The dynamics of boron when amending agricultural soil of the Mediterranean basin with biosolids: trials in leaching columns.

There is mainly a lack of boron (B) in soils with low amounts of organic matter and in acidic and sandy soils. This is especially true in irrigated land or humid regions, where leaching can occur. The results from studying the amount of available B will reveal the status of B in the soil of a specific plot of land. The experimentation was performed as a controlled study using leaching columns. A container was placed at the end of the columns to collect the infiltrated water. Three treatments were performed by applying different amounts of biosolids (T40: 40,000 kg ha-1, T80: 80,000 kg ha-1, T120: 120,000 kg ha-1), as well as a blank test or control treatment (T0). We conclude that the mobility of B in soil was generally low despite the addition of organic matter and humidity to the soil. This is an indication that there is no clear risk of aquifers being contaminated with B or plants being impacted by toxicity due to this micronutrient.

Bioavailability, mobility and leaching of phosphorus in a Mediterranean agricultural soil (ne Spain) amended with different doses of biosolids.

The precipitation of sparingly soluble calcium phosphate in calcareous soils decreases the bioavailability of macronutrients, which makes their addition by way of fertilisers necessary. Sludge resulting from treating urban wastewater does not only provide significant amounts of phosphorus, but also helps lower the pH, thus increasing its bioavailability. The loss of part of soil nutrients due to irrigation or rain can contaminate groundwater. In order to assess the movement of phosphorus, a experiment was conducted on percolation columns, to which different doses of wastes were applied. The pH decreased by as much as 0.89 units, as well as the assimilable and soluble P, in intervals of 20 cm of depth, obtaining maximum values of 254 mg P kg-1 and 1455 µg P kg-1 respectively, and the P present in the leached water collected, which did not surpass 95 µg PL-1. The intent was to learn which was the majoritarian inorganic formed crystalline phase that immobilised the movement of phosphorus through the percolation column. The results obtained by the diffraction of X-rays are not conclusive, although they point to the formation of octacalcium phosphate. The diffractograms of the studied samples have similar diffraction lines to those of apatites.

Diseño y validación de un cuestionario para estudiar hábitos saludables en adolescentes de 12-14 años / Design and validation of a questionnaire to study healthy habits among adolescents aged 12-14 years

Introducción. Los cambios sociales y culturales están alterando los hábitos de los jóvenes. Existen encuestas para medir dichas conductas, pero son de difícil interpretación. El objetivo del estudio fue diseñar y validar un cuestionario homogéneo para estudiar los hábitos en adolescentes de 12-14 años.Población y métodos. Estudio descriptivo y transversal para validación de un cuestionario. Los ítems fueron seleccionados tras revisión de la literatura y evaluación por expertos. El pretest fue administrado a una muestra piloto. Se determinó la fiabilidad mediante el alfa de Cronbach, y la validez del constructo, mediante un análisis factorial. Se aplicó a una muestra de padres de alumnos de cuatro centros de secundaria.Resultados. El coeficiente de Cronbach mostró valores próximos a 0,7 en tres de las cuatro subescalas y un valor global de 0,629, que demostró precisión y estabilidad. El análisis factorial determinó una validez de constructo adecuada, que mostró 4 factores: alimentación, actividad física, nuevas tecnologías y entorno. El cuestionario final tuvo 26 ítems y se aplicó a 421 participantes. Un 24,8 % presentaron hábitos deficientes, y un 3,4 %, muy poco saludables. Las adolescentes mostraron peores puntuaciones en actividad física (p < 0,001), y los adolescentes, en nuevas tecnologías, aunque no significativo.Conclusiones. Se obtuvo un instrumento válido, fiable y de fácil aplicación para evaluar conductas modificables en adolescentes. La inclusión de tecnologías y entorno adapta el cuestionario a los cambios actuales. Las dimensiones sobre uso de tecnologías y actividad física fueron las más deficitarias; las adolescentes se mostraron más sedentarias.

Introduction. Social and cultural changes are altering young people's habits. Some surveys measure such behaviors, but are hard to interpret. The objective of this study was to design and validate a homogeneous questionnaire to study habits among adolescents aged 12-14 years.Population and methods. Descriptive and cross-sectional study to validate a questionnaire. Items were selected after a bibliographic review and expert assessment. The pre-test was administered to a pilot sample. Reliability was established using Cronbach's alpha coefficient, and construct validity, using a factor analysis. It was administered to a sample of parents of students from 4 secondary schools.Results. Cronbach's coefficient showed values close to 0.7 in 3/4 subscales and an overall value of 0.629, showing accuracy and stability. Factor analysis determined an adequate construct validity, with 4 factors: eating, physical activity, new technologies, and environment. The final questionnaire included 26 items and was administered to 421 participants. Poor habits were observed in 24.8 % and very unhealthy, in 3.4 %. Girls had poorer scores in physical activity (p < 0.001), and boys, in new technologies, although it was not significant.Conclusions. The final instrument was valid, reliable, and easily administered to assess modifiable behaviors in adolescents. The inclusion of technologies and environment helps to adapt the questionnaire to current changes. The greatest deficit was observed in the technology use and physical activity domains; and girls were more sedentary.

Design and validation of a questionnaire to study healthy habits among adolescents aged 12-14 years. / Diseño y validación de un cuestionario para estudiar hábitos saludables en adolescentes de 12-14 años.

INTRODUCTION: Social and cultural changes are altering young people's habits. Some surveys measure such behaviors, but are hard to interpret. The objective of this study was to design and validate a homogeneous questionnaire to study habits among adolescents aged 12-14 years. POPULATION AND METHODS: Descriptive and crosssectional study to validate a questionnaire. Items were selected after a bibliographic review and expert assessment. The pre-test was administered to a pilot sample. Reliability was established using Cronbach's alpha coefficient, and construct validity, using a factor analysis. It was administered to a sample of parents of students from 4 secondary schools. RESULTS: Cronbach's coefficient showed values close to 0.7 in 3/4 subscales and an overall value of 0.629, showing accuracy and stability. Factor analysis determined an adequate construct validity, with 4 factors: eating, physical activity, new technologies, and environment. The final questionnaire included 26 items and was administered to 421 participants. Poor habits were observed in 24.8 % and very unhealthy, in 3.4 %. Girls had poorer scores in physical activity (p < 0.001), and boys, in new technologies, although it was not significant. CONCLUSIONS: The final instrument was valid, reliable, and easily administered to assess modifiable behaviors in adolescents. The inclusion of technologies and environment helps to adapt the questionnaire to current changes. The greatest deficit was observed in the technology use and physical activity domains; and girls were more sedentary.

Introducción. Los cambios sociales y culturales están alterando los hábitos de los jóvenes. Existen encuestas para medir dichas conductas, pero son de difícil interpretación. El objetivo del estudio fue diseñar y validar un cuestionario homogéneo para estudiar los hábitos en adolescentes de 12- 14 años. Población y métodos. Estudio descriptivo y transversal para validación de un cuestionario. Los ítems fueron seleccionados tras revisión de la literatura y evaluación por expertos. El pretest fue administrado a una muestra piloto. Se determinó la fiabilidad mediante el alfa de Cronbach, y la validez del constructo, mediante un análisis factorial. Se aplicó a una muestra de padres de alumnos de cuatro centros de secundaria. Resultados. El coeficiente de Cronbach mostró valores próximos a 0,7 en tres de las cuatro subescalas y un valor global de 0,629, que demostró precisión y estabilidad. El análisis factorial determinó una validez de constructo adecuada, que mostró 4 factores: alimentación, actividad física, nuevas tecnologías y entorno. El cuestionario final tuvo 26 ítems y se aplicó a 421 participantes. Un 24,8 % presentaron hábitos deficientes, y un 3,4 %, muy poco saludables. Las adolescentes mostraron peores puntuaciones en actividad física (p<0,001), y los adolescentes, en nuevas tecnologías, aunque no significativo. Conclusiones. Se obtuvo un instrumento válido, fiable y de fácil aplicación para evaluar conductas modificables en adolescentes. La inclusión de tecnologías y entorno adapta el cuestionario a los cambios actuales. Las dimensiones sobre uso de tecnologías y actividad física fueron las más deficitarias; las adolescentes se mostraron más sedentarias.

[The influence of a healthy lifestyle on body mass index in a sample of 12-14 year old individuals in Murcia (Spain)].

BACKGROUND: Excess weight and obesity in childhood is directly related to comorbidities that can have serious conse-quences for health. This study set out to identify the main modifiable lifestyles that influence the development of excess weight and obesity in childhood. METHODS: A cross-sectional study was carried out at seven secondary schools in Area V, Murcia, Spain. Questionnaires completed by parents were used to gather information about healthy habits in adolescents (ENHASA), The surveys con-sisted of four dimensions made up of modifiable lifestyle factors: nutrition, physical activity, new technologies and schoolmates. The adolescents' somatometric data was measured and classified according to the WHO categories for body mass index (BMI). ANOVA was used to compare the score differences among the BMI groups. RESULTS: The questionnaire was completed by the parents of 421 adolescents with an average age of 12 years. 21.1% pre-sented excess weight and 19.7% obesity. The score obtained by adolescents in the physical activity dimension decreased in the increased BMI group (score in normal weight 6.36 vs. 4.45 in obesity; p<0.001). The other three dimensions showed insignificant differences in scores between normal weight and obesity groups. CONCLUSION: Excess weight was present in 40.8% of the sample. Physical activity was the modifiable lifestyle to be most markedly linked to BMI. This outcome may help in planning specific strategies for sedentary lifestyles to reduce this dietary epidemic.

[Epstein-Barr virus primary infection in healthy children]. / Primoinfección por el virus de Epstein-Barr en niños sanos.

INTRODUCTION: The aim of this study is to assess epidemiological, clinical and laboratory characteristics of primary infection by Epstein-Barr virus (EBV) in children without previous diagnosis of any immune disease and its relationship with clinical presentation. PATIENTS AND METHODS: A retrospective study was conducted on all children from 0 to 15 years with IgM against viral capsid of EBV positive or indeterminate during a 22 month period. Epidemiological, clinical and laboratory data were analysed and compared between typical (mononucleosis syndrome) and non-typical clinical symptoms. RESULTS: The study included a total of 103 children, with a median age of 7 years (3-12.5 years). Almost two-thirds (63%) of patients had typical clinical signs, with a mononucleosis syndrome, and 37% had a non-typical presentation. The non-typical clinical group had a lower age (P=.03) and took less antibiotic than the typical clinical group (P=.015). From laboratory studies, there were no differences between the groups, except in RCP, which was higher in typical clinical group (P=.04). Heterophile antibodies were positive in 33% of patients. An indeterminate IgM against viral capsid was present in 20% of the patients, and most of them had an oligosymptomatic or atypical presentation. An IgM positive for other viruses was found in 21%, and 3 of them were suspicious of false positive for EBV. CONCLUSIONS: In the studied population, a primary infection due to EBV is common in younger ages, and they have usually an oligosymptomatic clinical presentation. A very low percentage of positive heterophile antibodies were found. Cases with indeterminate IgM against viral capsid are more frequent in the non-typical clinical group. Co-infection with other viruses is common.

A theory-based implementation program for alcohol screening and brief intervention (ASBI) in general practices: Planned development and study protocol of a cluster randomised controlled trial.

BACKGROUND: Previous studies have shown that alcohol screening and brief intervention (ASBI) in general practices can lead to significant reductions in alcohol consumption among patients, yet ASBI is rarely implemented into routine clinical practice. The aim of this paper is to describe the development and evaluation of an ASBI implementation program aimed at increasing ASBI delivery rates of general practitioners (GPs) and decreasing patients' alcohol consumption. METHODS/DESIGN: This study protocol describes the step-wise development and evaluation of an ASBI implementation program. A four-step method is used to identify relevant determinants of change and intervention components based on the Behaviour Change Wheel and the Theoretical Domains Framework. The program will be evaluated in general practices in The Netherlands in a two-arm cluster randomised controlled trial which investigates the effect of the program on GPs' ASBI delivery behaviour as well as on patients' alcohol consumption. DISCUSSION: Effective theory- and practice-based strategies to implement ASBI in general practices are highly needed. Using a stepwise method we described the development of a program consisting of an e-learning module, a tailored feedback module and environmental support and materials. We hypothesize that this program will result in an increase of GPs' ASBI delivery behaviour. Secondly, we expect an overall decrease in percentage of patients with excessive or problematic alcohol use and a higher proportion of patients from GPs receiving the ASBI implementation program decreasing their alcohol consumption, compared to patients from GPs in the control group. TRIAL REGISTRATION: NTR5539.

Results of the PAS Study: A Randomized Controlled Trial Evaluating the Effectiveness of a Web-Based Multiple Tailored Smoking Cessation Program Combined With Tailored Counseling by Practice Nurses.

This study investigated the effects of Web-based multiple computer tailoring and counseling by a practice nurse (MTC) compared with computer tailoring without counseling (MT) and usual care (UC) on smoking cessation rates, via a randomized controlled trial with 414 Dutch adult smokers, recruited by 91 practice nurses from May 2009 to June 2010. Logistic multilevel regression analyses were conducted with 24-hour point prevalence, 7-day point prevalence, and prolonged abstinence after 6 and 12 months as dependent variables and experimental condition as the independent variable. After 6 and 12 months, 38% and 56% of respondents were followed up, respectively. At both follow-ups, no main effects of the interventions could be identified when comparing them with care as usual and with each other-neither in analyses using available data nor in analyses using a negative scenario in which respondents lost to follow-up were considered to still be smoking. A Web-based multiple computer-tailored smoking cessation program combined with a single face-to-face counseling session by a practice nurse may not be more effective than this computer-tailored program alone or than usual smoking cessation care in the general practice setting. Yet before concluding that the addition of counseling to Web-based computer tailoring cannot be successful, more research needs to be conducted to identify the optimal number of counseling sessions to be combined with the Web-based program and to how to best attune the two modalities.

Effectiveness of video- versus text-based computer-tailored smoking cessation interventions among smokers after one year.

BACKGROUND: In western countries, smoking prevalence rates are high among smokers unmotivated to quit and those with a lower socioeconomic status (LSES). Multiple computer tailoring and the use of audio-visual aids may improve such interventions and increase cessation in LSES smokers. This study assessed the 12-month effectiveness of a video- and text-based computer-tailored intervention. METHODS: A randomized controlled trial in the Netherlands was used in which smokers were allocated to the video-based condition (VC) (N=670), the text-based condition (TC) (N=708) or the control condition (CC) (brief generic text advice) (N=721). After 12months, self-reported prolonged abstinence was assessed and biochemically verified in respondents indicating to have quit smoking. Three analysis strategies were used to assess the effects: (1) multiple imputation (MI); (2) intention-to-treat (ITT); (3) complete case analysis (CC). RESULTS: VC was more effective in prolonged abstinence compared to CC (odds ratio (OR)=1.90, p=.005) and the text-based condition (OR=1.71, p=.01). VC was furthermore more effective than TC. No differences were found for SES and motivational levels. Results were similar when using ITT and CC. For our secondary outcome seven-day point prevalence abstinence; however, neither VC (OR=1.17, p=.34) or TC (OR=0.91, p=.52) outperformed the CC. CONCLUSION: The video-based computer-tailored intervention was effective in obtaining substantial long-term abstinence compared to the text-based version and a brief generic text advice.

[Familial presentation of microdeletion and inverted microduplication with array-CGH]. / Microdelecion y microduplicacion inversa de presentacion familiar con array-CGH.

INTRODUCTION. Over the years the field of genetics has advanced significantly. Following the polymerase chain reaction and mass sequencing techniques, the array-CGH technique (comparative genomic hybridization) has helped to improve genetic procedures. A resolution of up to 200 kb is currently being accomplished in the human genome. CASE REPORTS. We report the case of two sisters with delays in developmental milestones and a characteristic phenotype with normal results from initial studies of the karyotype and subtelomeric regions. Array-CGH was later used to detect a deletion and duplication that were different in each of the sisters, this being the result of a balanced paternal translocation. In the two cases, despite being the result of the same translocation, the genetic and phenotype expression were different. CONCLUSIONS. The precision achieved by means of array-CGH is making it possible to establish a correlation between minimum gains or losses of the genome and the clinical features. Chromosome 3 codes for genes that play a fundamental role in neurological development (contactins, neurotransmitter modulator proteins, etc.) and chromosome 10 codes for proteins involved in apoptosis and proteins regulating transcription. In the literature there have been reports of chromosome 3 deletion syndrome and monosomy 10. Likewise, there are also descriptions of rearrangements between these chromosomes in individuals from the same family. Nevertheless, we describe two cases of a family with a micro-deletion and an inverted microduplication, detected by means of array-CGH, that have not been reported to date. This technique can provide a diagnostic and prognostic approximation as regards development and offer genetic counselling.

TITLE: Microdelecion y microduplicacion inversa de presentacion familiar con array-CGH.Introduccion. A lo largo de los años se han logrado avances en torno a la genetica; tras la reaccion en cadena de la polimerasa y las tecnicas de secuenciacion masiva, la tecnica array-CGH (comparative genomic hybridization) ha contribuido a mejorar los procedimientos geneticos. Actualmente esta consiguiendo una resolucion de hasta 200 kb en el genoma humano. Casos clinicos. Se presentan dos hermanas con retraso en los hitos del desarrollo y fenotipo caracteristico con estudio inicial de cariotipo y de regiones subtelomericas normales. Posteriormente, mediante array-CGH se detecto en cada una una delecion y una duplicacion diferentes, fruto de una translocacion equilibrada paterna. En ambas, siendo fruto de una misma translocacion, muestra diferente expresion genetica y fenotipica. Conclusiones. La precision conseguida mediante el array-CGH esta permitiendo correlacionar minimas ganancias o perdidas del genoma con la clinica. En el cromosoma 3 se encuentran codificados genes fundamentales en el desarrollo neurologico (contactinas, proteinas moduladoras de neurotransmisores…), y en el cromosoma 10, proteinas implicadas en la apoptosis y proteinas reguladoras de la transcripcion. En la bibliografia se han descrito el sindrome de delecion del cromosoma 3 y la monosomia 10. Igualmente, hay descritos reordenamientos entre estos cromosomas en individuos de una misma familia. Sin embargo, aportamos dos casos de una familia con una microdelecion y una microduplicacion inversa, detectados mediante array-CGH, no descritos hasta el momento. Dicha tecnica puede ofrecer una aproximacion diagnostica y pronostica en cuanto a la evolucion y ofertar consejo genetico.

Psychopathology in adults with 22q11 deletion syndrome and moderate and severe intellectual disability.

BACKGROUND: 22q11 deletion syndrome (22q11DS) is associated with mild or borderline intellectual disability (ID). There are hardly any reports on subjects with 22q11DS with moderate or severe ID, and therefore its behavioural and psychiatric characteristics are unknown. METHOD: We describe behavioural and psychiatric characteristics of 33 adults with 22q11DS and a Full-Scale IQ (FSIQ) below 55. Participants were divided into two groups: one group having a FSIQ ≤ 55 caused by intellectual decline (n = 21) and one group with a FSIQ ≤ 55 who had always functioned at this level (n = 12). RESULTS: High scores on psychopathology sub-scales were found for both subgroups. 22q11DS patients with intellectual decline showed higher rates of co-morbid psychopathology, particularly psychosis. Furthermore, psychosis and intellectual decline were positive correlated. CONCLUSION: This is the first report addressing adult patients with 22q11DS and moderate to severe ID. Overall we found high levels of psychopathology with higher scores of psychopathology in the intellectual decline group. Life time psychosis seems to be related to deterioration.

How to encourage smokers to participate in web-based computer-tailored smoking cessation programs: a comparison of different recruitment strategies.

The reach, retention and costs of four strategies aimed to recruit smokers for participation in a computer-tailored smoking cessation intervention was explored. The study was part of a randomized controlled trial whereby 832 respondents were randomized to three conditions. Smokers were invited by general practitioners (GPs), newspapers, Internet and other strategies (i.e. mailing organizations) to take part. ANOVA's/Chi-square tests explored sample differences. Logistic regression analyses investigated differences between the samples regarding retention and smoking behaviour. Smokers recruited via GPs (N = 144) had a lower educational level and suffered more from chronic obstructive pulmonary disease compared with respondents recruited via Internet (N = 307) (χ(2) = 11.554, df = 3, P = 0.009). Less motivated respondents recruited by GPs were more likely to return to study compared with the less motivated respondents recruited by 'other recruitment' strategies (χ(2) = 6.416, df = 3, P = 0.093). Highly addicted respondents recruited from newspapers (N = 213) were less likely to make a quit attempt compared with highly addicted respondents recruited by GPs (OR = 0.334, P = 0.035). Females from newspapers were less likely to remain abstinent compared with the GP sample (OR = 0.337, P = 0.005). Recruitment via GPs showed highest costs. Recruitment strategy influenced the type of smokers. Group differences were associated with different patterns of quitting.

Compensation mechanisms for lost productivity: a comparison between four European countries.

OBJECTIVE: Productivity costs are usually estimated by multiplying the wage with the period absent. This can lead to an overestimation if compensation mechanisms occur. Until now only Dutch data are available on the influence of compensation mechanisms on lost productivity, but between-country differences in frequency and type of compensation mechanisms can be expected. The objective of this study was to understand whether compensation mechanisms for days absent from paid work differ in type and frequency across countries and to explore whether this would result in between-country differences in relevant lost productivity. METHODS: Data from a cross-sectional survey among respondents with rheumatic disorders from four countries were the basis for this study. Analyses focused on respondents with paid employment who reported absence in the last 3 months. The different compensation mechanisms are described and the resulting lost productivity in terms of days absent was calculated with and without taking compensation mechanisms into account. Logistic regression analyses were performed to examine which variables influence compensation mechanisms leading to relevant lost productivity. RESULTS: The results indicate that compensation mechanisms occur and are relevant in all four countries. Between-country differences in the type and frequency of compensation mechanisms and relevant lost productivity were observed. The logistic regression analyses indicate that, correcting for other variables, this is also the case for the use of compensation mechanisms leading to relevant lost productivity. CONCLUSIONS: Between-country differences in compensation mechanisms in case of absenteeism exist and could vary to such an extent that foreign relevant lost productivity data should be used with caution.

The role of self-efficacy, recovery self-efficacy, and preparatory planning in predicting short-term smoking relapse.

OBJECTIVES: This study aims to identify the role of self-efficacy, recovery self-efficacy, and preparatory planning with regard to short-term smoking relapse. We also assessed whether the importance of these variables differed for smokers quitting individually and without help (self-quitters) and smokers quitting with the help of a smoking cessation course (group quitters). DESIGN: A longitudinal quasi-experimental study with follow-ups at 1 and 3 months after the quit attempt was conducted in order to assess the role of baseline self-efficacy, recovery self-efficacy, and preparatory planning on short-term relapse. METHODS: The recruitment included adult daily smokers (N= 121), quitting in a smoking cessation course (N= 57) and self-quitters (N= 64). Respondents received internet-based questionnaires 2 weeks before quitting (baseline) and 1 and 3 months after the quit attempt. Predictors of relapse were analysed using logistic regression analyses. RESULTS: Relapse at 1 and 3 months after the quit attempt was predicted by low levels of baseline self-efficacy. Simple slope analyses revealed that less preparatory planning significantly predicted relapse at 1 month after the quit attempt among group quitters, but not among self-quitters. Recovery self-efficacy was only predictive of relapse after 1 month when self-efficacy was excluded from the analyses. Moreover, among group quitters, the results indicated a borderline significant curved relation between recovery self-efficacy and relapse after 1 month. CONCLUSIONS: Our results suggest that more research is needed on the role of preparatory planning and recovery self-efficacy. Moreover, we recommend incorporating self-efficacy increasing techniques in relapse-prevention interventions.

No smoke without fire: The impact of future friends on adolescent smoking behaviour.

OBJECTIVE: This study examined the impact of future friends and the contribution of different social influence and selection processes in predicting adolescents' smoking behaviour by extending the theory of planned behaviour (TPB). We investigated the impact of previous smoking, direct pressure from friends, descriptive norms of present and future friends, smoking-based selection of future friends, and distinguished between reciprocal and desired friends. DESIGN: A longitudinal design with three measurements was used. METHODSL: The sample consisted of 1,475 Dutch high school students (mean age = 12.7 years) that participated as a control group in the European Smoking prevention Framework Approach study at three measurements. RESULTS: Structural equation modelling revealed that adolescent smoking was influenced by intention, previous smoking, descriptive norms of parents and siblings, and that desired as well as reciprocal friends were selected based on similar smoking behaviour. Future friends indirectly influenced adolescent smoking through intention, as did attitude, subjective norms of parents and siblings, previous smoking, and descriptive norms of reciprocal friends and siblings. CONCLUSIONS: The present results suggest that descriptive norms and selection of friends need to be considered as major factors explaining smoking behaviour among adolescents besides the TPB components. These insights contribute to the further refinement of smoking prevention strategies.

Systematic prevention of overweight and obesity in adults: a qualitative and quantitative literature analysis.

To date, most interventions aimed at preventing obesity have underemphasized the application of systematic intervention development, implementation and evaluation. The present review provides a thorough insight in factors promoting implementation and/or effectiveness in interventions aimed at preventing overweight/obesity among adults. A total of 46 studies evaluating interventions aimed at preventing obesity were reviewed, followed by both qualitative and quantitative analyses. The Intervention Mapping protocol and the Environmental Research framework for weight Gain prevention (EnRG) were applied to analyse and classify the included studies. The interventions were categorized by setting (workplace, community, health care) and target group (ethnic minorities, pregnant women, [pre]menopausal women, smokers, people with intellectual disabilities). Generally, interventions were found to have potential in changing energy balance-related behaviours and anthropometric outcomes. Effect sizes for changes in body mass index ranged between -0.09 and 0.45. When the programme goal specifically aimed at weight management, the intervention was found to be more successful than interventions with programme goals that were aimed at preventing cardiovascular disease or improving general health status. Although a considerable part of studies included motivational interventions, only some actually assessed the effects on potential cognitive mediators. A general lack of reporting underlying theoretical models for behaviour change was observed as well as the inclusion of linkage groups and strategies to promote empowerment.

Increasing fruit and vegetable intake among children: comparing long-term effects of a free distribution and a multicomponent program.

The aim of this study was to evaluate and compare the effectiveness of two primary school-based interventions on children's fruit and vegetable (F&V) consumption on the long term (2 years after the start of the interventions). Six primary schools were recruited and randomly assigned to (i) a daily free distribution program for the whole school or (ii) a multicomponent program consisting of a classroom curriculum and parental involvement (without free F&V), and six schools served as controls. Follow-up measurements were conducted at the end of the intervention (Follow-up I) and 1 year later (Follow-up II). Random coefficient analyses for longitudinal data showed that the effects of both interventions did not differ between the two follow-up measurements. The results showed similar effects for the free distribution program and the multicomponent program in increasing children's fruit consumption over time (respectively, 7.2 and 15.2 g day(-1)). The distribution program also increased children's vegetable consumption over time (3.25 g day(-1)), even after repeating the analyses using a pessimistic scenario. Despite the large dropout and its consequences for generalizability of our results, the distribution program is considered as the preferred intervention of the two, and implementation on a larger scale should be investigated.

[Adrenal incidentalomas. A disease on the increase]. / Incidentalomas suprarrenales. Una enfermedad en auge.

INTRODUCTION: Adrenal incidentalomas are unsuspected, clinically silent adrenal lesions discovered incidentally by imaging tests performed a priori for problems unrelated to the adrenal glands. The aim of this study was to present a series of incidentalomas and review the diagnostic process and treatment techniques. PATIENTS AND METHOD: Of a series of 63 patients studied and/or treated for adrenal disease, there were 34 patients with adrenal incidentalomas. The mean age of the patients with incidentaloma was 50.6 years. There were 23 women (67.6%) and 11 men (32.3%). All patients underwent hormonal investigations to rule out hyperfunction. Imaging techniques consisted of ultrasonography, computed tomography (CT) and/or magnetic resonance imaging (MRI) to determine the size and characteristics of the lesion. In patients with an indication for surgery, the lateral transabdominal approach was used in laparoscopic surgery and the anterior approach was used in open surgery. RESULTS: Of the 34 patients, 23 patients (67.6%) (18 women and 5 men) with a mean age of 50.9 years underwent surgery. The mean tumoral diameter was 10.18 cm. Incidentalomas were located in the right adrenal gland in 16 patients and in the left adrenal gland in 7 patients. Laparoscopic surgery was performed in 9 patients (39.1%) and open surgery was performed in the remaining 14 (60.8%). The mean length of hospital stay was 8.6 days in open surgery and 4 days in laparoscopic surgery. Complications consisted of pneumonia in 2 patients (8.6%). There was no intraoperative mortality in the series. Surgery was not performed in 11 patients (32.3%) (5 women and 6 men) with a mean age of 56.3 years. The mean size of the tumor in these patients, identified by CT, was 2.5 cm. These patients underwent subsequent monitoring with a mean follow-up of 32 months. CONCLUSIONS: Due to the high resolution of ultrasonography, CT and MRI, as well as the greater number of radiological investigations performed, identification of adrenal incidentalomas has increased. In our series these tumors represented 53.9% of adrenal disease.

Challenges to the peer influence paradigm: results for 12-13 year olds from six European countries from the European Smoking Prevention Framework Approach study.

OBJECTIVE: To examine whether smoking onset in young adolescents is predicted by peer or parental smoking. DESIGN: Longitudinal design with one pretest and one follow-up at 12 months. SETTING: Schools in Finland, Denmark, the Netherlands, the United Kingdom, Spain and Portugal. PARTICIPANTS: 7102 randomly selected adolescents from six countries. Mean age was 12.78 years. MAIN OUTCOME MEASURES: Smoking behaviour of adolescents, peers and parents. RESULTS: No support was found for peer smoking as an important predictor of smoking onset in most countries. Support was found for the selection paradigm, implying that adolescents choose friends with similar smoking behaviour. Support for the impact of parents on adolescent behaviour and the choice of friends was also found. CONCLUSIONS: Smoking uptake in this age cohort may be more strongly influenced by personal and parental influences than initially believed. Hence, social inoculation programmes teaching youngsters to resist the pressures to smoke may be less appropriate if youngsters have a positive attitude towards smoking, associate smoking with various advantages and look for peers with similar values. For this group attitudes towards smoking may thus guide future friend selection.