Difficulties Fulfilling Self-Care Needs Among Family Caregivers: An Observational Study.

IMPORTANCE: Assuming the care of a family member with a disability or chronic illness constitutes a health risk factor for caregivers, who frequently overlook their own self-care. OBJECTIVE: To analyze the self-care activities (SCAs) among caregivers of a family member with a disability or chronic illness and assess the impact on their satisfaction and quality of life (QoL). DESIGN: Descriptive, cross-sectional, analytic study. SETTING: Community. PARTICIPANTS: Five hundred caregivers of family members with a disability or chronic illness in the city of Zaragoza, Spain. OUTCOMES AND MEASURES: The family caregivers' occupational performance and satisfaction were assessed with the Canadian Occupational Performance Measure, and their QoL was assessed with the World Health Organization-Quality of Life. RESULTS: In total, 32.8% of family caregivers had difficulty in all activities related to self-care, 46.6% had difficulty sleeping and resting, 31.6% had difficulty receiving health-related treatments, and 31.2% had difficulty with physical exercise. Women and younger family caregivers showed greater impairment in self-care. Occupational performance, satisfaction, and QoL worsened as the number of affected activities increased. CONCLUSIONS AND RELEVANCE: Caring for a family member with a disability or chronic illness has a negative impact on the SCAs of caregivers, especially among female caregivers and those of younger age. Caregiving is also associated with lower occupational performance, satisfaction, and QoL. Plain-Language Summary: Caring for a family member with a disability or chronic illness can become a health risk for caregivers, who frequently ignore their own self-care. The study results found that women and younger family caregivers showed a greater decline in self-care. This study provides information to help occupational therapists to work with family caregivers to prevent a decline in their self-care and improve their quality of life.

Association between sociodemographic characteristics and level of knowledge about oral cancer among Mexican dental health professionals: a cross-sectional online survey.

BACKGROUND: A good level of knowledge in dentists is crucial for an early diagnosis of oral cancer (OC). In Latin America there are a few studies of OC knowledge among dentist, those has been performed in Brazil, Colombia, and Chile, and their results showed low level of OC knowledge. On the other hand, there is no publication in which the level of knowledge of dentists in Mexico has been addressed. Therefore, this study aimed to assess knowledge of OC and to determine the association of the level of knowledge with sociodemographic characteristics among dentists in Mexico. METHODS: A cross-sectional online survey was designed to obtain information via questionnaire. The questionnaire was developed in the Spanish language, and the content validity was determined. The study was conducted among Mexican dentists with a 23-item questionnaire that was designed to be anonymous. The sample size was calculated using the finite population formula. Based on the responses, the level of knowledge of OC was categorized as very low, low, regular, good, or excellent. Additionally, the association between sociodemographic characteristics and the level of knowledge about OC was evaluated. RESULTS: This research was conducted on a sample of 387 dentists. Most of the respondents were general dentists and worked in urban zones. The majority of dentists lacked a specialty (76.7%). Additionally, most of the respondents were students (44.2%). The level of knowledge of the participants was between regular and good (77.8%). On the other hand, concerning self-evaluation, most of the participants considered their knowledge of OC to be regular (50.6%). In addition, there was no association between sociodemographic characteristics and knowledge about OC. CONCLUSIONS: This research identified some weaknesses in most Mexican dentists' knowledge of OC.

External Apical Root Resorption in Orthodontic Patients Who Practice Combat Sports: A Case-Control Observational Pilot Study.

Orthodontic treatment could lead to undesirable effects such as external apical root resorption (EARR). Moreover, trauma to both the face and teeth can predispose to EARR. On the other hand, the practice of combat sports results in increased maxillofacial injuries. Consequently, our objective was to determine if there is a statistically significant difference in the EARR of the patients undergoing fixed orthodontic treatment who practice combat sports and controls. Our null hypothesis was that there is no difference in the EARR between patients undergoing orthodontic treatment who practice combat sports and the patients under the same treatment that do not practice combat sports. An observational, descriptive, and prospective case-control pilot study was designed. The exposed group consisted of patients that practice combat sports. Whereas the control group was conformed of patients that do not practice combat sports without a previous history of facial trauma and without face trauma during the orthodontic treatment. EARR of the maxillary and mandibular anterior teeth was measured using cone-beam computed tomography (CBCT). The CBCT scans were obtained from all patients prior to the beginning of the orthodontic treatment and 1 year later. At the end of the follow-up for the maxillary right central and lateral incisors of the exposed group, the EARR was significantly higher than the homologous teeth of the control group (p < 0.05). As a consequence, the patients treated orthodontically who practice combat sports could be more susceptible to EARR.

The COVID-19 pandemic: a new challenge for syndromic surveillance.

The COVID-19 pandemic is exerting major pressures on society, health and social care services and science. Understanding the progression and current impact of the pandemic is fundamental to planning, management and mitigation of future impact on the population. Surveillance is the core function of any public health system, and a multi-component surveillance system for COVID-19 is essential to understand the burden across the different strata of any health system and the population. Many countries and public health bodies utilise 'syndromic surveillance' (using real-time, often non-specific symptom/preliminary diagnosis information collected during routine healthcare provision) to supplement public health surveillance programmes. The current COVID-19 pandemic has revealed a series of unprecedented challenges to syndromic surveillance including: the impact of media reporting during early stages of the pandemic; changes in healthcare-seeking behaviour resulting from government guidance on social distancing and accessing healthcare services; and changes in clinical coding and patient management systems. These have impacted on the presentation of syndromic outputs, with changes in denominators creating challenges for the interpretation of surveillance data. Monitoring changes in healthcare utilisation is key to interpreting COVID-19 surveillance data, which can then be used to better understand the impact of the pandemic on the population. Syndromic surveillance systems have had to adapt to encompass these changes, whilst also innovating by taking opportunities to work with data providers to establish new data feeds and develop new COVID-19 indicators. These developments are supporting the current public health response to COVID-19, and will also be instrumental in the continued and future fight against the disease.

Patterns of animal-enrichment interaction in captive brown bears.

We studied the behavioral responses of three brown bears (Ursus arctos) to different types of enrichment devices to assess the predominant pattern of animal-enrichment interaction (PAI) to each type of enrichment. We assessed the bears' responses to feeding, sensory, and occupational enrichments over nine sessions. Using Pearson's correlation (r) and the coefficient of variation (CV)-we describe four models of PAIs: habituation, increasing, continuous, and fluctuating. The habituation model (r < 0 and p < 0.05; CV (%) > 0) consists of a loss of interest in the device over time and it occurred with the occupational device. The increasing model (r > 0 and p < 0.05; CV (%) > 0) consists of a sustained interest in the device over time and it was not observed for any device of this study. The continuous model (0 > r > 0 and p > 0.05; CV (%) < 100) consists of a consistent and unchanging interaction over time and it occurred with the feeding enrichments used in this study. The fluctuating PAI (0 > r > 0 and p > 0.05; CV (%) ≥ 100) consists of wide oscillations in the degree of interaction over time and we observed this pattern with sensory devices. Review of previous literature supports these classes of PAI, and suggests similar relationships between PAIs and the type of enrichment as we observed in this study.

Functional proteomics based on protein microarray technology for biomedical research.

This chapter traces a route through Proteomics from its origins to the present day. The different proteomics applications are discussed with a focus on microarray technology. Analytical microarrays, functional microarrays and reverse phase microarrays and their different applications are discussed. Several studies are mentioned where the great versatility of this approach is shown. Finally, the advantages and future challenges of microarray technology are outlined.

Motor Imagery and Mental Practice in the Subacute and Chronic Phases in Upper Limb Rehabilitation after Stroke: A Systematic Review.

Introduction: Motor imagery and mental practice can be defined as a continuous mechanism in which the subject tries to emulate a movement using cognitive processes, without actually performing the motor action. The objective of this review was to analyse and check the efficacy of motor imagery and/or mental practice as a method of rehabilitating motor function in patients that have suffered a stroke, in both subacute and chronic phases. Material and Methods. We performed a bibliographic search from 2009 to 2021 in the following databases, Medline (PubMed), Scopus, WOS, Cochrane, and OTSeeker. The search focused on randomized clinical trials in which the main subject was rehabilitating motor function of the upper limb in individuals that had suffered a stroke in subacute or chronic phases. Results: We analysed a total of 11 randomized clinical trials, with moderate and high methodological quality according to the PEDro scale. Most of the studies on subacute and chronic stages obtained statistically significant short-term results, between pre- and postintervention, in recovering function of the upper limb. Conclusions: Motor imagery and/or mental practice, combined with conventional therapy and/or with other techniques, can be effective in the short term in recovering upper limb motor function in patients that have suffered a stroke. More studies are needed to analyse the efficacy of this intervention during medium- and long-term follow-up.

The Utility of Ambulance Dispatch Call Syndromic Surveillance for Detecting and Assessing the Health Impact of Extreme Weather Events in England.

Extreme weather events present significant global threats to health. The National Ambulance Syndromic Surveillance System collects data on 18 syndromes through chief presenting complaint (CPC) codes. We aimed to determine the utility of ambulance data to monitor extreme temperature events for action. Daily total calls were observed between 01/01/2018−30/04/2019. Median daily 'Heat/Cold' CPC calls during "known extreme temperature" (identified a priori), "extreme temperature"; (within 5th or 95th temperature percentiles for central England) and meteorological alert periods were compared to all other days using Wilcoxon signed-rank test. During the study period, 12,585,084 calls were recorded. In 2018, median daily "Heat/Cold" calls were higher during periods of known extreme temperature: heatwave (16/day, 736 total) and extreme cold weather events (28/day, 339 total) compared to all other days in 2018 (6/day, 1672 total). Median daily "Heat/Cold" calls during extreme temperature periods (16/day) were significantly higher than non-extreme temperature periods (5/day, p < 0.001). Ambulance data can be used to identify adverse impacts during periods of extreme temperature. Ambulance data are a low resource, rapid and flexible option providing real-time data on a range of indicators. We recommend ambulance data are used for the surveillance of presentations to healthcare related to extreme temperature events.

Acceptance of a sterile male releases pilot project to reduce Aedes aegypti (Linnaeus, 1762) (Diptera: Culicidae) populations and its associated factors: A community-based cross-sectional survey in South Chiapas, Mexico.

Worldwide, vector-transmitted diseases account for more than 17% of all infectious diseases and cause more than 700,000 deaths annually. The primary strategy to control the transmission of dengue, chikungunya and Zika focuses on the control of their vectors. Vector control programs depend mainly on the use of insecticides. However, these measures have failed to yield the desired results because the lack of proper control decreases their effectiveness over time. Also, the effect of insecticide use on non-target organisms, environmental contamination, and the development of insecticide resistance impose continuous challenges for insecticide-dependant control programs. The sterile insect technique, on the other hand, is a non-polluting and environment-friendly technique. The use of sterile insects is generally well established in agriculture, but human health interventions often require a consensus that combines social perceptions with scientific evidence. Factors associated with acceptance of the releases of sterile male Aedes aegypti mosquitoes were assessed with logistic regression models for two communities (Rio Florido and Hidalgo) in Tapachula, Chiapas, Mexico. The favourable opinion of the respondents about the project workers, and the fact that the releases of sterile mosquitoes would be managed by the Secretaría de Salud, were found to be factors that supported the acceptance of sterile mosquito releases. Factors associated with disapproval were community (Rio Florido and Hidalgo) and the misbelief that sterile male mosquitoes can bite. The differences observed between the communities included in this study might be the result of experiences with the releases, of social and community organisation, and of leadership by social actors.

[Leaf epidermis ultrastructure of Zeugites (Poaceae: Panicoideae)]. / Ultraestructura de la epidermis foliar de Zeugites (Poaceae: Panicoideae).

The genus Zeugites comprises eleven species of neotropical grasses and it is principally distributed in Mexico, with some species extending to the Caribbean region, Central and South America. In this work, leaf epidermis ultrastructure of 11 species is described by the use of scanning electron microscopy. At least three specimens per species, that included herbarium and collected specimens, were used. An identification key and specific descriptions are included, in which the distinctive epidermal features are highlighted. The taxonomic valuable characters found were the following: presence or absence of prickles and macrohairs, intercostals short cells form and silica body form. Based on leaf epidermis characteristics, Zeugites species can be arranged into three groups: (1) species that lack prickles (Z. americana, Z. mexicana, Z. pringlei, Z. munroana and Z. sagittata); and lack macro hairs, with the exception of Z. pringlei; (2) species that have prickles (Z. latifolia and Z. smilacifolia); (3) species that have both, prickles and macrohairs (Z. capillaris, Z. hackelii, Z. pittieri and Z. sylvatica). The morphological features of leaf epidermis, support the relationship between the tribes Centotheceae and Paniceae.

Inter-individual Distance in Different Captive Packs of Iberian Wolf (Canis lupus signatus): Management Applications.

There is a tendency for the wolves of a pack to stay together assuming that there is a social bond between the pack members. A rough estimate of the strength of this bond can be obtained by measuring the distances between pack members. The aim of this study was to determine the inter-individual distance by calculating the Euclidian distance to determine the Iberian wolf cohesion in different pack compositions. The study subjects were seven captive Iberian wolves (Canis lupus signatus) housed at the Barcelona Zoo. Multifocal sampling methods were used for data collection, and instantaneous scans were made at 15-min during different sessions. Proximity relationships among these wolves in different pack composition were visualized using two-dimensional scaling analysis. The pair leader without offspring and the breeding pair with their offspring were significantly closer than the rest of the dyads which combinations were equidistant. During the pregnancy period, the breeding pair was significantly further than during the juvenile period. More studies in field and captivity by using Euclidian distance are necessary to improve social husbandry techniques, animal welfare and conservation programs.

Cephalometric Characteristics in Skulls with Artificial Deformation in a Pre-Columbian Civilization of the Peruvian Andes (Chavin Civilization 900 B.C. to 200 B.C.).

OBJECTIVE: To evaluate the cephalometric characteristics of skulls with and without artificial deformation in a pre-Columbian civilization of the Peruvian Andes (Chavin civilization 900 B.C. to 200 B.C.). MATERIALS AND METHODS: The study was observational, analytical, retrospective, and comparative in design. The image analysis unit was radiological with cephalometric measurement. The sample consisted of occipito-frontal dry skulls of the Chavín culture (n = 40) with and without artifical deformation, which underwent cephalometric radiography for analysis. RESULTS: The measurements of skull base size, anterior cranial base size, posterior cranial base size, posterior cranial base size, and cranial deflection were greater in the deformed than the non-deformed skulls (95.1 ± 6.6 vs. 92.3 ± 6.2 mm, 61.5 ± 3.6 vs. 61.4 ± 3.6 mm, 39.8 ± 3.4 vs. 38.1 ± 3.5 mm, 136 ± 26.9 vs. 135.0 ± 5.6 mm, and 35.7 ± 31.8 vs. 28.2 ± 14.6 mm, respectively). Significant differences were only found in the posterior cranial base size measurements between deformed and nondeformed skulls (P = 0.008). When comparing the characteristics of the skulls, significant differences were only found between the position of the posterior nasal spine and the maxilla size of the deformed versus the non-deformed skulls (P < 0.05). CONCLUSIONS: It is concluded that there are differences in the size, position, and inclination of the craniofacial structures between the artificially deformed skulls and the skulls that have not been artificially deformed by the old Chavin civilization.

Bibliometric Study of the National Scientific Production of All Peruvian Schools of Dentistry in Scopus.

OBJECTIVE: To perform a bibliometric analysis of the national scholarly output of all dental schools in Peru in Scopus through a retrospective study after the promulgation of the Peruvian University Law 30220 in 2014. METHODS: This was a descriptive, comparative, retrospective, and cross-sectional study. A search of the Scopus database was performed to identify scholarly output in dentistry between 2014 and 2019. A total of 287 scientific articles with affiliation with the dental faculties of Peruvian public and private universities were evaluated. The data was extracted from Scopus using a complex formula developed from the words of the thesaurus MeSh (Medline) and Emtree (base) with words related to dentistry combined with the AF-IDs of the Peruvian universities. RESULTS: The Top 10 in the scholarly output of all the Peruvian public and private dental schools were as follows: firstly, the Universidad Peruana Cayetano Heredia (UPCH), with 79 scholarly outputs publications and 5.2 citations per article, followed by the Universidad Nacional Mayor de San Marcos (UNMSM) with 53 scholarly outputs publications and 2.6 citations per article, and in third place, the Universidad Cientifica del Sur (UCSUR) with 49 scholarly outputs publications. In general, it was found that, of the 30 Faculties of Dentistry in Peru, only 10 in the public and private universities have a scholarly output greater than 5 to belong to the top 10. In addition, it was found that, according to the share of publications per journal quartile by the CiteScore Percentile of all the public and private Peruvian Faculties of Dentistry, in 2019, it presented the highest number of scientific publications in all quartiles with 20,33,14 and 43 articles in the quartiles Q1, Q2, Q3, and Q4, respectively. The highest number of scientific publications was produced in 2019 with 20, 33, 14, and 43 articles in quartiles Q1, Q2, Q3, and Q4, respectively. CONCLUSION: The UPCH, UNMSM, and UCSUR dental schools were the most productive. Both public and private universities presented an evident increase in their scientific publications in Scopus after the promulgation of the University Law 30220 in 2014.

Childhood Health Assets in a Spanish Neighborhood: Children and Families' Perception.

The health assets (HA; factors or resources that maintain or improves health) approach has hardly been incorporated in occupational therapy, and even less so in research focused on children's perception. The objective of this study was to provide context-specific empirical evidence regarding children and families' perception of childhood HA, paying special attention to the occupational dimension. We used a mixed methods design including qualitative research with 130 children using various techniques (brainstorming, focus groups, thematic drawing, and individual interview) and a descriptive study based on a questionnaire answered by 58 families. Most children related well-being to play occupations and belonging. We observed the influence of gender roles, ethnicity, and other socioeconomic factors in the identification and access to HA. We recommend delving into the relationship between the HA approach and occupational therapy, considering the children's perspective, interculturality, and gender perspectives.

Knowledge and Awareness of Effective Recycling of Dental Materials and Waste Management among Peruvian Undergraduate Students of Dentistry: A Logistic Regression Analysis.

OBJECTIVE: Biomedical waste management and recycling is a very important topic today to preserve the environment, especially at the university level where future specialists in the health sciences are trained. So, the aim of this study was to evaluate the knowledge and awareness about recycling of dental materials and waste management among Peruvian undergraduate students of dentistry. MATERIALS AND METHODS: This cross-sectional study evaluated 254 Peruvian undergraduate dentistry students from October 2019 to January 2020, at the National University of San Marcos. The associated factors evaluated were age (X1), sex (X2), year of study (X3), and marital status (X4), which were analyzed using a logit model to identify the influence of the intervening variables with a P value <0.05. RESULTS: None of the variables studied were considered to be a factor affecting the awareness, knowledge, and management of biomedical waste in Peruvian dentistry students, with the following odds ratios (OR) being obtained: age (OR = 0.96; confidence interval [CI]: 0.85-1.08), sex (OR = 1.69; CI: 0.98-2.90), year of study (OR = 1.18; CI: 0.91-1.54), and marital status (OR = 1.84; CI: 0.14-23.68). CONCLUSIONS: The results of this study show that Peruvian Public University students have knowledge and are aware of the need for adequate management and/or recycling of biomedical waste dental care products, with none of the possible associated variables studied significantly affecting this relationship.

Proposal for a provisional protocol for the care and identification of dental transmission routes of COVID-19 in Latin America: A Literature review.

BACKGROUND: The new coronavirus called COVID-19 originated in the city of Wuhan, China and has currently spread to different continents, leading the World Health Organization (WHO) to declare a "pandemic". Therefore, the aim of this review was to present a new proposal for a care protocol in Peruvian Dentistry: Provisional review of the diagnosis, treatment, epidemiological characteristics, routes of transmission and recommendations of COVID-19. MATERIAL AND METHODS: A search of digital scientific literature was made in the databases: Science Direct, Pubmed and Google Scholar. The Boolean operators AND, OR and NOT: "Covid-19" "Dental" "Routes of transmission. They were included Scientific articles published in English between December 2019 - March 2020. RESULTS: Different studies were found mainly of epidemiological, observational and experimental design. On March 6, 2020, the President of the Republic of Peru confirmed and declared in Peru the beginning of the first case of coronavirus. According to reports from the Ministry of Health (MINSA) as of July 30, there are: PCR (+) 108, 299; Rapid test (+) 292, 384 positive cases and 18, 816 deceased with a lethality of 4.7%. CONCLUSIONS: Within the limitations of this literature review, the presence of the virus is inevitable in dental practice. The dentist must understand the evolution of this microorganism like all vulnerable professionals in the health sciences. Key words:COVID-19, dentistry, Peru, protocol, routes of transmission.

Assessment of Structural Changes in Translucency and Opacity of Tooth Enamel against a Direct Demineralization Process: An In Vitro Study.

OBJECTIVE: The objective of this study was to assess in vitro the structural changes in translucency and opacity of tooth enamel following a direct demineralization process. MATERIALS AND METHODS: This experimental in vitro study evaluated 45 thirds (cervical, middle, and occlusal) of the tooth enamel surface of premolar teeth extracted from young adults divided into three groups of 15 specimens each: Group 1 (solution based on calcium, phosphorus, and fluorine), Group 2 (orthophosphoric acid 37%), and control group (distilled water). All underwent optical macroscopic examination with ×3 magnification to determine the initial translucency according to the variation of the medium in their intercrystalline spaces, and Thylstrup and Fejerskov Index was used. The experimental groups were then subjected to an artificial caries process during which the specimens were placed in an inorganic and organic solution of calcium, phosphorus, and fluorine at 37°C for 90 days with the acidic solution at pH 5 and the neutral solution at pH 7. The control specimens were placed in distilled water. Finally, all the specimens were assessed by polarization microscopy. RESULTS: In relation to the occlusal third, the highest proportion in Groups 1 and 2 was in Grades 2 and 3 (80%). A significant association was only observed between the experimental groups in the degree of translucency in the occlusal third (P = 0.002), whereas no association was found in relation to the degree of opacity in the middle and cervical thirds in either study group (P > 0.05). CONCLUSION: The resistance of enamel hydroxyapatite crystals increases from occlusal to cervical due to the greater presence of aprismatic enamel in the cervical horizontal third.

Emerging arboviruses (dengue, chikungunya, and Zika) in Southeastern Mexico: influence of socio-environmental determinants on knowledge and practices.

The proliferation of arboviruses and their vectors is influenced by a complex interplay between vector, environment and human behaviors. The aim of this work is to analyze the influence of socio-environmental determinants on knowledge and practices regarding arboviruses transmission, among the residents of three communities on the southern border of Mexico. Between June 2017 and August 2018, a set of 149 households from three communities of Tapachula (Chiapas) and Villahermosa (Tabasco) were covered. This study consists of the application of a community prevention project. Different surveys and methodological approaches were used. Associations between socio-environmental determinants and knowledge and practices for arboviruses transmission control were estimated by odds ratio. Logistic regression and qualitative techniques were used. Although around 75% of households had an adequate knowledge about arboviruses' origin and transmission, only 30% of them adopted adequate practices. Domestic risk practices were associated with serious deficiencies in water and sanitation services. Furthermore, a perception of greater risk and difficulty in complying with preventive measures were detected. An adequate knowledge does not necessarily lead to adequate prevention practices. Intermediate social determinants influence on the persistence of risk behaviors for arboviruses proliferation. Addressing such related aspects requires the achievement of an effective and sustainable vector management.