A revisited history of cacao domestication in pre-Columbian times revealed by archaeogenomic approaches.

Humans have a long history of transporting and trading plants, contributing to the evolution of domesticated plants. Theobroma cacao originated in the Neotropics from South America. However, little is known about its domestication and use in these regions. In this study, ceramic residues from a large sample of pre-Columbian cultures from South and Central America were analyzed using archaeogenomic and biochemical approaches. Here we show, for the first time, the widespread use of cacao in South America out of its native Amazonian area of origin, extending back 5000 years, likely supported by cultural interactions between the Amazon and the Pacific coast. We observed that strong genetic mixing between geographically distant cacao populations occurred as early as the middle Holocene, in South America, driven by humans, favoring the adaptation of T. cacao to new environments. This complex history of cacao domestication is the basis of today's cacao tree populations and its knowledge can help us better manage their genetic resources.

[Translated article] Treatment strategies in vertebral metastasis. Need for multidisciplinary committees from the perspective of the surgeon. Narration of literature.

Improvements in cancer diagnosis and treatment have improved survival. Secondarily, the number of patients who present a vertebral metastasis and the number with some morbidity in relation to these metastases also increase. Vertebral fracture, root compression or spinal cord injury cause a deterioration of their quality of life. The objective in the treatment of the vertebral metastasis must be the control of pain, maintenance of neurological function and vertebral stability, bearing in mind that in most cases it will be a palliative treatment. The treatment of these complications needs a multidisciplinary approach, radiologists, interventional radiologists, oncologists and radiation therapists, spine surgeons, but also rehabilitation or pain units. Recent studies show that a multidisciplinary approach of these patients can improve quality of life and even prognosis. In the present article, a review and reading of the literature on the multidisciplinary management of these patients is carried out.

Treatment strategies in vertebral metastasis. Need for multidisciplinary committees from the perspective of the surgeon. Narration of literatura. / Estrategias de tratamiento en la metástasis vertebral. Necesidad de comités multidisciplinarios desde la perspectiva del cirujano. Narración de la literatura.

Improvements in cancer diagnosis and treatment have improved survival. Secondarily, the number of patients who present a vertebral metastasis and the number with some morbidity in relation to these metastases also increases. Vertebral fracture, root compression or spinal cord injury cause a deterioration of their quality of life. The objective in the treatment of the vertebral metastasis must be the control of pain, maintenance of neurological function and vertebral stability, bearing in mind that in most cases it will be a palliative treatment. The treatment of these complications needs a multidisciplinary approach, radiologists, interventional radiologists, oncologists and radiation therapists, spine surgeons, but also rehabilitation or pain units. Recent studies show that a multidisciplinary approach of these patients can improve quality of life and even prognosis. In the present article, a review and reading of the literature on the multidisciplinary management of these patients is carried out.

Simulation in healthcare during COVID-19: An experience with residents in Anaesthesiology.

BACKGROUND: The restrictions to stop COVID-19 pandemic have had a negative impact in simulation, however, it is imperative to develop new strategies that facilitate healthcare education. OBJECTIVE: To describe a simulation in healthcare based on the learning of Non-Technical Skills (NTS) and performed under the restrictions of COVID-19 Pandemic. METHODS: Quasi-experimental study of an educational activity performed through simulation with anaesthesiology residents in November 2020. Twelve residents participated in two consecutive days. A questionnaire was filled related to the performance of NTS that encompasses leadership, teamwork and decision making. The complexity of the scenarios and the NTS results obtained between the two days were analysed. Advantages and challenges were documented when a clinical simulation is performed under COVID-19 restrictions. RESULTS: The global performance of the teams improved when comparing first and second day (79.5% vs 88.6%, p<0.01). Leadership was the worst section rated, however, was the one that showed the best improvement (70% vs 87.5%, p<0.01). The complexity of the simulation cases had no relation with the group performance in leadership and teamwork but affected task management results. General satisfaction was over 75%. The main challenges to develop the activity were the technology required to adapt virtuality to simulation and the time spent for the preparation of it. No cases of COVID-19 were reported within the first month after the activity. CONCLUSION: Clinical simulation can be done in the context of COVID-19 Pandemic, obtaining satisfactory learning results but requiring the adaptation of institutions to the new challenges it implies.

[Simulation in healthcare during COVID-19: An experience with residents in Anaesthesiology]. / Simulación sanitaria durante la COVID-19: una experiencia con los residentes de Anestesiología.

Background: The restrictions to stop COVID-19 pandemic have had a negative impact in simulation. However, it is imperative to develop new strategies that facilitate healthcare education. Objective: To describe a simulation in healthcare based on the learning of non-technical skills and performed under the restrictions of COVID-19 pandemic. Methods: Quasi-experimental study of an educational activity performed through simulation with Anaesthesiology residents in November 2020. Twelve residents participated in 2 consecutive days. A questionnaire was filled related to the performance of non-technical skills that encompasses leadership, teamwork and decision making. The complexity of the scenarios and the non-technical skills results obtained between the 2 days were analysed. Advantages and challenges were documented when a clinical simulation is performed under COVID-19 restrictions. Results: The global performance of the teams improved when comparing first and second day (79.5 vs. 88.6%, P < .01). Leadership was the worst section rated, however, was the one that showed the best improvement (70 vs. 87.5%, P < .01). The complexity of the simulation cases had no relation with the group performance in leadership and teamwork but affected task management results. General satisfaction was over 75%. The main challenges to develop the activity were the technology required to adapt virtuality to simulation and the time spent for the preparation of it. No cases of COVID-19 were reported within the first month after the activity. Conclusion: Clinical simulation can be done in the context of COVID-19 pandemic, obtaining satisfactory learning results but requiring the adaptation of institutions to the new challenges it implies.

Potential association of Trypanosoma cruzi DTUs TcV and TcVI with the digestive form of Chagas disease.

The relationship among genetic diversity of Trypanosoma cruzi and clinical forms of Chagas disease remain elusive. In order to assess the possible association between different T. cruzi Discrete Typing Units (DTUs) and the clinical pictures of the disease, 205 chronic patients from Salta province, Argentina, were analysed. One hundred and twenty-two of these patients were clinically categorized as: cardiac 38.5% (47/122), digestive 15% (18/122), cardio-digestive 16% (20/122) and asymptomatic 30% (37/122). From each patient, blood samples were taken for both, Polymerase Chain Reaction (PCR) targeting kDNA and blood culture analyses. The presence of T. cruzi kDNA was detected in 43% (88/205) of the patients. T. cruzi DTUs were identified in 74% (65/88) of the kDNA positive patients by PCR-hybridization using specific probes. We detected the presence of DTUs TcI, TcII, TcV and TcVI. Single infections (i.e. presence of only one DTU in the sample) were detected in 38.64% of the samples (34/88), while mixed infections were 35.23% (31/88). TcV was the most prevalent DTU (60.3%- 53/88). The association analyses showed, for the first time to the best of our knowledge, that TcV and TcVI were associated with the digestive form of Chagas Disease (Fisher p = .0001).

Effectiveness of an intervention in multicomponent exercise in primary care to improve frailty parameters in patients over 70 years of age (MEFAP-project), a randomised clinical trial: rationale and study design.

BACKGROUND: Physical activity may reverse frailty in the elderly, but we encounter barriers to the implementation of exercise programs in this population. Our main aim is to evaluate the effect of a multicomponent physical activity program, versus regular medical practice, on reverting pre-frailty status among the elderly, 12 months post-intervention. METHODS: Randomized parallel group multicenter clinical trial located in primary care setting, among non-dependent and pre-frail patients > 70 years old, including 190 patients (95 intervention, 95 control group). INTERVENTION: Multicomponent physical activity program (MEFAP, for its acronym in Spanish) with twelve 1.5 h-weekly sessions comprised of: 1. Informative session; 2. Exercises for improving aerobic resistance, muscle strength, propioception-balance and flexibility; and 3. Handing out of at-home exercise chart (twice/week). Main variable: pre-frailty according to the Fried phenotype. Secondary variables: sociodemographic, clinical and functional variables; exercise program adherence, patient satisfaction with the program and quality of life. We will perform an intention-to-treat analysis by comparing the retrogression from pre-frailty (1 or 2 Fried criteria) to robust status (0 Fried criteria) by the end of the intervention, 6 months and 12 months post-intervention. The accumulated incidence in each group will be calculated, as well as the relative risk (RR) and the number needed to treat (NNT) with their corresponding 95% confidence intervals. Protocol was approved by the Ethics Committee Hospital la Paz. DISCUSSION: Within the context of regular clinical practice, our results will provide evidence regarding the effects of exercise interventions on frailty among pre-frail older adults, a key population given their significant potential for functional, physical, and mental health improvement. TRIAL REGISTRATION: NCT03568084 . Registered 26 June 2018. Date of enrollment of the first participant to the trial: July 2nd 2018.

Acretismo placentario: un diagnóstico emergente. Abordaje quirúrgico no conservador / Placental accreta: an emerging diagnosis. Approach non-conservative surgical

RESUMEN El espectro de acretismo placentario es un fenómeno infrecuente del embarazo cuya incidencia ha aumentado considerablemente y que está caracterizado por el anclaje anormal de las vellosidades coriónicas al miometrio, lo cual aumenta la morbi-mortalidad materna durante la resolución quirúrgica. Según las capas uterinas comprometidas, serán clasificadas como placenta acreta (contacta miometrio), increta (penetra miometrio) y percreta (compromete todo el miometrio y/o eventualmente órganos adyacentes), siendo su mayor factor de riesgo: la cesárea anterior y la placenta previa. En este artículo se realizó una revisión bibliográfica abarcando definiciones, diagnóstico y las nuevas tendencias en manejo quirúrgico no conservador propuesto en la nueva guía de la Federación Internacional de Ginecología y Obstetricia publicada en 2018 y elaborando una discusión respecto a ellas.

SUMMARY Placenta accreta spectrum is an uncommon phenomenon of pregnancy whose incidence has increased considerably over time and is characterized by the abnormal anchoring of the chorionic villi to the myometrium, which increases maternal morbidity and mortality during surgical resolution. According to the compromised uterine layers, they will be classified as placenta accreta (contacts myometrium), increta (penetrates myometrium) and percreta (compromises the entire myometrium and / or possibly adjacent organs), being previous caesarean section and placenta previous its major risk factor. In this review, we included definitions, diagnosis, and the new topics in non-conservative surgical management developed by the International Federation of Obstetrics and Gynecolgy published in 2018, and developing a discussion of the topic.

Analysis of soluble or titanium dioxide derived titanium levels in human whole blood: consensus from an inter-laboratory comparison.

Exposure to titanium (Ti), via the ingestion of pigment grade Ti dioxide (TiO2), is commonplace for westernised populations. It may also occur as a consequence of metal ion leaching in subjects bearing Ti-containing implants. Accurate exposure analysis requires fit-for-purpose analytical methodology, especially for true measures of baseline levels. Inductively coupled plasma (ICP) techniques are, mainly, now used for bio-analysis of Ti. Since whole blood reference materials, certified for natural low levels of Ti, are not currently available, we undertook an inter-laboratory comparison of pooled human blood from fasted volunteers ±low level (+∼2.5 µg L-1) or high level (+10-20 µg L-1) spikes of soluble Ti or TiO2 particles. Seven established laboratories were enrolled to analyse the samples using ICP based techniques, which included at least one of ICP optical emission spectrometry (ICP-OES), high resolution ICP mass spectrometry (HR-ICP-MS), triple quadrupole ICP-MS (ICP-MS/MS) or single quadrupole ICP-MS (SQ-ICP-MS). Five laboratories diluted the blood for analysis whilst two performed acid digestion. Overall, we showed that the laboratories could, mostly, quantitatively detect modest levels of spiked Ti in blood. Markedly varying levels of Ti, however, were reported for the same baseline pooled sample (0.4-24.6 µg L-1) and, in this study, specificity was poor for SQ-ICP-MS. Digestion of samples caused sample contamination compromising limits of detection and accuracy, whilst simple dilution had no such problem, and remained linear in response for spikes with ionic and TiO2 particles. We conclude that measuring baseline levels of Ti in whole blood is challenging but should be readily achievable down to 0.5-1.5 µg L-1, if sample preparation avoids contamination and instrument techniques are used that negate polyatomic or isobaric interferences from the sample matrix. We also remind those relying upon Ti bio-analytical data for their experimental outcomes that (a) spiking and recovery experiments provide information only on linearity of detection but not at all on accuracy as this will not detect constant positive errors and that (b) biological standard materials for Ti generally contain high levels of the analyte and tend to mask baseline analytical errors. Caution may be required in interpreting the findings of some published Ti/TiO2 bio-exposure studies.

Risk factors associated with drug use before imprisonment in Peru.

OBJECTIVE: To assess the prevalence of drug abuse before prison admission and to identify associated sociodemographic and family history risk factors, according to gender, in prisons of Peru. MATERIALS AND METHODS: A secondary analysis was carried out with data from the First National Prisoner Census 2016, using a questionnaire of 173 items that was applied to the whole prison population of Peru. The types of drugs used before admission were analyzed according to characteristics of the penitentiary population, and generalized linear models were used to calculate prevalence ratios with 95% confidence intervals to identify possible factors associated with drug use. RESULTS: Out of a population of 76,180 prisoners, 71,184 (93.4%) answered the survey (men 67,071, 94.2%). The overall prevalence of drug consumption before admission was 24.4% (25.3 % in men and 9.1% in women), the highest prevalence in the 18-29 age group (36.3% in men and 14.9% in women). The most commonly used drugs were marijuana (58.2%), coca paste/cocaine or crack (40.3%) and inhalants (1%). The factors most strongly associated with consumption were having a family member who consumed drugs (59.8%), history of previous imprisonment (59.1%), unemployment (48.4%), relationships at school with classmates who had problems with the law (46.9%), background of a family member who attended a penitentiary (38.4%), and history of running away from home before age 15 (35.9%). CONCLUSIONS: In Peru, drug use is higher in the prison population than in the general population, and there are differences according to sex in the prevalence of drug use and associated factors prior to admission to a prison. The study demonstrated that childhood events, such as child abuse, having a family member imprisoned, having a family member who used drugs, or who previously abused alcohol, are factors associated with drug use in the penitentiary population. Some of these risk factors are modifiable, so it is important to consider these in the design of social and health policies focused on specific subpopulations to prevent drug use and crime.

Learning from clinical phenotypes: Low-dose biophotonics therapies in oral diseases.

This narrative review on the use of biophotonics therapies for management of oral diseases is written as a tribute to Prof. Crispian Scully. His seminal contributions to the field are highlighted by the detailed, comprehensive description of clinical presentations of oral diseases. This has enabled a more thorough, fundamental understanding of many of these pathologies by research from his group as well as inspired mechanistic investigations in many groups globally. In the same vein, a major emphasis of this narrative review is to focus on the evidence from human case reports rather than in vitro or in vivo animal studies that showcases the growing and broad impact of biophotonics therapies. The similarities and differences between two distinct forms of low-dose biophotonics treatments namely photodynamic therapy and photobiomodulation therapy are discussed. As evident in this review, a majority of these reports provide promising evidence for their clinical efficacy. However, a lack of adequate technical details, precise biological rationale, and limited outcome measures limits the current utility of these treatments. Future investigations should attempt to address these shortcomings and develop better designed, rigorous, controlled studies to fully harness the tremendous potential of low-dose biophotonics therapies.

Parathyroid hormone-related protein exhibits antioxidant features in osteoblastic cells through its N-terminal and osteostatin domains.

OBJECTIVES: Oxidative stress plays a major role in the onset and progression of involutional osteoporosis. However, classical antioxidants fail to restore osteoblast function. Interestingly, the bone anabolism of parathyroid hormone (PTH) has been shown to be associated with its ability to counteract oxidative stress in osteoblasts. The PTH counterpart in bone, which is the PTH-related protein (PTHrP), displays osteogenic actions through both its N-terminal PTH-like region and the C-terminal domain. METHODS: We examined and compared the antioxidant capacity of PTHrP (1-37) with the C-terminal PTHrP domain comprising the 107-111 epitope (osteostatin) in both murine osteoblastic MC3T3-E1 cells and primary human osteoblastic cells. RESULTS: We showed that both N- and C-terminal PTHrP peptides at 100 nM decreased reactive oxygen species production and forkhead box protein O activation following hydrogen peroxide (H2O2)-induced oxidation, which was related to decreased lipid oxidative damage and caspase-3 activation in these cells. This was associated with their ability to restore the deleterious effects of H2O2 on cell growth and alkaline phosphatase activity, as well as on the expression of various osteoblast differentiation genes. The addition of Rp-cyclic 3',5'-hydrogen phosphorothioate adenosine triethylammonium salt (a cyclic 3',5'-adenosine monophosphate antagonist) and calphostin C (a protein kinase C inhibitor), or a PTH type 1 receptor antagonist, abrogated the effects of N-terminal PTHrP, whereas protein phosphatase 1 (an Src kinase activity inhibitor), SU1498 (a vascular endothelial growth factor receptor 2 inhibitor), or an anti osteostatin antiserum, inhibited the effects of C-terminal PTHrP. CONCLUSION: These findings indicate that the antioxidant properties of PTHrP act through its N- and C-terminal domains and provide novel insights into the osteogenic action of PTHrP.Cite this article: S. Portal-Núñez, J. A. Ardura, D. Lozano, I. Martínez de Toda, M. De la Fuente, G. Herrero-Beaumont, R. Largo, P. Esbrit. Parathyroid hormone-related protein exhibits antioxidant features in osteoblastic cells through its N-terminal and osteostatin domains. Bone Joint Res 2018;7:58-68. DOI: 10.1302/2046-3758.71.BJR-2016-0242.R2.

Evaluation of bacterial adherence of clinical isolates of Staphylococcus sp. using a competitive model: An in vitro approach to the "race for the surface" theory.

OBJECTIVES: Implant-related infection is one of the most devastating complications in orthopaedic surgery. Many surface and/or material modifications have been developed in order to minimise this problem; however, most of the in vitro studies did not evaluate bacterial adhesion in the presence of eukaryotic cells, as stated by the 'race for the surface' theory. Moreover, the adherence of numerous clinical strains with different initial concentrations has not been studied. METHODS: We describe a method for the study of bacterial adherence in the presence of preosteoblastic cells. For this purpose we mixed different concentrations of bacterial cells from collection and clinical strains of staphylococci isolated from implant-related infections with preosteoblastic cells, and analysed the minimal concentration of bacteria able to colonise the surface of the material with image analysis. RESULTS: Our results show that clinical strains adhere to the material surface at lower concentrations than collection strains. A destructive effect of bacteria on preosteoblastic cells was also detected, especially with higher concentrations of bacteria. CONCLUSIONS: The method described herein can be used to evaluate the effect of surface modifications on bacterial adherence more accurately than conventional monoculture studies. Clinical strains behave differently than collection strains with respect to bacterial adherence.Cite this article: M. Martinez-Perez, C. Perez-Jorge, D. Lozano, S. Portal-Nuñez, R. Perez-Tanoira, A. Conde, M. A. Arenas, J. M. Hernandez-Lopez, J. J. de Damborenea, E. Gomez-Barrena, P. Esbrit, J. Esteban. Evaluation of bacterial adherence of clinical isolates of Staphylococcus sp. using a competitive model: An in vitro approach to the "race for the surface" theory. Bone Joint Res 2017;6:315-322. DOI: 10.1302/2046-3758.65.BJR-2016-0226.R2.

Epidemiological surveillance in dairy farms in the Pastaza province of Ecuador. / Vigilancia epidemiológica en predios lecheros de la provincia de Pastaza, Ecuador.

A survey was carried out on dairy cattle farms in Pastaza province to analyse the degree of compliance with epidemiological surveillance activities (based on the main technical aspects in Ecuador's Guide to Good Dairy Farming Practices) and to assess the reduction of the risk of introducing disease into dairy cattle. Visits were made to 70 dairy and dual-purpose beef/dairy farms, where the survey was conducted to evaluate technical aspects relating to epidemiological surveillance and the risk of introducing disease. In only one of the nine areas of application covered in the guide was compliance with technical requirements greater than 70%: milking and milk handling (78.59%). In the following areas, a compliance rate of 40-65% was achieved: records and traceability; siting of livestock farms and infrastructure, facilities and equipment; use and quality of water and animal feed; and management of veterinary products and agricultural pesticides. In the remaining areas, the compliance rate was less than 20%. On average, there was only 27.96% compliance with the technical elements evaluated. The results show that current guidelines for good dairy farming practices can be used to evaluate basic aspects of epidemiological surveillance and of the reduction of the risk of introducing disease into dairy farms. They also reveal shortcomings in these aspects in the Amazonian province of Pastaza, which need to be addressed appropriately to reduce their negative impact on animal health.

Les auteurs décrivent une étude réalisée dans les exploitations bovines laitières de la province de Pastaza (Équateur) afin de déterminer le niveau de conformité des activités de surveillance épidémiologique et d'atténuation du risque d'introduction de diverses maladies animales. L'enquête portait sur les principales exigences techniques décrites dans le Guide de bonnes pratiques d'élevage en production laitière. À cette fin, 70 exploitations bovines laitières ou mixtes ont été inspectées pour évaluer leurs performances en termes de surveillance épidémiologique et d'atténuation du risque d'introduction de maladies. Parmi les neuf domaines opérationnels décrits dans le Guide, seules la traite et la gestion du lait étaient conformes à plus de 70 % des exigences techniques (78,59 %). Pour les domaines suivants, la conformité portait sur 40 % à 65 % des exigences techniques : enregistrement et traçabilité ; agencement des élevages et des infrastructures, installations et équipements ; utilisation et qualité de l'eau et des aliments donnés aux animaux ; gestion des produits à usage vétérinaire et des insecticides à usage agricole. Les autres opérations étaient conformes à moins de 20 % des exigences techniques. En moyenne, 27,96 % seulement des exigences techniques évaluées étaient respectées. Les résultats de l'étude démontrent que les guides de bonnes pratiques d'élevage en production laitière peuvent servir de base pour évaluer les principaux aspects de la surveillance épidémiologique et des mesures d'atténuation des risques d'introduction de maladies dans les cheptels laitiers ; d'autre part, l'étude a révélé des défaillances concernant ces aspects dans la province amazonienne de Pastaza, auxquelles il conviendra de prêter l'attention nécessaire afin de limiter leur impact négatif sur la santé animale.

Con el objetivo de realizar un análisis del grado de cumplimiento de las actividades de vigilancia epidemiológica y la reducción de riesgo de entrada de enfermedades en los predios productores de leche bovina de la provincia Pastaza, tomando como base los principales aspectos técnicos contemplados en la Guía de Buenas Prácticas Pecuarias de Producción de Leche, se visitaron 70 predios lecheros y de doble propósito, en los que se realizó una encuesta que incluía aspectos relacionados con la vigilancia epidemiológica y el riesgo de introducción de enfermedades. De las nueve áreas establecidas en la guía, solo cumple más del 70% de los aspectos técnicos el área de ordeño y manejo de la leche (78,59%). Cumplen entre el 40% y el 65% las siguientes áreas: documentos y trazabilidad; ubicación de las explotaciones pecuarias e infraestructura, instalaciones y equipos; uso y calidad del agua y de la alimentación animal; y manejo de productos de uso veterinario y plaguicidas de uso agrícola; el resto cumplen menos de un 20%. De media, se cumple solo el 27,96% de los elementos técnicos evaluados. Los resultados demuestran que, a partir de las guías establecidas para las buenas prácticas pecuarias de producción de leche, se pueden evaluar los aspectos básicos de vigilancia epidemiológica y de reducción de riesgos de introducción de enfermedades en los predios lecheros, y que en la provincia amazónica de Pastaza existen deficiencias en estos aspectos, a los cuales es necesario brindar la atención adecuada para reducir el impacto negativo que ejercen en la sanidad animal.

Parasitosis intestinales en Altragracia de la Montaña, Estado Miranda, Venezuela: Influencia del programa para la eliminación de oncocercosis / Intestinal parasites in Altragracia de la Montaña, Miranda State, Venezuela: Influence of the program for onchocerciasis elimination

El objetivo general de este trabajo fue determinar la prevalencia de parasitosis intestinales y sus características epidemiológicas en cuatro comunidades de la parroquia Altagracia de la Montaña, Estado Miranda (Venezuela). Se desarrolló un estudio de corte transversal con una muestra constituida por 492 en su mayoría niños, en febrero de 2011. Previo consentimiento informado, se realizó una encuesta clínico-epidemiológica, extracción de sangre y exámenes coproparasitológicos con los métodos directo, Kato y cultivo en agar. El 60% de la población tenía al menos un parásito de transmisión hídrica y/o alimentos contaminados por heces de humanos y/o animales. La elevada frecuencia de protozoarios intestinales, especialmente Blastocystis sp., con predominio entre quienes viven con fallas en la disposición de excretas y baja calidad del agua para consumo humano, demuestran la persistencia de parasitosis intestinales como problema de salud pública; sin embargo, la influencia indirecta de la administración semestral de ivermectina y educación sanitaria con visión etnográfica impartida por el Programa para la Eliminación de Oncocercosis en Bucarito, una de las comunidades evaluadas, tuvo como efecto colateral no sólo disminuir la prevalencia de helmintos intestinales, sino de los protozoarios, a pesar de estar sometida a los mismos factores de riesgo que las comunidades restantes.

The aim of this study was to determine the prevalence of intestinal parasites and their epidemiological characteristics in four rural communities from Altagracia de la Montaña, Miranda State (Venezuela). A cross sectional study was conducted in February 2011 where 492 subjects were evaluated, mostly children. Informed consent was previously obtained. A clinical and epidemiological survey was done. Patients voluntarily brought a fresh stool sample for analysis with direct smear, Kato and agar culture; blood was extracted for eosinophil count. 60% of the evaluated people had at least one parasite transmitted by water or food contaminated by human or animal feces. The high prevalence of protozoa, specially Blastocystis sp., among those who live under poor living conditions such as inadequate feces disposal and low quality of drinking water, shows the persistence of intestinal parasites as a public health problem; nevertheless, indirect influence of ivermectin treatment every six months and health education with an ethnographic orientation given by the Onchocerciasis Elimination Programme in Bucarito, one of the evaluated communities, had an unexpected outcome not only diminishing the prevalence of helminthes but also the prevalence of intestinal protozoa, being this community under the same risk factors as the rest of the evaluated communities.

Percepciones de las personas que participan en el programa adulto mayor dependiente de la Fundación Cerro Navia Joven: una mirada desde la ocupación / Perceptions of people that participate in the dependent elderly program of the Cerro Navia Foundation: an occupational point of view

Chile se encuentra siendo testigo de una creciente problemática asociada al envejecimiento poblacional: el aumento de las necesidades de cuidado en personas mayores en situación de dependencia. A partir de esto, existen iniciativas que buscan dar respuesta a esta realidad, siendo una de ellas el Programa de Adultos Mayores Dependientes de la Fundación Cerro Navia Joven, experiencia de carácter comunitaria en la que una persona mayor voluntaria realiza semanalmente una visita domiciliaria, junto a un equipo especializado, a personas mayores que se encuentran en situación de dependencia y su cuidador/a, pertenecientes a la misma comuna. Frente a esto, esta investigación tiene como propósito el conocer cuáles son las percepciones de las personas participantes de este programa, conformada por la tríada persona mayor en situación de dependencia, su cuidador/a y la persona mayor voluntaria. Para esto, se realizó un estudio de tipo cualitativo, utilizando la entrevista como instrumento de recolección de la información. El análisis de datos se realizó empleando la técnica del análisis de contenido. Dentro de los resultados se identificaron factores como cambios asociados a la rutina, valoración del rol de voluntario/a, acompañamiento, establecimiento de vínculo, percepción de los beneficios de las visitas, motivación, percepción de los cuidados y del apoyo social, los que fueron analizados bajo la mirada de la ocupación.

We are witnessing a growing problem associated with an aging population: increased care needs in older people in situations of dependency. Given this, there are initiatives that seek to respond to this reality, one being the Dependent Elderly Program of the Cerro Navia Joven Foundation, a community experience in which an elderly volunteer does a weekly home visit, accompanied by a specialized team, to elderly people who are in a dependency situation and the caregiver, from the same neighborhood. Thus, this research aims to compile the perceptions of the participants of this program, formed by the triad dependent elderly, caregiver and elderly volunteer. For this, a qualitative study was conducted using the interview as a tool for collecting information. The data analysis was carried out using the content analysis technique. Amongst the results were identified factors such as changes associated to routine, assessment of the role of the volunteer, assistance, linkage establishment, perception of benefits of the visits, motivation, perception of care and social support, which were analyzed under the point of view of the occupation.