Online Cognitive-Behavioral Intervention on Adherence and Quality of Life in Elderly Adults with Diabetes: Two cases study

During the COVID-19 pandemic, elderly adults with type 2 diabetes mellitus (T2DM) have experienced difficulties to adhere to their therapy (TA), a situation which not only has had an impact on their glycemic control, but on their quality of life (QoL) as well. Telepsychology has proved to be an effective alternative to treat health-related complications in patients with this disease, however, results of same are unknown among the Latin American population. The aim of this study was determining the effect of Online Cognitive-Behavioral Therapy on TA, overall QoL and specific QoL in two elderly adults with T2DM. The case of a 62-year-old woman and a 60-year-old man who was offered an intervention consisting of nine sessions offered through a video conference platform is presented. The procedure included: psychoeducation, self-control training techniques, behavior reinforcement, feedback and problem solving. The Objective Clinical Change (OCC) evidences an increase in TA behaviors, such as use of medications, following a healthy diet (OCC≥ 0.20) and monitoring capillary blood glucose in the medium term (four months). Likewise, improve specific QoL for T2DM patients (OCC≤ -0.20). It is concluded that telepsychology is a low-cost, safe, feasible and effective type of therapy to increase and maintain TA behaviors, as well as to improve the QoL of patients suffering T2DM. Even though, more research is needed to increase the effectiveness of this therapy modality (AU)

Condición nutricional de escolares indígenas otomíes en situación de alta marginación / Nutritional status of indigenous Otomi schoolchildren in high marginal situation / Estado nutricional de população escolar de cultura indígena otomí em situação de alta marginalização

Resumen Introducción: El panorama de la salud y nutrición de la población mexicana se enmarca en la conjunción de desnutrición crónica infantil, sobre todo en el medio rural e indígena, y el incremento significativo del sobrepeso y obesidad. Esta información proveniente de encuestas arroja resultados generalizados, sin considerar las particularidades del contexto biosociocultural en que viven comunidades indígenas, codeterminante de la condición nutricional de éstas. Objetivo: Estudiar el estatus nutricional de un grupo de escolares de cultura otomí residentes en una comunidad de México en situación de marginación, considerando el contexto biosociocultural en el que viven. Métodos: Estudio prospectivo transversal realizado en una localidad del Estado de México. Muestra por conveniencia constituida por 214 menores, entre 6 y 12 años de edad. Se emplearon técnicas antropométricas internacionalmente aceptadas para recabar la estatura y el peso, y se calculó el IMC. El estatus de nutrición se estimó con base en el peso, la estatura y el IMC para la edad y se compararon con los referentes de la OMS. Resultados: La prevalencia de estatura baja para la edad y la desnutrición es menor, no así el sobrepeso/obesidad que afecta a un tercio de los menores. Solo para el IMC por edad y sexo hubo diferencias en ciertos grupos de edad. Las puntuaciones z de los tres indicadores son semejantes entre niños y niñas. Discusión y Conclusiones: En comparación con los parámetros nacional y estatal, los menores estudiados muestran prevalencia menor de sobrepeso y obesidad asociado a su contexto sociocultural.

Abstract Introduction: The health and nutrition outlook of the Mexican population may be framed in terms of chronic infant malnutrition, largely in the rural and indigenous sectors, and a significant increase in overweight and obesity. This general information is obtained from surveys without taking into account the biosociocultural context that is a codeterminant of the nutritional condition of many small indigenous communities. Objective: To study the nutritional status of Otomí school children living in a marginalized Mexican community from the perspective of the biosociocultural context in which they live. Methods: This is a prospective and transversal study carried out in a location of the state of México, México. The convenience sample was constituted by 214 children between 6 and 12 years old. Internationally accepted anthropometric techniques were used to collect data on the height and weight of these children. BMIs were calculated. The status of nutrition was estimated based on the expected weight, height, and BMI for each age. These data were compared with the corresponding WHO references. Results: The prevalence of low height and malnutrition related to the ages of these children was found to be low, but one in three of these children was found to be overweight or obese. There were some age groups differences regarding the BMI. The z scores of the three indicators are similar between boys and girls. Discussion and Conclusions: In comparison to the national and state parameters, the children studied showed a low prevalence of overweight and obesity associated with their sociocultural context.

Resumo Introdução: O panorama da saúde e nutrição da população mexicana se enquadra na conjunção de desnutrição infantil crónica, sobretudo no médio rural e indígena, e o incremento significativo do sobrepeso e obesidade. Esta informação vinda de enquetes gera resultados generalizados, sem considerar as particularidades do contexto biosociocultural em que vivem comunidades indígenas, co-determinante da condição nutricional destas. Objetivo: Estudar o estado nutricional de um grupo de escolares de cultura Otomí residentes em uma comunidade do México em situação de marginação, considerando o contexto biosociocultural em que vivem. Métodos: Estudo prospectivo transversal realizado em uma localidade do Estado do México. Amostra de conveniência constituída por 214 menores entre 6 e 12 anos de idade. Empregaram-se técnicas antropométricas internacionalmente aceitas para coletar a altura e o peso, e foi calculado o IMC. O estado de nutrição foi estimado com base no peso, a altura e o IMC para a idade e foram comparados com os referentes da OMS. Resultados: A prevalência da baixa altura para a idade e a desnutrição é menor, no entanto o sobrepeso/obesidade afeta a um terço dos meninos. Apenas para o IMC por grupos de idade e sexo houve diferenças em determinadas faixas etárias. As pontuações z dos três indicadores são semelhantes entre meninos e meninas. Discussão e Conclusões: Em comparação com os parâmetros nacionais e estaduais, os meninos estudados mostram menor prevalência de sobrepeso e obesidade associado ao seu contexto sociocultural.

Effect of gender and school level on disordered eating behaviours and attitudes in Mexican adolescents.

The aim of this study was to assess eating behaviours and attitudes in a community sample of 615 adolescent Mexican students recruited at a middle school (192 boys and 226 girls; mean age +/- standard deviation 13.56+/-0.09) and high school (90 boys and 107 girls; mean age 16.04+/-0.12 years), who completed the Eating Attitudes Test (EAT), the Bulimia Test (BULIT) and the Body Shape Questionnaire (BSQ). Multiple analysis of variance revealed the significant effect of gender on the negative feelings, body dissatisfaction, drive of thinness and perceived social pressure subscales, and school level on the body dissatisfaction and food preoccupation subscales. Among the high school girls, the gender x school level interaction had a significant effect on negative feelings, body dissatisfaction, drive of thinness, food preoccupation and perceived social pressure subscales. These data support previous findings concerning gender, and also suggest that perceived social pressure in the case of girls and food preoccupation in the case of boys could be important factors in the natural development of eating disorders.

Validity of the Eating Attitudes Test: a study of Mexican eating disorders patients.

OBJECTIVE: To evaluate the psychometric properties of the Mexican version of the Eating Attitudes Test (EAT-40) in clinical and control populations in Mexico City. METHOD: 276 female patients with eating disorders [52 with anorexia nervosa (AN), 102 with bulimia nervosa (BN) and 122 with eating disorders not otherwise specified (EDNOS)] and a comparison group of 280 normal control female subjects completed the EAT. RESULTS: The EAT had an adequate level of internal consistency in the clinical sample (Cronbach's alpha=0.90). Total score was significantly correlated with criterion group membership (r=0.77, p< or =0.0001), suggesting a high level of concurrent validity. There was a small overlap in the frequency distribution of the 2 groups (eating disorders and control) and only 6% of the normal controls scored as high as lowest anorexic and bulimic patients. The factorial analysis yielded five factors accounting for 46.6% of total variance: 1) Dietary restraint, 2) Bulimia, 3) Drive of thinness, 4) Food preoccupation and 5) Perceived social pressure. CONCLUSIONS: This study provides evidence that the Mexican version of the EAT is an economical, reliable and potentially useful instrument for research in this field.