Mindfulness-Based Program for Anxiety and Depression Treatment in Healthcare Professionals: A Pilot Randomized Controlled Trial.

In primary health care, the work environment can cause high levels of anxiety and depression, triggering relevant expert and individual change. Mindfulness-Based Stress Reduction (MBSR) programs reduce signs of anxiety and depression. The purpose of this sub-analysis of the total project, was to equate the effectiveness of the standard MBSR curriculum with the abbreviated version in minimizing anxiety and depression. This randomized controlled clinical trial enrolled 112 mentors and resident specialists from Family and Community Medicine and Nurses (FCMN), distributed across six teaching units (TU) of the Spanish National Health System (SNHS). Experimental group participants received a MBRS training (abbreviated/standard). Depression and anxiety levels were measured with the Goldberg Anxiety and Depression Scale (GADS) at three different time periods during the analysis: before (pre-test) and after (post-test) participation, as well as 3 months after the completion of intervention. Taking into account the pre-test scores as the covariate, an adjusted analysis of covariance (ANCOVA) showed significant depletion in anxiety and depression in general (F (2.91) = 4.488; p = 0.014; η2 = 0.090) and depression in particular (F (2, 91) = 6.653; p = 0.002; η2 = 0.128 at the post-test visit, maintaining their effects for 3 months (F (2.79) = 3.031; p = 0.050; η2 = 0.071-F (2.79) = 2.874; p = 0.049; η2 = 0.068, respectively), which is associated with the use of a standard training program. The abbreviated training program did not have a significant effect on the level of anxiety and depression. The standard MBSR training program had a positive effect on anxiety and depression and promotes long-lasting effects in tutors and resident practitioners. New research is needed to demonstrate the effectiveness of abbreviated versions of training programs.

Comorbilidad y factores sociodemográficos asociados a litiasis renal en personas de 40 a 65 años: estudio transversal / Comorbidity and socio-demographic factors associated with renal lithiasis in persons aged 40 to 65: A cross-sectional study

Fundamento y objetivo: La litiasis renal es una de las enfermedades urológicas más importantes. Parece estar relacionada con factores sociodemográficos y climáticos, estilos de vida y comorbilidad preexistente. El objetivo de este trabajo fue examinar la relación entre variables sociodemográficas, ciertos factores de riesgo y enfermedades crónicas, y la litiasis renal. Pacientes y método: Se realizó un estudio transversal, seleccionando a población española de 40 a 65 años, combinando 2 muestras aleatorias (PreLiRenA y PreLiRenE). Los datos fueron recogidos por encuestas telefónicas personales, recopilando información sobre variables sociodemográficas y la morbilidad percibida. También se recogieron datos sobre las temperaturas medias anuales en cada región española. Se realizó un análisis bivariado y multivariado. Resultados: Fueron encuestados 4.894 sujetos; el 51,3% eran mujeres; el 25% tenían entre 40 y 45 años; el 36% tenían educación primaria y el 31,4% eran de clase social baja. La prevalencia global de litiasis renal fue del 15,0% (intervalo de confianza al 95% [IC 95%] 14,5-15,5). Por medio del análisis multivariado, las variables que mostraron una fuerte relación estadística con la presencia de litiasis renal fueron: edad avanzada (61-65 años, OR=1,39; IC 95% 1,06-1,8), clase social alta (OR=1,98; IC 95% 1,29-2,62), antecedentes familiares de litiasis renal (OR=2,22; IC 95% 1,88-2,65), hipertensión arterial (OR=1,68; IC 95% 1,39-2,02) y sobrepeso/obesidad (OR=1,31; IC 95% 1,12-1,54). Se observó una correlación entre la litiasis renal y las temperaturas medias anuales en las regiones españolas (r=0,59; p=0,013). Conclusiones: Existe relación entre litiasis renal y edad avanzada, pertenecer a clases sociales altas, existencia de antecedentes familiares de urolitiasis, y tener hipertensión y sobrepeso/obesidad. La prevalencia de la litiasis renal es mayor en las zonas climáticas más cálidas (AU)

Background and objective: Renal lithiasis is one of the most important urological diseases. It seems to be related to different socio-demographic and climatic factors, lifestyle and pre-existing comorbidity. The aim of this study was to examine the relationship between socio-demographic variables, certain risk factors and chronic diseases and the renal lithiasis. Patients and method: A cross-sectional population-based study was carried out, selecting the Spanish population aged from 40 to 65 years, combining 2 random samples (PreLiRenA and PreLiRenE studies). Data were collected by personal telephone surveys, gathering information on socio-demographic variables and perceived morbidity. Data on annual average temperatures in each Spanish region were also collected. A bivariate and multivariate analysis was performed. Results: A total of 4,894 subjects were surveyed; 51.3% were women; 25% were aged 40-45 years, 36% had primary school education and 31.4% were of low social class. The overall prevalence of renal lithiasis was 15.0% (95% confidence interval [95% CI] 14.5-15.5). By means of multivariate analysis, the variables that showed a strong statistical relationship with the presence of renal lithiasis were: older age (61-65 years; OR=1.39; 95% CI 1.06-1.80), high social class (OR=1.98; 95% CI 1.29-2.62), family history of renal lithiasis (OR=2.22; 95% CI 1.88-2.65), high blood pressure (OR=1.68; 95% CI 1.39-2.02) and overweight/obesity (OR=1.31; 95% CI 1.12-1.54). A correlation was observed between renal lithiasis and average annual temperatures in the Spanish regions (r=0.59; P=.013). Conclusions: A relationship was observed between renal lithiasis and older age, belonging to higher social classes, the existence of a family history of urolithiasis, and hypertension and overweight or obesity. The prevalence of renal lithiasis is greater in warmer climate zones (AU)

Comorbidity and socio-demographic factors associated with renal lithiasis in persons aged 40 to 65: A cross-sectional study. / Comorbilidad y factores sociodemográficos asociados a litiasis renal en personas de 40 a 65 años: estudio transversal.

BACKGROUND AND OBJECTIVE: Renal lithiasis is one of the most important urological diseases. It seems to be related to different socio-demographic and climatic factors, lifestyle and pre-existing comorbidity. The aim of this study was to examine the relationship between socio-demographic variables, certain risk factors and chronic diseases and the renal lithiasis. PATIENTS AND METHOD: A cross-sectional population-based study was carried out, selecting the Spanish population aged from 40 to 65 years, combining 2 random samples (PreLiRenA and PreLiRenE studies). Data were collected by personal telephone surveys, gathering information on socio-demographic variables and perceived morbidity. Data on annual average temperatures in each Spanish region were also collected. A bivariate and multivariate analysis was performed. RESULTS: A total of 4,894 subjects were surveyed; 51.3% were women; 25% were aged 40-45 years, 36% had primary school education and 31.4% were of low social class. The overall prevalence of renal lithiasis was 15.0% (95% confidence interval [95% CI] 14.5-15.5). By means of multivariate analysis, the variables that showed a strong statistical relationship with the presence of renal lithiasis were: older age (61-65 years; OR=1.39; 95% CI 1.06-1.80), high social class (OR=1.98; 95% CI 1.29-2.62), family history of renal lithiasis (OR=2.22; 95% CI 1.88-2.65), high blood pressure (OR=1.68; 95% CI 1.39-2.02) and overweight/obesity (OR=1.31; 95% CI 1.12-1.54). A correlation was observed between renal lithiasis and average annual temperatures in the Spanish regions (r=0.59; P=.013). CONCLUSIONS: A relationship was observed between renal lithiasis and older age, belonging to higher social classes, the existence of a family history of urolithiasis, and hypertension and overweight or obesity. The prevalence of renal lithiasis is greater in warmer climate zones.

[Validity of AUDIT test for detection of disorders related with alcohol consumption in women]. / Validez del cuestionario AUDIT para la detección de problemas relacionados con el consumo de alcohol en mujeres.

BACKGROUND AND OBJECTIVE: Early detection of patients with alcohol problems is important in clinical practice. The AUDIT (Alcohol Use Disorders Identification Test) questionnaire is a valid tool for this aim, especially in the male population. The objective of this study was to validate how useful is this questionnaire in females patients and to assess their test cut-off point for the diagnosis of alcohol problems in women. PATIENTS AND METHOD: 414 woman were recruited in 2 health center and specialized center for addiction treatment. The AUDIT test and a semistructured interview (SCAN as gold standard) were performed to all patients. Internal consistency and criteria validity was assessed. RESULTS: Cronbach alpha was 0.93 (95% confidence interval [CI], 0.921-0.941). When the DSM-IV was taken as reference the most useful cut-off point was 6 points, with 89.6% (95% CI, 76.11-96.02) sensitivity and 95.07% (95% CI, 92.18-96.97) specificity. When CIE-10 was taken as reference the sensitivity was 89.58% (95% CI, 76.56-96.10) and the specificity was 95.33% (95% CI, 92.48-97.17). CONCLUSIONS: AUDIT is a questionnaire with good psychometrics properties and is valid for detecting dependence and risk alcohol consumption in women.

Validez del cuestionario AUDIT para la detección de problemas relacionados con el consumo de alcohol en mujeres / Validity of AUDIT test for detection of disorders related with alcohol consumption in women

Fundamento y objetivo: Es necesario disponer en la práctica clínica de cuestionarios breves para identificar tempranamente a pacientes con problemas relacionados con el consumo de alcohol. El cuestionario AUDIT (Alcohol use Disorders identification Test) es un instrumento que ha demostrado su validez, sobre todo entre la población masculina. El objetivo del presente estudio es validar su utilidad en las mujeres y el punto de corte más eficaz para esta población. Pacientes y método: Se incluyó a 414 mujeres reclutadas en 2 centros de salud y un centro de drogodependencias. Se administró el test AUDIT y se les realizó la entrevista semiestructurada SCAN (prueba de referencia). Se estimó la consistencia interna y la validez del criterio. Resultados: El alfa de Cronbach fue de 0,93 (intervalo de confianza [IC] del 95%, 0,921-0,941). El punto de corte más eficaz del test fue el de 6 puntos, con una sensibilidad del 89,6% (IC del 95%, 76,11-96,02) y una especificidad del 95,07% (IC del 95%, 92,18-96,97), tomando como referencia la DSM-IV. Si tomamos como criterio la CIE-10, la sensibilidad fue del 89,58% (IC del 95%;76,56-96,10) y la especificidad del 95,33% (IC del 95%, 92,48-97,17). Conclusiones: El AUDIT es un cuestionario con unas buenas propiedades psicométricas y válido para la detección del consumo de riesgo y dependencia en las mujeres

Background and objective: Early detection of patients with alcohol problems is important in clinical practice. The AUDIT (Alcohol Use Disorders Identification Test) questionnaire is a valid tool for this aim, especially in the male population. The objective of this study was to validate how useful is this questionnaire in females patients and to assess their test cutt-off point for the diagnosis of alcohol problems in women. Patients and method: 414 woman were recruited in 2 health center and specialized center for addiction treatment. The AUDIT test and a semistructrured interview (SCAN as gold standard) were performed to all patients. Internal consistence and criteria validity was assessed. Results: Cronbach alpha was 0.93 (95% confidence interval [CI], 0.921-0.941). When the DSM-IV was taken as reference the most useful cutt-off point was 6 points, with 89.6% (95% CI, 76.11-96.02) sensitivity and 95.07% (95% CI, 92.18-96.97) specificity. When CIE-10 was taken as reference the sensitivity was 89.58% (95% CI, 76.56-96.10) and the specificity was 95.33% (95% CI, 92.48-97.17). Conclusions: AUDIT is a questionnaire with good psychometrics properties and is valid for detecting dependence and risk alcohol consumption in women

[Utility of MALT (Münchner Alkoholismus Test) questionnaire for detection of alcoholism in women]. / Utilidad del cuestionario MALT (Münchner Alkoholismus Test) para el diagnóstico de alcoholismo en mujeres.

BACKGROUND AND OBJECTIVE: Patients identified as risk drinkers usually fill a questionnaire in order to assess their alcohol dependence. In our setting, the Münchner Alkoholismus Test (MALT) has been recommended, but there are not enough data about its validity and accuracy, particularly in women. The aim of this study was to assess the psychometric properties of this test in a female population. SUBJECTS AND METHOD: 414 woman were recruited in a Health Center and a Specialized Center for addiction treatment. MALT test and the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) semistructured interview (gold standard; DSM-IV and CIE-10 criteria) were performed to all patients. Internal consistence, criteria validity and the most diagnostic efficacy cut-off point (ROC curves) were assessed. RESULTS: The MALT average (standard deviation) score of the whole sample was 3.98 (9.48) points (95% confidence interval [CI], 3.07-4.90). Cronbach alpha was 0.939 (95% CI, 0.931-0.947). With a score of 4 or more points, the test had 100% (95% CI, 98.9-100) sensitivity and 95.4% (95% CI, 95.2-95.5) specificity. CONCLUSIONS: The MALT test has an excellent internal reliability and extremely good diagnostic accuracy. It is very useful to detect alcohol dependence in women. A cut-off of 4 or more points is proposed.

Utilidad del cuestionario MALT (Münchner Alkoholismus Test) para el diagnóstico de alcoholismo en mujeres / Utility of MALT (Münchner Alkoholismus Test) questionnaire for detection of alcoholism in women

Fundamento y objetivo: Los pacientes identificados como bebedores de riesgo pueden ser candidatos al cribado de dependencia alcohólica a través de cuestionarios. Entre éstos, en nuestro medio se ha recomendado el Münchner Alkoholismus Test (MALT), aunque hay pocas evidencias sobre su validez y fiabilidad, sobre todo en mujeres. El objetivo del presente estudio es comprobar sus propiedades psicométricas en la población femenina. Sujetos y método: Se incluyó en el estudio a 414 mujeres reclutadas en 2 centros de salud y un centro comarcal de drogodependencias. Se les administró el test MALT y se les realizó la entrevista semiestructurada Schedule for Clinical Assessment in Neuropsychiatry (SCAN) (cuarta edición del Diagnostic and Statistical Manual of Mental Disorders y décima edición de la Clasificación Internacional de Enfermedades). Se evaluaron la consistencia interna, la validez criterial y el punto de corte de mayor eficacia diagnóstica (curvas ROC). Resultados: En el total de la muestra se obtuvo una puntuación media (desviación estándar) con el MALT de 3,98 (9,48) puntos (intervalo de confianza [IC] del 95%, 3,07-4,90). El alfa de Cronbach fue de 0,939 (IC del 95%, 0,931-0,947). Con una puntuación de 4 o más, el cuestionario presenta una sensibilidad del 100% (IC del 95%, 98,9-100,0%) y una especificidad del 95,4% (IC del 95%, 95,2-95,5%). Conclusiones: Por su excelente fiabilidad interna y su extremada exactitud diagnóstica, el MALT es un instrumento de gran utilidad en las mujeres, y se propone como punto de corte el de 4 o más puntos

Background and objective: Patients identified as risk drinkers usually fill a questionnaire in order to assess their alcohol dependence. In our setting, the Münchner Alkoholismus Test (MALT) has been recommended, but there are not enough data about its validity and accuracy, particularly in women. The aim of this study was to assess the psychometric properties of this test in a female population. Subjects and method: 414 woman were recruited in a Health Center and a Specialized Center for addiction treatment. MALT test and the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) semistructured interview (gold standard; DSM-IV and CIE-10 criteria) were performed to all patients. Internal consistence, criteria validity and the most diagnostic efficacy cutt-off point (ROC curves) were assessed. Results: The MALT average (standard deviation) score of the whole sample was 3.98 (9.48) points (95% confidence interval [CI], 3.07-4.90). Cronbach alpha was 0.939 (95% CI, 0.931-0.947). With a score of 4 or more points, the test had 100% (95% CI, 98.9-100) sensitivity and 95.4% (95% CI, 95.2-95.5) specificity. Conclusions: The MALT test has an excellent internal reliability and extremely good diagnostic accuracy. It is very useful to detect alcohol dependence in women. A cut-off of 4 or more points is proposed