Mediterranean diet adherence and glycemic control in children and adolescents with type 1 diabetes.

To effectively manage type 1 diabetes (T1D) insulin is essential, with dosages based on lifestyle. The Mediterranean diet has demonstrated its advantages in preventing and enhancing the management of chronic diseases. Our objective was to investigate the potential mediation of sensor activity on the relationship between adherence to the Mediterranean diet and glycemic control in children and adolescents. A total of 150 children and adolescents (mean age = 13.09, SD = 3.54; 44% female) with T1D were recruited. Adherence to the Mediterranean diet was assessed using the KIDMED questionnaire which evaluates 16 items and gives higher scores when adherence is higher. Glycemic control and the duration of sensor activity were evaluated with data from flash glucose monitoring. The data confirmed our hypothesis by revealing that adherence to the Mediterranean diet positively influenced glycemic control (direct effect = 1.505; P < 0.01) and that this relationship was mediated by the duration of sensor activity (indirect effect = 0.531; P < 0.01).  Conclusions: Our results support the increased utilization of glycemic control devices, as they contribute to improve glycemic control and mediate on the positive relationship between adherence to the Mediterranean diet and adequate glycemic control. Furthermore, our findings highlight the importance of incorporating Mediterranean diet recommendations to achieve better glycemic control in children and adolescents with T1D. What is Known: • The Mediterranean diet and glycemic control have proven benefits in improving cardiovascular health in the general population. Scarce evidence exists of these benefits among children and adolescents with T1D. What is New: • Adherence to the Mediterranean diet and greater use of glucose monitoring devices in children and adolescents with T1D are related to better glycemic control. These variables can be enhanced by psychoeducational interventions such as structured diabetes education programs or peer group-based sessions, which highlights the importance of focusing on these aspects.

Efficacy of a Combined Acceptance and Commitment Intervention to Improve Psychological Flexibility and Associated Symptoms in Cancer Patients: Study Protocol for a Randomized Controlled Trial.

Psychological flexibility is a key concept of acceptation and commitment therapy (ACT). This factor has been linked with psychological wellbeing and associated factors, such as quality of life, in cancer patients. These and other positive results of acceptation and commitment therapy in cancer patients found in previous research could be enhanced by using mhealth tools. A three-arm randomized superiority clinical trial, with a pre-post-follow-up repeated measures intergroup design with a 1:1:1 allocation ratio is proposed. A hundred and twenty cancer patients will be randomly assigned to one of the following interventions: (1) face-to-face ACT + mobile application (app), (2) face-to-face ACT, and (3) Waitlist control group. The primary expected outcome is to observe significant improvements in psychological flexibility acceptance and action questionnaire- II (AAQ-II) in the face-to-face ACT + app group, after comparing baseline and post-treatment scores, and the scores will remain stable in the two assessment points, 3 and 6 months after the intervention. Secondary expected outcomes are significant increasing scores in quality of life (EORTC QLQ C-30) and post-traumatic-growth (PTGI-SF), and significant decreasing scores in anxiety and depression (HADS), insomnia (ISI) and fatigue (BFI) at the same assessment points. Also, it is expected that the scores of this group will be higher than the scores of the face-to-face ACT group and the waitlist control group. This study aims to assess the efficacy of a combined intervention (face-to face ACT + app) for psychological flexibility and associated symptoms in cancer patients. The results of this protocol may help to consider the use of acceptation and commitment therapy and mhealth applications in cancer settings as a valid therapeutic choice. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT05126823].

Exploración de los conocimientos sobre mutilación genital femenina del personal sanitario maternoinfantil de Melilla / Exploring the knowledge on female genital mutilation (FGM) for maternal and child health personnel in Melilla

OBJETIVO: Explorar los conocimientos y las habilidades que tienen los profesionales del área maternoinfantil de los centros sanitarios de Melilla sobre mutilación genital femenina (MGF). MATERIAL Y MÉTODOS: Estudio transversal descriptivo, realizado en Melilla, basado en una encuesta autoadministrada de preguntas abiertas sobre conocimientos y habilidades en relación con la MGF. Se seleccionaron las personas participantes por ser profesionales sanitarios en contacto con mujeres a las que se hubiera practicado una MGF. RESULTADOS Y DISCUSIÓN: De las 64 encuestas analizadas, el 67,2% de los profesionales afirman poseer conocimientos insuficientes sobre MGF y no le dan una gran relevancia al problema en el ámbito nacional. A pesar de ello, el 31,3% de la muestra afirma haber atendido a mujeres a las que se les había realizado dicha práctica. El porcentaje de la muestra de Melilla estaría por encima de los resultados encontrados en otros estudios nacionales, y por debajo de la media del porcentaje de casos identificados por el personal sanitario fuera de nuestras fronteras. CONCLUSIÓN: Observamos que los conocimientos del personal sanitario respecto a la MGF son insuficientes en lo referente a la práctica y a sus consecuencias, así como en los recursos disponibles para evitarla y la legislación que la regula. A pesar de no tener una buena formación sobre MGF, más de un 30% de la muestra afirma haberse encontrado con mujeres a quienes se les había practicado una mutilación tipo I o tipo II. Algunos encuestados añaden que quizás la han percibido pero no han sabido identificarla

OBJECTIVE: To explore the knowledge and skills that professionals maternal/child health centers area Melilla have on female genital mutilation (FGM). MATERIAL AND METHODS: Descriptive cross-sectional study conducted in Melilla. Based on a self-administered survey of open questions about the current knowledge and skills in relation to FGM. The participants were selected by the possibility of being health professionals in contact with women who had undergone FGM. RESULTS AND DISCUSSION: Of the 64 surveys analyzed, 67.2% of medical/child care professionals have inadequate knowledge of FGM and further, do not give great importance to FGM as a national problem. In addition, 31.3% of the sample stated they had treated women who had undergone FGM. The percentage of the sample of Melilla would be above the results found in other national studies, and would be below the average of the percentage of cases identified by the health professionals outside our borders. CONCLUSION: We observe that the knowledge of the health personnel regarding FGM is insufficient in relation to the practice and its consequences, as well as in the resources available to avoid it and the legislation that regulates it. Despite not having a good training on FGM, more than 30% of the sample claims to have met women who had undergone a type I or type II mutilation. Some respondents add that perhaps they have perceived it but have not been able to identify it

The role of coping strategies and self-efficacy as predictors of life satisfaction in a sample of parents of children with autism spectrum disorder / Estrategias de afrontamiento y autoeficacia como predictores de satisfacción vital en progenitores de menores con autismo

BACKGROUND: This research aims to understand the role of coping strategies and self-efficacy expectations as predictors of life satisfaction in a sample of parents of boys and girls diagnosed with autistic spectrum disorder. METHODS: A total of 129 parents (64 men and 65 women) answered a questionnaire on life-satisfaction, coping strategies and self-efficacy scales. RESULTS: Using a regression model, results show that the age of the child is associated with a lower level of satisfaction in parents. The results show that self-efficacy is the variable that best explains the level of satisfaction in mothers, while the use of problem solving explains a higher level of satisfaction in fathers. Men and women show similar levels of life satisfaction; however significant differences were found in coping strategies where women demonstrated higher expressing emotions and social support strategies than men. CONCLUSIONS: The development of functional coping strategies and of a high level of self-efficacy represents a key tool for adapting to caring for children with autism. Our results indicated the necessity of early intervention with parents to promote coping strategies, self-efficacy and high level of life satisfaction

ANTECEDENTES: esta investigación analiza el papel de las estrategias de afrontamiento y las expectativas de autoeficacia como predictores de la satisfacción vital en una muestra de progenitores de niños/as con autismo. MÉTODO: 129 progenitores (64 hombres y 65 mujeres) respondieron un cuestionario con escalas de satisfacción vital, estrategias de afrontamiento y autoeficacia. RESULTADOS: utilizando un modelo de regresión encontramos que la edad del hijo/a predice menor satisfacción en los progenitores conforme avanza el tiempo. Los resultados muestran diferencias entre ambos sexos: la autoeficacia es la variable que mejor explica el nivel de satisfacción de las madres, frente al uso de resolución de problemas en los padres. Ambos muestran niveles similares de satisfacción vital; sin embargo, encontramos diferencias significativas en el uso de estrategias de afrontamiento indicando que las mujeres manejan más estrategias relacionadas con expresión emocional y apoyo social en comparación con los hombres. CONCLUSIONES: el desarrollo de estrategias de afrontamiento funcionales y de una alta autoeficacia constituye una herramienta clave para la adaptación al cuidado de menores con autismo. Nuestros resultados indican la necesidad de una intervención temprana con padres y madres centrada en las estrategias de afrontamiento y autoeficacia para mejorar la satisfacción vital

The role of coping strategies and self-efficacy as predictors of life satisfaction in a sample of parents of children with autism spectrum disorder.

BACKGROUND: This research aims to understand the role of coping strategies and self-efficacy expectations as predictors of life satisfaction in a sample of parents of boys and girls diagnosed with autistic spectrum disorder. METHODS: A total of 129 parents (64 men and 65 women) answered a questionnaire on life-satisfaction, coping strategies and self-efficacy scales. RESULTS: Using a regression model, results show that the age of the child is associated with a lower level of satisfaction in parents. The results show that self-efficacy is the variable that best explains the level of satisfaction in mothers, while the use of problem solving explains a higher level of satisfaction in fathers. Men and women show similar levels of life satisfaction; however significant differences were found in coping strategies where women demonstrated higher expressing emotions and social support strategies than men. CONCLUSIONS: The development of functional coping strategies and of a high level of self-efficacy represents a key tool for adapting to caring for children with autism. Our results indicated the necessity of early intervention with parents to promote coping strategies, self-efficacy and high level of life satisfaction.

La atención temprana en los trastornos del espectro autista (TEA) / Early intervention in autism spectrum disorders (ASD)

En el presente artículo abordamos la intervención temprana en niñas y niños de 0 a 6 años con trastorno del espectro autista (TEA). A pesar de que la atención temprana es una disciplina bastante reciente, actualmente hay algunas evidencias sobre cómo trabajar y qué principios deben guiar dicha intervención. En nuestro caso nos centraremos en los principios que deben guiar la atención temprana a la hora de intervenir con niños y niñas con rasgos del trastorno de espectro autista. Es innegable la importancia que tiene la detección precoz de cualquier trastorno del desarrollo -y por ende del TEA- para la intervención temprana con los menores y sus familias. Una intervención temprana constituye un importante predictor en la recuperación funcional de estos menores, lo cual, unido a la creciente incidencia y prevalencia de estos trastornos, hace de nuestro objeto de estudio un tema creciente de gran interés científico y teórico

In this paper we will address early intervention in children with autism spectrum disorders (ASD) in ages ranging from birth to six years old. Early intervention is a very recent matter, but today we have some evidences about how to deal with it and the principles that must guide early intervention in children with autism spectrum disorders. The importance of early detection is undeniable in all developmental disorders in children with ASD as well, for an early intervention with children and their families. An early intervention is a very important predictor of functional recovery. Along with the growing incidence and prevalence of this kind of disorders, this makes our field of study a matter of increasing scientific and theoretical interest