No abstract

The aims of this study were to identify the cognitive and behavioral predictors of dropping out and to estimate the attrition rate during different phases of an intervention program to treat overweight and obesity in adolescents. Overweight/obese adolescents (n=156, aged: 13-16 years; 71 male and 85 female subjects) were included in a multicomponent (diet, physical activity and psychological support) family-based group treatment program. At baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up, we measured adolescents' cognitive and behavioral dimensions, together with the parents' perception of their child's behavior. Of the 156 adolescents selected, 112 completed the full program (drop-out rate of 28.2%). The risk of dropping out during the extensive phase increased by 20% for each unit increase in the adolescent's social insecurity score (odds ratio=1.20, 95% confidence interval=1.07-1.34, P=0.002). The adolescents who had a high interoceptive awareness showed a significant decrease of 13.0% in the probability of dropping out (odds ratio=0.87, 95% confidence interval=0.77-0.99, P=0.040). Adolescents' social insecurity was the main predictor of drop-out in a multicomponent family-group-based obesity treatment program. To reduce attrition rates in these programs, the individual's social insecurity level needs to be reduced, whereas the family's awareness of eating-related behavior needs adjustment.

Objective:  To determine the relationship between perception of aggression, personality disorders and psychiatric morbidity. Method:  Ninety nursing students were interviewed. A two‐stage transversal analysis was used, the first stage using the Spanish version of the general health questionnaire (GHQ‐28), the true‐false test of international personality disorders (IPDE) of Loranger, and the perception of aggression scale (POAS) of Jansen. For the second stage we used the Spanish version of the clinical interview schedule (CIS), and the full test of IPDE. Results:  Perception of aggression was mainly described as a violent reaction. There were no significant differences in the perception of aggression according to GHQ(+), CIS(+) and IPDE(+). There was a significant relationship between perception of aggression as violent reaction and gender. Conclusion:  Aggression was perceived by our nursing students as a violent reaction. A significant relationship with gender was observed.

We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support.

ResumenObjetivoAportar evidencias de la eficacia de una intervención comunitaria en salud, que incluye un programa de estimulación cognitiva, para prevenir el deterioro de las capacidades cognitivas en nuestra población de personas mayores con cognición normal que viven en la comunidad.DiseñoEnsayo clínico aleatorizado (normas grupo CONSORT).EmplazamientoCentro de salud San José Norte-Centro y Fundación La Caridad (Zaragoza).ParticipantesDoscientas una personas de 65 años o más, con puntuación MEC de 28 puntos o más, 101 aleatorizados en el grupo intervención y 100 en el grupo control.IntervencionesLa intervención se realizó en 10 sesiones de 45 min, una por semana, con material propio, los cuadernos de colores de activación mental. Estos cuadernos trabajan las áreas de memoria, orientación, lenguaje, praxis, gnosis, cálculo, percepción, razonamiento lógico, atención-concentración y programación.Mediciones principalesLas variables de resultado fueron MEC, Set-test, Barthel y Lawton-Brody.ResultadosAnalizando los incrementos sobre el nivel basal, para la variable MEC el grupo intervención obtiene, en media, 1,58 puntos más que el grupo control en la evaluación realizada inmediatamente después de la intervención. A los 6 meses la mejora es de 1,51 puntos y al año de 2,04 puntos. Todos estos incrementos son estadísticamente significativos al nivel usual del 5%. No se observan diferencias estadísticamente significativas entre el grupo intervención y control en las variaciones sobre el nivel basal de las variables en Set-test, Barthel y Lawton-Brody.ConclusionesLa estimulación cognitiva con nuestro programa es eficaz para mantener el rendimiento cognitivo, medido con la variable MEC, en nuestra población de personas mayores con cognición normal que viven en la comunidad. No hay evidencia de que esa mejora se transfiera a las actividades de la vida diaria medidas con Barthel y Lawton-Brody.