Design of an algorithm for the diagnostic approach of patients with joint pain.

BACKGROUND: Rheumatic diseases are a reason for frequent consultation with primary care doctors. Unfortunately, there is a high percentage of misdiagnosis. OBJECTIVE: To design an algorithm to be used by primary care physicians to improve the diagnostic approach of the patient with joint pain, and thus improve the diagnostic capacity in four rheumatic diseases. METHODS: Based on the information obtained from a literature review, we identified the main symptoms, signs, and paraclinical tests related to the diagnosis of rheumatoid arthritis, spondyloarthritis with peripheral involvement, systemic lupus erythematosus with joint involvement, and osteoarthritis. We conducted 3 consultations with a group of expert rheumatologists, using the Delphi technique, to design a diagnostic algorithm that has as a starting point "joint pain" as a common symptom for the four diseases. RESULTS: Thirty-nine rheumatologists from 18 countries of Ibero-America participated in the Delphi exercise. In the first consultation, we presented 94 items to the experts (35 symptoms, 31 signs, and 28 paraclinical tests) candidates to be part of the algorithm; 74 items (25 symptoms, 27 signs, and 22 paraclinical tests) were chosen. In the second consultation, the decision nodes of the algorithm were chosen, and in the third, its final structure was defined. The Delphi exercise lasted 8 months; 100% of the experts participated in the three consultations. CONCLUSION: We present an algorithm designed through an international consensus of experts, in which Delphi methodology was used, to support primary care physicians in the clinical approach to patients with joint pain. Key Points • We developed an algorithm with the participation of rheumatologists from 18 countries of Ibero-America, which gives a global vision of the clinical context of the patient with joint pain. • We integrated four rheumatic diseases into one tool with one common symptom: joint pain. It is a novel tool, as it is the first algorithm that will support the primary care physician in the consideration of four different rheumatic diseases. • It will improve the correct diagnosis and reduce the number of paraclinical tests requested by primary care physicians, in the management of patients with joint pain. This point was verified in a recently published study in the journal Rheumatology International (reference number 31).

Survey data on the impact of COVID-19 on parental engagement across 23 countries.

This data article describes the dataset of the International COVID-19 Impact on Parental Engagement Study (ICIPES). ICIPES is a collaborative effort of more than 20 institutions to investigate the ways in which, parents and caregivers built capacity engaged with children's learning during the period of social distancing arising from global COVID-19 pandemic. A series of data were collected using an online survey conducted in 23 countries and had a total sample of 4,658 parents/caregivers. The description of the data contained in this article is divided into two main parts. The first part is a descriptive analysis of all the items included in the survey and was performed using tables and figures. The second part refers to the construction of scales. Three scales were constructed and included in the dataset: 'parental acceptance and confidence in the use of technology', 'parental engagement in children's learning' and 'socioeconomic status'. The scales were created using Confirmatory Factor Analysis (CFA) and Multi-Group Confirmatory Analysis (MG-CFA) and were adopted to evaluate their cross-cultural comparability (i.e., measurement invariance) across countries and within sub-groups. This dataset will be relevant for researchers in different fields, particularly for those interested in international comparative education.

Quality of Chicken Fat by-Products: Lipid Profile and Colour Properties.

The growth in the production and consumption of chicken meat and related products is responsible for the formation a large number of by-products. Among these, abdominal and gizzard fat is usually considered as waste and thus is discarded, creating an environmental problem. This work aims to characterize chicken fat by-products, evaluating their lipid profile and colour properties for their potential use as fat sources in meat products in substitution of traditionally used fats. In addition, the role of farm location, keeping the feeding and other farmer routines fixed, in the lipid profile was also evaluated. "Parrilleros" Colombian chickens from three farms located in various geographical zones of the Antioquia region were selected. After slaughtering, abdominal and gizzard fat was obtained. Lipid profile was evaluated by gas chromatography and the CIELAB colour properties were assessed. The production results and the lipid profile of chicken fat by-products (abdominal and gizzard fat) was similar in the three farms studied, which is important for their potential application as fat source in the formulation of meat products. The predominant fatty acids were oleic, palmitic and linoleic acids, showing a higher amount of unsaturated fatty acids than the fat sources traditionally used for this purpose. Valorization of chicken by-products by the use of abdominal and gizzard fat as fat source in chicken meat products formulation could be a feasible alternative contributing to the poultry sector sustainability.

Quality Properties of Chicken Emulsion-Type Sausages Formulated with Chicken Fatty Byproducts.

During poultry slaughtering, fatty byproducts are generated, mainly comprising abdominal and gizzard fat, which are mostly discarded and result in consequent environmental problems. The objective of this work was to use these fatty byproducts as fatty raw material in the production of chicken sausages (emulsion-type). They were applied for the partial replacement (40% and 50%) of chicken skin (fatty source usually used in chicken sausages). The effect of these partial replacements on the quality properties (proximate composition, lipid profile, color, texture, and microbiological and sensory properties) of chicken sausages were assessed. Sausages with fatty byproducts added (40% and 50%) showed lower moisture but higher fat content than control. Nevertheless, all of them meet the nutritional requirements of the Colombian regulation for this type of meat product. Sausages with 40% and 50% substitution level showed similar texture properties and microbiological quality as control. When these fatty byproducts were used at 50% substitution level, differences in several color properties and sensorial attributes (color, flavor, and meat taste) were noticed with respect to control. When the substitution level was reduced to 40%, no sensorial differences were detected. Chicken fatty byproducts can be successfully applied as partial replacement of chicken skin in emulsion-type sausages.

The Moderating Effects of Social Problem-Solving in the Relationship between Risk Factors and Peer Victimization in Colombian Early Adolescents / Efectos Moderadores de la Habilidad de Solución de Problemas Sociales en la Relación entre Factores de Riesgo y Victimización en Adolescentes Colombianos / Efeitos Moderadores da Habilidade de Solução de Problemas Sociais na Relação entre Fatores de Risco e Vitimização em Adolescentes Colombianos

This study assessed the moderating effect of social problem-solving (SPS) in the association between risk factors and peer victimization in a sample of Colombian adolescents. Using structural equation modeling techniques, this study assessed the extent to which changes in victimization varied as a function of the interaction between risk factors and social problem-solving. Results showed that both aggression and avoidance were predictive of initial scores on victimization, but only avoidance was found to predict its change over time. Only a main effect of SPS was found at the beginning of the year; no moderating effects were found. Results are consistent with previous findings by confirming that avoidance and aggression are risk factors for peer victimization.

Este estudio examinó el rol moderador de la habilidad para resolver problemas sociales (SPS) en la asociación entre factores de riesgo y la victimización, en una muestra de adolescentes colombianos. Mediante el uso de técnicas de ecuaciones estructurales se evaluó qué tanto cambió la victimización a lo largo del tiempo, en función de la interacción entre factores de riesgo y la SPS. Los resultados mostraron que la agresión y la evitación son factores de riesgo y predicen puntajes iniciales en la victimización. Sin embargo, únicamente la evitación predijo los cambios de dicha variable en el tiempo. Adicionalmente, se encontró un efecto de la SPS en la victimización al inicio del año escolar, pero no se encontraron efectos moderadores. Los resultados son consistentes con estudios previos en los que se observa que la evitación y la agresión son factores de riesgo en la victimización.

Este estudo examinou o papel moderador da habilidade para resolver problemas sociais (SPS) na associação entre fatores de risco e a vitimização, em uma amostra de adolescentes colombianos. Mediante o uso de técnicas de equações estruturais, avaliou-se quanto a vitimização ao longo do tempo mudou, em função da interação entre fatores de risco e a SPS. Os resultados mostraram que a agressão e a evitação são fatores de risco e predizem pontuações iniciais na vitimização. Contudo, unicamente a evitação prediz as mudanças de dita variável no tempo. Adicionalmente, constatou-se um efeito da SPS na vitimização ao início do ano escolar, mas não se encontraram efeitos moderadores. Os resultados são consistentes com estudos prévios nos quais se observa que a evitação e a agressão são fatores de risco na vitimização.