Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian "Burnout Clinical Subtype Questionnaire" (BCSQ-36/BCSQ-12).

Primary healthcare personnel show high levels of burnout. A new model of burnout has been developed to distinguish three subtypes: frenetic, under-challenged, and worn-out, which are characterized as overwhelmed, under-stimulated, and disengaged at work, respectively. The aim of this study was to assess the psychometric properties of the long/short Brazilian versions of the "Burnout Clinical Subtypes Questionnaire" (BCSQ-36/BCSQ-12) among Brazilian primary healthcare staff and its possible associations with other psychological health-related outcomes. An online cross-sectional study conducted among 407 Brazilian primary healthcare personnel was developed. Participants answered a Brazil-specific survey including the BCSQ-36/BCSQ-12, "Maslach Burnout Inventory-General Survey", "Utrecht Work Engagement Scale", "Hospital Anxiety/Depression Scale", "Positive-Negative Affect Schedule", and a Visual Analogue Scale of guilt at work. The bifactor was the model with the best fit to the data using the BCSQ-36, which allowed a general factor for each subtype. The three-correlated factors model fit better to the BCSQ-12. Internal consistence was appropriate, and the convergence between the long-short versions was high. The pattern of relationships between the burnout subtypes and the psychological outcomes suggested a progressive deterioration from the frenetic to the under-challenged and worn-out. In sum, the Brazilian BCSQ-36/BCSQ-12 showed appropriate psychometrics to be used in primary healthcare personnel.

Effects of Mindfulness on Diabetes Mellitus: Rationale and Overview.

Diabetes mellitus (DM) is an emerging global healthcare problem and its prevalence is increasing at an alarming rate. Despite improvements in both medical and pharmacological therapies, a complex medical condition may demand a diversified approach, such as: drug therapy, healthy diet and exercises, diabetes education programs, adherence to medical treatment and active participation of the patients in their lifestyle changes, such as stress management. The concept of mindfulness is here defined as the awareness that unfolds from the intention to attentively observe the current experience in a non-judgmental and non-evaluative way. This state of awareness can be enhanced through the use of mindfulness-based interventions (MBIs), which have been associated to many physical and psychological health indicators. The aim of this overview is to offer the rationale and potential benefits of mindfulness in the control of DM and its complications. METHODS: a narrative review of the current and updated literature available on online database and which came up using the terms "mindfulness" and "diabetes mellitus". Mindfulness-based Interventions (MBIs) can be seen as preventive and complementary interventions in DM, particularly for the relief of symptoms related to depression and anxiety in diabetic patients and also in the management of other factors, including mindful eating, physical exercises and treatment adherence. Although many studies only present research protocols, mindfulness seems to have beneficial effects on all aspects of diabetes, including incidence, control and complications. Furthermore, longer term and more carefully controlled trials are necessary in order to draw consistent conclusions on the beneficial role of MBIs on DM.

Impacto de estratégias de educação nutricional sobre variáveis antropométricas e conhecimento alimentar / Impact of nutritional education strategies on anthropometric variables and nutrition knowledge / Impacto de estrategias de educación nutricional sobre variables antropométricas y conocimiento alimentario

Avaliar o impacto de um programa de educação nutricional sobre o estadonutricional e conhecimento alimentar de pacientes com excesso de peso. Métodos: Estudo longitudinal, de natureza quantitativa, realizado entre setembro e outubro de 2012, com amostra constituída por 15 pacientes com excesso de peso (sobrepeso: Índice de Massa Corpórea (IMC)>25,0kg/m2 e <30kg/m2, e obesidade: IMC>30kg/m2), frequentadores de um grupo de educação alimentar em uma Unidade Básica de Saúde (UBS). A intervenção nutricional ocorreu em seis encontros semanais (M1: triagem geral e M2 a M7: 6 intervenções nutricionais), sendo aplicado um questionário para avaliar o conhecimento dos participantes sobre os assuntos a serem discutidos antes e após a intervenção. Antes do primeiro encontro e na última intervenção, foram aferidos peso, altura e perímetro de cintura. Realizou-se teste não paramétrico de Wilcoxon, com nível de significância de 5%, para analisar a média do número de acertos nas questões e na evolução nutricional. Resultados: Após a estratégia de educação nutricional, houve uma redução média de 1,51kg do peso inicial; o valor médio de IMC passou de 37,41lg/m² para 36,85lg/m²; o perímetro de cintura apresentou redução média de 5,6cm; além do aumento no número de acertos dos questionários. Conclusão: A estratégia de educação nutricional parece ter influenciado na boa evolução do estado nutricional dos participantes, propiciando redução de medidas antropométricas e ampliando os conhecimentos sobre alimentação saudável...

To assess the impact of a nutrition education program on the nutritional status and food knowledge of patients with overweight. Methods: A longitudinal quantitative study, performed between September and October 2012, with sample consisting of 15 patients with excessive weight (overweight: Body Mass Index or BMI between 25kg/m2 and 29,9kg/m2; and obesity: above 30kg/m2), enrolled in a group of food education in a Primary Healthcare Unit. Nutritional intervention occurred in six weekly meetings (M1: general screening; and M7 to M2: 6 nutritional interventions), being applied a questionnaire assessing the participants? knowledge on the subjects to be discussed before and after the intervention. Prior to the first meeting and in the last intervention, measures of weight, height and waist circumference were obtained. Nonparametric Wilcoxon tests were performed, with a significance level of 5%, to analyze the average number of correct answers and the nutritional outcome. Results: Following the nutritional education strategy, there was an average reduction of 1.51kg in relation to the initial weight; the average BMI increased from 37.41kg/m² to 36.85kg/m²; waist circumference showed mean reduction of 5.6cm; and the number of correct answers in the questionnaires increased. Conclusion: The nutritional education strategy seems to have influenced the good evolution of the participants? nutritional status, leading to a decrease in the anthropometric measures and increasing knowledge about healthy eating...

Evaluar el impacto de un programa de educación nutricional sobre el estado nutricional y conocimiento alimentario de pacientes con exceso de peso. Métodos: Estudio longitudinal de naturaleza cuantitativa realizado entre septiembre y octubre de 2012 con una muestra de 15 pacientes con exceso de peso (sobrepeso: Índice de Masa Corpórea (IMC)>25,0kg/m2 y <30kg/ m2, y obesidad: IMC>30kg/m2), frecuentadores de un grupo de educación alimentaria en una Unidad Básica de Salud (UBS). La intervención nutricional se dio en seis encuentros semanales (M1: selección general y M2 a M7: 6 intervenciones nutricionales), com la aplicación de un cuestionario para evaluar el conocimiento de los participantes sobre los asuntos discutidos antes y después de la intervención. El peso, la altura y el perímetro de cintura fueron medidos antes del primer encuentro y en la última intervención. Se realizó el test no paramétrico de Wilcoxon con nivel de significancia de 5% para analizar la media del número de aciertos en las cuestiones y en la evolución nutricional. Resultados: Hubo una reducción media de 1,51kg del peso inicial; el valor médio del IMC cambió de 37,41lg/m² para 36,85lg/m²; el perímetro de cintura presentó reducción media de 5,6cm; además Del aumento del número de aciertos de los cuestionarios después de la estrategia de educación nutricional. Conclusión: La estratégia de educación nutricional parece haber influenciado en la buena evolución del estado nutricional de los participantes llevando a una reducción de medidas antropométricas y ampliando los conocimientos de alimentación saludable...

Nutritional intervention programme among a Japanese-Brazilian community: procedures and results according to gender.

OBJECTIVE: To describe the results of a nutritional intervention programme among Japanese-Brazilians according to gender. DESIGN: A non-controlled experimental study. SETTING: The research included three points of clinical, nutritional and physical activity evaluation: at baseline (in 2005), after the first year and at the end of the second year (in 2007). The paired Student t test and multiple linear regression analysis were used to evaluate changes in the subjects' profile (clinical, nutritional and physical activity variables). SUBJECTS: Japanese-Brazilians (n 575) of both genders, aged over 30 years. RESULTS: We verified statistically significant reductions in body weight (0.9 kg), waist circumference (2.9 cm), blood pressure, fasting blood glucose (>3 mg/dl) and total cholesterol (>20 mg/dl) and its fractions, in both genders. We also found reductions in intake of energy (among men), protein (among women) and fat (both genders) and increases in intake of total fibre (among women) and carbohydrate (among men). CONCLUSIONS: The intervention programme indicated meaningful benefits for the intervention subjects, with changes in their habits that led to a 'healthier' lifestyle positively impacting their nutritional and metabolic profile.

[Reproducibility and validity of a food frequency questionnaire]. / Reprodutibilidade e validade do questionário de freqüência de consumo de alimentos.

OBJECTIVE: Methods to evaluate food consumption still need improvement. A study was conducted to verify the reproducibility and validity of a food frequency questionnaire (FFQ) among overweight adults. METHODS: The study was carried out in a private university in São Paulo, Brazil. The study sample consisted of 146 individuals of both sex with body mass index =25 kg/m2 and age between 18 and 60 years old. For reproducibility the FFQ was applied by trained interviewers at two different instances with a mean interval time of 47 days. For validity, data collected from the FFQ were compared with those obtained from the average of 3 different daily records of a 24-hour dietary recall (mean interval time: 15 days). Validity and reproducibility of data on calories and macronutrients consumption was assessed using pondered kappa statistics and intraclass correlation coefficient. RESULTS: A higher variability in the reporting of regular food consumption was seen among obese than overweight individuals. Concerning reproducibility, kappa statistical values varied from 0.23 (carbohydrates and fats) to 0.40 (calories), and intraclass correlation coefficients ranged from 0.28 (protein) to 0.54 (total calories). For FFQ validity, the highest kappa value was 0.25 (calories), and the intraclass correlation coefficient was 0.21 (protein). CONCLUSIONS: Food consumption reports of overweight individuals tend to be underestimated. Despite its limitations, FFQ could be used in epidemiological studies to assess the regular food consumption of overweight individuals.