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Revisiting the beyond BMI paradigm in excess weight diagnosis and management: A call to action
Full text linkAdolphe Quételet, a 19th-century Belgian sociologist and statistician, pioneered the incorporation of statistics into social sciences. He initiated the development of anthropometry since he was interested in identifying the proportions of the 'ideal man'. He devised a ratio between weight and height, originally termed the Quételet Index, and today widely known and used as the body mass index or BMI. In 1835, he demonstrated that a normal curve accommodates the distribution of human traits articulating his reasoning on human variance around the average. Quételet's long-lasting legacy of the establishment of a simple measure to classify people's weight relative to an ideal for their height endures today with minor variations having dramatically influenced public health agendas. While being very useful, the limitations of the BMI are well known. Thus, revisiting the beyond BMI paradigm is a necessity in the era of precision medicine with morphofunctional assessment representing the way forward via incorporation of body composition and functionality appraisal. While healthcare systems were originally designed to address acute illnesses, today's demands require a radical rethinking together with an original reappraisal of our diagnosis and treatment approaches from a multidimensional perspective. Embracing new methodologies is the way forward to advance the field, gain a closer look at the underlying pathophysiology of excess weight, keep the spotlight on improving diagnostic performance and demonstrate its clinical validity. In order to provide every patient with the most accurate diagnosis together with the most appropriate management, a high degree of standardization and personalization is needed
Necesidades del adolescente con un proceso crónico y su familia en la transición de la atención pediátrica a la adulta
No full textIntroducción: Las enfermedades crónicas repercuten en la vida del adolescente y su familia,
generando preocupación en la adolescencia, momento en el que se acerca el cambio de la atención
pediátrica a la adulta. Por ello, la transición supone una oportunidad para que los profesionales
proporcionen una atención centrada en las necesidades del adolescente y su familia.
Objetivo: Conocer las necesidades del adolescente con un proceso crónico y su familia durante la
transición de la atención pediátrica a la adulta.
Metodología: Se realizó una revisión de la literatura en las bases de datos de PubMed, CINAHL y
PsycINFO en octubre de 2023.
Resultados: Los resultados se agruparon en tres apartados: Contemplando al adolescente y su
familia desde una mirada holística, Empoderando al adolescente sobre su autocuidado y
Acompañando al adolescente en el camino de la transición.
Conclusiones: Se ha observado que el adolescente y su familia tienen necesidades insatisfechas
durante la transición. Por ello, se cree necesario que la enfermera sea referente en esta etapa y que
se realicen más investigaciones que ayuden a abordar dichas necesidades.Title: Needs of the adolescent with a chronic condition and its family in the transition from pediatric to
adult care.
Introduction: Chronic diseases have an impact on the life of the adolescent and their family,
generating worry in adolescence, a time when the change from pediatric to adult care is approaching.
Therefore, transition is an opportunity for professionals to provide care focused on the needs of the
adolescent and its family.
Objective: To find out the needs of the adolescent with a chronic condition and its family during the
transition from pediatric to adult care.
Methodology: A review of the literature was carried out in PubMed, CINAHL and PsycINFO
databases in October 2023.
Results: The results were grouped into three categories: Considering the adolescent and their family
from a holistic perspective, Empowering the adolescent about their self-care, and Accompanying the
adolescent on the path of transition.
Conclusions: It has been observed that the adolescent and its family have unmet needs during the
transition. Therefore, it is necessary for the nurse to be a reference professional at this stage and for
more research to be carried out to help address these needs
Instruments for assessing family functioning in adults patients with cancer: a systematic review of measurement properties
No full textObjectives: To identify instruments for assessing family functioning in adults patients with cancer and summarize their psychometric properties.
Methods: Psychometric systematic literature review was conducted to June 2023 using four databases:
PubMed, CINAHL, Psych INFO, and Web of Science. The psychometric properties of the instruments and the
methodological quality of the studies were evaluated using the Consensus-based Standards for the Selection
of Health Measurement Instruments (COSMIN) checklist. The Grading of Recommendations, Assessment,
Development and Evaluation (GRADE) was used to rate the best available evidence.
Results: Forty-four studies reporting 13 instruments were included. The instruments measured varied attributes of family functioning and the dimensions were heterogeneous. The Cancer Communication Assessment
Tool for Patients and Families (CCAT-PF) was rated the highest in terms of both methodological rigor and
instrument quality. However, the Family Adaptability and Cohesion Evaluation Scale (FACES) and the Ice-Expressive Family Functioning Questionnaire (ICE-EFFQ) offer a more comprehensive measure of family
functioning, since they assess multiple dimensions of family functioning and demonstrate high-quality measurement properties.
Conclusions: Instruments to assess family functioning were heterogeneous and exhibited limited reliability
and validity. The FACES and the ICE-EFFQ seem to be the most suitable measures for adult cancer patients
and their families. Future research should aim to refine the content of existing instruments and rigorously
assess their psychometric properties.
Implications for Nursing Practice: Given the profound impact of cancer on family functioning, the initial step in
crafting effective interventions is providing valid and reliable instruments to measure the impact of these
interventions. This paper could assist nursing professionals in making informed decisions regarding the most
suitable instrument for assessing family functioning in adults patients living with life-threatening illness as
is the case with cancer
Experiencias y necesidades de la familia cuidadora de una persona con insuficiencia cardíaca
No full textIntroducción: La insuficiencia cardíaca (IC) es una enfermedad que afecta a la capacidad del corazón
para bombear sangre, limitando las actividades diarias de las personas. Esta patología afecta a las
familias de los pacientes; sin embargo, también puede fortalecer los lazos familiares. Este tema es
crucial para abordar integralmente las necesidades de los pacientes y sus familias.
Objetivo: Conocer las experiencias y necesidades de las familias cuidadoras de un miembro
diagnosticado de insuficiencia cardíaca.
Metodología: Se lleva a cabo una revisión narrativa de la literatura realizando una búsqueda
bibliográfica en las bases de datos PubMed y CINAHL durante los meses de octubre, noviembre y
diciembre de 2023.
Resultados: Mediante el análisis de los artículos se detectan distintas necesidades: adaptarse a la
nueva vida, tener estrategias de afrontamiento y apoyos.
Conclusiones: Esta revisión destaca la importancia de atender las necesidades de las familias
cuidadoras de un miembro con insuficiencia cardíaca. Las necesidades más prevalentes son las de
información y apoyo por parte del equipo sanitario. Las familias sufren varios impactos; pero
encuentran significado y crecimiento personal en la situación. Es importante seguir investigando para
mejorar la atención y calidad de vida de estas familias.Introduction: Heart failure (HF) is a condition that affects the heart's ability to pump blood, limiting
people's activities. This condition affects patients' families; however, it can also strengthen family
relations. This topic is crucial for comprehensively addressing the needs of patients and their families.
Objective: Understanding the experiences and needs of caregiver families with a diagnosed member
of heart failure.
Methodology: A narrative literature review was conducted by searching the PubMed and CINAHL
databases during the months of October, November, and December 2023.
Results: Through the analysis of the articles, different needs are identified: adapting to the new life,
having coping strategies, and support.
Conclusions: This review emphasizes the importance of addressing the needs of caregiving families
of a member with heart failure. The most prevalent needs are information and support. Families
experience various impacts but find meaning and personal growth in the situation. It is important to
continue researching to improve the care and quality of life of these families
Modelo de negocio de alquiler de moda para grandes almacenes en España
No full textEl propósito de esta tesis es desarrollar un Plan de Negocio integral para Sorella, una empresa
innovadora en el sector de la moda en España, enfocada en el alquiler de prendas de lujo
accesible y premium. Ya son varios los grandes almacenes que ofrecen servicios de alquiler a
sus clientes pero ninguno en España. Es por ello que Sorella, buscará ser la marca de El Corte
Inglés que cubra este vacío en el mercado. Este proyecto proporciona una alternativa sostenible
al consumo tradicional de moda, permitiendo a los consumidores acceder a ropa de alta calidad
por periodos determinados sin necesidad de comprar, manteniéndose al día con las últimas
tendencias. Además de realizar un análisis de mercado, se realizará una estrategia para cada
una de las ramas principales en una marca de nueva creación desde el plan de producto hasta
su viabilidad financiera. Aprovechando los beneficios específicos de los servicios de alquiler,
como la asequibilidad y la conveniencia, la estrategia de Sorella desarrollará una propuesta de
valor atractiva que conecte con los clientes objetivo
How do Spanish emerging adults feel? Exploring depression, anxiety and stress from a longitudinal and gender analysis
No full textEmerging adulthood is a particularly vulnerable period with higher rates of health-related symptoms and mental disorders. The main aim of the present study was to explore the depression, anxiety and stress levels in a sample of Spanish emerging adults from a longitudinal perspective and taking gender differences into account. The analysis was conducted at two different moments in 2015 (W1) and three years later in 2018 (W2). Participants were Spanish emerging adults (n = 132 men, 268 women at W1; n = 132 men, 266 women at W2) aged between 18 and 29 years (M = 20.31, SD = 2.04 at W1; M = 23.66, SD = 2.08 at W2) participated in the TAE (Transición a la Adultez en España) research project. The validated Spanish version of the DASS-21 was used to measure depression, anxiety and stress levels. Results indicated continuity (mean-level) and high stability (rank-order) in depression, anxiety and stress levels during the initial and intermediate years of emerging adulthood without gender moderation. Results also indicated that there are no differences in depression and anxiety between men and women in both W1 and W2 but women reported higher levels of stress than men specially at W2. The findings highlight that it is crucial to take steps to mitigate the internal symptoms suffered by emerging adults and, particularly, stress suffered by emerging adult women. In this sense, these findings underline that it is crucial that more comprehensive public services and policies are provided to support emerging adults with mental health concerns based on empirical knowledge
Exploring optimal high-pressure processing conditions on a (poly) phenol-rich smoothie through response surface methodology
Full text linkFruit and vegetable-based smoothies offer an excellent way to increase the consumption of (poly)phenols. Among
preservation technologies, required to extend their shelf-life, high-pressure processing (HPP) coped with the
main drawback of traditional treatments. In this study, response surface methodology (RSM) was used to predict
the optimal combination of pressure and holding time to obtain a microbiologically safe beverage without
compromising sensory properties and (poly)phenols. Thus, different pressure levels (300–600 MPa) and holding
times (2–10 min) were applied to a (poly)phenol-rich green smoothie. All HPP-treated smoothies showed reductions in microbial counts compared to untreated smoothie, and no changes in pH, total soluble solids, total
phenolic content, antioxidant capacity and colour parameters, except a decrease of red/green coordinate (a*),
and then maintaining the original green colour. The several (poly)phenol subclasses determined by LC-MS/MS
were differently influenced by HPP conditions, even total (poly)phenolic compounds were similarly affected
among HPP treatments. The overall desirability function revealed 600 MPa and 6 min as the optimal combination of pressure and holding time on the smoothie. Our research highlights the effectiveness of pressure-based
technologies as preservation tool in fruit and vegetable-based beverages, along with the maintenance of their
appreciated characteristics, such as colour or (poly)phenolic compounds
The role of target-specific shared reality in interpersonal interactions and protective health behaviours
No full textShared reality—the experience of sharing common inner states (e.g. feelings, beliefs) with other people about a given topic or target—is a ubiquitous human experience. With research on the construct of shared reality burgeoning in various domains, we examined a fundamental, yet understudied topic: the role of experiencing shared reality about a target in real-time conversations and real-world contexts. Across five studies conducted in various contexts (total N = 973), we developed a measure of target-specific shared reality (SR-T) and examined its role in interpersonal interactions and protective health behaviours. In our initial Studies (1a-2), we developed a measure of SR-T and establish psychometric, construct and criterion validity. In Study 3, we established predictive validity by investigating the link between SR-T and important interpersonal interaction constructs (e.g. interpersonal rapport and epistemic trust in the partner). In Study 4 (preregistered), SR-T moderated the effect of close others’ attitudes on vaccination and precautionary behaviours against COVID-19 during the Omicron-variant peak (2022). Our findings suggest that the experience of SR-T, assessed with a valid measure, is linked to important dimensions of interpersonal interactions and health decisions in the real world
Neoadjuvant therapy versus upfront surgery in resectable pancreatic cancer: reconstructed patient-level meta-analysis of randomized clinical trials
No full textBackground: Neoadjuvant treatment has shown promising results in patients with borderline resectable pancreatic ductal
adenocarcinoma. The potential benefits of neoadjuvant treatment on long-term overall survival in patients with resectable pancreatic
ductal adenocarcinoma have not yet been established. The aim of this study was to compare long-term overall survival of patients
with resectable pancreatic ductal adenocarcinoma based on whether they received neoadjuvant treatment or underwent upfront surgery.
Methods: A systematic review including randomized clinical trials on the overall survival outcomes between neoadjuvant treatment and
upfront surgery in patients with resectable pancreatic ductal adenocarcinoma was conducted up to 1 August 2023 from PubMed, MEDLINE
and Web of Science databases. Patient-level survival data was extracted and reconstructed from available Kaplan–Meier curves. A
frequentist one-stage meta-analysis was employed, using Cox-based models and a non-parametric method (restricted mean survival
time), to assess the difference in overall survival between groups. A Bayesian meta-analysis was also conducted.
Results: Five randomized clinical trials comprising 625 patients were included. Among patients with resectable pancreatic ductal
adenocarcinoma, neoadjuvant treatment was not significantly associated with a reduction in the hazard of death compared with
upfront surgery (shared frailty HR 0.88, 95% c.i. 0.72 to 1.08, P = 0.223); this result was consistent in the non-parametric restricted mean
survival time model (+2.41 months, 95% c.i. −1.22 to 6.04, P < 0.194), in the sensitivity analysis that excluded randomized clinical trials
with a high risk of bias (shared frailty HR 0.91 (95% c.i. 0.72 to 1.15; P = 0.424)) and in the Bayesian analysis with a posterior shared frailty
HR of 0.86 (95% c.i. 0.70 to 1.05).
Conclusion: Neoadjuvant treatment does not demonstrate a survival advantage over upfront surgery for patients with resectable
pancreatic ductal adenocarcinoma