[Knowledge, use and opinion about written informed consent in primary healthcare nurses: CONOSER pilot project]. / Conocimiento, implementación y opinión acerca del consentimiento informado por escrito de las enfermeras de atención primaria: proyecto piloto CONOSER.

OBJECTIVE: To know the knowledge, implementation and opinion on informed consent of generalist nurses, specialists and primary care residents. DESIGN: Descriptive cross-sectional study using an online self-administered 'ad hoc' questionnaire. SETTING: Primary care nurses in Madrid, from November 2020 to March 2021. PARTICIPANTS: Sample of 114 nurses: 91 generalist, 20 specialists and 3 residents. MAIN MEASUREMENTS: Sociodemographics, knowledge, implementation and opinion. RESULTS: The response rate was 27.7%. As a general rule, 48.2% indicated that informed consent was collected verbally, as established by law, with differences being found between categories, this percentage being higher in specialists and residents (P=0.004), and within specialists in those who had obtained their speciality by internal resident nurse (IRN) (P<0.0001). In addition, specialists and residents were those who most identified the legal norm regulating informed consent (P<0.0001). In terms of implementation and opinion, all groups obtained similar results. DISCUSSION: There are no previous studies that have analysed these aspects of informed consent comparing the different categories. Studies from other healthcare and geographical areas show that nurses have greater knowledge, although the demand for specific training in bioethics and biolaw is greater in the nurses participating in this study. CONCLUSIONS: Nurses have adequate knowledge about informed consent, use it in clinical practice and have an appropriate conception of it, being higher in some items in specialist nurses IRN and in residents.

Concordance among diagnostic criteria for metabolic syndrome is inconsistent in Spanish adolescents.

BACKGROUND: The metabolic syndrome (MetS), although more frequent in adults, is a growing health problem in adolescent population. There are different criteria for the diagnosis, however without a consensus of which is the best to be used in this population. The heterogeneity of the different diagnostic criteria makes it necessary to carry out more studies that analyse the degree of agreement among these criteria. The present study was aimed to evaluate the agreement between different criteria for diagnosis of MetS in adolescents. MATERIALS AND METHODS: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2 years) randomly recruited from 18 schools in south-east Spain. MetS was diagnosed by eight different criteria. RESULTS: The criteria proposed by the IDF showed the highest mean values for WC and systolic blood pressure in boys and girls with MetS, and the lowest for glucose and triglycerides in boys. Depending on the diagnostic criteria used, the prevalence of MetS cases in boys ranged from 5.5% to 14.9%, while in girls varied from 3.4% to 32.6%. Both in boys and girls, the criteria proposed by the IDF was the less concordant with the other suggested criteria, while those proposed by Duncan et al, Rodriguez-Moran et al and Cruz and Goran, were very concordant among each other. However, in girls, concordance values were not as high as those found for boys. CONCLUSION: The variability observed in the agreement among the existing criteria suggests the need to validate uniform criteria for the diagnosis of MetS in adolescents.

Serum leptin as a mediator of the influence of insulin resistance on hepatic steatosis in youths with excess adiposity.

BACKGROUND AND AIMS: The relationship between insulin resistance (IR) and hepatic steatosis (fatty liver) is well known; however, the extent to which the satiety hormone leptin acts as a confounder or mediator in this relationship is uncertain. We examined whether the association between IR and hepatic steatosis is mediated by leptin in Colombian adolescents with excess adiposity. METHODS AND RESULTS: A total of 122 adolescents (mean age: 13.4 years; 68% girls) participated in the study. We assessed body composition, hepatic steatosis (as defined by the controlled attenuation parameter [CAP]), cardiometabolic risk factors (body mass index, waist circumference, body composition), biochemical variables (leptin, insulin, glucose, lipid profile, cardiometabolic Z-score, transaminases, etc.), and physical fitness (cardiorespiratory fitness and grip strength). Partial correlation, regression, and mediation analyses were conducted using the Barron and Kenny framework. RESULTS: Ninety-two youths (75.4%) had IR. Mediation analysis revealed a positive relationship between Homeostasis Model Assessment-IR (HOMA-IR) and CAP (ßdir = 3.414, 95% confidence interval [CI]: 1.012 to 5.816, p < 0.001), which was attenuated when leptin was included in the model, thus indicating that leptin mediates this relationship (ßind = 1.074, 95% CI: 0.349 to 2.686, p < 0.001). The percentage of the total effect mediated by leptin was 21%. Regarding sex, the mediation effect of leptin remains significant among boys (ßind = 0.962, 95% CI: 0.009 to 2.615, p < 0.001), but not in girls (ßind = 0.991, 95% CI: 1.263 to 5.483, p = 0.477). CONCLUSIONS: The findings are clinically relevant to consider leptin levels as a surrogate marker of insulin sensitivity when assessing youths with excess adiposity and/or suspected Nonalcoholic hepatic steatosis or nonalcoholic fatty liver disease (NAFLD).

Dietary Inflammatory Index Scores Are Associated with Pressure Pain Hypersensitivity in Women with Fibromyalgia.

OBJECTIVE: Pain hypersensitivity has been described as one of the most disabling symptoms of fibromyalgia syndrome (FMS). Here we analyzed the relationship between an anti-inflammatory diet profile and the pressure pain thresholds (PPTs) of tender point sites and other fibromyalgia-related symptoms in patients with FMS. METHODS: This cross-sectional study included 95 women diagnosed with FMS and 98 menopause-status matched controls. The Dietary Inflammatory Index (DII) was calculated by conducting a 24-hour diet recall interview. The PPTs of tender point sites and self-reported global pain levels were evaluated by algometry and the visual analog scale, respectively. Disease severity, fatigue, sleep anxiety, and central sensitization were also evaluated. RESULTS: Linear regression analysis revealed that the PPTs of tender point sites including the occiput (ß = 0.234, 95% confidence interval [CI] = 0.016-0.452, P = 0.036), trapezius (ß = 0.299, 95% CI = 0.083-0.515, P = 0.007), zygapophyseal joint (ß = 0.291, 95% CI = 0.022-0.559, P = 0.035), second rib (ß = 0.204, 95% CI = 0.060-0.348, P = 0.006), gluteus (ß = 0.591, 95% CI = 0.110-1.072, P = 0.017), greater trochanter (ß = 0.379, 95% CI = 0.016-0.742, P = 0.041), and knee (ß = 0.482, 95% CI = 0.117-0.850, P = 0.011) were associated with DII score after adjustments for the age, menopausal status, and global energy levels reported by the patients with FMS. No significant differences were found for the cases or controls between the DII score and the remaining clinical symptoms. Analyses of covariance showed that the PPTs of the aforementioned tender point sites were also significantly associated (P < 0.05) with the DII score quartiles in patients with FMS, but no significant differences were found between these quartiles and the other clinical symptoms. CONCLUSIONS: A pro-inflammatory diet was associated with pain hypersensitivity in patients with FMS.

Prior percutaneous coronary intervention is associated with low health-related quality of life after coronary artery bypass graft.

The success of a coronary artery bypass graft surgery has been shown to be related to health-related quality of life, and being able to predict this is extremely useful. We investigate the associations between health-related quality of life and sociodemographic and clinical characteristics, and examine the impact of prior percutaneous coronary interventions on health-related quality of life in Palestinian patients undergoing a coronary artery bypass graft for the first time. A cross-sectional study was conducted on a convenience sample of 119 Palestinian patients. The Short Form-36 Health Survey was applied 1 year after the coronary artery bypass graft surgery. An analysis of variance shows that as age increases, health-related quality of life decreases. In contrast, the higher the level of education, job security, and salary, the higher the health-related quality of life. Patients who had undergone prior percutaneous endovascular interventions had a worse health-related quality of life than those who had not. In conclusion, a history of prior percutaneous endovascular interventions in addition to sociodemographic factors should be considered by nursing staff so that they can deliver high-quality patient care.

SOX6 rs7117858 polymorphism is associated with osteoporosis and obesity-related phenotypes.

BACKGROUND: SOX6 has been recently proposed as a pleiotropic gene for obesity and osteoporosis. The aim of this study was to investigate whether the rs7117858 genetic variant in SOX6 was associated with bone mass assessed by quantitative ultrasound (QUS) and obesity-related measures in a population of young adults. METHODS: A cross-sectional study was conducted in 550 unrelated healthy individuals of Caucasian ancestry (381 (69.3%) female and 169 (30.7%) male; mean age 20.46 ± 2.69). Bone mass was assessed through calcaneal QUS) parameter (BUA, dB/MHz). Obesity-related traits including weight, body mass index (BMI), fat mass (FM) and fat-free mass (FFM) were analysed. RESULTS: The linear regression analysis revealed that the rs7117858 SNP was significantly associated with FFM after adjustments for covariables in the whole sample (P = 0.027, ß (95% CI) = 0.053 (0.092, 1.516). In addition, a significant association with QUS measurement adjusted for confounding factors was found in females (P = 0.043, ß (95% CI) = 0.104 (0.138. 8.384). CONCLUSIONS: We demonstrate for the first time that SOX6 influence FFM and QUS trait in a population of young adults, suggesting the implication of this gene in obesity and osteoporosis-related phenotypes during early adulthood.

Use of dietary supplements by pregnant women in Colombia.

BACKGROUND: During pregnancy, the need for certain nutrients increases. This study assessed the prevalence and socio-demographic factors associated with dietary supplement use in a representative sample of pregnant women in Colombia. METHOD: Data for this study were obtained from a cross-sectional, nationally representative survey (ENSIN, 2010). A total of 1856 pregnant women, 13-49 years of age, were recruited. The use of prenatal dietary supplements (Vitamins A, C or E) was treated as a binary outcome (used at some time or never sued during pregnancy when prescribed by a doctor) in multinomial analyses. Sociodemographic data and associated factors were assessed by computer-assisted personal interview technology. RESULTS: Of the sample, 1123 women (68.6%) reported taking prenatal dietary supplements at some stage during their pregnancy. Most users had a high socioeconomic level (79.5%), were in their third trimester of pregnancy (79.5%), were 30-49 years of age (74.0%), and lived in the central region of Colombia (73.8%). The multivariate logistic regression showed that third trimester of pregnancy (OR 6.2;95% CI 4.0 to 9.3), high educational level (OR 2.3; 95% CI 1.5 to 3.4), high socioeconomic level -SISBEN IV or more- (OR 2.0; 95% CI 1.4 to 2.8), residence in the Atlantic region (north) (OR 2.6; 95% CI 1.7 to 3.6), Eastern region (OR 2.0; 95% CI 1.3 to 3.1), central region (OR 2.6; 95% CI 1.7 to 3.9), Pacific region (west) (OR 1.5; 95% CI 1.0 to 2.3), and belonging to the mestizo (others) ethnic group (OR 1.2; 95% CI 1.0 to 2.6), were all associated with a higher probability of dietary supplement intake. CONCLUSION: The prevalence of prenatal dietary supplements in pregnant women in Colombia was found to be substantial. The variables significantly associated with their use were educational level, socioeconomic level, trimester of pregnancy, geographic level and ethnic group. These results indicate the necessity of implementing new health policies that guarantee uniform access to nutritional supplements for all population sectors, especially in countries, such as Colombia, who are currently undergoing a process of nutritional transition.

Validation of multi-frequency bioelectrical impedance analysis versus dual-energy X-ray absorptiometry to measure body fat percentage in overweight/obese Colombian adults.

OBJECTIVES: To verify the validity of multi-frequency bioelectrical impedance analysis (mBCA) for predicting body fat percentage (BF%) in overweight/obese adults using dual-energy X-ray absorptiometry (DXA) as the reference method. METHODS: Forty-eight adults participated (54% women, mean age = 41.0 ± 7.3 years old). The Pearson's correlation coefficient was used to evaluate the correlation between BIA and BF% assessed by DXA. The concordance between BF% measured by both methods was obtained with Lin's concordance correlation coefficient and Bland-Altman difference plots. RESULTS: Measures of BF% were estimated as 39.0 (SD = 6.1) and 38.3 (SD = 6.5) using DXA and mBCA, respectively. The Pearson's correlation coefficient reflected a strong correlation (r =.921, P = .001). The paired t-test showed a significant mean difference between these methods for obese men BF% of -0.6 [(SD 1.95; 95% CI = -4.0 to 3.0), P =.037]. Overall, the bias of the mBCA was -0.6 [(SD 2.2; 95% CI = -5.0 to 3.7), P =.041], which indicated that the mBCA method significantly underestimated BF% in comparison to the reference method. Finally, in both genders, Lin's concordance correlation coefficient showed a strong agreement. More specifically the DXA value was ρc = 0.943 (95% CI = 0.775 to 0.950) and the mBCA value was ρc = 0.948 (95% CI = 0.778 to 0.978). CONCLUSIONS: Our analysis showed a strong agreement between the two methods as reflected in the range of BF%. These results show that mBCA and DXA are comparable methods for measuring body composition with higher body fat percentages. However, due to broad limits of agreement, we can only recommend mBCA for groups of populations.

Dietary inflammatory index and cardiovascular risk factors in Spanish children and adolescents.

Dietary inflammatory potential is an established risk factor for adverse cardiovascular events. In this study we analyzed the relation between the Dietary Inflammatory Index (DII) and cardiovascular risk factors, based on anthropometric, body composition, blood pressure, and heart rate parameters in children and adolescents. We conducted a cross-sectional study of 428 Spanish schoolchildren (mean age 12.32 ± 1.84), whose DII was calculated, based on a 24-hr diet recall over 3 days. Anthropometric measurements were taken, and body composition analyzed by bioelectrical impedance analysis. Blood pressure and heart rate parameters were assessed with an automatic monitor. Pubertal stage was assessed based on Tanner criteria. We analyzed the DII both as a continuous variable and as a category variable based on quartiles. Linear regression analysis revealed that the DII was significantly associated with waist to height ratio (WHtR) (p = .026; B = 0.128, 95% CI [.001-.016]) after adjusting for age, sex, total energy intake, and Tanner stage. All macro- and micronutrient intakes were found to be higher in the DII Q1 (anti-inflammatory diet) except for caffeine. This study provides preliminary evidence of a significant association between the DII and WHtR, an index of cardiovascular risk. The results obtained indicate that the inflammatory potential of the diet may play a role in children and adolescents becoming overweight or developing obesity. Future studies in young people should be conducted to validate and further explore these relationships.

Dietary inflammatory index, bone health and body composition in a population of young adults: a cross-sectional study.

Diet quality has been postulated as a relevant factor in disorders like obesity and osteoporosis as it modulates inflammatory biomarkers. The aim of this study was to investigate whether the dietary inflammatory index (DII) is associated with bone health status and body composition parameters in a population of young adults. The study population consisted of 599 young adults (aged 20.41 ± 2.72). Linear regression analysis revealed that weight and fat-free mass (FFM) were significantly associated with the DII after adjustments for age, sex and total energy (ß = -0.91, 95% CI -1.782, -0.213, p = .013 and ß = -0.059, 95% CI -0.842, -0.107, p = .011, respectively). Our results suggest that the inflammatory potential of diet, measured using the DII, is associated with obesity-related parameters such as FFM and weight, although it may not contribute to osteoporosis in early adulthood.

Factors Influencing the Life Experiences of Individuals With Inflammatory Bowel Disease.

Inflammatory bowel disease has a negative impact on individuals perception of their health status and is associated with disabling processes that have physical, social, and work repercussions. The objectives of this study were to describe the life experiences of individuals with Crohn disease and ulcerative colitis and to develop a theoretical framework to describe the relationships of these diseases with personal and clinical factors. A qualitative study on the basis of grounded theory was conducted, involving individual and semistructured interviews on the life experiences of 14 adults of different ages with inflammatory bowel disease in relapse or inactive phase. The individuals in relapse phase and those with a short time since diagnosis had the most negative perceptions of their health, and experienced impaired ability for daily activities. The life experiences of individuals with inflammatory bowel disease were influenced by the time since diagnosis and the disease phase, with no gender difference in either factor. The predominant strategy of participants for coping with the disease was to pursue normality. According to these findings, nursing interventions should focus on the initial adaptation phase and on coping strategies during active phases of the disease.

Analysis of SNP-SNP interactions and bone quantitative ultrasound parameter in early adulthood.

BACKGROUND: Osteoporosis individual susceptibility is determined by the interaction of multiple genetic variants and environmental factors. The aim of this study was to conduct SNP-SNP interaction analyses in candidate genes influencing heel quantitative ultrasound (QUS) parameter in early adulthood to identify novel insights into the mechanism of disease. METHODS: The study population included 575 healthy subjects (mean age 20.41; SD 2.36). To assess bone mass QUS was performed to determine Broadband ultrasound attenuation (BUA, dB/MHz). A total of 32 SNPs mapping to loci that have been characterized as genetic markers for QUS and/or BMD parameters were selected as genetic markers in this study. The association of all possible SNP pairs with QUS was assessed by linear regression and a SNP-SNP interaction was defined as a significant departure from additive effects. RESULTS: The pairwise SNP-SNP analysis showed multiple interactions. The interaction comprising SNPs rs9340799 and rs3736228 that map in the ESR1 and LRP5 genes respectively, revealed the lowest p value after adjusting for confounding factors (p-value = 0.001, ß (95% CI) = 14.289 (5.548, 23.029). In addition, our model reported others such as TMEM135-WNT16 (p = 0.007, ß(95%CI) = 9.101 (2.498, 15.704), ESR1-DKK1 (p = 0.012, ß(95%CI) = 13.641 (2.959, 24.322) or OPG-LRP5 (p = 0.012, ß(95%CI) = 8.724 (1.936, 15.512). However, none of the detected interactions remain significant considering the Bonferroni significance threshold for multiple testing (p<0.0001). CONCLUSION: Our analysis of SNP-SNP interaction in candidate genes of QUS in Caucasian young adults reveal several interactions, especially between ESR1 and LRP5 genes, that did not reach statistical significance. Although our results do not support a relevant genetic contribution of SNP-SNP epistatic interactions to QUS in young adults, further studies in larger independent populations would be necessary to support these preliminary findings.

The rs3736228 polymorphism in the LRP5 gene is associated with calcaneal ultrasound parameter but not with body composition in a cohort of young Caucasian adults.

The aim of the present study was to investigate the possible influence of low-density lipoprotein receptor-related protein 5 (LRP5) and sclerostin (SOST) genes as genetic factors contributing to calcaneal quantitative ultrasound (QUS) and body composition variables in a population of young Caucasian adults. The study population comprised a total of 575 individuals (mean age 20.41years; SD 2.36) whose bone mass was assessed through QUS to determine broadband ultrasound attenuation (BUA, dB/MHz). Body composition measurements were performed using a body composition analyser. Seven single-nucleotide polymorphisms (SNPs) of LRP5 (rs2306862, rs599083, rs556442 and rs3736228) and SOST (rs4792909, rs851054 and rs2023794) were selected as genetic markers and genotyped using TaqMan OpenArray® technology. Linear regression analysis was used to test the possible association of the tested SNPs with QUS and body composition parameters. Linear regression analysis revealed that the rs3736228 SNP of LPR5 was significantly associated with BUA after adjustment for age, sex, weight, height, physical activity and calcium intake (P = 0.028, ß (95% CI) = 0.089 (0.099-1.691). For the remaining SNPs, no significant association with the QUS measurement was observed. Regarding body composition, no significant association was found between LRP5 and SOST polymorphisms and body mass index, total fat mass and total lean mass after adjustment for age and sex as covariates. We concluded that the rs3736228 LRP5 genetic polymorphism influences calcaneal QUS parameter in a population of young Caucasian adults. This finding suggests that LRP5 might be an important genetic marker contributing to bone mass accrual early in life.

Associations between body composition, nutrition, and physical activity in young adults.

OBJECTIVE: The aim of the present study is to investigate the associations between total energy, macronutrient intakes, and physical activity (PA) and body composition by assessing body fat mass, fat-free mass, and BMI in a population of young adults. METHODS: The study population consisted of 605 young Spanish adults (median age 20.38 ± 2.67). Body composition, including fat mass and fat-free mass, was calculated with body composition analyzer. Daily energy and macronutrient intakes were measured using a 72-h recall method. The International PA Questionnaire was used to assess PA and sedentary time. Linear regression analyses were performed to test the possible associations between nutrition, PA factors, and body composition. RESULTS: Linear regression analyses revealed that BMI has a significant positive association with protein intake (P = .004, B = 0.088, 95% CI 0.028-0.149) and an inverse association with carbohydrate intake (P = 0.034, B = -0.027, 95% CI -0.053 - -0.002). Protein intake also demonstrated a significant association with fat-free mass, but the size of the effect was smaller (P = .027, B = 96.965, 95% CI 11.250-182.679). There was evidence of a positive association between total PA and moderate-to-vigorous PA (P < .001, B = 15.630, 95% CI 6.989 -24.270) and fat-free mass (P < .001, B = 20.208, 95% CI 9.694 -30.723). When fat mass was used as the outcome variable, there was no evidence of any association with the PA, total energy, and macronutrient intakes variables analyzed. CONCLUSIONS: Our findings suggest that PA variables were consistently associated with body composition, specifically fat-free mass. Dietary factors also have influence over body composition; we showed that protein intake is significantly associated with fat-free mass and BMI.

Normative data for quantitative calcaneal ultrasound in young males and females.

OBJECTIVE: The quantitative ultrasound (QUS) method has been recognized as an optimal screening tool for assessing bone mass status. The aim of this study was to provide standardized values for bone health status measured by the QUS technique based on age, sex, and body mass index (BMI). METHODS: The study population consisted of 1322 healthy individuals (822 females and 500 males) aged 14-25 years. Bone mass in both calcaneus was estimated with QUS to obtain Broadband ultrasound attenuation (BUA) (dB/MHz). RESULTS: The linear models revealed statistically significant differences between bone mass status of the calcaneus and age, sex, and BMI (P < .001). Bone mass increased at a rate of approximately 0.015 units per year after the age of 14 and these values increased in approximately 0.1 units in males in comparison to females. There was an increase of approximately 0.17 units for each increase in categories of BMI. CONCLUSION: It is crucial to provide standardized values for the QUS parameter in young males and females to allow reliable comparisons and evaluate trends in preventive programs that may enable the identification of individuals at risk for osteoporosis.

Association study of estrogen receptor alpha gene polymorphisms with bone mass assessed by quantitative ultrasound in young adults.

Different genetic variants in estrogen receptor alpha (ESR1) have been shown to influence bone phenotypes including quantitative bone ultrasound in elderly. We aimed to investigate the role of ESR1 polymorphisms in bone mass assessed by calcaneal quantitative ultrasound (QUS) in a population of young adults. The study sample consisted of 466 healthy individuals of Caucasian ancestry (315 females and 152 males) aged 18 and 25 years (median age 20.39 ± 2.70). Six ESR1 polymorphisms (rs302033, rs2982552, rs2982575, rs2504063, rs2234693-PvuII and rs9340799-XbaI) were selected as genetic markers and genotyped. Bone mass in the right calcaneus was estimated with QUS. In the unadjusted analysis, rs2982575 polymorphism was significantly associated with quantitative ultrasound parameter in the whole sample (p = 0.014, ß (95% CI) = -0.114 (-1.023, -0.115). However, after adjusting for multiple confounding factors, this association did not remain significant. For the rest of the selected polymorphisms in ESR1, no significant association was observed with calcaneal parameter. Linkage disequilibrium analysis identified a single LD block for the ESR1 gene including PvuII and XbaI SNPs (pair-wise r 2 = 0.66). Our results revealed a lack of significant association between ESR1 polymorphisms and calcaneal quantitative ultrasound in a cohort of young adults suggesting that ESR1 gene do not play a major role in the acquisition of bone mass during early adulthood.

Using LMS tables to determine waist circumference and waist-to-height ratios in Colombian children and adolescents: the FUPRECOL study.

BACKGROUND: Waist circumference (WC) and waist-to-height ratio (WHtR) are often used as indices predictive of central obesity. The aims of this study were: 1) to obtain smoothed centile charts and LMS tables for WC and WHtR among Colombian children and adolescents; 2) to evaluate the utility of these parameters as predictors of overweight and obesity. METHOD: A cross-sectional study was conducted of a sample population of 7954 healthy Colombian schoolchildren [3460 boys and 4494 girls, mean age 12.8 (±2.3) years]. Weight, height, body mass index (BMI), WC and WHtR were measured, and percentiles were calculated using the LMS method (Box-Cox, median and coefficient of variation). Appropriate cut-off points of WC and WHtR for overweight and obesity, according to International Obesity Task Force definitions, were selected using receiver operating characteristic (ROC) analysis. The discriminating power of WC and WHtR is expressed as area under the curve (AUC). RESULTS: Reference values for WC and WHtR are presented. Mean WC increased and WHtR decreased with age for both genders. A moderate positive correlation was observed between WC and BMI (r = 0.756, P < 0.01) and between WHtR and BMI (r = 0.604, P < 0.01). ROC analysis revealed strong discrimination power in the identification of overweight and obesity for both measures in our sample population. Overall, WHtR was a slightly better predictor of overweight/obesity (AUC 95% CI 0.868-0.916) than WC (AUC 95% CI 0.862-0.904). CONCLUSION: This paper presents the first sex and age-specific WC and WHtR percentiles for Colombian children and adolescents aged 9.0-17.9 years. The LMS tables obtained, based on Colombian reference data, can be used as quantitative tools for the study of obesity and its comorbidities.

RANKL/RANK/OPG Polymorphisms and Heel Quantitative Ultrasound in Young Adults.

BACKGROUND: The receptor activator of the nuclear factor-kappa B ligand (RANKL), the receptor activator of nuclear factor-kappa B (RANK), and the osteoprotegerin (OPG) signaling pathway play an important role in the regulation of bone remodeling and osteoclast differentiation. Quantitative ultrasound (QUS) is a relatively recent and noninvasive method providing structural information on microstructure, bone elasticity, and connectivity. However, in contrast to bone mineral density measurements, the possible association of the RANKL/RANK/OPG pathway with heel QUS has not been analyzed. OBJECTIVES: The aim of this study was to assess, for the first time, the contribution of the RANKL/RANK/OPG pathway genes in the genetic background of heel QUS parameters. METHODS: Ten single-nucleotide polymorphisms (SNPs) of RANKL (rs9594759, rs12585014, rs7988338, rs2148073), RANK (rs1805034, rs12458117, rs3018362), and OPG (rs4355801, rs3102735, rs2073618) were selected as genetic markers and genotyped using Open Array technology in 575 self-reported Caucasian individuals aged 18-25. Bone mass in the right calcaneus was estimated with QUS to obtain the broadband ultrasound attenuation (BUA) measurement (dB/MHz). Linear regression analyses were performed to test the possible association between the SNPs and BUA. RESULTS: Linear regression analysis of all the tested SNPs revealed no significant association with the BUA parameter after adjusting for age, gender, weight, height, physical activity, and calcium intake. The lowest p-value was observed for the rs9594759 RANKL polymorphism and heel QUS (p = .06; b* = -.075, 95% CI [-0.960, 0.028]). CONCLUSION: Our results suggest that the polymorphism of the RANKL, RANK, and OPG genes does not make a significant genetic contribution to heel ultrasound measurements in a population of young Caucasian adults. Further studies replicating the results in independent populations are needed to support these initial findings.

Need of improvement of diet and life habits among university student regardless of religion professed.

At present, few studies have assessed the possible influence of culture and religion on healthy eating habits among the university population. The aim of this study was to identify differences in healthy and eating habits among university students of different religions. A cross-sectional study was performed with a sample population of 257 students (22.4 ± 4.76 y) at the campus of the University of Granada in Melilla (Spain). The quality of diet was assessed by the Healthy Eating Index (HEI) and the adherence to the Mediterranean diet by a validated score (MDS). There were a higher prevalence of overweight in Christian boys and girls compared to Muslims. Muslim students omit breakfast and dinner more often than Christians. Significant differences in sodium intake (p < 0.001) were observed among boys of Christian and Muslim faith, with significantly higher intakes in Christians. In contrast, a higher cholesterol intake (p = 0.038) was observed in Muslim girls compared to Christians. Regarding alcohol intake, its consumption being much higher among students of Christian faith. Likewise, there were no significant differences in the quality of the diet as assessed by HEI, this being of poor, together with a low adherence to the Mediterranean diet in both groups. Muslim university students have a lower risk of drinking alcohol (OR = 7.88, 95% CI = 4.27, 14.54). Few differences were found between girls and boys in both religions although the Mediterranean Diet Score was lower for girls. In conclusion, Melilla university students eat low quality foods and have little adherence to the Mediterranean diet regardless of the religion professed or gender, although Christians tend to drink more alcohol and to smoke more cigarettes and Muslims skip some meals.

A randomized controlled trial of the effect of a photographic display with and without music on pre-operative anxiety.

AIMS: To determine the effectiveness of photographic display at reducing pre-operative anxiety in an ear, nose and throat surgery unit; alone and in combination with music. BACKGROUND: The waiting time prior to the surgery is often unpleasant and a time of anxiety for patients. Anxiety can affect physical recovery and psychological well-being; lengthening convalescence and hospital stay after the surgery. Improving pre-operative anxiety is a challenge with potential impacts on improving patients' satisfaction and well-being and decreasing the cost of care. DESIGN: A clinical trial was conducted with two intervention groups and one control group. METHODS: The sample consisted of 180 subjects from the otolaryngology major ambulatory surgery unit in a tertiary hospital in the province of Granada, with 60 subjects per group. The outcome variables measured were state anxiety, heart and respiratory rate and blood pressure. The data were collected from May-December 2013. RESULTS: After the intervention, in the comparison between control group and photographic display group, all variables had lower means in the intervention group, although a significant P value was only obtained for respiratory rate using one-way anova test. When comparing control group and photographic display combined with music group, using one-way anova test, all mean values were lower in the intervention group and a significant P value were observed for all variables except diastolic blood pressure. CONCLUSION: Photographic display in combination with music is more effective at reducing pre-operative anxiety than the standard intervention and photographic display alone.