RESULTS A total of 22 studies with 552 individuals (age range: 20-31 years; 59.1% male) were included. The meta-analysis included 10 RCTs that reported valid outcome data. Higher BDNF levels were observed when HIE interventions were compared with non-exercise (p-ES = 0.55, 95%CI: 0.12-0.98; I2 = 25.7%; n = 4 studies) and light-intensity exercise (p-ES = 0.78, 95%CI: 0.15-1.40; I2 = 52.4%; n = 3 studies) but not moderate-intensity exercise (p-ES = 0.93, 95%CI: -0.16 to 2.02; I2 = 88.5%; n = 4 studies) conditions. CONCLUSION In comparison to non-exercise or light-intensity exercises, an immediate increase in BDNF levels may occur when young adults perform HIE. Given the benefits obtained maximizing circulating BDNF when performing HIE and its potential effects on brain health, our findings suggest that HIE could be recommended by clinicians as a useful exercise strategy to healthy adults.
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Affiliation(s)
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain; Universidad Politécnica y Artística del Paraguay, Asunción 2024, Paraguay.
| | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain; Faculty of Medicine, Universidad Autónoma de Chile, Talca 3460000, Chile
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain; Postgraduate Program in Public Health, Universidad Estadual de Londrina, Londrina 86051-990, Brazil
| | - Blanca Notario-Pacheco
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain
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Saz-Lara A, Bruno RM, Cavero-Redondo I, Álvarez-Bueno C, Notario-Pacheco B, Martínez-Vizcaíno V. Corrigendum: Association Between Arterial Stiffness and Blood Pressure Progression With Incident Hypertension: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:877296. [PMID: 35369327 PMCID: PMC8964452 DOI: 10.3389/fcvm.2022.877296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Rosa María Bruno
- INSERM U970, Paris Cardiovascular Research Centre-PARCC, Université de Paris, Paris, France
- Pharmacology Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Rehabilitation in Health Research Center (CIRES), Universidad de las Américas, Santiago, Chile
- *Correspondence: Iván Cavero-Redondo
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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Álvarez-Bueno C, Cavero-Redondo I, Bruno RM, Saz-Lara A, Sequí-Dominguez I, Notario-Pacheco B, Martinez-Vizcaino V. Intima Media Thickness and Cognitive Function Among Adults: Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc 2022; 11:e021760. [PMID: 35179392 PMCID: PMC9075078 DOI: 10.1161/jaha.121.021760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Carotid structural changes measured by intima media thickness (IMT) have been related to cognitive complaints during aging. Therefore, the aims of this meta‐analysis were (1) to elucidate the relationship between vascular status, measured as IMT, and cognitive domains distinguishing between global cognition, executive functions, memory and attention; and (2) to explore whether demographic (ie, age and sex), clinical (ie, body mass index and IMT baseline values), and procedure characteristics influence this association. Methods and Results We performed a systematic review of MEDLINE (via PubMed), Scopus, and Web of Science databases from their inception to June 2021. Studies meeting the following inclusion criteria were included: (1) the participants were adults; (2) the exposure was carotid IMT; (3) the outcome was cognitive function, including global cognition, executive function, memory, and attention measured using standardized tests; and (4) the study design was cross‐sectional or longitudinal including unadjusted and adjusted analyses. A total of 19 cross‐sectional and 15 longitudinal studies were included and demographic (age and sex), clinical (body mass index and baseline IMT values), and procedure characteristics were analyzed as potential mediator or moderators of the association. Conclusions Our data support negative associations between IMT and cognitive function in cross‐sectional studies. The association between IMT and cognition lost significance in longitudinal studies and when controlling for covariates in cross‐sectional studies. Finally, the strength of these associations seems not to be modified by age, sex, body mass index, and baseline IMT values. This systematic review and meta‐analysis adds to the evidence supporting the use of IMT as a measure for identifying patients at risk of cognitive decline.
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Affiliation(s)
- Celia Álvarez-Bueno
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Universidad Politécnica y Artística del Paraguay Asunción Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Rehabilitation in Health Research Center (CIRES)Universidad de las Americas Santiago Chile
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine University of Pisa Italy.,INSERM U970 and Université de Paris Paris France
| | - Alicia Saz-Lara
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain
| | | | | | - Vicente Martinez-Vizcaino
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Facultad de Ciencias de la Salud Universidad Autónoma de Chile Talca Chile
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Saz-Lara A, Bruno RM, Cavero-Redondo I, Álvarez-Bueno C, Notario-Pacheco B, Martínez-Vizcaíno V. Association Between Arterial Stiffness and Blood Pressure Progression With Incident Hypertension: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:798934. [PMID: 35224042 PMCID: PMC8873377 DOI: 10.3389/fcvm.2022.798934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Arterial stiffness is an independent predictor of cardiovascular and all-cause mortality that is classically regarded as a consequence of arterial hypertension. However, a growing number of studies have shown that arterial stiffness is involved in the pathogenesis and prognosis of arterial hypertension. Thus, in this systematic review and meta-analysis, we aimed to assess whether arterial stiffness, as measured by pulse wave velocity, systolic blood pressure and diastolic blood pressure are associated with incident hypertension. Methods The Scopus, PubMed, Web of Science and Cochrane Library databases were searched from inception to March 30, 2021. The DerSimonian and Laird method was used to compute pooled relative risk estimates and their respective 95% confidence intervals of association between incident hypertension with pulse wave velocity, systolic blood pressure and diastolic blood pressure. Results Our findings provide a synthesis of the evidence supporting that the higher arterial stiffness (RR: 1.09; 95% CIs: 1.05, 1.12), systolic blood pressure (RR: 1.08; 95% CIs: 1.05, 1.10) and diastolic blood pressure (RR: 1.08; 95% CIs: 1.04, 1.12) are associated with incident hypertension in normotensive adult subjects, with similar independent predictive values. However, our results should be interpreted with caution because the meta-analyses performed showed considerable heterogeneity. Conclusions Our results showed that higher pulse wave velocity, systolic blood pressure and diastolic blood pressure are associated with incident hypertension. These findings are of clinical importance, supporting arterial stiffness as an additional tool for the prevention of arterial hypertension and being a fundamental component to reduce cardiovascular morbidity and mortality. Systematic Review Registration This study was registered in PROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=236435 (Registration number: CRD42021236435).
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Affiliation(s)
- Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Rosa María Bruno
- INSERM U970, Paris Cardiovascular Research Centre-PARCC, Université de Paris, Paris, France
- Pharmacology Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Rehabilitation in Health Research Center (CIRES), Universidad de las Américas, Santiago, Chile
- *Correspondence: Iván Cavero-Redondo
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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9
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Guijarro-Herráiz MM, Arias-Palencia NM, Lucas-de la Cruz L, Guijarro-Herráiz B, Notario-Pacheco B, Palomo-Carrión R, García-Klepzig JL, Solera-Martínez M. Alternatives to continuous positive airway pressure treatment in sleep apnoeas and hypopnoeas syndrome related to myofunctional and postural reeducation therapy: protocol for a systematic review. BMJ Open 2021; 11:e049286. [PMID: 34857560 PMCID: PMC8640639 DOI: 10.1136/bmjopen-2021-049286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The main treatment for sleep apnoeas and hypopnoeas syndrome (SAHS) is continuous positive airway pressure (CPAP). However, patients sometimes do not adhere to the treatment protocol. Supplementary and complementary therapies have appeared as alternatives. Some of the therapies which are especially important are those related to myofunctional (MFT) and postural therapy (PT), as all of them are non-invasive, and their application is simpler than that of CPAP. We aim to present a protocol for a systematic review and meta-analysis for investigating new SAHS treatments, including the protocols and frequency of use and the effects they have on patient signs, symptoms and quality of life. METHODS AND ANALYSIS The literature search will be conducted using the Cochrane, Web of Science, Medline (via PubMed) and Scopus databases, from January 2020 to December 2020. All types of studies written in English and Spanish that investigate the use of alternative SAHS treatments related to MFT, or more importantly, the combination of MFT and PRT, will be selected. To evaluate their quality, the Critical Appraisal Checklist for Analytical Cross-Sectional will be applied. The primary factor valued in the studies will be the inclusion of MFT and PT reeducation in the treatment. Subgroup analyses will be carried out evaluating the specific type of treatments chosen and the improvements or deteriorations in the level of health and quality of life in the patients. Finally, several patient-related outcomes, namely sleep quality, quality of life and sleep Apnoeas and Hypoapnoeas Index, will be examined. ETHICS AND DISSEMINATION In this case, ethical approval is not necessary. The data used in the review will be exclusively obtained from published studies, implying there are no privacy concerns. The information obtained will be relevant to understand if the new treatments applied in SAHS are effective, and if postural and MFT therapy used together can be considered an appropriate approach to treat this disease.The results will be published in a peer-reviewed journal.
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Affiliation(s)
| | | | | | | | | | - Rocio Palomo-Carrión
- Faculty of Phsysiotheray, Universidad de Castilla-La Mancha - Campus de Toledo, Toledo, Spain
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Redondo-Tébar A, Ruiz-Hermosa A, Martínez-Vizcaíno V, Martín-Espinosa NM, Notario-Pacheco B, Sánchez-López M. Health-related quality of life in developmental coordination disorder and typical developing children. Res Dev Disabil 2021; 119:104087. [PMID: 34598015 DOI: 10.1016/j.ridd.2021.104087] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 08/27/2021] [Accepted: 09/16/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To analyse: 1) the differences in health-related quality of life (HRQoL) between typically developing (TD) children and children with developmental coordination disorder (DCD) according to parents' and children's perception, and 2) the differences and level of agreement between parents and children's perceptions in HRQoL in both children's samples. METHODS Cross-sectional analysis in 115 Spanish schoolchildren 4-to-7 years. Motor competence and HRQoL were assessed using the MACB-2 and the KINDL-R questionnaire, respectively. RESULTS ANCOVA model showed that children with DCD children obtained lower scores in physical well-being, friends, school and total HRQoL dimensions than TD peers after controlling for covariates (p < 0.05). Moreover, parents' perception scores in HRQoL were lower in children with DCD than in TD peers (79.7 vs 84.8; p = 0.022). Student T-tests for repeated-measures showed non-significant differences between children and parents' perceptions in mean HRQoL scores, by motor competence categories. The intraclass correlations coefficients between parents and children's perception of HRQoL was moderate in DCD category (0.62; p = 0.024) and small in TD category (0.29; p = 0.049). CONCLUSIONS Children under 6 years old with DCD have lower HRQoL scores than their TD peers. No differences were found between children's and parents' perceptions in total HRQoL, although the perceptions of children and parents in DCD category showed a significantly higher level of agreement than TD children. Interventions aimed at promoting motor skills in school settings during the preschool age seem necessary to improve children's quality of life.
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Affiliation(s)
- Andrés Redondo-Tébar
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, España.
| | - Abel Ruiz-Hermosa
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, España; Universidad de Castilla-La Mancha, GENUD Toledo Reseach Group, Toledo, Spain.
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, España; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile.
| | | | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, España; Universidad de Castilla-La Mancha, Facultad de Enfermería, Cuenca, España.
| | - Mairena Sánchez-López
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, España; Universidad de Castilla-La Mancha, Facultad de Educación, Ciudad Real, España.
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Saz-Lara A, Martínez-Vizcaíno V, Sequí-Domínguez I, Álvarez-Bueno C, Notario-Pacheco B, Cavero-Redondo I. The effect of smoking and smoking cessation on arterial stiffness: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2021; 21:297-306. [PMID: 34741612 DOI: 10.1093/eurjcn/zvab102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 09/18/2021] [Accepted: 10/20/2021] [Indexed: 11/13/2022]
Abstract
AIMS One of the most important mechanisms by which smoking contributes to cardiovascular disease is endothelial dysfunction, including arterial stiffness. However, the effects of smoking and smoking cessation on arterial stiffness remain unclear. This meta-analysis aimed to evaluate the effect of smoking and smoking cessation on arterial stiffness in the adult population. METHODS AND RESULTS Random effects models were used to compute pooled estimates of effect size (ES) and their respective 95% confidence intervals (95% CIs) and %change in pulse wave velocity (PWv) (m/s) for the acute and chronic effect of smoking and smoking cessation, and for the effect of smoking cessation vs. the pooled ES estimate for the effect of smoking cessation vs. maintaining this behaviour. Thirteen studies were included in the meta-analysis. Smoking cessation decreased the PWv (ES -0.52, 95% CI -1.02 to -0.03, 3.5% m/s) compared to those maintaining this behaviour. Pooled estimates of both smoking conventional cigarettes and vaping significantly increased the PWv (ES 0.68, 95% CI 0.39-0.98, 10.0% m/s; and ES 0.37, 95% CI 0.14-0.61, 4.7% m/s, respectively). In addition, smoking cessation was effective in reducing arterial stiffness but only in healthy subjects (ES -0.95, 95% CI -1.85 to -0.05, -6.7% m/s). The chronic effect of smoking showed non-significant results on arterial stiffness. CONCLUSION Our results show that arterial stiffness levels decrease after smoking cessation. These findings are of clinical importance, as smoking cessation partially reverses the effects of smoking on arterial stiffness.
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Affiliation(s)
- Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16071 Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16071 Cuenca, Spain.,Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Irene Sequí-Domínguez
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16071 Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16071 Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16071 Cuenca, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16071 Cuenca, Spain.,Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Santiago, Chile
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Martínez-Vizcaíno V, Garrido-Miguel M, Redondo-Tébar A, Notario-Pacheco B, Rodríguez-Martín B, Sánchez-López M. The "Fat but Fit" Paradigm from a Children's Health-Related Quality of Life Perspective. Child Obes 2021; 17:449-456. [PMID: 34009010 DOI: 10.1089/chi.2021.0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The fat but fit paradigm originally argues that the detrimental influence of obesity on cardiovascular risk and mortality could be counterbalanced by normal to high cardiorespiratory fitness (CRF) levels. The aim of the study was to determine whether there is a relationship between categories of the fat but fit conceptual model and health-related quality of life (HRQoL) in children. Materials and Methods: Cross-sectional cluster analyses of the MOVI-daFit! baseline data were conducted in 507 children aged 9 to 11 years in Cuenca, Spain. BMI, body fat percentage, VO2 max estimate, and HRQoL (measured by the KIDSCREEN questionnaire) were assessed. Results: The cluster analysis of BMI/body fat percentage and VO2 max estimate z-scores resulted in a four-cluster solution that fit the four categories included in the fat but fit paradigm: fat unfit (FU), unfat unfit (UU), fat but fit (FF), and unfat fit (UF). Analysis of variance (ANOVA) models showed the expected mean trends by cluster category: an increasing trend (FU<UU<FF<UF) in terms of VO2 max estimate and, conversely, a decreasing trend (FU>FF>UU>UF) in terms of adiposity (p < 0.05). These models also indicated, in the whole sample, that schoolchildren in the FF and UF clusters scored higher on physical well-being, psychological well-being, and total HRQoL scores than their peers in the FU and UU clusters (p < 0.05). The results were similar regardless of gender and whether BMI or body fat percentage was used for clustering. Conclusions: This study reinforces the fat but fit paradigm with respect to a previously unexplored outcome, HRQoL, by indicating that CRF may be mediating in the relationship between obesity and HRQoL. Clinical Trial Registration number: NCT03236337.
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Affiliation(s)
- Vicente Martínez-Vizcaíno
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Medicine, Universidad Autónoma de Chile, Providencia Talca, Chile
| | - Miriam Garrido-Miguel
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Nursing, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Andrés Redondo-Tébar
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Blanca Notario-Pacheco
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Beatriz Rodríguez-Martín
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Health Sciences, Universidad de Castilla-La Mancha, Talavera de la Reina, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
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Saz-Lara A, Cavero-Redondo I, Álvarez-Bueno C, Notario-Pacheco B, Reina-Gutiérrez S, Sequí-Domínguez I, Ruiz JR, Martínez-Vizcaíno V. What type of physical exercise should be recommended for improving arterial stiffness on adult population? A network meta-analysis. Eur J Cardiovasc Nurs 2021; 20:696-716. [PMID: 33837399 DOI: 10.1093/eurjcn/zvab022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/27/2021] [Accepted: 03/10/2021] [Indexed: 12/24/2022]
Abstract
AIMS Physical exercise has been associated with a reduction in arterial stiffness, a subclinical process underlying cardiovascular disease. However, the effect of different types of exercise (aerobic, resistance, combined, interval training, stretching, or mind-body modalities) on arterial stiffness is unclear. This network meta-analysis aimed to examine the effectiveness of different types of exercise on arterial stiffness as measured by pulse wave velocity in adults. METHODS AND RESULTS We searched Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE (via Pubmed), Embase, and Web of Science databases, for randomized clinical trials including at least a comparison group, from their inception to 30 June 2020. A frequentist network meta-analysis was performed to compare the effect of different types of physical exercise on arterial stiffness as measured by pulse wave velocity. Finally, 35 studies, with a total of 1125 participants for exercise intervention and 633 participants for the control group, were included. In the pairwise meta-analyses, the exercises that improved arterial stiffness were: interval training [effect size (ES) 0.37; 95% confidence interval (CI) 0.01-0.73], aerobic exercise (ES 0.30; 95% CI 0.13-0.48) and combined exercise (ES 0.22; 95% CI 0.04-0.40). Furthermore, the network meta-analysis showed that mind-body interventions were the most effective type of exercise to reduce the pulse wave velocity (ES 0.86; 95% CI 0.04-1.69). In addition, combined exercise (ES 0.35; 95% CI 0.08-0.62), aerobic exercise (ES 0.33; 95% CI 0.09-0.57), and interval training (ES 0.33; 95% CI 0.02-0.64) showed significant improvements. CONCLUSION Our findings showed that aerobic exercise, combined exercise, interval training, and mind-body exercises were the most effective exercise modalities for reducing arterial stiffness, assuming an important role in the prevention of cardiovascular diseases.
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Affiliation(s)
- Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain.,Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Av. República 71, Santiago, Chile
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Mayor Sebastián Bullo, 001518 Asunción, Paraguay
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Sara Reina-Gutiérrez
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Irene Sequí-Domínguez
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through physical activity Research Group (PROFITH), Department of Physical Activity and Sports Education, Sport and Health, University Research Institute (iMUDS), Faculty of Sports Science, University of Granada, Crta Alfacar s/n. 18011 Granada, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain.,Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Av. Pedro de Valdivia 425, Talca, Chile
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Saz-Lara A, Álvarez-Bueno C, Martínez-Vizcaíno V, Notario-Pacheco B, Sequí-Dominguez I, Cavero-Redondo I. Are Advanced Glycation End Products in Skin Associated with Vascular Dysfunction Markers? A Meta-Analysis. Int J Environ Res Public Health 2020; 17:ijerph17186936. [PMID: 32972023 PMCID: PMC7559442 DOI: 10.3390/ijerph17186936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 12/22/2022]
Abstract
Evidence exists regarding the association between advanced glycation end products and different cardiovascular disease subclinical processes, such as arterial stiffness and atherosclerosis. With this systematic review and meta-analysis, we aimed to provide a synthesis of the evidence regarding the association of arterial stiffness measured by pulse wave velocity and atherosclerosis measured by carotid intima media thickness with skin autofluorescence. A systematic search was performed using: MEDLINE (PubMed), SCOPUS, and Web of Science, until 30 March 2020. Cross-sectional studies or baseline data from prospective longitudinal studies were considered. The DerSimonian and Laird method was used to calculate the pooled estimates of correlation coefficients and the corresponding 95% confidence intervals (CI) for the association of pulse wave velocity and carotid intima media thickness with skin autofluorescence. Twenty-five studies were included in the systematic review and meta-analysis, including 6306 subjects. The pooled correlation coefficient was 0.25 (95% CI: 0.18, 0.31) for pulse wave velocity and skin autofluorescence, and 0.31 (95% CI: 0.25, 0.38) for carotid intima media thickness and skin autofluorescence. This systematic review and meta-analysis provide a synthesis of the evidence showing a positive weak association of pulse wave velocity and carotid intima media thickness with skin autofluorescence.
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Affiliation(s)
- Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
- Universidad Politécnica y Artística del Paraguay, 001518 Asuncion, Paraguay
- Correspondence:
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 3460000 Talca, Chile
| | - Blanca Notario-Pacheco
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
| | - Irene Sequí-Dominguez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
- Universidad Politécnica y Artística del Paraguay, 001518 Asuncion, Paraguay
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Romero-Gómez B, Guerrero-Alonso P, Carmona-Torres JM, Notario-Pacheco B, Cobo-Cuenca AI. Mood Disorders in Levothyroxine-Treated Hypothyroid Women. Int J Environ Res Public Health 2019; 16:ijerph16234776. [PMID: 31795239 PMCID: PMC6926863 DOI: 10.3390/ijerph16234776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 02/07/2023]
Abstract
Background: Hypothyroidism has several symptoms (weight gain, arrhythmias, mood changes, etc.). The aims of this study were (1) to assess the prevalence of anxiety and depression in levothyroxine-treated hypothyroid women and in women without hypothyroidism; (2) to identify variables associated with anxiety and depression. Methods: A case-control study was performed with 393 women. Case-group: 153 levothyroxine-treated hypothyroid women. Control-group: 240 women without hypothyroidism. Convenience sampling. Instrument: The Hamilton Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. Results: The prevalence of anxiety in levothyroxine-treated hypothyroid women was higher than in women without hypothyroidism (29.4% vs. 16.7%, χ2 p < 0.001). The prevalence of depression in the case group was higher than in the control group (13.1% vs. 4.6%, χ2 p < 0.001). Levothyroxine-treated hypothyroid women were more likely to have anxiety (OR = 2.08, CI: 1.28-3.38) and depression (OR = 3.13, IC = 1.45-6.45). Conclusion: In spite of receiving treatment with levothyroxine, women with hypothyroidism are more likely to have depression and anxiety. Health professionals need to assess the mood of women with hypothyroidism. Although levothyroxine is a good treatment for the symptoms of hypothyroidism, it may not be enough to prevent development or persistence of depression and anxiety by itself.
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Affiliation(s)
- Benjamín Romero-Gómez
- Hospital El Tomillar de Sevilla, Servicio Andaluz de Salud (SAS), 41500 Alcalá de Guadaira, Spain;
| | | | - Juan Manuel Carmona-Torres
- Facultad de Fisioterapia y Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, 45005 Toledo, Spain;
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla la Mancha, 45005 Toledo, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
- Correspondence: ; Tel./Fax: +34-925-268800 (ext. 5819)
| | - Blanca Notario-Pacheco
- Facultad de Enfermería de Cuenca, Universidad de Castilla la Mancha, 16071 Cuenca Toledo, Spain;
- Grupo de Investigación CESS, Universidad de Castilla la Mancha, 16071 Cuenca, Spain
| | - Ana Isabel Cobo-Cuenca
- Facultad de Fisioterapia y Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, 45005 Toledo, Spain;
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla la Mancha, 45005 Toledo, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
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Ubago-Guisado E, Gracia-Marco L, Cavero-Redondo I, Martinez-Vizcaino V, Notario-Pacheco B, Pozuelo-Carrascosa DP, Adalia EG, Álvarez-Bueno C. Effect of different types of exercise on health-related quality of life during and after cancer treatment: a protocol for a systematic review and network meta-analysis. BMJ Open 2019; 9:e031374. [PMID: 31685509 PMCID: PMC6858167 DOI: 10.1136/bmjopen-2019-031374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Cancer (and survival) is known to affect the quality of life. Strategies as physical activity and exercise during and after cancer may improve health-related qualify of life (HRQOL) outcomes and are, therefore, of clinical and public health importance. To the best of our knowledge, comparative evidence of the effect of the different types of exercise on improving HRQOL in cancer patients has not been synthesised thus far. We aim to conduct a systematic review and network meta-analysis in order to synthesise all available evidence regarding the effect of different types of exercise interventions on HRQOL during and after cancer treatment. METHODS AND ANALYSIS MEDLINE (via PubMed), Web of Science, Embase, The Cochrane Library and SPORTDiscus will be searched from inception to December 2018 for relevant randomised controlled trials (RCTs) and non-RCTs. Studies assessing physical activity and exercise interventions in cancer patients (during treatment) and survivors (after treatment) will be selected. Two independent reviewers will identify eligible studies. After quality appraisal and data extraction, we will conduct meta-analyses for outcomes of interest, including data from mental and physical dimensions of cancer-specific and/or generic HRQOL questionnaires. Risk of bias assessments will be completed using the Quality Assessment Tool for Quantitative Studies. Study heterogeneity will be measured by the I2 statistic. Bayesian (and traditional approach) network meta-analysis will be performed when possible to determine the comparative effect of the different physical activity or exercise interventions. ETHICS AND DISSEMINATION This systematic review and network meta-analysis will synthesise evidence on the effect of different types of exercise interventions on HRQOL during and after cancer treatment. The results will be disseminated by publication in a peer-reviewed journal and through scientific conferences and symposia. Ethical approval will not be required because the data used for this work will be exclusively extracted from published studies. PROSPERO REGISTRATION NUMBER CRD42019125028.
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Affiliation(s)
- Esther Ubago-Guisado
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Luis Gracia-Marco
- PROFITH 'PROmoting FITness and Health Through Physical Activity' Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Growth, Exercise, Nutrition and Development Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politecnica y artística del Paraguay, Asunción, Paraguay
| | - Vicente Martinez-Vizcaino
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | | | | | - Esther G Adalia
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politecnica y artística del Paraguay, Asunción, Paraguay
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García-Camacha A, García-Camacha I, Martínez-Andrés M, Notario-Pacheco B, Rodríguez-Martín B. Pilot testing the effectiveness of the Healthy Ageing Supported by Internet and Community programme for promoting healthy lifestyles for people over 65 years of age. Scand J Caring Sci 2019; 34:636-647. [PMID: 31614020 DOI: 10.1111/scs.12765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 08/29/2019] [Indexed: 11/29/2022]
Abstract
Active ageing is associated with physical, social and mental wellbeing, as well as the participation and integration of older people in society. Currently, demographic changes represent a major challenge while reinforcing the need to improve our current understanding of active ageing and promote appropriate interventions suitable for older people. The aim of this pilot study was to evaluate the impact of the Healthy Ageing Supported by Internet and Community training programme for acquiring the knowledge and skills necessary for adopting a healthy lifestyle in community-dwelling adults over 65 years of age. This study was conducted between 2015 and 2016 and was based on a convenience sample of individuals who responded to questionnaires. The study participants comprised all those who were included in the training programme (n = 71, 47 mentors and 24 participants in peer groups). The statistical analysis demonstrated the effectiveness of the programme regarding feasibility and expected results (p < 0.05 for most items, individually, as well as for the total scores of each test dimension). The programme was based on peer group training and the use of information and communication technologies and proved to be effective for acquiring the knowledge and skills necessary for adopting a healthy lifestyle. Furthermore, increased health scores were obtained in the physical, mental and social domains. It could also be beneficial for other groups of older people in order to support their integration into society, enhance their social skills and decrease any feelings of loneliness and rejection.
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Affiliation(s)
| | | | | | | | - Beatriz Rodríguez-Martín
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Talavera de la Reina (Toledo), Spain.,School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Hernández Luengo M, Álvarez-Bueno C, Pozuelo-Carrascosa DP, Berlanga-Macías C, Martínez-Vizcaíno V, Notario-Pacheco B. Relationship between breast feeding and motor development in children: protocol for a systematic review and meta-analysis. BMJ Open 2019; 9:e029063. [PMID: 31530597 PMCID: PMC6756461 DOI: 10.1136/bmjopen-2019-029063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 08/05/2019] [Accepted: 08/12/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The recommendations of most health organisations encourage mothers to keep exclusive breast feeding during the first 6 months and combining breast feeding with complementary feeding at least during the first and second years, due to the numerous immunologic, cognitive developmental and motor skill benefits that breast feeding confers. Although the influence of breast feeding on motor development during childhood has been studied, the findings are inconsistent, and some studies have even reported no effect. This manuscript presents a protocol for a systematic review and meta-analysis, with the aim of reviewing the relationship between breast feeding and motor skill development in children in terms of duration, exclusivity or non-exclusivity of breast feeding. METHODS AND ANALYSIS The search will be conducted using Medline (via PubMed), EMBASE, Web of Science and Cochrane Library from inception to December 2019. Observational studies (cross-sectional and follow-up studies) written in English or Spanish that investigate the association between breast feeding and motor development in children will be included. This systematic review and meta-analysis protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The Critical Appraisal Checklist for Analytical Cross-Sectional Studies and The Newcastle-Ottawa Quality Assessment Scale for longitudinal studies will be used to assess the quality of included studies. The effect of breast feeding on motor skill development will be calculated as the primary outcome. Subgroup analyses will be carried out based on the characteristics of motor skill development and the population included. ETHICS AND DISSEMINATION Ethical approval is not required because the data used will be obtained from published studies, and there will be no concerns about privacy. The findings from this study will be relevant information regarding the association of breast feeding with motor development in children and could be used encourage to improve breastfeeding rates. The results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42018093706.
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Affiliation(s)
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Ciudad Real, Spain
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Sanabria-Martínez G, Poyatos-León R, Notario-Pacheco B, Álvarez-Bueno C, Cavero-Redondo I, Martinez-Vizcaino V. Effects of physical exercise during pregnancy on mothers' and neonates' health: a protocol for an umbrella review of systematic reviews and meta-analysis of randomised controlled trials. BMJ Open 2019; 9:e030162. [PMID: 31519677 PMCID: PMC6747876 DOI: 10.1136/bmjopen-2019-030162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/21/2019] [Accepted: 08/16/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION A growing interest has emerged on the effects of exercise during gestation. Several systematic reviews and meta-analyses have shown that prenatal exercise could reduce the mothers' risk for some disorders. Despite this, evidence regarding the risk of caesarean section, birth weight or Apgar score at delivery is still controversial. Furthermore, practitioners are reluctant to recommend exercise to pregnant women suffering from some disorders, such as hypertension, pre-eclampsia or pregnant women with obesity. Moreover, the scarcity of studies addressing the risks and benefits of exercise at higher intensity prevent practitioners from recommending it at higher dosages. Umbrella reviews represent an appropriate design to elucidate the reasons behind the contradictory findings of previous systematic reviews. METHODS This protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the Cochrane Collaboration Handbook. Medline, EMBASE, Web of Science, Cochrane database of systematic reviews, Epistemonikos, Prospero register and SPORTDiscuss databases will be searched to identify systematic reviews, meta-analyses and randomised controlled trials that examine the effect of exercise on pregnancy outcomes from inception to August 2019. Searches will be conducted from September to November 2019. STATISTICAL ANALYSIS Methodological quality will be evaluated using the AMSTAR 2 tool. The certainty of evidence and strength of recommendations for meta-analyses will be assessed by the Grading of Recommendations Assessment, Development and Evaluation framework. The summary effect sizes will be calculated through the use of random-effects and fixed-effects models. Heterogeneity among studies will be assessed using the I2 statistic, and evidence of excess significance bias and evidence of small study effects will also be evaluated. ETHICS AND DISSEMINATION Ethical approval will not be needed for this review protocol. The results will be disseminated to academic audiences by peer-reviewed publications. Furthermore, results will be disseminated to clinical audiences through professionals' associations and social networks, and may influence guidelines developers in order to improve outcomes in mothers and offspring. PROSPERO REGISTRATION NUMBER CRD42019123410.
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Affiliation(s)
- Gema Sanabria-Martínez
- Hospital Virgen de la Luz, Servicio de Salud de Castilla-La Mancha, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Raquel Poyatos-León
- Hospital Virgen de la Luz, Servicio de Salud de Castilla-La Mancha, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Vicente Martinez-Vizcaino
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autonoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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Pascual-Morena C, Martínez-Vizcaíno V, Álvarez-Bueno C, Pozuelo-Carrascosa DP, Notario-Pacheco B, Saz-Lara A, Fernández-Rodriguez R, Cavero-Redondo I. Exercise vs metformin for gestational diabetes mellitus: Protocol for a network meta-analysis. Medicine (Baltimore) 2019; 98:e16038. [PMID: 31232936 PMCID: PMC6636956 DOI: 10.1097/md.0000000000016038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The purpose of this protocol is to provide a network meta-analysis methodology that compares the effects of metformin and physical exercise in the prevention and treatment of gestational diabetes mellitus (GDM) and its associated fetal and maternal morbidity. METHODS AND ANALYSIS This protocol conforms to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the recommendations of the Cochrane Collaboration Handbook. An electronic search will be conducted in MEDLINE, EMBASE, Web of Science and the Cochrane Library, from the inception until July 2019. There will be no language restrictions. The Cochrane Collaboration tool for assessing risk of bias (RoB2) and the quality assessment tool for quantitative studies will be used. The Grading of Recommendations, Assessment, Development and Evaluation scale will be used to evaluate the strength of the evidence. A Bayesian network meta-analysis will be carried out, which allows direct and indirect comparison of the interventions, for the risk of GDM, prematurity, caesarean section, macrosomia, hypertensive disorders, insulin requirement, and differences in basal glucose, maternal weight, and weight of the newborn. DISCUSSION With this protocol, a methodology is established that resolves the limitations of previous meta-analysis. It will be possible to determine the difference of effect between physical exercise and metformin in the main outcomes of the GDM, as well as the type and intensity of the exercise, and the dose of metformin, more effective. ETHICS AND DISSEMINATION The data included in the network meta-analysis will be obtained from trials that meet accepted ethical standards and the Declaration of Helsinki. The results will be published in a peer-reviewed journal. The evidence obtained could be included in the guidelines of clinical practice in pregnancy. STRENGTHS AND LIMITATIONS A comprehensive methodology is established for the analysis, through network meta-analysis, of the comparative efficacy of metformin and physical exercise in gestational diabetes mellitus. The results obtained could help medical professionals by establishing the best evidence-based interventions which may be recommended for these population groups. REGISTRATION NUMBER PROSPERO CRD42019121715.
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Affiliation(s)
- Carlos Pascual-Morena
- Universidad de Castilla – La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla – La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Celia Álvarez-Bueno
- Universidad de Castilla – La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | | | - Alicia Saz-Lara
- Universidad de Castilla – La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | - Iván Cavero-Redondo
- Universidad de Castilla – La Mancha, Health and Social Research Center, Cuenca, Spain
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Martínez-Vizcaíno V, Cavero-Redondo I, Saz-Lara A, Pozuelo-Carrascosa DP, Notario-Pacheco B, Gómez-Marcos MA, Álvarez-Bueno C. Comparative effect of statins and types of physical exercise on arterial stiffness: Protocol for network meta-analysis. Medicine (Baltimore) 2019; 98:e15484. [PMID: 31096447 PMCID: PMC6531074 DOI: 10.1097/md.0000000000015484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The purpose of this study protocol is to provide the methodology for a review to compare the effect of statins vs physical exercise interventions and the effect of different types of physical exercise, on reducing arterial stiffness associated with cardiovascular diseases and mortality. METHODS AND ANALYSIS The literature search will be conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases from their inception until July 31, 2019. We will include randomized controlled trials, nonrandomized experimental studies, and controlled pre-post studies assessing the effect in the general population of statins and physical exercise interventions on arterial stiffness measured by pulse wave velocity. The Cochrane Collaboration's tool and the Quality Assessment Tool for Quantitative Studies will be used to assess the risk of bias for studies included in the systematic review. A Bayesian network meta-analysis will be carried out to determine the comparative effect of the different physical exercise interventions and/or statin intervention. ETHICS AND DISSEMINATION This study will generate evidence about the effectiveness of both statins and exercise on reducing arterial stiffness that potentially can be transferred to patients and practitioners. Moreover, in light of the importance of reducing arterial stiffness for preventing cardiovascular disease, the evidence provided by this study will be potentially suitable to be included in cardiovascular clinical practice guidelines. STRENGTHS AND LIMITATIONS This protocol describes the methods of a study examining, using network meta-analysis strategies, the efficacy of statins and different types of exercise on improving arterial stiffness, which is an early marker of atherosclerosis. The results of this study could immediately help clinicians to recommend the best evidence-based intervention to their patients to reduce arterial stiffness and, as a consequence, prevent major complications, such as heart failure, stroke, or myocardial infarction. TRIAL REGISTRATION NUMBER PROSPERO CRD42019123120.
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Affiliation(s)
- Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | | | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center. Health Service of Castilla y León (SACYL), Primary Care Prevention and Health Promotion Research Network (REDIAPP)
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
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Parra-Fernandez ML, Rodríguez-Cano T, Perez-Haro MJ, Onieva-Zafra MD, Fernandez-Martinez E, Notario-Pacheco B. Structural validation of ORTO-11-ES for the diagnosis of orthorexia nervosa, Spanish version. Eat Weight Disord 2018; 23:745-752. [PMID: 30196527 PMCID: PMC6244547 DOI: 10.1007/s40519-018-0573-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The ORTO-11-ES questionnaire is a tool to assess the pathological obsession displayed by some individuals regarding healthy eating. The aims of this study were (1) to confirm the factor structure of the Spanish version of ORTO-11-ES using confirmatory factor analysis (CFA) and (2) to examine the possible association between the ORTO-11-ES score, gender and body mass index (BMI). METHODS The sample comprised 492 students from the University of Castilla la Mancha, Spain. Of these, 280 were women (56.9%). Participants were surveyed using the ORTO-11-ES questionnaire. RESULTS The confirmatory factor analysis (CFA) supported the 11 elements and 3 domains of this tool as the better fitting model; for the Comparative Fit Index (CFI) and the Tucker-Lewis Index (TLI), the values were 0.94 and 0.91, respectively, and the Root Mean-Square Error of Approximation (RMSEA) was 0.058. The tendency towards orthorexic behavior is more associated with the female gender. The BMI had no influence on the tendency for ON. CONCLUSIONS This study is the first attempt to confirm the three-factor structure of a Spanish version of the ORTO-15 questionnaire. These findings suggest that the ORTO-11-ES may be a valuable tool for identifying subjects with specific eating behavior patterns. This information may be useful for health professionals involved in the research, development and implementation of interventions catered to individuals suffering from this eating disorder. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
| | | | - Maria José Perez-Haro
- Biostatech Advice, Training and Innovation in Biostatistics, S.L Santiago de Compostela, A Coruña, Spain
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Lucas-de la Cruz L, Martínez-Vizcaíno V, Cañete García-Prieto J, Arias-Palencia N, Diez-Fernandez A, Milla-Tobarra M, Notario-Pacheco B. Movement behaviors and cardiometabolic risk in schoolchildren. PLoS One 2018; 13:e0207300. [PMID: 30427939 PMCID: PMC6235312 DOI: 10.1371/journal.pone.0207300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/29/2018] [Indexed: 11/19/2022] Open
Abstract
Growing evidence has accumulated in recent years showing that movement behaviors have important implications for health in children, especially for cardiovascular health, whose risk factors could track from childhood to adulthood. However, these findings are mixed and inconsistent in children. The aim of this study was to examine the relationship between different movement behaviors (sedentary behavior, physical activity and sleep duration) and cardiometabolic risk in schoolchildren. The study shows cross-sectional results of baseline measurement from 146 Spanish schoolchildren, aged 8-to-11 years old, participating in the MOVI-2 study. Movement behaviors were determined using accelerometry combined with self-reported sleep time. Cardiometabolic risk was assessed using a validated metabolic syndrome index. Logistic regression analysis showed that higher levels of vigorous physical activity (OR = 0.110, p = 0.004) and sleeping more than 9 hours (OR = 0.269, p = 0.015) could be protective factors against metabolic syndrome risk in children. ANCOVA analysis showed associations between vigorous physical activity and waist circumference (p < 0.001), and sleep time with insulin resistance (p = 0.017) and lipid profile (p = 0.035). No association was observed between light and moderate physical activity, sedentary behavior and metabolic syndrome (index and components). No statistically significant differences were found for blood pressure and any of the movement behaviors. Our data suggest that both the amount of vigorous physical activity accumulated and sleep duration are independently associated with higher cardiometabolic risk in children.
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Affiliation(s)
- Lidia Lucas-de la Cruz
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Jorge Cañete García-Prieto
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, Spain
- Universidad de Castilla-La Mancha, Faculty of Nursing, Albacete, Spain
| | - Natalia Arias-Palencia
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, Spain
- Universidad de Castilla-La Mancha, Faculty of Education, Cuenca, Spain
| | - Ana Diez-Fernandez
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, Spain
- * E-mail:
| | - Marta Milla-Tobarra
- Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, Universidad de Castilla-La Mancha, Cuenca
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Social and Health Research Center, Cuenca, Spain
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Parra-Fernández ML, Rodríguez-Cano T, Onieva-Zafra MD, Perez-Haro MJ, Casero-Alonso V, Fernández-Martinez E, Notario-Pacheco B. Prevalence of orthorexia nervosa in university students and its relationship with psychopathological aspects of eating behaviour disorders. BMC Psychiatry 2018; 18:364. [PMID: 30424750 PMCID: PMC6234674 DOI: 10.1186/s12888-018-1943-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/25/2018] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Orthorexia nervosa (ON) is characterized by an obsession with healthy eating, which may lead to severe physical, psychological and social disorders. It is particularly important to research this problem in populations that do not receive clinical care in order to improve early detection and treatment. OBJECTIVE The aim of this study was to research the prevalence of ON in a population of Spanish university students and to analyze the possible associations between ON and psychological traits and behaviors that are common to ED. METHOD A cross-sectional study with 454 students from the University of Castilla La Mancha, Spain. In total, 295 women and 159 men participated, aged between 18 and 41 years. The ORTO-11-ES questionnaire and the Eating Disorder Inventory (EDI-2) were used for this study. The chi squared test was used to compare the homogeneity among the different groups. RESULTS The scores on the ORTO-11-ES suggested that 17% of students were at risk of ON. The scores on the EDI-2 for the group at risk of ON were significant, compared to the remaining individuals, regarding their drive for thinness (17.1% vs 2.1%), bulimia (2.6% vs 0%), body dissatisfaction (26.3% vs. 12.4%), perfectionism (14.5% vs 4.8%), interoceptive awareness (13.2% vs 1.3%), asceticism (15.8% vs 3.7%) and impulsiveness (9.2% vs 1.9%). DISCUSSION AND CONCLUSION These findings suggest that many of the psychological and behavioral aspects of ED are shared by people who are at risk of ON. Future research should use longitudinal data, examining the temporal relationship among these variables or other underlying variables that may contribute to the concurrence of ED and ON.
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Affiliation(s)
| | | | | | - María José Perez-Haro
- Biostatech Advice, Training and Innovation in Biostatistics, S.L Santiago de Compostela, A Coruña, Spain
| | - Víctor Casero-Alonso
- School of Industrial Engineers, University of Castilla-La Mancha, Ciudad Real, Spain
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Herráiz-Adillo Á, Piñar-Serrano O, Mariana-Herráiz JÁ, Martínez-Vizcaíno V, Pozuelo-Carrascosa DP, Notario-Pacheco B. Physical examination to screen for peripheral artery disease in a defined Primary Care population: A diagnostic accuracy study. Int J Clin Pract 2018; 72:e13253. [PMID: 30222240 DOI: 10.1111/ijcp.13253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/10/2018] [Accepted: 07/31/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Peripheral arterial disease (PAD) is an underdiagnosed prevalent disease which implies high cardiovascular risk. Professionals usually depend on physical examination to screen for PAD. OBJECTIVE To assess the diagnostic accuracy of physical examination to screen for PAD in a rural Primary Care population and to evaluate the nurse-physician level of agreement in pedal pulse palpation. METHODS Diagnostic accuracy study in which two experienced professionals (physician-nurse) prospectively performed pedal pulse palpation (grading as absent, reduced, normal, or bounding), femoral bruit auscultation and calf circumference (index tests) comparing with Doppler ABI (reference test, positive cut-off: 0.9 ≥ ABI ≥ 1.4) in 158 consecutive subjects. INCLUSION CRITERIA presence of diabetes, dyslipidaemia, hypertension, smoking habit (current or former), or age ≥ 65. RESULTS Of 315 legs included, PAD was confirmed in 38 (12.1%) legs. Absent dorsalis pedis (DP) and posterior tibial (PT) pulses were found in 37 (11.7%) and 67 (21.3%) legs, respectively. Regarding nurse evaluation, when a positive test was set if DP or PT were absent (more sensitive cut-off), sensitivity was = 86.8 (95% CI: 74.8-98.9), specificity = 82.7 (95% CI: 78.0-87.3), likelihood ratio+ = 5.01 (95% CI: 3.77-6.67), likelihood ratio- = 0.16 (95% CI: 0.07-0.36), and diagnostic odds ratio (dOR) = 31.5 (95% CI: 11.7-84.8). Age, diabetes, and calcification (ABI ≥ 1.4) influenced the rate of a false negative finding in pedal palpation. Physician-nurse weighted kappa coefficient was = 0.649 (95% CI: 0.599-0.699). The presence of a femoral bruit auscultation had a dOR = 3.8 (95% CI: 1.1-13.1), and a calf circumference <34.55 cm had a dOR = 3.2 (95% CI: 1.6-6.4). CONCLUSIONS AND RELEVANCE In a mainly asymptomatic Primary Care population, pedal pulse palpation was by far the best diagnostic test, with good diagnostic accuracy and inter-rater agreement. In view of a high sensitivity and capacity to rule out the disease, pedal pulse palpation could be performed as a screening test for PAD and individuals at high cardiovascular risk.
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Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Olga Piñar-Serrano
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Cuenca, Spain
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Franquelo-Morales P, Sánchez-López M, Notario-Pacheco B, Miota-Ibarra J, Lahoz-García N, Gómez-Marcos MÁ, Martínez-Vizcaíno V. Association Between Health-Related Quality of Life, Obesity, Fitness, and Sleep Quality in Young Adults: The Cuenca Adult Study. Behav Sleep Med 2018; 16:347-355. [PMID: 27754696 DOI: 10.1080/15402002.2016.1228638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objectives of this study were to examine in university students: (a) the mean differences in the HRQoL among fat mass percentage, cardiorespiratory fitness (CRF) and sleep quality categories; and (b) the independent associations among fat mass percentage, CRF, and sleep quality with HRQoL. PARTICIPANTS 376 students, 18-30 years old, from the University of Castilla-La Mancha in Cuenca, Spain (during 2009-2010). METHOD Cross-sectional study measuring % fat mass (DXA), CRF (20-m shuttle run test), sleep quality (Pittsburgh Sleep Quality Index), and HRQoL (SF-12 questionnaire). RESULTS The mean in Mental Component Summary (MCS) in men (p = .029) was lower in students in upper quartiles of % fat mass than in peers in other categories of % fat mass. Among men, MCS was significantly lower among those in the lowest quartile of CRF (p = .015), and among women, Physical Component Summary (PCS) was significantly lower among those in the lowest quartile of CRF (p = .047). MCS dimension of the HRQoL was lower in both men (p = .001) and women (p < .001) in upper quartiles of sleep quality. Multiple linear regression models showed that in men, CRF was associated with MCS (β = 0.25, p = .031), and sleep quality was associated with PCS (β = -0.24, p = .027) and MCS (β = -0.38, p < .001). In women, CRF was associated with PCS (β = 0.17, p = .018) and sleep quality with MCS (β= -0.44, p < .001). CONCLUSIONS Finally, our findings suggest that, regardless of adiposity and fitness, having good sleep habits may positively influence the quality of life in young adults.
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Affiliation(s)
| | - Mairena Sánchez-López
- b Social and Health Care Research Center, Universidad de Castilla-La Mancha , Cuenca , Spain.,c School of Education, Universidad de Castilla-La Mancha , Ciudad Real , Spain
| | - Blanca Notario-Pacheco
- b Social and Health Care Research Center, Universidad de Castilla-La Mancha , Cuenca , Spain
| | - José Miota-Ibarra
- b Social and Health Care Research Center, Universidad de Castilla-La Mancha , Cuenca , Spain
| | - Noelia Lahoz-García
- b Social and Health Care Research Center, Universidad de Castilla-La Mancha , Cuenca , Spain
| | | | - Vicente Martínez-Vizcaíno
- b Social and Health Care Research Center, Universidad de Castilla-La Mancha , Cuenca , Spain.,e Facultad de Ciencias de la Salud , Universidad Autónoma de Chile , Talca , Chile
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Herráiz-Adillo Á, Cavero-Redondo I, Álvarez-Bueno C, Bidner J, Martínez-Vizcaíno V, Notario-Pacheco B. Spectrum effect and spectrum bias in the oscillometric ankle brachial index to diagnose peripheral arterial disease: Clinical implications. Atherosclerosis 2018. [PMID: 29529395 DOI: 10.1016/j.atherosclerosis.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS The diagnostic performance of the oscillometric ankle brachial index (ABI) to detect peripheral arterial disease (PAD) varies among populations, suggesting a spectrum effect. When this heterogeneity modifies post-test probabilities, a spectrum bias arises. This study evaluates the presence and influence of spectrum effect and spectrum bias on test performance and clinical decisions. METHODS Oscillometric and Doppler ABI were compared in two settings: Primary-Care (333 legs) and Vascular-Service (41 legs). Spectrum effect was assessed using stratification and logistic regression, while spectrum bias was assessed through graphical and statistical tests based on predictive values and likelihood ratios, respectively. RESULTS Across subgroups, sensitivity ranged from 61.5% to 90.9%, and specificity from 81.8% to 99.1%. Logistic regression confirmed a spectrum effect in setting, diabetes, smoking status and age (univariate), and setting and diabetes (multivariate model). The positive likelihood ratio ranged from 5.0 to 89.1 in subgroups, leading to a spectrum bias in diabetic, smoking (both subgroups) and age (both subgroups). Therefore, a positive test ruled in differently the disease across subgroups, with a high rate of false positives in diabetic, smoking and >75-year-old patients. The negative likelihood ratio ranged from 0.09 to 0.39 in subgroups, with significant spectrum bias in Primary-Care patients, non-diabetics and smokers. Thus, in these subgroups, a negative test ruled out the disease with less certainty. CONCLUSIONS Spectrum effect and spectrum bias were found in oscillometric ABI to detect PAD, potentially affecting clinical decisions, especially for positive tests. Information about spectrum variables and the application of specific subgroups indicators are necessary.
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Affiliation(s)
- Ángel Herráiz-Adillo
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain; Health Service of Castilla-La Mancha (SESCAM), Department of Primary Care, Tragacete, Cuenca, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain
| | - Johana Bidner
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain; Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile.
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain
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Lucas-de la Cruz L, Martín-Espinosa N, Cavero-Redondo I, González-García A, Díez-Fernández A, Martínez-Vizcaíno V, Notario-Pacheco B. Sleep patterns and cardiometabolic risk in schoolchildren from Cuenca, Spain. PLoS One 2018; 13:e0191637. [PMID: 29360869 PMCID: PMC5779683 DOI: 10.1371/journal.pone.0191637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/07/2018] [Indexed: 12/11/2022] Open
Abstract
Sleep seems to have a significant influence on the metabolic syndrome (MetS). However, results in this association are still inconsistent in children. The aim of this study was to examine the influence of sleep characteristics in the MetS (index and factors) in Spanish children. Cross-sectional study including a sample of 210 children aged 8-to-11-years belonging to 20 schools from the province of Cuenca, Spain was conducted. Cardiometabolic risk and actigraphy sleep patterns were determined and analysed using correlation coefficients, ANCOVA models and a propensity score derivation model. Overall, children in the lower time in bed category and those who went to bed later (> 23:15h) showed worse values in the cardiometabolic profile and risk index. Differences were observed when the total time in bed was below 9h 15mins. Our study shows that short sleep duration could be a risk factor for cardiometabolic risk in children, and bedtime may independently influence this risk. In addition, our data suggests that children’s sleep hygiene should be incorporated in parenting educational programs.
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Affiliation(s)
- Lidia Lucas-de la Cruz
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- * E-mail:
| | - Alberto González-García
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Ana Díez-Fernández
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Faculty of Nursing, Cuenca, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
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Parra-Fernandez ML, Rodríguez-Cano T, Onieva-Zafra MD, Perez-Haro MJ, Casero-Alonso V, Muñoz Camargo JC, Notario-Pacheco B. Adaptation and validation of the Spanish version of the ORTO-15 questionnaire for the diagnosis of orthorexia nervosa. PLoS One 2018; 13:e0190722. [PMID: 29320545 PMCID: PMC5761893 DOI: 10.1371/journal.pone.0190722] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 12/19/2017] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was the validation and analysis of the psychometric properties of a Spanish translation of the ORTO-15 questionnaire; an instrument designed to assess orthorexia nervosa behavior. Four hundred and fifty-four Spanish university students (65% women) aged between 18 and 51 years (M = 21.48 ± 0.31) completed the Spanish version of ORTO-15 and the Eating Disorders Inventory-2 (EDI-2). The Principal Component Analysis suggested a three-factor structure for the abbreviated 11-item version of the instrument. The internal consistency of the measurement was adequate (Cronbach's alpha = 0.80). The proposed test demonstrated a good predictive capacity at a threshold value of <25 (efficiency 84%, sensitivity 75% and specificity 84%). Our results support the psychometric properties of the proposed Spanish shortened-version of the ORTO-15 as being a reliable tool for assessing orthorexia nervosa. Its use is expected to greatly contribute to a better understanding of the impact of this disorder in Spain.
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Affiliation(s)
| | | | | | - Maria José Perez-Haro
- School of Industrial Engineers, University of Castilla-La-Mancha, Ciudad Real, Spain
| | - Víctor Casero-Alonso
- School of Industrial Engineers, University of Castilla-La-Mancha, Ciudad Real, Spain
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Herráiz-Adillo Á, Soriano-Cano A, Martínez-Hortelano JA, Garrido-Miguel M, Mariana-Herráiz JÁ, Martínez-Vizcaíno V, Notario-Pacheco B. Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study. Blood Press 2017; 27:121-122. [PMID: 29232986 DOI: 10.1080/08037051.2017.1415700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ángel Herráiz-Adillo
- a Department of Primary Care , Health Service of Castilla-La Mancha (SESCAM) , Tragacete , Cuenca , Spain.,b Health and Social Research Center , Universidad de Castilla-La Mancha , Cuenca , Spain
| | - Alba Soriano-Cano
- b Health and Social Research Center , Universidad de Castilla-La Mancha , Cuenca , Spain
| | | | - Miriam Garrido-Miguel
- b Health and Social Research Center , Universidad de Castilla-La Mancha , Cuenca , Spain
| | | | - Vicente Martínez-Vizcaíno
- b Health and Social Research Center , Universidad de Castilla-La Mancha , Cuenca , Spain.,c Facultad de Ciencias de la Salud , Universidad Autónoma de Chile , Talca , Chile
| | - Blanca Notario-Pacheco
- b Health and Social Research Center , Universidad de Castilla-La Mancha , Cuenca , Spain
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Herráiz-Adillo Á, Soriano-Cano A, Martínez-Hortelano JA, Garrido-Miguel M, Mariana-Herráiz JÁ, Martínez-Vizcaíno V, Notario-Pacheco B. Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study. Blood Press 2017; 27:112-119. [DOI: 10.1080/08037051.2017.1400903] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Alba Soriano-Cano
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | | | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Herráiz-Adillo Á, Cavero-Redondo I, Álvarez-Bueno C, Martínez-Vizcaíno V, Pozuelo-Carrascosa DP, Notario-Pacheco B. Factors affecting the validity of the oscillometric Ankle Brachial Index to detect peripheral arterial disease. INT ANGIOL 2017; 36:536-544. [PMID: 28893061 DOI: 10.23736/s0392-9590.17.03860-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The use of oscillometric Ankle Brachial Index (ABI) to diagnose peripheral arterial disease (PAD) has raised concern, especially due to a lack of agreement and sensitivity. This study aimed to evaluate those factors affecting the validity of oscillometric ABI in comparison to Doppler ABI to detect PAD. METHODS Through univariate and multivariate linear regression, we studied those factors affecting the differences between oscillometric and Doppler ABI; through univariate and multivariate logistic regression we analyzed the false negative rate of oscillometric ABI to detect PAD. RESULTS We analyzed 197 consecutive subjects (394 legs) from two settings: Primary Care and Vascular Service. The means of oscillometric ABI and Doppler ABI were 1.094 (95% CI: 0.843-1.345) and 1.073 (95% CI: 0.769-1.374) (P<0.001), respectively. In men, covariates explaining the differences between oscillometric and Doppler ABI were Doppler ankle blood pressure (β=-0.610, P<0.001), ankle circumference (β=0.176, P=0.004) and oscillometric brachial blood pressure (β=0.136, P=0.037); in women, those were weight (β=0.351, P<0.001) and Doppler ankle blood pressure (β=-0.318, P<0.001). Sensitivity and specificity of oscillometric ABI to detect PAD were 80.6% and 97.4%, respectively, and covariates explaining the rate of false negatives in PAD population were setting (Exp(β)=17.21, P=0.009) and tobacco (packs/year) (Exp(β)=1.049, P=0.002). CONCLUSIONS Although some factors influencing the lack of agreement between oscillometric and Doppler ABI were identified, the correction of oscillometric ABI seems impractical, since Doppler is needed, the bias is not always uniformly distributed and its clinical relevance is small. According to sensitivity, borderline oscillometric ABI in Primary Care settings and smokers suggest PAD.
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Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care of Tragacete, Health Service of Castilla-La Mancha (SESCAM), Cuenca, Spain
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain -
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
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Herráiz-Adillo Á, Cavero-Redondo I, Álvarez-Bueno C, Martínez-Vizcaíno V, Pozuelo-Carrascosa DP, Notario-Pacheco B. The accuracy of an oscillometric ankle-brachial index in the diagnosis of lower limb peripheral arterial disease: A systematic review and meta-analysis. Int J Clin Pract 2017; 71. [PMID: 28851093 DOI: 10.1111/ijcp.12994] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/30/2017] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Peripheral arterial disease (PAD) remains underdiagnosed and undertreated, partly because of limitations in the Doppler ankle-brachial index (ABI), the non-invasive gold standard. OBJECTIVE This systematic review and meta-analysis aims to compare the diagnostic accuracy of the oscillometric ABI and the Doppler ABI, and to examine the influence of two approaches to analysis: legs vs subjects and inclusion of oscillometric errors as PAD equivalents vs exclusion. METHODS Systematic searches in EMBASE, MEDLINE, Web of Science and the Cochrane Library databases were performed, from inception to February 2017. Random-effects models were computed with the Moses-Littenberg constant. Hierarchical summary receiver operating characteristic curves (HSROC) were used to summarise the overall test performance. RESULTS Twenty studies (1263 subjects and 3695 legs) were included in the meta-analysis. The pooled diagnostic odds ratio (dOR) for the oscillometric ABI was 32.49 (95% CI: 19.6-53.8), with 65% sensitivity (95% CI: 57-74) and 96% specificity (95%CI: 93-99). In the subgroup analysis, the "per subjects" group showed a better performance than the "per legs" group (dOR 36.44 vs 29.03). Similarly, an analysis considering oscillometric errors as PAD equivalents improved diagnostic performance (dOR 31.48 vs 28.29). The time needed for the oscillometric ABI was significantly shorter than that required for the Doppler ABI (5.90 vs 10.06 minutes, respectively). CONCLUSIONS AND RELEVANCE The oscillometric ABI showed an acceptable diagnostic accuracy and feasibility, potentially making it a useful tool for PAD diagnosis. We recommend considering oscillometric errors as PAD equivalents, and a "per subject" instead of a "per leg" approach, in order to improve sensitivity. Borderline oscillometric ABI values in diabetic population should raise concern of PAD.
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Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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Álvarez-Bueno C, Cavero-Redondo I, Lucas-de la Cruz L, Notario-Pacheco B, Martínez-Vizcaíno V. Association between pre-pregnancy overweight and obesity and children’s neurocognitive development: a systematic review and meta-analysis of observational studies. Int J Epidemiol 2017; 46:1667. [DOI: 10.1093/ije/dyx178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Álvarez-Bueno C, Cavero-Redondo I, Lucas-de la Cruz L, Notario-Pacheco B, Martínez-Vizcaíno V. Association between pre-pregnancy overweight and obesity and children’s neurocognitive development: a systematic review and meta-analysis of observational studies. Int J Epidemiol 2017; 46:1653-1666. [DOI: 10.1093/ije/dyx122] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2017] [Indexed: 01/19/2023] Open
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Pozuelo-Carrascosa DP, Martínez-Vizcaíno V, Sánchez-López M, Bartolomé-Gutiérrez R, Rodríguez-Martín B, Notario-Pacheco B. Resilience as a mediator between cardiorespiratory fitness and mental health-related quality of life: A cross-sectional study. Nurs Health Sci 2017; 19:316-321. [DOI: 10.1111/nhs.12347] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/03/2017] [Accepted: 02/17/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - Vicente Martínez-Vizcaíno
- Social and Health Care Research Center; University of Castilla-La Mancha; Cuenca Spain
- School of Health Sciences; Autonomous University of Chile; Talca Chile
| | - Mairena Sánchez-López
- Social and Health Care Research Center; University of Castilla-La Mancha; Cuenca Spain
- School of Education; University of Castilla-La Mancha; Ciudad Real Spain
| | | | - Beatriz Rodríguez-Martín
- School of Occupational Therapy, Speech Therapy and Nursing; University of Castilla-La Mancha; Talavera de la Reina Spain
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Torres-Costoso A, Pozuelo-Carrascosa DP, Álvarez-Bueno C, Ferri-Morales A, Miota Ibarra J, Notario-Pacheco B, Martínez-Vizcaíno V. Insulin and bone health in young adults: The mediator role of lean mass. PLoS One 2017; 12:e0173874. [PMID: 28323845 PMCID: PMC5360249 DOI: 10.1371/journal.pone.0173874] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 02/28/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The positive relationship between lean mass (LM) and bone health is well known, but a positive association between insulin and LM has also been described. Insulin has some anabolic properties on bone through the stimulation of osteoblast differentiation, yet the role of LM as a confounder or mediator in this relationship remains uncertain. OBJECTIVE To examine whether the association between insulin levels and bone health is mediated by LM. METHODS A cross-sectional study was conducted at the Castilla La Mancha University (Spain) involving 466 young adults (113 young men; 19.5±2.3 years). LM and total-body bone mineral content (BMC) were measured by dual energy x-ray absorptiometry, and insulin was measured in fasting serum samples. RESULTS Young adults with high total LM had higher values of total-body BMC than their peers after controlling for age and sex, this relationship persisted after adjusting for insulin levels (p<0.001). In mediation analyses, insulin levels were positively associated with total-body BMC (b = 0.05; p<0.001) and total LM acted as an intermediate variable, attenuating the association between insulin levels and total-body BMC (b = -31.98; p>0.05) as indicated by Sobel test values for indirect effect (z = 4.43; p<0.001). CONCLUSIONS LM plays an important role in the relationship between insulin levels and bone health, in such a way that while increases in LM have a positive influence on bone health, they are also negatively associated with insulin levels.
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Affiliation(s)
- Ana Torres-Costoso
- Universidad de Castilla-La Mancha. School of Nursing and Physiotherapy, Toledo, Spain
| | | | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain
| | | | - Jose Miota Ibarra
- Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile. Facultad de Ciencias de la Salud., Talca, Chile
- * E-mail:
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Herráiz-Adillo Á, Martínez-Vizcaíno V, Cavero-Redondo I, Álvarez-Bueno C, Garrido-Miguel M, Notario-Pacheco B. Diagnostic Accuracy Study of an Oscillometric Ankle-Brachial Index in Peripheral Arterial Disease: The Influence of Oscillometric Errors and Calcified Legs. PLoS One 2016; 11:e0167408. [PMID: 27898734 PMCID: PMC5127576 DOI: 10.1371/journal.pone.0167408] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/14/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Peripheral arterial disease (PAD) is an indicator of widespread atherosclerosis. However, most individuals with PAD, in spite of being at high cardiovascular risk, are asymptomatic. This fact, together with the limitations of the Doppler ankle-brachial index (ABI), contributes to PAD underdiagnose. The aim of this study was to compare oscillometric ABI and Doppler ABI to diagnose peripheral arterial disease, and also to examine the influence of oscillometric errors and calcified legs on the PAD diagnoses. METHODS AND FINDINGS We measured the ankle-brachial indexes of 90 volunteers (n = 180 legs, age 70 ± 14 years, 43% diabetics) using both oscillometer OMRON-M3 and Doppler. For concordance analyses we used the Bland and Altman method, and also estimated the intraclass correlation coefficient. Receiver Operating Characteristic Curves were used to examine the diagnostic performance of both methods. The ABI means were 1.06 ± 0.14 and 1.04 ± 0.16 (p = 0.034) measured by oscillometer and Doppler ABIs respectively, with limits of agreement of ± 0.20 and intraclass correlation coefficient = 0.769. Oscillometer yielded 23 "error" measurements, and also overestimated the measurements in low ankle pressures. Using Doppler as gold standard, oscillometer performance for diagnosis of PAD showed an Area Under Curve = 0.944 (sensitivity: 66.7%, specificity: 96.8%). Moreover, when considered calcified legs and oscillometric "error" readings as arteriopathy equivalents, sensitivity rose to 78.2%, maintaining specificity in 96%. The best oscillometer cut-off point was 0.96 (sensitivity: 87%, specificity: 91%, positive likelihood ratio: 9.66 and negative likelihood ratio: 0.14). CONCLUSION Despite its limitations, oscillometric ABI could be a useful tool for the diagnosis of PAD, particularly when considering calcified legs and oscillometric "errors" readings as peripheral arterial disease equivalents.
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Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha. Health and Social Research Center. Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
- * E-mail:
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha. Health and Social Research Center. Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha. Health and Social Research Center. Cuenca, Spain
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Lucas-de la Cruz L, Martínez-Vizcaino V, Álvarez-Bueno C, Arias-Palencia N, Sánchez-López M, Notario-Pacheco B. Reliability and validity of the Spanish version of the Children's Sleep Habits Questionnaire (CSHQ-SP) in school-age children. Child Care Health Dev 2016; 42:675-82. [PMID: 27279384 DOI: 10.1111/cch.12357] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 03/02/2016] [Accepted: 05/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep disorders in schoolchildren are a common problem worldwide, and when are not adequately diagnosed and treated, their negative impact on daytime functioning may be significant. The aim of this study was to evaluate the psychometric properties of the Spanish version of the Children's Sleep Habits Questionnaire (CSHQ). METHODS Participants were 286 school-aged children from a community-based sample, aged 4 to 7 years. The sleep behaviour was evaluated using the CSHQ and actigraphy (ActiSleep monitor). The CSHQ was adapted to the Spanish language. The internal consistency of the questionnaire and the test-retest reliability between scores at baseline and three-weeks-later were estimated. Associations between CSHQ items and accelerometer sleep quality indicators were used as indicators of concurrent validity. RESULTS Cronbach's alpha coefficients for the subscales ranged from 0.60 to 0.81, and 0.81 for the full scale; the intraclass correlation coefficients ranged from 0.56 to 0.81. A moderate correlation was observed in sleep latency and awakenings measurements using both parents' reported sleep habits (CSHQ-SP) and sleep quality indicators (ActiSleep). CONCLUSIONS The CSHQ-SP has demonstrated adequate psychometric properties, and it serves as a useful instrument for clinical and research setting.
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Affiliation(s)
- L Lucas-de la Cruz
- Universidad de Castilla-La Mancha, Health and Social Research Center, Spain.,Universidad de Castilla-La Mancha, Faculty of Nursing, Spain
| | - V Martínez-Vizcaino
- Universidad de Castilla-La Mancha, Health and Social Research Center, Spain.,Universidad de Castilla-La Mancha, Faculty of Nursing, Spain.,Universidad Autónoma de Chile, Health Sciences Faculty, Talca, Chile
| | - C Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Spain
| | - N Arias-Palencia
- Universidad de Castilla-La Mancha, Health and Social Research Center, Spain.,Universidad de Castilla-La Mancha, Faculty of Education, Spain
| | - M Sánchez-López
- Universidad de Castilla-La Mancha, Health and Social Research Center, Spain.,Universidad de Castilla-La Mancha, Faculty of Education, Spain
| | - B Notario-Pacheco
- Universidad de Castilla-La Mancha, Health and Social Research Center, Spain.,Universidad de Castilla-La Mancha, Faculty of Nursing, Spain
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Rodríguez-Martín B, Martínez-Andrés M, Notario-Pacheco B, Martínez-Vizcaíno V. Conceptualizaciones sobre la atención a personas con demencia en residencias de mayores. CAD SAUDE PUBLICA 2016; 32:e00163914. [DOI: 10.1590/0102-311x00163914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 08/27/2015] [Indexed: 11/21/2022] Open
Abstract
A pesar de la importancia de las percepciones familiares en el análisis de la atención en residencias de mayores, apenas se han indagado estos ascpetcos. El objetivo de este estudio es conocer las preferencias y las áreas de mejora percibidas por los familiares sobre los cuidados a personas con demencia. Se realizó un estudio cualitativo, a partir de la Teoría Fundamentada, combinando dos técnicas de recogida de datos (observación participante y entrevistas en profundidad) en una muestra teórica de familiares de personas con demencia institucionalizadas. El modelo de atención óptima a personas con demencia, percibido por los participantes, se basó en una atención especializada e individualizada y en la participación de la familia en el cuidado. Entre las áreas de mejora se incluyeron aspectos relacionados con una mayor formación específica en Geriatría, relaciones humanas y con la cultura del trabajo institucional. Frente a la vigente tendencia de tecnificación del cuidado, las familias exigen una atención personalizada y en pequeña escala, donde ellas mismas sean parte activa del proceso de atención.
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Martínez-Vizcaíno V, Solera-Martínez M, Cavero-Redondo I, García-Prieto JC, Arias-Palencia N, Notario-Pacheco B, Martínez-Andrés M, Mota J, Sánchez-López M. Association between parental socioeconomic status with underweight and obesity in children from two Spanish birth cohorts: a changing relationship. BMC Public Health 2015; 15:1276. [PMID: 26695508 PMCID: PMC4687138 DOI: 10.1186/s12889-015-2569-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/03/2015] [Indexed: 12/01/2022] Open
Abstract
Background Our objective was twofold: to estimate the prevalence of underweight, overweight, and obesity in two birth cohorts (1999–2000 and 2007–2008) from Castilla-La Mancha, Spain; and to examine the association between parental socioeconomic status (SES) and weight status in these two cohorts. Methods Cross-sectional analysis of baseline measurements was utilised in two cluster randomised trials. Using population-based samples of children from Castilla-La Mancha, Spain, 1158 children with a mean age of 9.5 years, born in the years 1999–2000 and 1588 children with a mean age of 5.3 years born in the years 2007–2008 participated. Children were classified according to the body mass index cut-offs proposed by the International Obesity Task Force criteria. An index of SES was calculated using questions regarding parental education and occupation levels. Results Prevalence of underweight was higher in the 2007–2008 birth cohort (20.5 %, 95 % CI: 18.5, 22.5) than in the 1999–2000 birth cohort (8.1 %, 95 % CI: 6.5, 9.7), and the overweight/obesity prevalence was 20.4 % (95 % CI: 18.4, 22.5) and 35.5 % (95 % CI: 32.7, 38.3) respectively. In the lower SES stratum, in the 2007–2008 birth cohort, the prevalence of underweight and overweight/obesity was 36.7 % (95 % CI: 22.2, 51.2) and 16.3 % (95 % CI: 4.9, 27.7) respectively, and 22.2 % (95 % CI: 2.8, 60.0) and 55.5 % (95 % CI: 21.2, 86.3) in the 1999–2000 cohort. The ratio between underweight:overweight/obesity showed higher values for all SES categories in 2007–2008 cohort, but particularly in the lower SES group (0.4 in the 1999–2000 cohort and 2.2 in the 2007–2008 cohort). Conclusion Underweight prevalence was lower in the cohort of children born in 1999–2000, and the prevalence of overweight and obesity was lower in the cohort of children born in 2007–2008. Furthermore, while in the 1999–2000 children’s cohort underweight was more frequent amongst children from high SES families and overweight/obesity was more frequent in children from low SES families, in the 2008–2009 children’s cohort the opposite was true. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2569-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España. .,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile.
| | - Montserrat Solera-Martínez
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Jorge Cañete García-Prieto
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Natalia Arias-Palencia
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Maria Martínez-Andrés
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España.
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
| | - Mairena Sánchez-López
- Universidad de Castilla-La Mancha: Health and Social Research Center, Cuenca, Castilla-La Mancha, España. .,Universidad de Castilla-La Mancha: School of Education, Ciudad Real, Castilla-La Mancha, España.
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García-Hermoso A, Notario-Pacheco B, Recio-Rodríguez J, Martínez-Vizcaíno V, Rodrigo de Pablo E, Magdalena Belio J, Gómez-Marcos M, García-Ortiz L. Sedentary behaviour patterns and arterial stiffness in a Spanish adult population – The EVIDENT trial. Atherosclerosis 2015; 243:516-22. [DOI: 10.1016/j.atherosclerosis.2015.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 10/01/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
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Recio-Rodriguez JI, Gomez-Marcos MA, Patino-Alonso MC, Puigdomenech E, Notario-Pacheco B, Mendizabal-Gallastegui N, de la Fuente ADLC, Otegui-Ilarduya L, Maderuelo-Fernandez JA, de Cabo Laso A, Agudo-Conde C, Garcia-Ortiz L. Effects of kiwi consumption on plasma lipids, fibrinogen and insulin resistance in the context of a normal diet. Nutr J 2015; 14:97. [PMID: 26374292 PMCID: PMC4572627 DOI: 10.1186/s12937-015-0086-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/10/2015] [Indexed: 11/29/2022] Open
Abstract
Background and aims Among fruits, kiwi is one of the richest in vitamins and polyphenols and has strong anti-oxidant effects. We aimed to analyze the relationship between the consumption of kiwi and plasma lipid values, fibrinogen, and insulin resistance in adults within the context of a normal diet and physical-activity. Methods Cross-sectional study. Participants (N = 1469), who were free of cardiovascular diseases, completed a visit, which included the collection of information concerning the participant’s usual diet and kiwi consumption using a previously validated, semi-quantitative, 137-item food-frequency-questionnaire. Fasting laboratory determinations included plasma lipids, fibrinogen and insulin resistance. Regular physical-activity was determined using accelerometry. Results Consumers of at least 1 kiwi/week presented higher plasma values of HDL-cholesterol (mean difference 4.50 [95 % CI: 2.63 to 6.36]) and lower triglyceride values (mean difference −20.03 [95 % CI: −6.77 to −33.29]), fibrinogen values (mean difference −13.22 [95 % CI: −2.18 to −24.26]) and HOMAir values (mean difference −0.30 [95 % CI: −0.09 to −0.50]) (p < 0.05, for all comparisons) than those who consumed less than 1 kiwi per week. In an adjusted logistic regression analysis, this group had a lower odds-ratio for presenting plasmatic fibrinogen concentrations above 400 mg/dL (OR = 0.68, 95 % CI 0.49 to 0.95), HDL-Cholesterol plasma values below 45 mg/dL (OR = 0.57, 95 % CI 0.36 to 0.91) and a HOMAir above 3 (OR = 0.61, 95 % CI 0.37 to 1.00). Conclusions Consumption of at least one kiwi/week is associated with lower plasma concentrations of fibrinogen and improved plasma lipid profile in the context of a normal diet and regular exercise.
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Affiliation(s)
- Jose I Recio-Rodriguez
- La Alamedilla Health Centre, Castilla and León Health Service-SACYL, redIAPP, IBSAL, Salamanca, Spain. .,Unidad de Investigación, Centro de Salud La Alamedilla, Avda. Comuneros 27-31, 37003, Salamanca, Spain.
| | - Manuel A Gomez-Marcos
- La Alamedilla Health Centre, Castilla and León Health Service-SACYL, redIAPP, IBSAL, Salamanca, Spain
| | | | - Elisa Puigdomenech
- Passeig de Sant Joan Health Center, Catalan Health Center, Barcelona, Spain
| | | | | | | | | | | | - Angela de Cabo Laso
- La Alamedilla Health Centre, Castilla and León Health Service-SACYL, redIAPP, IBSAL, Salamanca, Spain
| | - Cristina Agudo-Conde
- La Alamedilla Health Centre, Castilla and León Health Service-SACYL, redIAPP, IBSAL, Salamanca, Spain
| | - Luis Garcia-Ortiz
- La Alamedilla Health Centre, Castilla and León Health Service-SACYL, redIAPP, IBSAL, Salamanca, Spain
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Cavero-Redondo I, Álvarez-Bueno C, Pozuelo-Carrascosa DP, Díez-Fernández A, Notario-Pacheco B. Risk of extrapyramidal side effects comparing continuous vs. bolus intravenous metoclopramide administration: a systematic review and meta-analysis of randomised controlled trials. J Clin Nurs 2015; 24:3638-46. [PMID: 26373874 DOI: 10.1111/jocn.12984] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2015] [Indexed: 10/23/2022]
Abstract
AIMS AND OBJECTIVES To provide evidence about whether intravenous metoclopramide continuous infusion is associated with fewer extrapyramidal side effects than bolus infusion. BACKGROUND Many studies have described the effects produced by the administration of metoclopramide, as a continuous intravenous infusion or intravenous bolus directly, but there is a lack of consensus about the best administration of this drug to minimise extrapyramidal side effects. DESIGN A meta-analysis was conducted. METHODS The search data base was conducted in: Cochrane Library, PubMed, Web of Knowledge and Scopus, to collect randomised controlled trials examining the association between extrapyramidal side effects and intravenous metoclopramide continuous or bolus infusion. Meta-analyses were conducted for the eligible randomised controlled trials by Comprehensive Meta-Analysis. Risk difference and 95% CIs were calculated with the Cochran's Q-statistic, and heterogeneity was assessed with the I(2) test. RESULTS Eleven randomised controlled trials were included. Meta-analysis showed that continuous intravenous infusion of metoclopramide produced less extrapyramidal side effects (8%; 95% CI, 5-11%; p < 0·001; I(2) = 65%). These improvements were particularly strong in studies scored ≥3 in the Jadad scale (12%; 95% CI, 3-24%; I(2) = 0%), in emergency patients (12%; 95% CI, 2-25%; I(2) = 0%), in patients who used concomitant drugs (9%; 95% CI, 5-12%; I(2) = 80%) and when observation (8%; 95% CI, 5-14%; I(2) = 69%) or analogue scale (7%; 95% CI, 1-13%; I(2) = 64%) were used to quantify the number of extrapyramidal reactions in patients. CONCLUSIONS Compared with bolus administration, continuous intravenous infusion of metoclopramide reduces the appearance of extrapyramidal side effects. RELEVANCE TO CLINICAL PRACTICE Continuous infusion is an effective intervention to reduce in patients discomfort caused by the extrapyramidal side effects of metoclopramide. Clinicians also reduce the time spent on alleviating these unwanted effects.
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Affiliation(s)
- Iván Cavero-Redondo
- Social and Health Care Research Center (CESS), University of Castilla La Mancha, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Social and Health Care Research Center (CESS), University of Castilla La Mancha, Cuenca, Spain
| | | | | | - Blanca Notario-Pacheco
- Social and Health Care Research Center (CESS), University of Castilla La Mancha, Cuenca, Spain
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Pardo-Guijarro MJ, Martínez-Andrés M, Notario-Pacheco B, Solera-Martínez M, Sánchez-López M, Martínez-Vizcaíno V. Self-reports versus parental perceptions of health-related quality of life among deaf children and adolescents. J Deaf Stud Deaf Educ 2015; 20:275-82. [PMID: 25986604 DOI: 10.1093/deafed/env018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/20/2015] [Indexed: 05/15/2023]
Abstract
The aim of this study was to assess the agreement between deaf children's and adolescents' self-ratings of health-related quality of life (HRQoL) and their parents' proxy reports. This observational cross-sectional study included 114 deaf 8- to 18-years-old students and proxy family members. HRQoL was measured using the KIDSCREEN-27 questionnaire, which was adapted to Spanish sign language for children, with a written version for parents. Respondents completed a self-administered paper questionnaire. Parents' and children's mean scores differences were not significant, except for the "Autonomy and Parents" and "Peers and Social Support" dimensions. Children aged 8-11 years scored higher in some domains of QoL compared to those aged 12-18 years. The level of agreement between children/adolescents' and parents/proxies' responses was acceptable, except for the dimension "Autonomy and Parents." Overall, deaf children/adolescents' self-ratings of HRQoL did not differ from their parents' proxy reports; however, differences were found in the dimensions that explored the quality of the interaction of children/adolescents and parents, the perceived level of autonomy, and social relations and support.
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Martínez-Vizcaino V, Mota J, Solera-Martínez M, Notario-Pacheco B, Arias-Palencia N, García-Prieto JC, González-García A, Álvarez-Bueno C, Sánchez-López M. Rationale and methods of a randomised cross-over cluster trial to assess the effectiveness of MOVI-KIDS on preventing obesity in pre-schoolers. BMC Public Health 2015; 15:176. [PMID: 25884885 PMCID: PMC4350633 DOI: 10.1186/s12889-015-1512-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 02/09/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Childhood obesity has become an alarming worldwide increasing public health problem. The earlier adiposity rebound occurs, the greater the risk of becoming obese during puberty and adolescence. It has been speculated about the potential influence of vigorous physical activity on modifying the age of onset of adiposity rebound. Moreover, studies aimed to evaluate the effectiveness of physical activity interventions programs on reducing adiposity and other cardiovascular risk factors in children younger than 6 years are scarce. This paper describes the rationale and methods of a study aimed to test the effectiveness of a two-years multidimensional pre-school intervention on preventing obesity and improving physical fitness during the adiposity rebound period. METHODS/DESIGN Twenty-one schools from the provinces of Cuenca and Ciudad Real, Spain, were randomised to an intervention and a control arm. In the first academic year, children in third grade of pre-school and first grade of primary school in the intervention group received the physical activity intervention (MOVI-KIDS). After an academic year schools were crossed over to the alternative arm. According to the socio-ecological model, the intervention included children, their parents and teachers, and the school environment where MOVI-KIDS was conducted. MOVI-KIDS consisted of: i) three-h/week sessions of recreational non-competitive physical activity in after-school time; ii) educational materials to parents and teachers about physical activity benefits and sedentary lifestyle risks; and iii) modifications in the playground to promote physical activity during recess. Baseline and post-intervention outcomes are going to be measured in both arms three times, at the beginning and at the end of first academic year, and at the end of the second academic year. Primary outcomes included body mass index, waist circumference, triceps skinfold thickness, percentage of both body fat and fat-free mass, and blood pressure. Secondary end points were physical activity, fitness, and carotid intima-media thickness. DISCUSSION This paper reports the design of a randomised cross-over cluster trial aimed at assessing the effectiveness of the multidimensional physical activity intervention (MOVI-KIDS) during two years in pre-school children. TRIAL REGISTRATION Clinical trials.gov: NCT01971840 . (Date of registration: Initial Release: 10/07/2013; Record Verification: 23/10/2013).
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Affiliation(s)
- Vicente Martínez-Vizcaino
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile.
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
| | - Montserrat Solera-Martínez
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
| | - Blanca Notario-Pacheco
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
| | - Natalia Arias-Palencia
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
| | - Jorge Cañete García-Prieto
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
| | - Alberto González-García
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
| | - Celia Álvarez-Bueno
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
| | - Mairena Sánchez-López
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n 16071, Cuenca, Spain.
- Facultad of Education, Universidad of Castilla-La Mancha, Ciudad Real, Spain.
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Díez-Fernández A, Sánchez-López M, Gulías-González R, Notario-Pacheco B, Cañete García-Prieto J, Arias-Palencia N, Martínez-Vizcaíno V. BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis. PLoS One 2015; 10:e0116506. [PMID: 25590619 PMCID: PMC4295865 DOI: 10.1371/journal.pone.0116506] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 12/10/2014] [Indexed: 12/17/2022] Open
Abstract
Objective Muscular fitness levels have been associated with cardiometabolic risk in children, although whether body weight acts as a confounder or as an intermediate variable in this relationship remains controversial. The aim of this study was to examine whether the association between muscular fitness and cardiometabolic risk factors is mediated by body mass index (BMI). Design and Methods Cross-sectional study using a sample of 1158 schoolchildren aged 8-11 years from the province of Cuenca, Spain. We measured anthropometrics and biochemical variables and we calculated a muscular fitness index as the sum of z-scores of handgrip dynamometry/weight and standing long jump, and we estimated a previously validated cardiometabolic risk index (CMRI). Linear regression models were fitted for mediation analysis to assess whether the association between muscular fitness and cardiometabolic risk was mediated by BMI. Results Children with normal weight (NW) had a better cardiometabolic risk profile than their overweight (OW) or obese (OB) peers after controlling for muscular fitness. Marginal estimated mean±SE values for NW, OW and OB categories of CMRI were -0.75±0.06<0.84±0.10<2.18±0.16 in boys and -0.73±0.06<0.96±0.10<2.71±0.17 in girls, both p<0.001. Children with higher levels of muscular fitness had a better cardiometabolic risk profile (CMRI marginal estimated mean±SE 1.04±0.13>0.05±0.09>-1.16±0.13 for lower, middle and upper quartiles of muscular fitness in boys and 1.01±0.16>0.10±0.09>-1.02±0.15 in girls, both p<0.001), but differences disappeared when controlling for BMI. BMI acted as a full mediator between muscular fitness and most cardiometabolic risk factors (Sobel test z=-11.44 for boys; z=-11.83 for girls; p<0.001 in CMRI mediation model) and as a partial mediator in the case of waist circumference (Sobel test z=-14.86 for boys; z=-14.51 for girls; p<0.001). Conclusions BMI mediates the association between muscular fitness and cardiometabolic risk in schoolchildren. Overall, good muscular fitness is associated with lower cardiometabolic risk, but particularly when accompanied by normal weight.
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Affiliation(s)
- Ana Díez-Fernández
- Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain
- Faculty of Occupational Therapy, Speech Therapy and Nursing, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain
- Faculty of Education, University of Castilla-La Mancha, Ciudad Real, Spain
| | | | | | | | | | - Vicente Martínez-Vizcaíno
- Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
- * E-mail:
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Martínez-Vizcaíno V, Sánchez-López M, Notario-Pacheco B, Salcedo-Aguilar F, Solera-Martínez M, Franquelo-Morales P, López-Martínez S, García-Prieto JC, Arias-Palencia N, Torrijos-Niño C, Mora-Rodríguez R, Rodríguez-Artalejo F. Gender differences on effectiveness of a school-based physical activity intervention for reducing cardiometabolic risk: a cluster randomized trial. Int J Behav Nutr Phys Act 2014; 11:154. [PMID: 25491026 PMCID: PMC4295398 DOI: 10.1186/s12966-014-0154-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 11/28/2014] [Indexed: 11/25/2022] Open
Abstract
Background Studies that have examined the impact of a physical activity intervention on cardiometabolic risk factors have yielded conflicting results. The objective of this study was to assess the impact of a standardized physical activity program on adiposity and cardiometabolic risk factors in schoolchildren. Methods Cluster randomized trial study of 712 schoolchildren, 8–10 years, from 20 public schools in the Province of Cuenca, Spain. The intervention (MOVI-2) consisted of play-based and non-competitive activities. MOVI-2 was conducted during two 90-minute sessions on weekdays and one 150-minute session on Saturday mornings every week between September 2010 and May 2011. We measured changes in adiposity (overweight/obesity prevalence, body mass index [BMI], triceps skinfold thickness [TST], body fat %, fat-free mass, waist circumference) and other cardiometabolic risk factors (LDL-cholesterol, triglycerides/HDL-cholesterol ratio, insulin, C-reactive protein and blood pressure). The analyses used mixed regression models to adjust for baseline covariates under cluster randomization. Results Among girls, we found a reduction of adiposity in intervention versus control schools, with a decrease in TST (−1.1 mm; 95% confidence interval [CI] -2.3 to −0.7), body fat % (−0.9%; 95% CI −1.3 to −0.4), waist circumference (−2.7 cm; 95% CI −4.5 to −0.9), and an increase in fat-free mass (0.3 kg; 95% CI 0.01 to 0.6). The intervention also led to lower serum LDL-cholesterol and insulin levels. Among boys, a reduction in waist circumference (−1.4 cm; 95% CI −2.6 to −0.1; P = 0.03), and an increase in fat-free mass (0.5 kg; 95% CI 0.2 to 0.9; P = 0.003) was associated with the intervention versus control schools. The prevalence of overweight/obesity or underweight, BMI, and other cardiometabolic risk factors was not modified by the intervention. No important adverse events were registered. Conclusions An extracurricular intervention of non-competitive physical activity during an academic year, targeting all schoolchildren regardless of body weight, is a safe and effective measure to reduce adiposity in both genders and to improve cardiometabolic risk profile in girls. Trial registration Clinical trials NCT01277224. Electronic supplementary material The online version of this article (doi:10.1186/s12966-014-0154-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vicente Martínez-Vizcaíno
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain. .,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, ᅟ, Chile.
| | - Mairena Sánchez-López
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain. .,School of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain.
| | - Blanca Notario-Pacheco
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
| | | | | | | | | | - Jorge C García-Prieto
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
| | - Natalia Arias-Palencia
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
| | - Coral Torrijos-Niño
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
| | | | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
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Notario-Pacheco B, Martínez-Vizcaíno V, Trillo-Calvo E, Pérez-Yus MC, Serrano-Parra D, García-Campayo J. Validity and reliability of the Spanish version of the 10-item CD-RISC in patients with fibromyalgia. Health Qual Life Outcomes 2014; 12:14. [PMID: 24484847 PMCID: PMC3922630 DOI: 10.1186/1477-7525-12-14] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 01/27/2014] [Indexed: 11/15/2022] Open
Abstract
Background No resilience scale has been validated in Spanish patients with fibromyalgia. The aim of this study was to evaluate the validity and reliability of the 10-item CD-RISC in a sample of Spanish patients with fibromyalgia. Methods Design: Observational prospective multicenter study. Sample: Patients with diagnoses of fibromyalgia recruited from primary care settings (N = 208). Instruments: In addition to sociodemographic data, the following questionnaires were administered: Pain Visual Analogue Scale (PVAS), the 10-item Connor-Davidson Resilience scale (10-item CD-RISC), the Fibromyalgia Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS), the Chronic Pain Acceptance Questionnaire (CPAQ), and the Mindful Attention Awareness Scale (MAAS). Results Regarding construct validity, the factor solution in the Principal Component Analysis (PCA) was considered adequate, so the KMO test had a value of 0.91, and the Barlett’s test of sphericity was significant (χ2 = 852.8; gl = 45; p < 0.001). Only one factor showed an eigenvalue greater than 1, and it explained 50.4% of the variance. PCA and Confirmatory Factor Analysis (CFA) results did not show significant differences between groups. The 10-item CD-RISC scale demonstrated good internal consistency (Cronbach’s alpha = 0.88) and test-retest reliability (r = 0.89 for a six-week interval). The 10-item CD-RISC score was significantly correlated with all of the other psychometric instruments in the expected direction, except for the PVAS (−0.115; p = 0.113). Conclusions Our study confirms that the Spanish version of the 10-item CD-RISC shows, in patients with fibromyalgia, acceptable psychometric properties, with a high level of reliability and validity.
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Affiliation(s)
- Blanca Notario-Pacheco
- Social and Health Care Research Center, University of Castilla-La Mancha, Edificio Melchor Cano Santa Teresa Jornet Street, 16071 Cuenca, Spain.
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Díez-Fernández A, Sánchez-López M, Mora-Rodríguez R, Notario-Pacheco B, Torrijos-Niño C, Martínez-Vizcaíno V. Obesity as a mediator of the influence of cardiorespiratory fitness on cardiometabolic risk: a mediation analysis. Diabetes Care 2014; 37:855-62. [PMID: 24198304 DOI: 10.2337/dc13-0416] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The relationship between cardiorespiratory fitness (CRF) and metabolic syndrome (MetS) is well known, although the extent to which body weight may act as a confounder or mediator in this relationship is uncertain. The aim of this study was to examine whether the association between CRF and cardiometabolic risk factors is mediated by BMI. RESEARCH DESIGN AND METHODS A cross-sectional study including 1,158 schoolchildren aged 8-11 years from the province of Cuenca, Spain, was undertaken. We measured height, weight, waist circumference (WC), blood pressure, fasting plasma lipid profile and insulin, and CRF (20-m shuttle run test). A validated cardiometabolic risk index was estimated by summing standardized z scores of WC, log triglyceride-to-HDL cholesterol ratio (TG/HDL-c), mean arterial pressure (MAP), and log fasting insulin. To assess whether the association between CRF and cardiometabolic risk was mediated by BMI, linear regression models were fitted according to Baron and Kenny procedures for mediation analysis. RESULTS In girls, BMI acts as a full mediator in the relationship between CRF and cardiometabolic risk factors, with the exception of log TG/HDL-c ratio. In boys, BMI acts as a full mediator in the relationship between CRF and both log TG/HDL-c ratio and MAP, and as a partial mediator in the relationship between CRF and cardiometabolic risk factors. CONCLUSIONS BMI mediates the association between CRF and MetS in schoolchildren. Overall, good levels of CRF are associated with lower cardiometabolic risk, particularly when accompanied by weight reduction.
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