Background. Climate change and global health are inextricably linked. Thus, health systems and their professionals must adapt and evolve without losing quality of care. Aim(s). To identify health and environmental co-benefits derived from a sustainable diet and promotion strategies that favor its implementation. Methods. A systematic search for articles published on sustainable diets and human/planetary health published between 2013 and 2020 was conducted on the databases PubMed, Cinahl, Scopus and Trip from 4 to 7 May 2020 in accordance with the PRISMA guideline. Results. A total of 201 articles was retrieved, but only 21 were included. A calorie-balanced diet mainly based on food of plant origin that would allow the attainment of 60% of daily caloric requirements and a low protein intake from animal foods (focusing in fish and poultry) could significantly reduce global morbi-mortality and the dietary environmental impact maintaining a framework of sustainability conditioned by the consumption of fresh, seasonal, locally produced and minimally packaged products. Discussion. The implementation of sustainable diets requires working on the triangulation of concepts of food–health–environment from schools and that is permanently reinforced during all stages of the life by healthcare workers, who should establish the appropriate modifications according to the age, gender and health situation.
The aim of this study was to evaluate a diet intervention implemented by our hospital in order to determinate its capacity to improve the eating pattern of patients with an ileostomy, facilitating the implementation new eating-related behaviors, reducing doubt and dissatisfaction and other complications. The study was conducted with a quasi-experimental design in a tertiary level hospital. The elaboration and implementation of a nutritional intervention consisting of a Mediterranean-diet-based set of menus duly modified that was reinforced by specific counseling at the reintroduction of oral diet, hospital discharge and first follow-up appointment. Descriptive, bivariate and multivariate analyses were performed. The protocol was approved by the competent Ethics Committee. The patients of the intervention group considered that the diet facilitated eating five or more meals a day and diminished doubt and concerns related to eating pattern. Most patients (86%) had a favorable experience regarding weight recovery and a significant reduction of all-cause readmissions and readmission with dehydration (p = 0.015 and p < 0.001, respectively). The intervention helped an effective self-management of eating pattern by patients who had a physical improvement related to hydration status, which, together with an improvement in weight regain, decreased the probability of readmissions.
Background: Despite increased attention, acute and persistent post-operative pain are not treated efficiently and interventions against acute pain are therefore of clinical importance and should be welcomed. Aims and objectives:To evaluate the effectiveness of wound infiltration with 0.5% bupivacaine for pain management in the immediate post-operative period in patients that underwent cardiac surgery with sternotomy. Design:The study was performed employing a single-centre nonrandomized experimental design to evaluate a prospective cohort of patients recruited from June to December of 2017.Methods: A single-centre study with a non-randomized experimental design compared the pain perceived by 137 patients undergoing to cardiac surgery within which 68 patients who received infiltration of bupivacaine and 69 patients received infiltration with saline solution. Pain measures were made with the numeric rating scale (NRS) at 2, 12, 24, and 48 hours. Socio-demographic and clinical variables were included too and descriptive, bivariate, and multivariate logistic regression analyses were performed.Results: A statistically significant difference was found between the means of the NRS scores in favour of the intervention group. Cohen's d showed a significant effect size. NRS scores were grouped into NRS ≥4 or NRS <4 and similar results were found. Multivariate logistic regression analyses showed the absence of confounding factors that could call results into question. Conclusion:Subcutaneous infiltration of 0.5% bupivacaine in the surgical site of patients who have undergone cardiac surgery showed clinically and statistically significant pain relief compared with patients who received saline infiltration throughout the first 12 hours after surgery. This intervention provides promising preliminary results that, alone or in conjunction with other nursing interventions, could constitute an important therapeutic tool for this area of nursing clinical practice.
Official population consumption data are frequently used to characterize the diet of countries; however, this information may not always be representative of reality. This study analyses the food consumption of the Spanish population by reconstructing the whole food chain. The results have been compared with the data provided by the National Consumption Panel to which the food losses/waste reported in the literature along the distribution chain have been added. The difference between them allowed a new calculation of the estimated food consumption that was subjected to a dietary-nutritional analysis. Most of the foods were consumed more than those officially reported (range of 5–50%). The unhealthy ratios of consumed foods and recommended servings were: meat products (Rcr = 3.6), fruits and legumes (Rcr = 0.5), and nuts (Rcr = 0.14). Caloric intake surpasses needs. The results were consistent with the data on the prevalence of overweight and obesity in Spain, as well as with the prevalence of associated diseases. To make a judgment about the quality of a country’s diet, it is necessary to have reliable data on food consumption, as well as energy and nutrient intake. This study encourages other authors to implement this method to verify and quantify the possible difference between official and real consumption data.
Background Demographic changes and the increased chronical diseases burden are global challenges that cannot go unnoticed by healthcare systems, which must be organized without losing sight of the increasing influence of social determinants. Aim To evaluate the results of a primary care program implemented to reduce health inequalities associated with social determinants in patients with type 2 diabetes. Method An exploratory pilot retrospective cross‐sectional study that includes secondary data of 404 nonrandomized patients belonging to socially depressed areas and conventional areas. Descriptive, bivariate, and multivariate analyses were performed. Results The age of the subjects included in the study was 66.80 ± 9.7 years with a proportion of 56.7% men. Proportions of patients from socially depressed areas and adherence to the Nursing Follow‐up Program were around 33% and 60%, respectively. The obesity rate was 51%, percentage of patients with HbA1c<7% was 59%. No significant differences were found between patients belonging to socially depressed areas and those who do not, except for greater adherence to nursing follow‐up programs. Multivariate models assessed chronical complications as health outcomes (cardiovascular diseases, retinopathy, and nephropathy) as health outcomes showing the influence of previously described risk factors. However, in none of the models did belonging to a socially depressed area or adherence to the Nursing Follow‐up Program were predictors. Conclusions The program has proven to be efficient in equating the health outcomes related with cardiovascular risk of patients from both types of areas. Well‐directed health policies could bring primary care systems closer to sustainable development goals through the reduction of health disparities that affect socially vulnerable groups. Clinical relevance To introduce a risk strategy and to adopt a family approach, contemplating the sociocultural and educational differences that diversely affect men and women in their health status has proven to be useful in reducing health disparities due to social determinants in patients with type 2 diabetes.
Background/purpose Many studies suggest that insulin resistance in obese patients bridges mental illness. Our objective was to identify the association between levels of depression and anxiety with insulin resistance, and its relationship with obesity and abdominal obesity Methods A cross-sectional analytical study was carried out in Honduras. Sociodemographic variables, anthropometric parameters, HOMA index, and level of severity of anxiety and depression were collected, and a descriptive, bivariate, and multivariate were performed. Results In a sample of 381 adult patients, the bivariate analysis showed a statistic association of insulin resistance with all remaining variables. However, multivariate analysis showed a significative association of anxiety with BMI, depression, waist circumference, and insulinemia, while depression was associated with HOMA, anxiety, insulinemia, glycemia, and waist circumference. Conclusions Our results provide important evidence of a direct and growing association between HOMA-IR and the severity of depression, and indirectly with anxiety. Secondarily, also with anthropometric factors (BMI and WC), traditionally associated with cardiovascular risk. This finding has important implications both for the early diagnosis of these mental pathologies, taking into account HOMA-IR values, and for preventive interventions focused on maintaining blood insulin levels.
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