Background: The study explored potential mediation by executive functions (behavioral regulation index [BRI] and metacognition index [MI]) in association between perceived stress, prenatal distress, emotional control, and dietary intake (total calorie, total fat, added sugar, fruits, and vegetables).
Methods: 70 overweight or obese pregnant women completed validated online surveys and two 24-hour dietary recalls. Path analyses were performed.
Results: Increased perceived stress was associated with increased BRI both directly (p < 0.001) and indirectly through increased MI (perceived stress to MI: p < 0.001, MI to BRI: p < 0.001). Subsequently, increased BRI was associated with increased total fat intake (p = 0.01). Two-stage mediation was found in the association of prenatal distress with total fat intake. Increased prenatal distress was associated with increased MI (p < 0.001). Higher MI was associated with higher BRI (p < 0.001), and higher BRI was associated with increased total fat intake (p = 0.01).
Conclusions: Future intervention studies for overweight or obese pregnant women might focus on stress management to alleviate perceived stress and prenatal distress or on strategies to boost executive functions, each of which might ultimately help to reduce total fat intake.
By virtue of being in a developing country with ongoing expanding of the healthcare system, establishing or at least renovating a Pediatric critical care unit (PICU) has become a necessity. As intensivists and healthcare providers, we excel at our job as clinicians; however, we perform less than perfect when it comes to participating in establishing new PICUs and deliberately building and designing an EBM and patient-centered PICU with a complete understanding of the technical and non-clinical processes during commissioning or operational phases like construction, physical layout (blueprint), Biomedical engineering aspects, equipment, supply, and work-environment enhancement. If all healthcare providers -and especially intensivists- avoid being involved actively in PICUs designing process at their institution, they will miss an opportunity to gain a new perspective as well as they might contribute to a fragmented process of ICU design and a suboptimal result that might impact the PICU environment, patient journey and eventually the quality of care in that ICU. The PICU designing processes should be handled via a multi-professional team approach in an integrated -not parallel- manner that includes clinical and non-clinical personnel. Therefore, the processes will be more integrated, and they will finish the project efficiently, effectively, safely, and patient-centered way. This paper is an expert opinion and literature review that describes a conceptual framework to guide simple and practical mental processes in establishing and designing processes for new PICUs in developing countries. We called this preparedness tool: the 4S framework (system, space, staff, and stuff). It is a well-known preparedness tool that is commonly used in planning new projects by project leaders. Therefore, we utilized it in establishing a new PICU intended to meet the national and international accreditation standards and requirements. This unique preparedness tool will help establish an easy conceptual framework for all healthcare providers to grasp the complex -clinical and non-clinical- processes of establishing new PICUs and develop a holistic approach to this complex project. Note: The authors had leading roles in establishing or renovating many PICUs in Saudi Arabia, in both private and governmental hospitals, and would like to share their novel conceptual framework for establishing new PICUs in developing countries.
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