Actions taken and barriers encountered by professionals working with adults with intellectual disabilities who experience grief: a qualitative approach.

Experience of grief has increased among people with intellectual disability because of their longer life expectancy. Professionals supporting this population are often critical of the lack of adequate tools for dealing with this situation. The objective of this study was to identify the strategies and barriers that these professionals are confronted with when dealing people with intellectual disability who are going through the grieving process. A qualitative study was conducted involving 20 professionals working with people with intellectual disability. Four themes were extracted using thematic analysis: Exclusion of clients from end-of-life and grief processes, Strategies to support the client's grief process, Emotional and personal difficulties faced by the professionals, and Coping and regulation of the professional's grief process. Barriers identified by these professionals include not having the specific skills to support clients in their grief and the emotional impact of the death of a client.

Evaluation of the lights4violence program: reduction in machismo and acceptance of violence among adolescents in Europe.

BACKGROUND: Machismo and acceptance of violence (AV) against women are part of the social construction of hegemonic masculinity and are related to the risk of dating violence. This study aims to analyze the effectiveness of the Lights4Violence program in reducing machismo and AV in secondary school students from different European cities. METHODS: Quasi-experimental longitudinal study using a convenience sample of 1,146 high school students from different European cities (12-17 years old) including 575 intervention group students (59.1% girls) and 571 control group students (62.7% girls). We performed linear regression models to identify the effect of the intervention, modelling the difference in means in machismo and AV (dependent variables) between wave-2 and wave-1. RESULTS: An interaction was identified between the group variable and the empathy variable. In wave-2, girls with high empathy at baseline in the intervention group obtained lower mean AV scores (ß: -0.131; p = 0.004). However, the boys in the intervention group (reference: control group) with low empathy at baseline registered a significant increase in the mean values of machismo (ß: 0.247; p < 0.001). CONCLUSION: The importance of empathy is shown in the effectiveness of interventions to reduce machismo and AV in adolescents. While the Lights4Violence program focuses on promoting healthy relationships, there were some controversial results. It is possible that some children, especially those with less empathy, may have felt "challenged" during the intervention and/or assessment. This suggests the need for the development of interventions that also consider psychological processes and integrate the promotion of positive expressions of masculinity.

Effects of a mindfulness-based programme on the health- and work-related quality of life of healthcare professionals.

BACKGROUND AND OBJECTIVES: The objective of mindfulness-based stress reduction (MBSR) programmes is to promote awareness of the present moment without judging, evaluating or reacting to the different thoughts or emotions that may arise. Development of these abilities appears especially important for healthcare professionals. The objective of this study was to evaluate the effectiveness and medium- and long-term effects of a MBSR programme for primary care (PC) health professionals on their health-related quality of life and quality of work life. DESIGN: Randomised clinical trial using an intervention and control group with follow-up of the experimental group. SETTING: Primary Care centres in the Alicante Public Health Service (Spain). PARTICIPANTS: Participants were PC health professionals (N = 58) divided between an intervention group receiving the 8-week MBSR programme and a control group receiving a theoretical training session alone. METHOD: Both groups were evaluated at baseline and at 8 weeks, and the intervention group was additionally evaluated at 3-, 6-, 9- and 12-month postprogramme. RESULTS: In comparison to the control group, the intervention group obtained higher scores postintervention for mindfulness, health-related quality of life, mood and compassion satisfaction and a lower score for burnout. Improvements in mindfulness, mood and burnout syndrome persisted at 12 months after the programme. CONCLUSIONS: In conclusion, MBSR is an effective intervention to enhance the health-related quality of life and quality of work life of Primary Care Health professionals.

Feeling of grief and loss in parental caregivers of adults diagnosed with intellectual disability.

BACKGROUND: The diagnosis of intellectual disability in children can produce complex grief-related feelings in their parents. Previous studies have focused on the moment of the diagnosis or the early life of the children, and little research has been conducted on their feelings of grief in adulthood. The objective was to analyse the process of grief/loss in parents of adult offspring with intellectual disability. METHOD: The intentional sampling included sixteen parents who responded to semi-structured interviews. A qualitative study was conducted based on grounded theory. RESULTS: Five categories were identified: "Reception of the diagnosis", "Emotional bonds with the child", "Experience of loss and feelings in response to intellectual disability diagnosis", "Recurrent grief" and "Coping strategies". CONCLUSIONS: Recurring feelings of loss experienced by parents in relation to their child's diagnosis persist over time. Specialized emotional interventions are needed to help parents to reduce the intensity of their feelings of grief.

Psychometric Properties of the Spanish Version of the Homophobic Content Agent Target Scale Among Adolescent Students.

This study examined the psychometric properties and factor structure of the Spanish version of the Homophobic Content Agent Target (HCAT) scale in a sample of 1848 high school students. Participants completed an online survey including measures of homophobic bullying, depression, and anxiety. The factor structure showed adequate fit indices in Spanish adolescents similar to the original scale. An exploratory factor analysis showed a simple factor solution of two related factors strongly correlated describing the extent to which students use homophobic language (agent) and the extent to which students are called homophobic epithets (target) due to sexual orientation. The Spanish HCAT scale showed high Cronbach's alpha coefficient at the subscale score levels, as well as good convergent validity. This study contributes a Spanish-language validated measure of homophobic victimization to be used among adolescents. Implications for understanding homophobic bullying in adolescents are discussed.

The Medical Outcome Study-HIV Health Survey: A systematic review and reliability generalization meta-analysis.

The Medical Outcome Study-HIV Health Survey (MOS-HIV) is one of the most used questionnaires for the evaluation of the health-related quality of life (HRQoL) in people living with HIV (PLWHIV) in both medical settings and research studies. This study aimed to estimate the average reliability of the MOS-HIV scores and to evaluate the characteristics of the studies that could explain the variability between reliability estimates. Furthermore, the study aimed to estimate the induction rate of the reliability of the MOS-HIV. A systematic review of the previous literature, including studies that reported α and/or test-retest coefficients with the data at hand for the total score of the MOS-HIV and the subscales, was conducted. Fifty studies (52 samples; N = 14,132) were included in the reliability generalization meta-analysis. The average α coefficient for the total score of MOS-HIV was .91 and above .80 for all of the subscales, except for role functioning, which had an average coefficient of .76. Different study dimensions were related to the heterogeneity of reliability between studies. Reliability induction was found to be 76.1%. The results obtained in the present study indicate that the MOS-HIV is a reliable instrument for HRQoL evaluation in PLWHIV, for clinical and research purposes. In the clinical practice of health services, nurses could employ this gold standard for reliable evaluations of HRQoL in PLWHIV.

Psychometric properties of the Spanish version of the mild cognitive impairment questionnaire.

The prevalence of mild cognitive impairment (MCI) has significantly increased in recent years. No specific instruments are available in Spanish for assessing health-related quality of life (HRQoL) in people with MCI. The aim of this study was to adapt transculturally and validate the mild cognitive impairment questionnaire (MCQ) in Spanish people with MCI. A standardized transcultural adaptation process was carried out, and the structural equivalence of the Spanish version of the scale was examined. In addition, we studied the reliability and construct validity of the instrument. The sample comprised 100 people with MCI, with a mean age of 79.5 years. In a confirmatory factor analysis, we found the instrument had a one-factor structure and adequate internal consistency. Related to the construct validity, we found meaningful relationships with measures of HRQoL and depression. Our results indicate that the Spanish version of the MCQ is a reliable and valid tool for measuring HRQoL in Spanish patients with MCI. The availability of specific tools, such as the MCQ allows nurses to evaluate new intervention strategies to improve the HRQoL of these patients. Furthermore, this scale can be used by researchers and clinicians to improve the standards of care provided to this population.

Visual memory tests enhance the identification of amnestic MCI cases at greater risk of Alzheimer's disease.

OBJECTIVES: To investigate whether amnestic mild cognitive impairment (aMCI) identified with visual memory tests conveys an increased risk of Alzheimer's disease (risk-AD) and if the risk-AD differs from that associated with aMCI based on verbal memory tests. PARTICIPANTS: 4,771 participants aged 70.76 (SD = 6.74, 45.4% females) from five community-based studies, each a member of the international COSMIC consortium and from a different country, were classified as having normal cognition (NC) or one of visual, verbal, or combined (visual and verbal) aMCI using international criteria and followed for an average of 2.48 years. Hazard ratios (HR) and individual patient data (IPD) meta-analysis analyzed the risk-AD with age, sex, education, single/multiple domain aMCI, and Mini-Mental State Examination (MMSE) scores as covariates. RESULTS: All aMCI groups (n = 760) had a greater risk-AD than NC (n = 4,011; HR range = 3.66 - 9.25). The risk-AD was not different between visual (n = 208, 17 converters) and verbal aMCI (n = 449, 29 converters, HR = 1.70, 95%CI: 0.88, 3.27, p = 0.111). Combined aMCI (n = 103, 12 converters, HR = 2.34, 95%CI: 1.13, 4.84, p = 0.023) had a higher risk-AD than verbal aMCI. Age and MMSE scores were related to the risk-AD. The IPD meta-analyses replicated these results, though with slightly lower HR estimates (HR range = 3.68, 7.43) for aMCI vs. NC. CONCLUSIONS: Although verbal aMCI was most common, a significant proportion of participants had visual-only or combined visual and verbal aMCI. Compared with verbal aMCI, the risk-AD was the same for visual aMCI and higher for combined aMCI. Our results highlight the importance of including both verbal and visual memory tests in neuropsychological assessments to more reliably identify aMCI.

Spanish version of the Parkinson's Disease Questionnaire-Carer (PDQ-Carer).

BACKGROUND: Parkinson's caregivers are frequently affected by a range of physical and psychological factors affecting to the quality of life (QoL) of patients and caregivers. However, while there are well-validated QoL instruments for patients, few specific measures has been developed for caregivers of patients with PD. This study examined the psychometric properties of the Spanish version of the Parkinson Disease Questionnaire-Carer (PDQ-Carer) for use in PD caregivers. METHODS: The PDQ-Carer and the Short Form-36 Health Survey (SF-36) were completed by sample of 73 caregivers of patients with PD in Spain (71.8 % females; 63.6 ± 12.3 years old). RESULTS: Psychometric analysis confirmed the reliability and validity of the Spanish version of the PDQ-Carer. The internal consistency was found to be satisfactory for the four PDQ-Carer domains: Personal and Social Activities, Depression and Anxiety, Self-care and Stress with Cronbach's alpha values ranging 0.80 to 0.95. The PDQ-Carer was significantly correlated with the eight SF-36 domains (r = -0.31 to -0.59, p < 0.001) supporting the concurrent validity of the instrument. CONCLUSIONS: Overall, these results provide preliminary evidence of the utility of the Spanish version of the PDQ-Carer in non-professionals caregivers.

A relaxation technique enhances psychological well-being and immune parameters in elderly people from a nursing home: a randomized controlled study.

BACKGROUND: The aging process involves a decline in immune functioning that renders elderly people more vulnerable to disease. In residential programs for the aged, it is vital to diminish their risk of disease, promote their independence, and augment their psychological well-being and quality of life. METHODS: We performed a randomized controlled study, evaluating the ability of a relaxation technique based on Benson's relaxation response to enhance psychological well-being and modulate the immune parameters of elderly people living in a geriatric residence when compared to a waitlist control group. The study included a 2-week intervention period and a 3-month follow-up period. The main outcome variables were psychological well-being and quality of life, biomedical variables, immune changes from the pre-treatment to post-treatment and follow-up periods. RESULTS: Our findings reveal significant differences between the experimental and control groups in CD19, CD71, CD97, CD134, and CD137 lymphocyte subpopulations at the end of treatment. Furthermore, there was a decrease in negative affect, psychological discomfort, and symptom perception in the treatment group, which increased participants' quality of life scores at the three-month follow-up. CONCLUSIONS: This study represents a first approach to the application of a passive relaxation technique in residential programs for the elderly. The method appears to be effective in enhancing psychological well-being and modulating immune activity in a group of elderly people. This relaxation technique could be considered an option for achieving health benefits with a low cost for residential programs, but further studies using this technique in larger samples of older people are needed to confirm the trends observed in the present study. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number Register ISRCTN85410212.

Measuring attention of ADHD patients by means of a computer game featuring biometrical data gathering.

ADHD is a neurodevelopmental disorder diagnosed mainly in children, marked by inattention and hyperactivity-impulsivity. The symptoms are highly variable, such as different ages of onset and potential comorbidities, contributing to frequent misdiagnoses. Professionals note a gap in modern diagnostic tools, making accurate identification challenging. To address this, recent studies recommend gamification for better ADHD diagnosis and treatment, though further research is essential to confirm its efficacy. This work aims to create a serious game, namely "Attention Slackline", to assess attention levels. The game, designed with expert input, requires players to concentrate on a specific point to recognize specific patterns while managing distractions. A controlled experiment tested its precision, and results were compared with established attention tests by a correlation analysis. Statistical analysis confirmed the game's validity, especially in tracking attention through correct responses and errors. Preliminary evidence suggests that "Attention Slackline" may serve as a credible instrument for the assessment of attentional capacities in individuals with ADHD, given that its outcomes have been empirically shown to correlate with those derived from a well-established attention assessment methodology.

Impact of COVID-19 on quality of life in survivors with pulmonary sequelae.

SARS-CoV-2 respiratory infection is still under study today, mainly because of its long-term effects. This study aims to analyse health status and health-related quality of life (HRQoL) in survivors of coronavirus pneumonia (COVID-19) who have developed pulmonary sequelae. Prospective observational study of patients diagnosed with COVID-19 pneumonia between February and May 2020. Reviews were conducted at 3 and 12 months after hospital discharge. HRQoL was assessed by administration of the SF-36 questionnaire and data related to medical records and physical examination were also collected. In addition, chest X-ray, computed tomography and pulmonary function test were included as additional tests. 305 patients were admitted for COVID-19 pneumonia of which 130 (42.6%) completed follow-up. The mean age of the enrolled group was 55.9 ± 15.9 years. The most prevalent persistent symptoms were dyspnea (37.3%) and asthenia (36.9%). Pulmonary sequelae were detected in 20.8% of participants. The most frequent alteration was ground ground glass opacities (GGO) (88.9%), with mild extension. Fibrotic changes were found in only 2% of cases. When comparing the two groups, at 3 and 12 months of evolution, lower scores in the vitality (VT) and mental health (MH) domains were found only in the group without sequelae. Days of hospitalisation and Charlson index acted as influential factors on HRQoL. Minimal or mild pulmonary sequelae of SARS-CoV-2 do not cause further deterioration of HRQoL. Repeated medical care and pulmonary rehabilitation are effective tools to improve HRQoL.

A comparative study of differences between parents and teachers in the evaluation of environmental sensitivity.

Introduction: The inextricable bond between humans and the environment underscores the pivotal significance of environmental sensitivity. This innate trait encompasses a wide array of ways individuals perceive, process, and react to various internal and external stimuli. The evaluation of this trait in children is generally conducted by parents. However, little is known about the concordance of the parents reports with those conducted by others, such as teachers. Children's behavior assessment is a current and relevant issue and finding out more positive results could make improvements in different contexts, such as home, clinics and schools. Objective: This study examines agreements and discrepancies between parents and teachers as raters of environmental sensitivity in Spanish children. Methods: Participants were 124 parents and eight teachers of youngsters between 3 and 10 years, who completed a paper survey providing information about parental and school variables and environmental sensitivity. Results: Parents and teachers mostly differ when rating environmental sensitivity, being parents the raters who score higher levels of this trait than teachers. Also, poor intra-class coefficients of reliability are found in both the items of HSCS, the dimensions and the general factor of environmental sensitivity among the informants. Conclusion: The present investigation provides novel findings related to inter-rater assessment on environmental sensitivity and how these different informants could affect in the report. This study also highlights the need of making and validating new and specific tools to assess environmental sensitivity for teachers.

Spanish validation of the simple lifestyle indicator questionnaire: validity and reliability analysis.

Introduction: It has been shown that lifestyle is a highly modifiable determinant having a direct effect on the health status. Therefore, short and simple questionnaires assessing the lifestyle of the general and clinical population are needed to create interventions on behavioral aspects that can improve the health status. The Simple Lifestyle Indicator Questionnaire (SLIQ) is a validated health scale in English that combines five lifestyle factors: diet, exercise, alcohol consumption, tobacco use, and stress level. The objective of this study was to validate the SLIQ questionnaire in Spanish by analyzing the scale's validity and reliability. Its discriminatory power of the scale was also examined by evaluating the differences in health outcomes according to the levels of adherence to a healthy lifestyle. Methods: The sample consisted of 745 participants with an average age of 39.94 (SD: 16.99). A transcultural adaptation process was carried out to validate the SLIQ questionnaire in the Spanish context, to determinate the structural equivalence of the Spanish version as compared to the English version, and to assess the psychometric properties of the scale. PREDIMED and IPAQ scales were used to analyze the convergent validity of the Spanish version of the SLIQ regarding to diet and exercise, and the questionnaires SF-12 and DASS-21 questionnaires were used to assess the capacity of the Spanish version of the SLIQ to discriminate health status related to different levels of reported lifestyles. Results: Regarding validity, the results indicate significant correlations between the different dimensions of the SLIQ questionnaire and those used as a reference. As for reliability, the test-retest analyses reveal a high temporal consistency for the scores obtained on the questionnaire. Finally, the differences found in anxiety, depression, and quality of life, with regard to the different levels of adherence in the SLIQ questionnaire, suggest that the questionnaire's Spanish version has adequate discriminatory power. Discussion: The obtained correlation coefficients between the SLIQ and the other standardized measures pointed out the adequate convergent validity of the instrument. Moreover, the test-retest results demonstrated the stability of the results obtained through this questionnaire. Finally, the lifestyle categories derived from the SLIQ showed a high ability to discriminate between participants' health profiles. Hence, it can be concluded that the Spanish version of the SLIQ questionnaire is a valid and reliable tool for the quick and effective assessment of lifestyle.

Predicting Alzheimer's disease with practice effects, APOE genotype and brain metabolism.

After the paper Cognition or genetics. Predicting progression to Alzheimer's disease with practice effects, APOE genotype and brain metabolism [Neurobiol Aging, 2018; 71:234-240] was published, we identified a coding error of one of the variables analyzed. To correct, update and expand the previous work, we compared simple and complex regression-based Reliable Change Index (RCIRB) to analyze the risk of progression to AD (AD-risk) after six years using either delayed recall or recognition scores. Auditory Verbal Learning Test scores at six months for 394 individuals with normal cognition from the ADNI were used to build the regression. In 816 individuals with amnestic mild cognitive impairments, the AD-risk was associated with age, brain metabolism, APOE-ε4, recognition hits, the discrimination index, and low practice effects in the complex RCIRB only. The complex RCIRB outperformed the simple RCIRB. Small correlations were found between practice effects and both Aß (highest r = 0.218) and TAU (highest r = -0.183). RCIRB are computationally simple and provide sensitive AD-risk estimates in combination with APOE-ε4 and FDG-PET.

Psychometric Properties of the Spanish Version of the Highly Sensitive Child Scale: The Parent Version.

Environmental sensitivity is the ability to perceive, register and process information about the environment, which differs among children and adolescents. The Highly Sensitive Child (HSC) scale has been used to assess environmental sensitivity in youngsters. The HSC scale is a short and 12-item adapted version of the Highly Sensitive Person (HSP) scale. The aim of this pilot study is to transculturally adapt the Highly Sensitive Child (HSC) scale, and to analyze its factorial structure, reliability and validity. First, a transcultural adaptation was conducted by bilingual experts. Second, once the questionnaire was translated, the psychometric properties were analyzed. The Spanish version of the HSC scale was administered to parents answering about information of 141 children between 6 and 10 years old. The Spanish version of the Emotionality, Activity and Sociability Survey (EAS) was also applied. The results of the confirmatory factor analysis confirmed the three-factor structure of sensitivity in our Spanish sample. This structure included the following dimensions: (1) Ease of Excitation (EOE), (2) Low Sensory Threshold (LST), and (3) Aesthetic Sensitivity (AES). Moreover, both Cronbach's α and McDonald's ω values indicated that the Spanish version of the HSC scale was a reliable measure of environmental sensitivity, as a general factor of sensitivity (α = 0.84), and even in its three dimensions: EOE (α = 0.86), LST (α = 0.77) and AES (α = 0.73). Finally, the correlations for convergent validity showed positive associations, especially among the three dimensions of SPS and Emotionality (EOE r = 0.351; LST r = 0.274; AES r = 0.259), which was one of the domains of the EAS survey. The pilot study provided interesting results, which showed a reliable and valid replication of the original structure of sensitivity in the Spanish samples.

Effects of Impulsivity on Competitive Anxiety in Female Athletes: The Mediating Role of Mindfulness Trait.

It has been demonstrated that athletes in competitive sports suffer from high levels of competitive anxiety, especially in the case of females. In this sense, it is necessary to identify possible risk and protective factors of those athletes in this collective who suffer from this type of anxiety. However, few studies analyze the relationship between Physical Activity (PA) and anxiety, identifying the possible mediation effect of trait variables such as impulsivity and mindfulness in female athletes. Hence, the aims of this study were: to determine differences between PA levels with anxiety, mindfulness, and impulsiveness; to identify the predictive value of sociodemographic factors and physical activity, impulsivity, and mindfulness on anxiety factors; and to analyze the possible mediating effects of mindfulness on the relationship between impulsivity and anxiety. A total of 242 female athletes underwent an assessment of physical activity, anxiety, mindfulness traits, and impulsivity using validated questionnaires. Data were analyzed according to (1) individual or collective sport, and (2) PA levels according to energy expended (METs min/day). Participants were grouped by light, moderate, and vigorous PA levels. There were 30.5% elite athletes and 73.2% collective sports athletes. Mean age was 22.1 years and mean light, moderate, and vigorous PA were 86.1 ± 136.2, 114.4 ± 159.8, and 370.1 ± 336.3 METs min/day, respectively. Those athletes performing vigorous PA exhibited lower levels of impulsiveness and higher mindfulness traits. As expected, the mindfulness trait was a mediating factor in the relationship between impulsiveness and each factor of competitive anxiety (cognitive, somatic, and self-efficacy). Female athletes could suffer competitive anxiety, especially those who present higher levels of impulsivity. However, higher levels of mindfulness traits seem to be a protective factor in the effects of impulsivity on anxiety in this population and have demonstrated to be significant mediators in this association. Further studies are needed with other female athletes to replicate these results and to determine the specific protective mechanisms of mindfulness traits in preventing competitive anxiety.

Impact of COVID-19 Pandemic on Academic Stress and Perceived Classroom Climate in Spanish University Students.

The COVID-19 pandemic has caused several changes in society, especially in the educational context, where several learning methodologies and social interactions have been modified significantly. This fact could have had a negative impact on academic stress levels of students and the classroom climate, especially in the university context. The main aim of the present study was to identify changes in academic stress and the perceived classroom climate caused by COVID-19 in a sample of Spanish university students. Academic stress was evaluated trough the Stressor Academic Scale (SAS) and perceived classroom climate employing the Perceived Classroom Responsibility Climate (PCRC) questionnaire. A longitudinal study was conducted. 135 students (97 females and 38 males) from the Gastronomy (n = 31) and Criminology (n = 104) degrees were evaluated before and after the COVID-19 lockdown in Spain. Academic stress levels and perceived classroom climate were analyzed before (Time 1) and after (Time 2) the lockdown declaration. An increase in academic stress was found, especially in the categories regarding Teachers' Methodological Deficiencies, Academic Over-Burden and Beliefs About Performances. Females and final year students suffered higher levels of academic stress. No differences were found between Time 1 and 2 in perceived classroom climate. The obtained results point out a significant increase of academic stress in university students due to the COVID-19 pandemic in Spain. The implemented educational changes and the uncertainty that resulted from the pandemic could have a significant negative impact on mental health in this population, resulting in higher levels of academic stress, especially in females and final year students. Future studies should analyze the strategies that students are employing to cope with these educational challenges and intervention strategies to promote them in the context of higher education.

Assessment Strategies to Evaluate the Mediterranean Lifestyle: A Systematic Review.

The Mediterranean Lifestyle (MLS) has been related to better health and quality of life. However, there is no consensus on how to assess this lifestyle. The main objective of this work was to systematically review the methodology used in different studies on the evaluation of the MLS. The specific objectives were (1) to analyze the MLS components evaluated in previous studies, (2) to explore the assessment instruments available for the analysis of the MLS, and (3) to identify the psychometric properties of these instruments. The search was carried out using the PubMed, Scopus, Web of Science, and ScienceDirect databases with the purpose of identifying those published articles in which the MLS was assessed. The review included 26 studies linked to the assessment of the MLS. Of these studies, only four exclusively used a tool to analyze MLS components globally. These studies included two questionnaires and three different indexes. None of them, however, evaluated all of the recognized MLS components, and food preparation was the least frequently evaluated component. Given the clear importance of analyzing MLS adherence and the lack of consensus in previous research, an evaluation tool needs to be created to comprehensively assess all of the MLS dimensions by means of appropriate psychometric properties.

Effectiveness of a Two-Year Multicomponent Intervention for the Treatment of Overweight and Obesity in Older People.

This study aimed to assess the effectiveness of a two-year intervention based on the Mediterranean diet for the treatment of overweight and obesity in a sample of 51 older people from the Mediterranean city of Alicante (Spain). We also examined the effects of the intervention on psychological well-being. The participants were randomly assigned to the experimental and control groups. The experimental group received group nutritional education sessions, an individualized dietary-nutritional treatment based on a Mediterranean diet, and a physical activity program; the control group received Mediterranean nutritional education in a written format. The experimental group showed a greater loss in weight (p = 0.017) and percentage of fat mass (p = 0.049), and a greater reduction in body mass index (BMI) (p = 0.014) and waist circumference (p = 0.010). Both groups improved their depression scores using the PHQ-9; however, no significant improvement was seen in adherence to the Mediterranean diet (PREDIMED) and anxiety level (GAD-7). These results suggest that a two-year intervention based on the Mediterranean diet allows an older population with overweight or obesity to achieve greater weight loss and a greater decrease in BMI, waist circumference, and fat mass percentage. In relation to psychological well-being, depression levels improved at the end of said intervention.