The influence of alcohol consumption on Self-Rated Health and Mood during the COVID-19 pandemic in Spain.

Introduction: There is evidence of a significant upturn of certain unhealthy lifestyle choices such as Alcohol Consumption during the COVID-19 pandemic. Objective: To analyze whether Alcohol Consumption has increased since the onset of pandemic and whether it affects the relationship between Mood and Self-Rated Health among adult Spanish population. Methodology: Study of two cross-sectional cohorts (1-initial period of confinement COVID-19 pandemic, 2-between fifth and sixth waves of pandemic) to examine Alcohol Consumption in the relationship between Mood and Self-Rated Health using a moderation analysis with PROCESS macro for SPSS. Results: 5,949 people (62.1% women) participated in the study. Alcohol Consumption showed a significant increase, with men consuming more Alcohol than women in both periods (58.6% vs. 44.7% and 72.1% vs. 56.7%, respectively, p < 0.001). The moderation analysis revealed that sex and Alcohol Consumption conditioned the relationship between Mood and Self-Rated Health in the first survey, with a greater effect on women, who stated that not consuming Alcohol had a positive effect on the relationship between Mood and Self-Rated Health (B: -0.530; p < 0.001). Discussion: Currently it is about of implementing strategies to manage the pandemic-some of them aimed at promoting healthy living and stress management as assets that favor healthy lifestyles with fewer risk factors. New studies are needed to address the social thresholds of alcohol consumption, considering different perspectives for understanding variations in the intrapersonal and social perception of drunkenness, as this has been shown to be inconsistent across cultures and time periods.

Social support as a mediator in the relationship between technostress or academic stress and health: analysis by gender among university students.

Introduction: This research aims to study the role of social support as a mediator in the relationship between technostress or academic stress and health in university students. Methods: A descriptive, quantitative cross-sectional study has been carried out through a self-reported survey answered by 389 students during March and April 2022. The current level of health was the outcome variable. Technostress and academic stress were the criterion variables. Perceived social support was the mediator variable. The sociodemographic variables and ICT use at the educational level were the independent variables. Results: Women have higher levels of technostress and academic stress than men. Social support significantly and positively mediates the relationship between academic stress and self-perceived health in men. Discussion: There is a clear need to develop new social management strategies that assist students in developing stable and long-lasting social networks, which can reduce stress during the student period and provide personal tools for later working life.

Association between sense of coherence and depression in patients with chronic pain: A systematic review and meta-analysis.

BACKGROUND: Chronic pain is a common complaint having distressing consequences for those that suffer from it. Pain and depression concur within the context of comorbidity, and both share underlying stress conditions. Sense of coherence (SOC) is a factor that determines how well an individual manages stress and stays healthy. Its relationship with depression has been frequently reported in the literature. Our objective was to assess the amount of evidence available regarding the association between SOC and depression in patients suffering from chronic pain. METHODS: A systematic review and meta-analysis were performed. Searches were conducted between November 01 and December 31, 2020 in PubMed, Web of Science, Embase, PsycINFO, Psicodoc, ScienceDirect and Dialnet. There were no restrictions regarding the date of publication of the study. Evidence related to the relationship between SOC and depression in patients with chronic pain was summarized and compared. RESULTS: A total of 163 articles were identified. We included 9 papers in the qualitative and quantitative synthesis. The pooled correlation coefficient was -0.55 (95%: -0.70; -0.41) and was not modified after removing any study. The heterogeneity across the studies was considerable (I2 = 94.8%; p < 0.001). The random-effects meta-regression models for the association between SOC and depression showed that age (p = 0.148) and percentage of women (p = 0.307) were not related to heterogeneity across studies. No publication bias was detected (p = 0.720). CONCLUSIONS: At first glance, the included studies give the impression that SOC is an important factor in depression levels of patients with chronic pain. Most of the included studies revealed a moderate association between SOC and depressive symptoms.

Associations between Psychological Variables, Knowledge, Attitudes, Risk Perceptions and Health Behaviours towards COVID-19 among Adolescents.

There is currently little scientific evidence available that allows us to understand patterns of knowledge, risk perception, attitudes, and behaviours among adolescents in relation to COVID-19. This study aims to analyse the relationship between knowledge about COVID-19, risk perception, and psychological variables and the adherence to preventive measures among the adolescent population. It is a descriptive cross-sectional study, which included adolescents between the ages of 12 and 18 (n = 354). The questionnaire was sent to several secondary schools chosen by convenience sampling and following a non-probabilistic snowball sampling. Descriptive, univariate, and multivariate analyses were carried out in order to determine whether knowledge about COVID-19, risk perception, tolerance of frustration, planning and decision-making, family functionality, self-efficacy, self-esteem, and social skills are related to preventive measures. The adoption among adolescents of behaviours which protect them against COVID-19 depends on knowledge about the disease, the perception of the risk it poses to them, as well as their tolerance of frustration and planning and decision-making abilities. The relationship between the individual variables among adolescents with the adoption of behaviours which protect them against COVID-19 has been confirmed. The development of intervention and communication strategies that take the psychosocial situation of adolescents into account will help to increase the adoption of protective health behaviours in the context of a pandemic.

Knowledge, Attitudes, Risk Perceptions, and Practices of Spanish Adolescents Toward the COVID-19 Pandemic: Validation and Results of the Spanish Version of the Questionnaire.

Background: Adolescence is a period with physical, psychological, biological, intellectual, and social changes in which there is usually little perception of risk. COVID-19 has generated constant situations of change and uncertainty worldwide. During the pandemic, the acquisition of preventive behaviors has been relevant. Various studies carried out with adults associate risk perception and the implementation of preventive behaviors with knowledge about the COVID-19 and with age, but there are not many studies with adolescents. Therefore, the objective is to validate, in Spanish, the questionnaire of the knowledge, attitudes, risk perceptions, and practices of adolescents toward the pandemic, and analyze it according to sociodemographic characteristics. Method: This study was a descriptive cross-sectional study, which included adolescents between the ages of 12-18 (n = 354). First, a translation and a back-translation of the questionnaire were performed. The questionnaire was presented in several high schools chosen by convenience sampling and following a non-probabilistic snowball sampling. Reliability and validity analyses were then carried out and the relationships between the different sociodemographic variables (gender, place of residence, level of education, if the person was in a sentimental relationship, and financial aid) were analyzed. Results: The reliability of the questionnaire is acceptable (ordinal alpha = 77%). Knowledge was higher in women, and in those with a higher level of education; and were lower in those who lived in smaller towns, as well as in those who had a member of their family receiving financial aid. In terms of attitudes and risk perceptions, younger adolescents had higher scores, and those who had a member of their family receiving financial aid, lower. Conclusion: The questionnaire is a reliable tool in the Spanish adolescent population. Knowledge was influenced by gender, place of residence, level of education, and financial aid. Attitudes and risk perceptions were influenced by age and financial aid. For practices, no predictors were found. In general, adolescents scored lower on knowledge about COVID-19, but they scored higher on COVID-19 safety practices.

Influence of Compliance to Diet and Self-Efficacy Expectation on Quality of Life in Patients with Celiac Disease in Spain.

The purpose of this study is to understand the health-related quality of life (HRQoL) in patients with celiac disease (CD) and analyze its main determinants. A transversal descriptive study of 738 patients with celiac disease was carried out. A series of questionnaires were answered related to their HRQoL, adherence to a gluten-free diet (GFD), and self-efficacy beliefs among other relevant variables. Regression analyses were carried out in order to explore the predictive variables in adherence to the GFD and HRQoL. A total of 61.2% showed a good HRQoL, and the main predictors of HRQoL were specific self-efficacy, adherence to the diet, risk perception, time since diagnosis, and age. While 68.7% of participants showed good or excellent adherence to the GFD, and the main predictors of adherence were specific self-efficacy, perceived adoption of recommended behaviors, HRQoL and gender. The HRQoL of patients with CD, and adherence to the GFD in Spain, are good. It is the self-efficacy expectation, measured specifically and not generally, which is the best predictor of both adherence and HRQoL. It is necessary to develop programs to improve the HRQoL of patients with CD that focus on improving specific self-efficacy.

The effect of self-efficacy expectations in the adherence to a gluten free diet in celiac disease.

Objective: To analyse the effect of general and specific self-efficacy on the adherence to a gluten free diet (GFD) in patients with celiac disease along with the effect of other relevant variables.Design: 271 patients with celiac disease participated in this transversal descriptive study and completed a series of questionnaires regarding adherence (CDAT), general self-efficacy (GSES) and specific self-efficacy (Celiac-SE) and quality of life (CD-Qol), among others.Main Outcome Measures: Dependent variable was adherence to the Gluten Free Diet (GFD). Main independent variables were general self-efficacy, specific self-efficacy and quality of life. Model tests were conducted using regression analysis.Results: 71.9% of patients show an excellent or good adherence to the diet. Higher levels of adherence are positively associated to a high expectancy of specific self-efficacy, to the perceived adoption of recommended behaviours, risk perception and better quality of life (these variables accounted for 36.4% of the variance in the adherence to a GFD, p < .001).Conclusions: Specific self-efficacy rather than general has a predictive value in adherence to a GFD. Therefore, we need to develop and transculturally adapt new instruments to assess specific self-efficacy. Celiac-SE has proved to be a useful scale for this objective.

Prevalence of celiac disease in primary care: the need for its own code.

BACKGROUND: Celiac disease (CD) is an autoimmune chronic enteropathy of the small intestine caused by exposure to gluten in genetically predisposed individuals. CD is not easy to diagnose due to its unspecific symptomatology, especially in adults, a diagnosed/undiagnosed ratio of 1:7 is estimated. CD does not have its own code in the International Classification of Primary Care (ICPC) but it is coded under code D99 "Disease digestive system, other", which hinders diagnosis, intervention and research. The aim of this study is to investigate the prevalence of CD in Aragón, Spain, using the information available from Primary Care, as well as to discuss the difficulties involved in determining prevalence of CD from data collected at this level of medical intervention. METHODS: We designed an epidemiological cross-sectional study and analysed 26,964 electronic clinical records from the Aragonese Health Service under code ICPC D99 collected up to December 31st, 2016. The clinical records were classified by their editable field "descriptor" according to their probability of being related to CD. Analyses of gender, age, age at diagnosis, province and health sector were carried out. RESULTS: We found 4534 clinical records under 293 different descriptors with a high probability of referring to CD. Prevalence in Aragón was estimated to be 0.35% ranging from 0.24 to 0.81% with important differences among health sectors. CONCLUSIONS: The prevalence of 0.35% is a long way from the generally accepted 1% but within the usually considered ratio 1:7 of diagnosed:undiagnosed cases. Differences among sectors should be carefully analysed. Lacking its own ICPC code, diagnosis of CD in Primary Care Services is not included in a single category, but it is distributed under several descriptors, which makes it difficult to offer any firm diagnosis for treatment and hinders research. Finally, the high prevalence of CD justifies its own ICPC code and the need to withdraw CD from the generic D99 code "Disease digestive system other".

Validation of Five Facets Mindfulness Questionnaire - Short form, in Spanish, general health care services patients sample: Prediction of depression through mindfulness scale.

The validation of Five Facets Mindfulness Questionnaire (FFMQ)-short version was performed in a general population of a city in a region of Galicia (Spain), the sample was composed of randomly selected Spanish Health Care patients (N = 845). The results on the goodness of fit of the non-hierarchical, five-dimensional factorial model met the criteria for good and acceptable model adjustment (after eliminating item 18 and despite the correlations detected among the errors included in the model), explaining a 55.5%.of the variance. As the second objective has been analysed the association between the scores obtained in the different facets of the FFMQ-SF and the risk of suffering an episode of depression. (The Odd Ratio, the Hosmer-Lemeshow test and the ROC curve were calculated.) Participants who were currently suffering from an episode of depression were more likely to have low scores in "describing" facet of Mindfulness (adjusted OR = 1.58, 95% CI = 1.04-2.40, linear trend: χ2 = 3.74, df = 1, p = 0.053) as well as low scores on "acting with awareness" (adjusted OR = 2.19, 95% CI = 1.461-3.30, linear trend: χ2 = 9.52, df = 1; = 0.002) and "non judging" (adjusted OR = 2.05, 95% CI = 1.36-3.09, linear trend: χ2 = 143.21, df = 1; p <0.001). Participants with a previous episode of depression were more likely to have low scores on the subscale "acting with awareness" (adjusted OR = 2.37, 95% CI = 1.43-3.93, linear trend: χ2 = 9.62, df = 1, p = 0.002) and "non-reactivity" (adjusted OR = 2.14, 95% CI = 1.28-3.56, linear trend: χ2 = 8.30; df = 1; p = 0.004. Questionnaire FFMQ-SF is an adequate questionnaire for the evaluation of mindfulness in non-clinical multi- occupational population.

Value congruence, control, sense of community and demands as determinants of burnout syndrome among hospitality workers.

Employees working in the hospitality industry are constantly exposed to occupational stressors that may lead employees into experiencing burnout syndrome. Research addressing the interactive effects of control, community and value congruence to alleviate the impact of workplace demands on experiencing burnout is relatively limited. The present study examined relationships among control, community and value congruence, workplace demands and the three components of burnout. A sample of 418 employees working in a variety of hospitality associations including restaurants and hotels in Spain were recruited. Moderation analyses and linear regressions analyzed the predictive power of control, community and value congruence as moderating variables. Results indicate that control, community and value congruence were successful buffers in the relationships between workplace demands and the burnout dimensions. The present findings offer suggestions for future research on potential moderating variables, as well as implications for reducing burnout among hospitality employees.

Relation of the Psychological Constructs of Resilience, Mindfulness, and Self-Compassion on the Perception of Physical and Mental Health.

PURPOSE: Health factors that enhance an individual's ability to perceive and maintain health and well-being are referred to as "health assets". Of these assets, resilience, mindfulness and self-compassion are considered to be of special importance. The objective of this study was to analyze the association between these psychological constructs on the perception of physical and mental health in a general population. PATIENTS AND METHODS: A descriptive and analytical cross-sectional study was conducted with 845 participating subjects. The outcome variable was the individual´s perception of physical and mental health, measured using the SF-36 questionnaire. The independent variables were: sociodemographic variables, medical information, physical activity performance (using the International Physical Activity Questionnaire), tobacco and alcohol consumption, anxiety and/or depression (using the Goldberg Anxiety and Depression Scale), resilience (using the Connor-Davidson Resilience Scale), mindfulness (with the Five Facets of Mindfulness Questionnaire Short Form) and self-compassion (using the Self-compassion scale-short form). A correlation analysis, simple linear regression and multiple linear regression were carried out, controlling for the influence of the distinct independent variables. RESULTS: The constructs of resilience, mindfulness and self-compassion are significant, in the perception of both physical and mental health. Other factors appearing in the multiple regression are gender, age, educational level, physical activity and tobacco consumption, in a positive or negative sense. CONCLUSION: The study of these associations is fundamental for the understanding of underlying regulation processes of healthy lifestyles in the general population.

Development and Validation of a Specific Self-Efficacy Scale in Adherence to a Gluten-Free Diet.

The aim of this study was to develop a scale to assess the levels of specific self-efficacy in order to enhance adherence to a gluten-free diet and the life quality of celiac patients. Celiac disease is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed people. The only treatment is a strict lifelong gluten-free diet. Within the framework of Social Cognitive Theory, expectation of self-efficacy is understood as the degree in which a person believes himself to be capable of performing a certain task (e.g., adhering to a gluten-free diet), a construct which has been widely studied in its relation with adopting healthy behaviors, but scarcely in relation to celiac disease. A validation study was carried out in various stages: preparation of the protocol; construction of the questionnaire and a pilot run with 20 patients; validation of the scale with 563 patients and statistical analysis. A 25-item scale was developed. Feasibility was excellent (99.82% of participants completed all the questions). Factorial analysis pointed to the existence of five factors that explained 70.98% of the variance with a Cronbach alpha of 0.81 for the scale overall and between 0.64 and 0.90 for each factor. The scale showed a Spearman's Rho coefficient of 0.279 with the General self-efficacy Scale. This easily administered scale provides good psychometric properties for evaluating specific self-efficacy of celiac patients in adhering to treatment. It seeks to be the first scale that provides not only a measurement of specific self-efficacy in celiac disease, but also to determine its levels for each of the areas as a first step toward designing interventions of self-management and empowerment programs to cope with the disease.

Variabilidad en adecuación de las peticiones de analíticas por atención primaria para dislipemia, diabetes mellitus e hipertensión arterial / Variability in the suitability of the Primary Care laboratory requests for dyslipidaemia, diabetes mellitus, and arterial hypertension

Introducción. Existe una elevada variabilidad en la adecuación de las solicitudes de determinaciones de laboratorio para el diagnóstico y seguimiento de la hipertensión arterial, la dislipemia y la diabetes mellitus (factores de riesgo cardiovascular), siendo esta una de las actividades preventivas y asistenciales más importantes y numerosas que se llevan a cabo en atención primaria (AP). El objetivo del presente estudio fue analizar la variabilidad en la adecuación existente en los procedimientos analíticos solicitados rutinariamente por los médicos de AP en relación con el diagnóstico y seguimiento de la hipertensión arterial, la dislipemia y la diabetes mellitus, y valorar comparativamente los costes de dichas solicitudes analíticas rutinarias y las alternativas propuestas por la evidencia. Material y métodos. Estudio transversal, retrospectivo, descriptivo desarrollado en el sector sanitario de Teruel (75.800 habitantes: 50,20% hombres y 49,80% mujeres), 24,20% mayores de 65años, distribuidos en 17 equipos de AP, en el año 2012. Resultados. Se han procesado un total de 725.179 determinaciones analíticas. Se realizaron 174.608 determinaciones en el seguimiento de las patologías de estudio, de las que el 69,74% no estaban justificadas por los protocolos de seguimiento. El nivel de control analítico de las tres patologías estudiadas es bajo, y las analíticas solicitadas difieren muy poco entre sí. Conclusiones. La diferencia entre lo que la evidencia determina que debe solicitarse para el diagnóstico y seguimiento de la hipertensión arterial, la dislipemia y la diabetes mellitus presenta un elevado porcentaje y coste asociado, dejando patente la necesidad de mejorar en la utilización de los recursos sanitarios (AU)

Introduction. There is a wide variability in the suitability of the requests for laboratory determinations for the diagnosis and follow-up of arterial hypertension, dyslipidaemia, and diabetes mellitus (cardiovascular risk factors). This is one of the most important and numerous preventive and care activities to be performed and carried out in Primary Care. The aim of the present study was to analyse the variability in the adequacy of the routine analytical procedures requested by Primary Care physicians in relation to the diagnosis and follow-up of hypertension, dyslipidaemia and diabetes mellitus, and to compare the costs of such applications comparatively, as well as the alternatives proposed by the evidence. Material and methods. A cross-sectional, retrospective, descriptive study was conducted in 2012 in the Teruel health sector (75,800 inhabitants: 50.20% male and 49.80% female), with 24.20% over 65years, and distributed into 17 Primary Care Teams. Results. A total of 725,179 determinations were processed. There were 174,608 determinations in the follow-up of the pathologies studied, of which 69.74% were not justified by the follow-up protocols. The level of analytical control of the three pathologies studied is low, and the requested laboratory tests differ very little from one another. Conclusions. The difference between what the evidence determines should be requested for the diagnosis and follow-up of hypertension, dyslipidaemia and diabetes mellitus has a high percentage and associated cost, showing the need to improve the use of health resources (AU)

Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions.

BACKGROUND: Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. METHODS: A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. RESULTS: Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having implemented some change to promote their health. The most powerful motivators to change lifestyles are having a disease, fear of becoming ill and taking care of oneself to maintain health. Health-care users believe that the main difficulties are associated with the physical, social, working and family environment, as well as lack of determination and motivation. They also highlight the need for more information. In relation to the assets and deficits of the neighbourhood, each group identifies those closer to their role. CONCLUSIONS: Generally, participants showed a holistic and positive concept of health and a more traditional, individual approach to health promotion. We consider therefore crucial to depart from the model of health services that focuses on the individual and the disease toward a socio-ecological health model that substantially increases the participation of health-care users and emphasizes health promotion, wellbeing and community participation.

Beyond the consultation room: Proposals to approach health promotion in primary care according to health-care users, key community informants and primary care centre workers.

BACKGROUND: Primary health care (PHC) is the ideal setting to provide integrated services centred on the person and to implement health promotion (HP) activities. OBJECTIVE: To identify proposals to approach HP in the context of primary care according to health-care users aged 45-75 years, key community informants and primary care centre (PCC) workers. METHODS: Descriptive-interpretive qualitative research with 276 participants from 14 PCC of seven Spanish regions. A theoretical sampling was used for selection. A total of 25 discussion groups, two triangular groups and 30 semi-structured interviews were carried out. A thematic interpretive contents analysis was carried out. RESULTS: Participants consider that HP is not solely a matter for the health sector and they emphasize intersectoral collaboration. They believe that it is important to strengthen community initiatives and to create a healthy social environment that encourages greater responsibility and participation of health-care users in decisions regarding their own health and better management of public services and resources. HP, care in the community and demedicalization should be priorities for PHC. Participants propose organizational changes in the PCC to improve HP. PCC workers are aware that HP falls within the scope of their responsibilities and propose to increase their training, motivation, competences and knowledge of the social environment. Informants emphasize that HP should be person-centred approach and empathic communication. HP activities should be appealing, ludic and of proven effectiveness. CONCLUSIONS: According to a socio-ecological and intersectoral model, PHC services must get actively involved in HP together with community and through outreach interventions.

Síntesis de los procedimientos analíticos recomendados por la evidencia en factores de riesgo cardiovascular / Summary of analytical procedures recommended by the evidence on cardiovascular risk factors

Los eventos cardiovasculares suponen un importante problema de salud a nivel mundial. Se consideran como factores de riesgo cardiovascular esenciales el tabaquismo, la hipertensión arterial, la dislipidemia y la diabetes mellitus. Existe una elevada variabilidad en la solicitud de determinaciones de laboratorio en la práctica médica, incluyendo la disparidad de criterio en las determinaciones analíticas para controlar dichas patologías. El objetivo es sintetizar la evidencia científica disponible sobre los diferentes procedimientos analíticos de rutina recomendados en el diagnóstico y control de la dislipidemia, la diabetes mellitus y la hipertensión arterial. Se realizó una revisión de la bibliografía existente sobre las recomendaciones de las principales sociedades y organizaciones científicas, nacionales e internacionales, acerca de las determinaciones de laboratorio precisas para el diagnóstico, control y seguimiento de dichas patologías. Se obtuvieron un total de 34 documentos, una vez revisada la evidencia científica y calidad de los mismos, el análisis se centró en seis documentos. Las principales recomendaciones son: a) diabetes: glucemia basal en ayunas, hemoglobina glucosilada, perfil lipídico, creatinina, sistemático de orina, sedimento de orina, microalbuminuria, ionograma; anual. b) Dislipidemia: perfil lipídico completo; periodicidad anual o en función de los niveles de LDL-colesterol. Si hay tratamiento con estatinas: transaminasas, creatina fosfoquinasa. c) Hipertensión arterial: glucosa, colesterol total, creatinina y análisis sistemático de orina; perfil lipídico, ácido úrico, ionograma y microalbuminuria; anual. Con estas recomendaciones se pretende ayudar en la mejora de los procedimientos de solicitud de analíticas respecto de lo que la evidencia científica recomienda, tratando de reducir la variabilidad (AU)

Cardiovascular events pose a major health problem worldwide. Smoking, hypertension, dyslipidemia and diabetes mellitus are considered essential cardiovascular risk factors. There is a high variability in laboratory determinations application in medical practice, including the disparity of criteria in analytical determinations to control these diseases. The aim is to summarize the available scientific evidence on the different routine analytical procedures recommended in the diagnosis and control of dyslipidemia, diabetes and hypertension. A bibliographic review of the existing literature about recommendations of the main scientific societies and organizations, national and international, about precise laboratory determinations for diagnosis, monitoring and control of these diseases was performed. A total of 34 documents were obtained, once scientific evidence and quality of them revised, the analysis focused on six documents. The main recommendations are: a) diabetes: baseline fasting plasma glucose, glycosylated hemoglobin, lipid profile, creatinine, urinalysis, urine sediment, microalbuminuria, electrolytes; annual. b) Dyslipidemia: complete lipid profile; based on annual or LDL- cholesterol basis. If statin therapy: transaminases, creatine phosphokinase. c) Hypertension: glucose, total cholesterol, creatinine and systematic urinalysis; lipid profile, uric acid, electrolytes and microalbuminuria; annual. These recommendations are intended to assist in improving the application of analytical procedures on what scientific evidence recommends, trying to reduce variability (AU)

Adaptación transcultural y validación del Celiac Dietary Adherence Test. Un cuestionario sencillo para determinar la adherencia a la dieta sin gluten / Transcultural adaptation and validation of the Celiac Dietary Adherence Test. A simple questionnaire to measure adherence to a gluten-free diet

Antecedentes y objetivos: la dieta sin gluten es, hasta la fecha, el único tratamiento para la enfermedad celiaca, pero revisiones sistemáticas indican que sólo entre un 42% y un 91% de los pacientes siguen la dieta estrictamente, dependiendo del método de evaluación y de la definición de adherencia. Es importante contar con herramientas adaptadas transculturalmente que permitan evaluar la adherencia más allá de preguntas autoinformadas o de invasivas analíticas. El objetivo es adaptar transculturalmente y validar el Celiac Dietary Adherence Test de Leffler a la población española en lengua castellana. Métodos: estudio transversal observacional en dos fases: una primera de traducción/retrotraducción por cuatro traductores cualificados y una fase de validación en la que se aplicó el cuestionario a 306 pacientes de Aragón con enfermedad celiaca entre los 12 y los 72 años. Se evaluaron la estructura factorial, la validez de criterio y la consistencia interna. Resultados: la traducción al castellano mantuvo sus 7 ítems con una estructura de 3 factores. a factibilidad fue muy buena con todas las preguntas contestadas y con efectos suelo y techo muy bajos (4,3% y 1%, respectivamente). La correlación de Spearman con las escalas de autoeficacia y calidad de vida y la pregunta autoinformada resultaron estadísticamente significativas (p < 0,01). Aplicando los criterios de este cuestionario se obtuvo una adherencia del 72,3%. Conclusión: la adaptación española del CDAT muestra unas propiedades psicométricas adecuadas, por lo que su uso estaría indicado para el estudio de la adherencia a la dieta sin gluten en entornos clínicos y de investigación (AU)

Background and aims: A gluten-free diet is to date the only treatment available to celiac disease sufferers. However, systematic reviews indicate that, depending on the method of evaluation used, only 42% to 91% of patients adhere to the diet strictly. Transculturally adapted tools that evaluate adherence beyond simple self-informed questions or invasive analyses are, therefore, of importance. The aim is to obtain a Spanish transcultural adaption and validation of Leffler’s Celiac Dietary Adherence Test. Methods: A two-stage observational transversal study: translation and back translation by four qualified translators followed by a validation stage in which the questionnaire was administered to 306 celiac disease patients aged between 12 and 72 years and resident in Aragon. Factorial structure, criteria validity and internal consistency were evaluated. Results: The Spanish version maintained the 7 items in a 3-factor structure. Reliability was very high in all the questions answered and the floor and ceiling effects were very low (4.3% and 1%, respectively). The Spearman correlation with the self-efficacy and life quality scales and the self-informed question were statistically significant (p < 0.01). According to the questionnaire criteria, adherence was 72.3%. Conclusion: The Spanish version of the Celiac Dietary Adherence Test shows appropriate psychometric properties and is, therefore, suitable for studying adherence to a gluten-free diet in clinical and research environments (AU)

Transcultural adaptation and validation of the Celiac Dietary Adherence Test. A simple questionnaire to measure adherence to a gluten-free diet.

BACKGROUND AND AIMS: A gluten-free diet is to date the only treatment available to celiac disease sufferers. However, systematic reviews indicate that, depending on the method of evaluation used, only 42% to 91% of patients adhere to the diet strictly. Transculturally adapted tools that evaluate adherence beyond simple self-informed questions or invasive analyses are, therefore, of importance. The aim is to obtain a Spanish transcultural adaption and validation of Leffler's Celiac Dietary Adherence Test. METHODS: A two-stage observational transversal study: translation and back translation by four qualified translators followed by a validation stage in which the questionnaire was administered to 306 celiac disease patients aged between 12 and 72 years and resident in Aragon. Factorial structure, criteria validity and internal consistency were evaluated. RESULTS: The Spanish version maintained the 7 items in a 3-factor structure. Reliability was very high in all the questions answered and the floor and ceiling effects were very low (4.3% and 1%, respectively). The Spearman correlation with the self-efficacy and life quality scales and the self-informed question were statistically significant (p < 0.01). According to the questionnaire criteria, adherence was 72.3%. CONCLUSION: The Spanish version of the Celiac Dietary Adherence Test shows appropriate psychometric properties and is, therefore, suitable for studying adherence to a gluten-free diet in clinical and research environments.

A factor confirmation and convergent validity of the "areas of worklife scale" (AWS) to Spanish translation.

BACKGROUND: Perceived incongruity between the individual and the job on work-life areas such as workload, control, reward, fairness, community and values have implications for the dimensions of burnout syndrome. The "Areas of Work-life Scale" (AWS) is a practical instrument to measure employees´ perceptions of their work environments. AIMS: Validate a Spanish translation of the AWS, and it relationship with Masclach Burnout Inventory dimensions. METHODS: The study was conducted in three medium-sized hospitals and seven rural and urban Primary Care centres (N = 871) in Spain. The "Maslach Burnout Inventory General Survey" (MBI-GS) and AWS were applied. We developed a complete psychometric analysis of its reliability, and validity. RESULTS: Data on the reliability supported a good internal consistency (Cronbach α between .71, and .85). Construct validity was confirmed by a six factor model of the AWS as a good measure of work environments (χ²(352) = 806.21, p < 0.001; χ²/df = 2.29; CFI = 0.935, RMSEA = 0.039); concurrent validity was analysed for its relationship with other measures (opposing dimensions to burnout, and MBI), and each correlation between dimensions and sub-dimensions were statistically significant; as well, predictive validity, by a series of Multiple Regression Analysis examined the resulting patterns of the Confirmatory Factor Analysis (CFA) confirms the relationship between the work-life areas and burnout dimensions. CONCLUSIONS: Leiter and Maslach's AWS has been an important instrument in exploring several work-life factors that contribute to burnout. This scale can now be used to assess the quality of work-life in order to design and assess the need for intervention programs in Spanish-speaking countries.