Using Participatory Implementation Science to Advance Health Equity.

Participatory approaches to implementation science (IS) offer an inclusive, collaborative, and iterative perspective on implementing and sustaining evidence-based interventions (EBIs) to advance health equity. This review provides guidance on the principles and practice of participatory IS, which enables academic researchers, community members, implementers, and other actors to collaboratively integrate practice-, community-, and research-based evidence into public health and health care services. With a foundational focus on supporting academics in coproducing knowledge and action, participatory IS seeks to improve health, reduce inequity, and create transformational change. The three main sections of this review provide (a) a rationale for participatory approaches to research in implementation science, (b) a framework for integrating participatory approaches in research utilizing IS theory and methods, and (c) critical considerations for optimizing the practice and impact of participatory IS. Ultimately, participatory approaches can move IS activities beyond efforts to make EBIs work within harmful systems toward transformative solutions that reshape these systems to center equity.

Histology of atherosclerotic plaque from coronary arteries of deceased patients after coronary artery bypass graft surgery. / Histología de la placa de ateroma en arterias coronarias de fallecidos después de una revascularización miocárdica quirúrgica.

BACKGROUND AND AIM: Ischaemic heart disease is an important health problem. The characteristics of atherosclerotic plaques determine patient outcome. The aim of this study was to determine the histological grade of coronary atherosclerotic lesions in deceased patients after coronary artery bypass graft surgery, and to identify the complications of the severe plaques. METHOD: A descriptive, cross-sectional, prospective study was carried out on 21 anatomical pieces of deceased patients over a period of 3 years. The epicardial coronary arteries were sectioned transversally every 1cm, and the odd numbered fragments and the regions of the anastomosis with the grafts were selected. They were embedded in paraffin, stained with haematoxylin-eosin, and the histological slides were studied using an Olympus BHM microscope. RESULTS: An age over 50 years (85.7%), male gender (81.0%), and smoking (66.7%) predominated. Peri-operative infarction (38.1%) and cardiogenic shock (33.3%) were the main direct causes of death. The majority of the grafts were of venous origin (64.6%), and 149 lesions were detected, of which 116 (77.8%) were severe plaques, and 47.4% of them were located in the left anterior descending artery. The large majority (81.9%) of the lesions were located in the arterial segments proximal to the graft. A total of 255 histological complications were detected in the severe plaques, with 75.0% showing calcification. Hypertensive patients had more plaques with more complications, but no statistically significant association was found between these variables. CONCLUSIONS: Severe plaques predominated, mostly located in the proximal segments of the coronary arteries, and the left anterior descending was the most affected artery. Calcification was the most observed complication in the severe plaques.

Heavy Metals in Muscle Tissue of Pterois volitans from the Veracruz Reef System National Park, Mexico.

Concentrations of cadmium (Cd), lead (Pb), vanadium (V), and zinc (Zn) were measured in the muscle of 30 specimens of Pterois volitans, captured on April 2018, in the Veracruz Reef System National Park (VRSNP), Veracruz, Mexico. Concentrations, in the samples, were quantified with atomic absorption spectrophotometry (AAS), after microwave digestion. Results of the mean concentration, in descending order were V = 7.3 ± 0.7; Pb = 0.66 ± 0.07; Zn = 0.43 ± 0.14; and Cd = 0.03 ± 0.01 mg kg-¹ dry weight. These values did not exceeded limits established in the Mexican National Standard (NOM-242-SSA1-2009), of Cd and Pb (0.5 mg kg-¹) wet weight. This means that consumption of lionfish from this site does not pose a potential risk for human health.

Study of pharmaceuticals in surface and wastewater from Cuernavaca, Morelos, Mexico: Occurrence and environmental risk assessment.

The present work describes the first known study to date on the occurrence of pharmaceuticals in surface water and wastewater of Cuernavaca, the capital of the state of Morelos (México). Selected pharmaceuticals (a total of 35) were extracted from the collected water samples with a generic solid phase extraction (SPE) protocol and determined in the sample extracts by means of high-performance liquid chromatography coupled to electrospray ionization-tandem mass spectrometry (HPLC-ESI-MS/MS). A screening level risk assessment combining the measured environmental concentrations (MECs) with dose-response data based on predicted no-effect concentrations (PNECs) was also applied to estimate Hazard Quotients (HQs) for the pharmaceuticals detected in the investigated area. A total of twelve pharmaceuticals were found in the water samples analyzed, with detection frequencies above 78% and in most cases of 100%. Overall, the most abundant pharmaceuticals in surface water were the analgesic and anti-inflammatory drugs naproxen (732-4880ng/L), acetaminophen (354-4460ng/L), and diclofenac (258-1398ng/L), and the lipid regulator bezafibrate (286-2100ng/L). On the contrary, other compounds like the ß-blocker atenolol and the psychiatric drug carbamazepine were found at only a few ng or tens of ng per liter in the Apatlaco River. Despite the fact that some of the most abundant compounds showed good removal (>97%) during wastewater treatment, concentrations downstream the WWTP were only slightly lower than upstream. This indicates the existence of additional inputs of untreated wastewater into the river. Based on the obtained HQ-values, the concentrations of ibuprofen, sulfamethoxazole, diclofenac and naproxen present in the river could pose a high toxicity risk for the aquatic ecosystem. These findings highlight these pharmaceuticals as relevant organic contaminants in the area of study and the need to further monitor them in order to adopt appropriate measures to safeguard the ecosystem, and eventually human health.

Validación de la calidad de las preguntas en un examen final de la asignatura Morfofisiología Humana / Validation of the quality of questions in a final examination of the subject Human Morphophysiology

Introducción: el índice de dificultad y el poder de discriminación son indicadores fáciles de calcular y útiles para el análisis de la correspondencia entre los resultados esperados y los obtenidos de un instrumento evaluativo. Objetivo: evaluar la calidad de las preguntas del examen final ordinario de Morfofisiología Humana V. Métodos: fueron incluidos en esta investigación los 265 exámenes teóricos realizados por los estudiantes del segundo año en la Facultad de Medicina No. 2 de la Universidad de Ciencias Médicas de Santiago de Cuba, durante el curso 2011-2012, a los que se les calculó el índice de dificultad y el poder de discriminación en cada una de las 7 preguntas aplicadas. Resultados: las preguntas de respuesta alternativa, que evaluaban los contenidos sobre la sangre y el corazón, mostraron un índice de dificultad por debajo de 0,1 y un poder de discriminación inferior a 0,2, lo que hace necesaria su reformulación en próximos instrumentos evaluativos. Los valores más altos para ambos indicadores fueron 0,34 y 0,86, respectivamente, y correspondieron a una pregunta de selección múltiple sobre vasos sanguíneos y linfáticos, siguiéndoles en orden las preguntas de respuesta abierta. Conclusiones: se demostró la pertinencia de la mayoría de las preguntas, destacándose la capacidad de 5 de ellas para distinguir estudiantes de alto y bajo rendimientos.

Introduction: the difficulty index and the discrimination power are easy indicators to calculate and useful for the analysis of the correspondence between the expected and obtained results of an evaluative instrument. Objective: to evaluate the quality of questions of the regular final examination of Human Mophophysiology V. Methods: the 265 theoretical examinations carried out by the second year students in the Medical Faculty No. 2 of the Medical University in Santiago de Cuba, during the course 2011-2012 were included in this investigation, to which the difficulty index and the discriminating power were calculated in each of the 7 applied questions. Results: the questions with alternative answer which evaluated the contents on blood and heart, showed a difficulty index below 0.1 and a discriminating power lower than 0.2, making necessary their reformulation in future evaluative instruments. The highest values for both indicators were 0.34 and 0.86, respectively, and they corresponded to a question of multiple selections on blood and lymphatic vessels, followed in order by the questions of open answer. Conclusions: the relevancy of most of the questions was demonstrated, and the capacity of 5 of them to distinguish students of high and low performances was emphasized.

Efecto cicatrizante del extracto fluido de Romerillo (Bidens Alba Linné) / Cicatrisant effect of fluid extract of romerillo (Bildens Alba Linné)

De la planta Bidens alba Linné, conocida popularmente como romerillo, se han realizado numerosas investigaciones e informado diversos efectos curativos; la población refiere su uso como cicatrizante sobre lesiones de la piel. Este trabajo tiene como objetivo indagar sobre el efecto cicatrizante del extracto fluido de esta planta, para lo cual se tomaron 40 ratones Balb-c a los que se les practicó una herida abierta en la región dorsal, en la que se aplicaron diariamente las diferentes sustancias objeto de estudio. Se pudo comprobar que el extracto fluido, con 4,5 por ciento de sólidos totales de Bidens alba Linné, favorece el proceso de cicatrización