Implicit attitudes towards risky driving: Development and validation of an affect misattribution procedure for speeding.

The present study aimed to develop and validate an instrument for measuring implicit attitudes towards speeding, based on the Affect Misattribution Procedure (AMP). The data collected from 140 drivers supported the reliability of the AMP (α=0.80). Results provided some support for the construct validity of the AMP, through its convergence with explicit attitudes towards speeding (r=0.22). Also, the AMP incrementally predicted driving violations (ΔR2=0.034) and traffic accidents (ΔR2=0.022), above and beyond demographic variables and explicit attitudes towards speeding, thus providing initial evidence for its criterion validity. The multiplicative interaction effect between implicit and explicit attitudes (in predicting the same criterion variables) was not supported. Overall, our results provide support for Speeding-AMP's validity and reliability, which can be successfully used in research concerning risky driving behavior.

Ketoanalogue-Supplemented Vegetarian Very Low-Protein Diet and CKD Progression.

Dietary protein restriction may improve determinants of CKD progression. However, the extent of improvement and effect of ketoanalogue supplementation are unclear. We conducted a prospective, randomized, controlled trial of safety and efficacy of ketoanalogue-supplemented vegetarian very low-protein diet (KD) compared with conventional low-protein diet (LPD). Primary end point was RRT initiation or >50% reduction in initial eGFR. Nondiabetic adults with stable eGFR<30 ml/min per 1.73 m(2), proteinuria <1 g/g urinary creatinine, good nutritional status, and good diet compliance entered a run-in phase on LPD. After 3 months, compliant patients were randomized to KD (0.3 g/kg vegetable proteins and 1 cps/5 kg ketoanalogues per day) or continue LPD (0.6 g/kg per day) for 15 months. Only 14% of screened patients patients were randomized, with no differences between groups. Adjusted numbers needed to treat (NNTs; 95% confidence interval) to avoid composite primary end point in intention to treat and per-protocol analyses in one patient were 4.4 (4.2 to 5.1) and 4.0 (3.9 to 4.4), respectively, for patients with eGFR<30 ml/min per 1.73 m(2) Adjusted NNT (95% confidence interval) to avoid dialysis was 22.4 (21.5 to 25.1) for patients with eGFR<30 ml/min per 1.73 m(2) but decreased to 2.7 (2.6 to 3.1) for patients with eGFR<20 ml/min per 1.73 m(2) in intention to treat analysis. Correction of metabolic abnormalities occurred only with KD. Compliance to diet was good, with no changes in nutritional parameters and no adverse reactions. Thus, this KD seems nutritionally safe and could defer dialysis initiation in some patients with CKD.

Periodontal status, inflammation, and malnutrition in hemodialysis patients - is there a link?

BACKGROUND: Periodontal disease (PDD) was associated with inflammation, malnutrition, and higher mortality in hemodialysis (HD) patients. STUDY DESIGN AND OBJECTIVE: Cross-sectional observational study, aiming to assess the prevalence of PDD and the possible relationship among PDD, inflammation, and malnutrition in HD patients. SETTINGS AND PARTICIPANTS: Single HD center, 263 patients (age: 57.4 ± 12.3 years; 60% males; HD vintage 6.6 ± 4.9 years; the primary renal diseases were mainly primary glomerular nephropathies in 34% cases, with 11% diabetic nephropathy). MEASUREMENTS: Oral health status was assessed by the Silness and Loe plaque index, loss of clinical attachment level, periodontal pocket depth according to World Health Organization recommendations, by a single examiner. Patients were stratified by periodontal pocket depth (PPD): normal oral status/mild PDD (PPD < 4 mm), moderate PDD (PPD 4-5 mm), and severe PDD (PPD ≥ 6 mm). Demographic, smoking status, hematologic, dialysis-related data and parameters of the nutritional (Subjective Global Assessment score, anthropemetrical, and biochemical) and inflammatory status were collected. RESULTS: Poor periodontal status was shown by 75% of patients, 23% of them with severe PDD. Patients with PDD were older; higher percentages of them were smokers, diabetics, had malnutrition, and inflammation. Subjects with severe PDD had higher HD vintage, lower hemoglobin, and required higher darbepoetin doses than those with healthy periodontium. Darbepoetin resistance index was higher in patients with severe PDD than in those with normal periodontium. Models of multivariable linear logistic regression for the potential promoters and for the consequences of PDD revealed smoking and HD duration as significant contributors; increased C-reactive protein was associated with severe PDD. LIMITATION: Cross-sectional observational design. CONCLUSIONS: Impaired periodontal health is highly prevalent in HD patients. PDD is more frequent in elderly diabetic smokers and in those with longer HD vintage; smoking and HD duration seems to be the most important determinants. The prevalence is higher in malnourished and in inflamed patients; inflammation seems to accompany PDD and to influence anemia response to treatment.