Acute respiratory failure among lung transplant adults requiring intensive care: Changing spectrum of causative organisms and impact of procalcitonin test in the diagnostic workup.

BACKGROUND: The aim was to identify the causing organisms and assess the association of procalcitonin (PCT) with bacterial pneumonia within 24 hours of intensive care unit admission (ICU-A) among lung transplant (LT) adult recipients. METHODS: Secondary analysis from a prospective cohort study. All LT adults admitted to ICU for acute respiratory failure (ARF) over 5 years were included. Patients were followed until hospital discharge or death. RESULTS: Fifty-eight consecutive LT patients were enrolled. The most important cause of ICU-A due to ARF was pneumonia 29 (50%) followed by acute rejection 3 (5.2%) and bronchiolitis obliterans syndrome exacerbation 3 (5.2%). Microorganisms were isolated from 22/29 cases with pneumonia (75.9%): 17 (77.2%) bacterial, 4 (18.2%) viral, 1 (4.5%) Aspergillus fumigates, with Pseudomonas aeruginosa being the most common cause (45.5%) of pneumonia, with 10 patients presenting chronic colonization by P aeruginosa. Median [Interquartile range (IQR)] PCT levels within 24 hours after admission were higher in pneumonia (1.5 µg/L; IQR:0.3-22.0), than in non-pneumonia cases (0.2 µg/L; IQR:0.1-0.7) (P = .019) and PCT levels within 24 hours helped to discriminate bacterial pneumonia (8.2 µg/L; IQR:0.2-43.0) from viral pneumonia and non-pneumonia cases (0.2 µg/L; IQR:0.1-0.7). The overall negative predictive value for bacterial pneumonia was 85.1%, increasing to 91.6% among episodes after 6 months of LT. CONCLUSIONS: Causes of severe pneumonia in LT are changing, with predominant role of P aeruginosa and respiratory viruses. PCT ≤ 0.5 µg/L within 24 hours helps to exclude bacterial pneumonia diagnosis in LT adults requiring ICU-A. A negative PCT test allows antimicrobial de-escalation and requires an alternative diagnostic to bacterial pneumonia.

Study protocol: intervention in maternal perception of preschoolers' weight among Mexican and Mexican-American mothers.

BACKGROUND: Childhood obesity is a public health issue negatively affecting children's physical and psychosocial health. Mothers are children's primary caregivers, thus key players in childhood obesity prevention. Studies have indicated that mothers underestimate their children's weight. If mothers are unaware of their children's weight problem, they are less likely to participate in activities preventing and treating excess weight. The "Healthy Change" intervention is designed to change maternal perception of child's weight (MPCW) through peer-led group health education in childcare settings. METHODS/DESIGN: The "Healthy Change" is a multicenter two-arm randomized trial in four centers. Three centers are in Mexican States (Nuevo Leon, Tamaulipas, and Zacatecas). The fourth center is in San Antonio, Texas, USA. A total of 360 mother-child pairs (90 pairs per center) are to be randomly and evenly allocated to either the intervention or the control group. Intervention group will receive four-session group obesity prevention education. Control group will receive a four-session personal and food hygiene education. The education is delivered by trained peer-mother promotoras. Data will be collected using questionnaires and focus groups. The primary outcome is a change in proportion of mothers with accurate MPCW. Secondary outcomes include change in maternal feeding styles and practices, maternal self-efficacy and actions for managing child excessive weight gain. McNemar's Test will be used to test the primary outcome. The GLM Univariate procedure will be used to determine intervention effects on secondary outcomes. The models will include the secondary outcome measures as the dependent variables, treatment condition (intervention/control) as the fixed factor, and confounding factors (e.g., mother's education, children's gender and age) as covariates. Sub-analyses will be performed to compare intervention effects on primary and secondary outcomes between the samples from Mexico and Texas, USA. Qualitative data will be analyzed through analysis of inductive content. A combined coding model will be developed and used to code transcripts using the NVivo software. DISCUSSION: Healthy Change intervention could help change MPCW, an initial step for obesity prevention among preschoolers. This study presents a first of its kind intervention available in Spanish and English targeting Mexican and Mexican-American mothers in Mexico and USA. TRIAL REGISTRATION: ISRCTN12281648.

[Maternal perception of her child's weight and unrelated children less than 1 year old]. / Percepción materna del peso del hijo y de niños no emparentados menores de un año.

AIMS: To evaluate the maternal perception of their child's weight (MPCW) and perception of unrelated children's weight. DESIGN: Cross-sectional. LOCATION: Maternal and Child Nursing Health Department at 6 Units of Family Medicine. PARTICIPANTS: 486 dyads (mother and child under 1 year). MAIN MEASUREMENTS: The following question was applied: "I think my child is", and images were provided according the child's gender. Children's weight and height were measured. RESULTS: A total of 20.5% of the mothers of overweight (OW) children accurately perceived this situation, while none of the mothers of obese (OB) children did (κ=0.14±0.03, Z=5.36, p=.001). By images, 63.3% of mothers of OW children and 33.3% of mothers of OB children perceived this situation (κ=0.01±0.02, Z=0.73, p=.46). Most mothers selected the image of OW child as the image of a healthy child (κ=-0.04±0.01, Z=-2.65, p=.008), the image of a child under 1 year (κ=-0.01±0.02, Z=-0.86, p=.38) and the image that they would like their child to look like (κ=0.0004±0.01, Z=0.02, p=.98). CONCLUSION: The mothers do not perceive the OW-OB of their children.

[Maternal Predictors of Body Mass Index of Pre-school and School Age Children]. / Predictores maternos del índice de masa corporal del hijo pre-escolar y escolar.

The objective was to identify maternal variables that could be used as predictors of the child's body mass index (BMI). We considered the following variables: (a) socio-demographic (age, education, occupation, marital status and family income); (b) anthropometric (BMI); and (c) upbringing strategies (monitoring and limits for eating habits, monitoring and sedentary behavior limits, discipline and control in feeding. A predictive correlational study was carried out with 537 dyads (mother-child). Children enrolled in 4 public schools (2 for pre-school children and 2 for primary school children) were selected for probabilistic, random sampling. The mothers answered the Feeding and Activity Upbringing Strategies Scale, giving socio-demographic information and the dyads' weight and height was measured. The data were analyzed for correlations and path analysis. It was found that the average age of mothers was 34.25 years (SD=6.91), with 12.40 years of education (SD=3.36), 53.3% mentioned that they were housewives and 46.7% had a paid job outside of the home; 38.5% showed pre-OB and 27.3% some degree of OB. The child's average age was 7.26 years (SD=2.46), and 3.2% showed low weight, 59.6% normal weight and 37.2% OW-0B. It was found that working outside the home, having a higher maternal BMI, less control and more discipline in feeding are variables that predict higher BMI in the child. We recommend the design of interventions to reduce and treat the child's OW-OB taking into account the predictors that were found.

Less underestimaton of excess weight by the categorical than the visual method. Its determinants and feeding practices in Mexican mothers of children aged 2 to 12 years.

Introduction: Introduction: perceived body weight refers to the subjectively assessed weight, which may not correspond to the objectively measured weight. Statistics show that 14 % to 83 % of parents misperceive their children's weight status, with a propensity for underestimation. Objective: we compared the accuracy of the visual versus the categorical method. We also identified factors and feeding practices associated with excess weight underestimation. Material and methods: we carried out a cross-sectional study in five states of Mexico with 1,845 mother-child dyads of children aged 2-12 years. The mothers were interviewed about weight perception with two methods, visual and categorical. The Child Feeding Questionnaire identified maternal feeding practices. Actual weight and height were categorized according to WHO criteria. Analysis consisted of Cohen's kappa estimation, multivariate logistic regression, and Mann-Whitney tests. Results: more mothers correctly identified the weight of their children with the categorical than with the visual method (68 % vs 42 %, p < 0.0001). The excess weight underestimation was lower (49 % vs 82 %, p < 0.0001) and the degree of agreement was higher with the categorical method (kappa, 0.39 and 0.08). The better results remained regardless of age. Age 2-5 years increased the odds of overweight/obesity underestimation. Feeding practices differed by weight perception category, child's age, and method of assessment. Conclusions: the categorical method was more accurate. Recognition of correct weight perception is one of the first actions required for controlling childhood overweight/obesity.

Introducción: Introducción: la percepción del peso corporal se refiere al peso evaluado subjetivamente, que puede no corresponder al peso medido objetivamente. Las estadísticas muestran que entre el 14 % y el 83 % de los padres tienen una percepción inadecuada del estado del peso de sus hijos, predominando la subestimación. Objetivo: comparar la precisión del método categórico y la del visual e identificar los factores y prácticas de alimentación asociados a la subestimación del exceso de peso. Material y métodos: se realizó un estudio transversal en cinco estados de México con 1,845 díadas madre-hijo de niños de 2-11 años. Las madres fueron entrevistadas sobre su percepción del peso con un método visual y uno categórico. El Cuestionario de Alimentación Infantil identificó las prácticas de alimentación. El peso y la altura se clasificaron con los criterios de la OMS. Se estimó la kappa de Cohen y se utilizaron la regresión logística multivariada y las pruebas de Mann-Whitney. Resultados: más madres identificaron correctamente el peso de sus hijos con el método categórico que con el visual (68 % vs. 42 %, p < 0,0001). La subestimación del exceso de peso fue menor (49 % vs 82 %, p <0,0001) y el grado de concordancia mayor con el método categórico (kappa: 0,39 y 0,08). Los resultados se mantuvieron independientemente de la edad. La edad de 2-5 años aumentó la probabilidad de subestimar el sobrepeso/obesidad. Las prácticas de alimentación difirieron por categoría de percepción del peso, edad del niño y método de evaluación. Conclusiones: el método categórico fue más preciso. El reconocimiento de la correcta percepción del peso constituye una de las primeras acciones para el control del sobrepeso/obesidad infantil.

[Parenting stress, maternal feeding styles related to preschooler body mass index]. / Estrés de la crianza, estilos maternos de alimentación y su relación con el índice de masa corporal del preescolar.

Introduction: Introduction: excess weight in childhood is influenced by multiple factors; parenting could contribute to this problem, given that during the infant stage the parents, and mainly the mother, are responsible for providing food and feeding their children. Objective: to explore the relationship of parenting stress and maternal feeding styles with preschool BMI. Materials and methods: a cross-sectional study. A total of 382 dyads, mother and child (3-5 years of age) participated. The children attended public preschool institutions. Participating mothers completed the Parenting Stress Scale and the Caregiver Feeding Styles Questionnaire. Weight and height were measured, and the child's BMI was calculated. Results: 34 % of the mothers more frequently used an indulgent style, 28.2 % of the preschool children had overweight-obese. Mothers with an authoritative style had the highest mean range of parenting stress compared to other categories (H = 15.302, gl = 3, p = 0.002). Maternal schooling, responsibility and demand dimensions were identified as contributing to preschooler BMI. Conclusion: parenting stress and feeding styles are variables that contribute to the risk of overweight-obesity in prescho.

Introducción: Introducción: el exceso de peso en la infancia se ve influenciado por múltiples factores; la crianza podría contribuir a este problema, dado que durante la etapa infantil son los padres y principalmente la madre los responsables de proporcionar alimento y de alimentar a sus hijos. Objetivo: explorar la relación del estrés de la crianza y los estilos maternos de alimentación con el IMC del hijo preescolar. Materiales y métodos: estudio transversal. Participaron 382 díadas madre e hijo, los últimos de 3-5 años. Los hijos asistían a instituciones públicas de educación preescolar. Las madres participantes contestaron la Escala de Estrés de la Crianza y el Cuestionario de Estilos de Alimentación del Cuidador. Se midió peso, talla y se calculó el IMC del preescolar. Resultados: el 34 % de las madres utilizaban con mayor frecuencia un estilo indulgente y el 28,2 % de los hijos preescolares tenía sobrepeso-obesidad. Las madres con estilo autoritario presentaban el rango promedio más alto de estrés de la crianza comparado con las otras categorías (H = 15,302, gl = 3, p = 0,002). Se identificó que la escolaridad materna, la dimensión de la responsabilidad y la demanda contribuyen al IMC del hijo preescolar. Conclusión: el estrés de la crianza y los estilos de alimentación son variables que contribuyen al riesgo de sobrepeso-obesidad en los hijos preescolares.

Mechanical ventilation in pediatric intensive care units during the season for acute lower respiratory infection: a multicenter study.

OBJECTIVE: To describe the characteristics and outcomes of mechanical ventilation in pediatric intensive care units during the season of acute lower respiratory infections. DESIGN: Prospective cohort of infants and children receiving mechanical ventilation for at least 12 hrs. SETTING: Sixty medical-surgical pediatric intensive care units. PATIENTS: All consecutive patients admitted to participating pediatric intensive care units during a 28-day period. MEASUREMENTS AND MAIN RESULTS: Of 2,156 patients admitted to pediatric intensive care units, 1185 (55%) received mechanical ventilation for a median of 5 days (interquartile range 2-8). Median age was 7 months (interquartile range 2-25). Main indications for mechanical ventilation were acute respiratory failure in 78% of the patients, altered mental status in 15%, and acute on chronic pulmonary disease in 6%. Median length of stay in the pediatric intensive care units was 10 days (interquartile range 6-18). Overall mortality rate in pediatric intensive care units was 13% (95% confidence interval: 11-15) for the entire population, and 39% (95% confidence interval: 23 - 58) in patients with acute respiratory distress syndrome. Of 1150 attempts at liberation from mechanical ventilation, 62% (95% confidence interval: 60-65) used the spontaneous breathing trial, and 37% (95% confidence interval: 35-40) used gradual reduction of ventilatory support. Noninvasive mechanical ventilation was used initially in 173 patients (15%, 95% confidence interval: 13-17). CONCLUSION: In the season of acute lower respiratory infections, one of every two children admitted to pediatric intensive care units requires mechanical ventilation. Acute respiratory failure was the most common reason for mechanical ventilation. The spontaneous breathing trial was the most commonly used method for liberation from mechanical ventilation.

[Evaluation of the maternal perception of childhood overweight-obesity and maternal recognition of health risk in a Mexican border city]. / Percepción materna de sobrepeso-obesidad infantil y riesgos de salud en Nuevo Laredo, Tamaulipas, México.

OBJECTIVES: To evaluate 1) maternal perception (MP) of their child's weight, 2) MP of overweight-obesity (OW-OB) of unrelated children (URC),3) MP of image with health risk, and 4) recognition of OW-OB health risks. MATERIAL AND METHODS: A total of 325 mother-child dyads participated. A panel with 7 images was used.The child's body mass index was the gold standard. RESULTS: A total of 84 of 100 mothers of OW-OB children did not accurately perceive their children's weight. Of the total sample, 97.5% perceived the OW-OB of URC and 83.1% the OW-OB image with health risk. Most of the mothers recognized the health risks. CONCLUSION: It is necessary to design multidisciplinary intervention programs to help mothers of OW-OB children accurately recognize their children's weight and, thus, reduce the high prevalence of OW-OB in our population.

[Evaluation of the maternal perception of her child's weight and body mass index heritability in mestizas dyads in Southeastern Mexico]. / Evaluación de la percepción materna del peso del hijo y de la heredabilidad del IMC en diadas mestizas del Sureste de México.

Descriptive correlational study. The objectives were the following: 1) evaluate maternal perception of her child's weight through two test, Word-perception (WVP) test and the Body mass index (BMI) of the child as perceived by the mother (Body weight index perception [BWIP]); 2)evaluate the sensitivity and specificity of the tests, and 3) quantify BMI heritability (h2) in 173 mother-child dyads. WP was assessed by asking the question, How do you think your child is? For assessing BWIP, the mother referred the child's eight and height, and we calculated the child's BMI as perceived by the mother. The weight and height of the mothers and their children were measured. We found that 10.3% of mothers of children with Overweight (OW) and 1.8% of mothers of children with Obesity (OB) perceived their children adequately by means of WP; by means of the BWIP test, 38.5 and 67.3% of mothers of children with OW and OB, respectively, exhibited adequate perception. BWIP sensitivity was 55.3% and specificity was 54.4%. BWI h2 was 15%. We was concluded that mothers did not perceive the OW-OB of their children, and that asking the mother for the weight and height of the child (BMIP) will aids her to perceive the OW-OB of her child. The BWI h2 indicate that the lifestyle factors of this population contribute to OW-OB. Given the broad socioeconomic and cultural diversity, these results of the southeastern Mexican state of Campeche should be evaluated with similar study designs.

[Analysis of the psychometric properties of the Eating Behavior Self-efficacy Scale in Mexican adolescents]. / Análisis de las propiedades psicométricas de la Escala de Autoeficacia de la Conducta Alimentaria en adolescentes mexicanos.

INTRODUCTION: Introduction: self-efficacy plays an important role in eating behaviors; for example, excess weight is associated with low EC and poor nutrition. The Eating Behavior Self-Efficacy Scale (EACA) identifies the ability to control the intake of healthy, and of high-calorie foods. Objective: to evaluate the psychometric properties of EACA in adolescents residing in northeast Mexico, and to analyze the relationship of self-efficacy with sex, age, and nutritional status of participants. Methods: confirmatory factor analyses (CFA) were performed, and both reliability (internal consistency) and convergent validity of EACA were analyzed. A total of 467 adolescents who were studying the 7th to 9th grade of basic education, and who were residents in northeast Mexico were enrolled. Results: the goodness-of-fit indices of the proposed model were acceptable: CMIN/DF = 2.831; CFI = 0.952; GFI = 0.931; AGFI = 0.905; SRMS = 0.318, and RMSEA = 0.063), as was internal consistency (α = 0.90). Mean age was 13.54 years (SD = 0.93), and weight ranged from 30.9 to 130.4 kg (SD = 13.33). Conclusions: the CFA of the proposed model has a high internal consistency, and the four-factor structure has an adequate fit. It can be used to measure self-efficacy in relation to eating behavior in Mexican adolescents. It is recommended to test this model in similar populations.

INTRODUCCIÓN: Introducción: la autoeficacia (AE) desempeña un rol importante en las conductas relacionadas con la alimentación; por ejemplo, el exceso de peso se asocia con una baja AE y una alimentación inadecuada. La Escala de Autoeficacia de la Conducta de Alimentación (EACA) permite identificar la capacidad de control de la ingesta de alimentos saludables y de alimentos altamente calóricos. Objetivo: evaluar las propiedades psicométricas de la EACA en adolescentes residentes en el noreste de México y analizar la relación de la AE con el sexo, la edad y el estado nutricional de los participantes. Métodos: se realizó un análisis factorial confirmatorio (AFC) y se analizaron la fiabilidad (consistencia interna) y la validez convergente de la EACA. Participaron 467 adolescentes que cursaban entre el 7º y el 9º grado de educación básica, residentes en el noreste de México. Resultados: los índices de bondad del ajuste del modelo propuesto fueron aceptables: (CMIN/DF = 2,831; CFI = 0,952; GFI = 0,931; AGFI = 0,905; SRMS = 0,318 y RMSEA = 0,063), así como la consistencia interna (α = 0,90). La edad promedio era de 13,54 años (DE = 0,93) y el peso oscilaba entre 30,9 y 130,4 kg (DE = 13,33). Conclusiones: el AFC del modelo propuesto tiene una consistencia interna alta y la estructura factorial de cuatro factores tiene un ajuste adecuado. Puede utilizarse para medir la AE en relación con la conducta de alimentación de los adolescentes mexicanos. Se recomienda contrastar este modelo en poblaciones similares.

[Confirmatory factor analysis of the Comprehensive Feeding Practices Questionnaire in Mexican mothers of preschool children]. / Análisis factorial confirmatorio del Cuestionario Integral de Prácticas de Alimentación en madres mexicanas de niños preescolares.

INTRODUCTION: Introduction: identifying maternal attitudes and behaviors related to child feeding could be difficult since the underlying constructs are abstract and complex. Different questionnaires have been used to identify these constructs: one of the most widely used is the Comprehensive Feeding Practices Questionnaire (CFPQ), which had been validated in different populations. However, no previous study ever validated the CFPQ in Mexican mothers. Material and methods: a process of cultural adaptation was done to adapt the CFPQ to Mexican mothers, and subsequently a confirmatory factor analysis was done. A total of 300 mother-preschooler pairs participated. Weight and height were measured and the nutritional status was obtained. Results: the CFPQ is a useful questionnaire to identify child feeding practices, since the model's goodness of fit indices were acceptable (CFI = 0.943, TLI = 0.937, NFI = 0.874 and RMSEA = 0.042), as was the internal consistency of the CFPQ. Conclusion: the CFPQ version that was translated into Spanish and adapted to Mexican mothers demonstrated significant internal reliability, and therefore is useful to identify and describe maternal child-feeding practices.

INTRODUCCIÓN: Introducción: identificar las actitudes y comportamientos de las madres en relación con la alimentación infantil puede resultar difícil ya que los constructos subyacentes son abstractos y complejos. Para identificar estos constructos se han utilizado diferentes cuestionarios: uno de los más utilizados es el Cuestionario Integral de Prácticas de Alimentación (CIPA), que se ha validado en diferentes poblaciones. Sin embargo, ningún estudio previo ha validado el CIPA en madres mexicanas. Material y métodos: se realizó un proceso de adaptación transcultural para adecuar el CIPA a las madres mexicanas y, posteriormente, se ejecutó un análisis factorial confirmatorio. Participaron 300 diadas madre-hijo/a en edad preescolar. Se realizaron mediciones del peso y la talla del preescolar y se obtuvo el estado nutricio. Resultados: el CIPA es un cuestionario útil para identificar las prácticas de alimentación infantil dado que los índices de bondad de ajuste del modelo fueron aceptables (CFI = 0,943, TLI = 0,937, NFI = 0,874 y RMSEA = 0,042), así como la consistencia interna. Conclusión: la versión del CIPA traducida al español y adaptada a las madres mexicanas demostró una fiabilidad interna significativa, por lo cual resulta útil para identificar y describir las prácticas maternas de alimentación infantil.

The Head of Fannia pusio (Fanniidae: Diptera) as A Novel Source of Morphometric Data for Assessing of Variation Along Geographic and Biological Lines.

Fannia Robineau-Desvoidy, 1830 is the most diverse genus in the family Fanniidae (Diptera), with 288 species, many of which are include many of sanitary, economic and legal interest. The morphological homogeneity within the genus often makes species determination difficult. The best option for correct identification is to combine molecular and morphological analyses. The variation in the shape of a selection of body characters can be assessed by Geometric Morphometrics using the head as an innovative structure. Sex must be accounted for as a key covariate in this kind of study, since Fannia, as many other Diptera, has a sexually dimorphic head structure, with holoptic males and dicoptic females. Firstly, we analysed a set of Fannia sp. specimens sampled across the Iberian Peninsula (2012-2015), of which Fannia pusio (Wiedemann, 1830) was found to be the most abundant species. Our analyses provide significant morphological information. Fannia pusio exhibits clear intraspecific morphometric variation along an Iberian-wide East-West axis. A similar pattern emerged when comparing a laboratory-bred colony and wild samples.

7th to 9th grade obese adolescents' perceptions about obesity in Tamaulipas, Mexico.

The objective was to explore obese adolescents perceptions about obesity among students in the seventh to ninth grade of a public school in Tamaulipas, Mexico. This is a qualitative study. Participants were 24 adolescents with a body mass index equal to or greater than the 95th percentile. Semistructured interviews were conducted until data saturation was reached and the meaning was understood. The adolescents defined obesity according to standards of measurement. They identified the hereditary factor as the main obesity cause, tended to underestimate obesity and had low self-esteem. They reported problems to do physical exercise and get clothes in order to improve their image, and feel rejected by their peers in school. It was identified that these adolescents have psychological defense mechanisms against obesity and that some of them are making efforts to lose weight. Obesity entails social and psychological health implications for persons suffering from this problem. Interventions should be put in practice.

[Benefits and barriers perceived by Mexican adolescents for consuming fruit and vegetables]. / Beneficios y barreras percibidos por adolescentes mexicanos para el consumo de frutas y verduras.

The objectives of this descriptive study were to establish the benefits and barriers perceived by adolescents for consuming fruit and vegetables, and to determine gender differences. A random sample of 829 adolescents attending public secondary schools in Matamoros, Tamaulipas was recruited (398 were males, and 431) with a mean age of 13.11 +/- 0.93 years. A scale of benefits and barriers for consuming fruit and vegetables was used. The most important perceived benefits for males were: "I'd take care of my health eating more fruit and vegetables" (4.24 +/- 0.99), "I like the taste of fruit" (4.21 +/- 1.06), and "eating fruit and vegetables would give me more vitamins and minerals (4.20 +/- 1.07). For females the perceived benefits were: "I like the taste of fruits" (4.48 +/- 0.81), and "I'd take care of my health eating more fruit and vegetables" (4.41 +/- 0.91). Adolescents of both genders, pointed out as barrier pesticides in fruit and vegetables (3.14 +/- 1.31 for males and 2.97+1.22 for females). Findings showed that perceived benefits and barriers have differences by gender. Females perceive higher benefits 24.25+9.15 (p = 0.001). Males perceived higher barriers 24.94 +/- 7.28 (p = 0.001). In conclusion, benefits and barriers are different by gender. Given the great cultural diversity in Mexico, these findings in students residing in this border city must be validated with similarly designed studies.

Maternal satisfaction with maternal-infant nursing care in Campeche, Mexico.

OBJECTIVE: Evaluate and compare maternal-satisfaction (global and areas) with maternal-child nursing care (MSMINC) and to explore the relationship of MSMINC with wait time, length of visit, and maternal age and education. METHODS: Cross-sectional descriptive study comprising 213 mothers. Group 1 (n = 84), mothers of children aged <1 year, and Group 2 (n = 129), mothers of children between 1 and 4 years of age. The patient satisfaction scale was applied. RESULTS: Global MSMINC was 76.26 and 79.21 for Groups 1 and 2, respectively. No associated factors were found in Group 1. In Group 2, wait time was associated with MSMINC in the technical-professional area (F = 3.13; df = 128; B = -0.21; p = 0.01). CONCLUSIONS: The fact that these study participants identified only MSMINC-associated factors in the technical-professional area may indicate that care is centered on technical procedures. Given that MSMINC-associated factors were not identified in Group 1, we recommend exploration of maternal expectations and perceptions of care.

Less underestimaton of excess weight by the categorical than the visual method. Its determinants and feeding practices in Mexican mothers of children aged 2 to 12 years / Menor subestimación del exceso de peso por el método categórico que por el visual. Determinantes y prácticas de alimentación en madres mexicanas de niños de 2 a 12 años

Introduction: perceived body weight refers to the subjectively assessed weight, which may not correspond to the objectively measured weight.Statistics show that 14 % to 83 % of parents misperceive their children’s weight status, with a propensity for underestimation.Objective: we compared the accuracy of the visual versus the categorical method. We also identified factors and feeding practices associatedwith excess weight underestimation.Material and methods: we carried out a cross-sectional study in five states of Mexico with 1,845 mother-child dyads of children aged 2-12years. The mothers were interviewed about weight perception with two methods, visual and categorical. The Child Feeding Questionnaire identifiedmaternal feeding practices. Actual weight and height were categorized according to WHO criteria. Analysis consisted of Cohen’s kappa estimation,multivariate logistic regression, and Mann-Whitney tests.Results: more mothers correctly identified the weight of their children with the categorical than with the visual method (68 % vs 42 %, p <0.0001). The excess weight underestimation was lower (49 % vs 82 %, p < 0.0001) and the degree of agreement was higher with the cate-gorical method (kappa, 0.39 and 0.08). The better results remained regardless of age. Age 2-5 years increased the odds of overweight/obesityunderestimation. Feeding practices differed by weight perception category, child’s age, and method of assessment.Conclusions: the categorical method was more accurate. Recognition of correct weight perception is one of the first actions required forcontrolling childhood overweight/obesity.(AU)

Introducción: la percepción del peso corporal se refiere al peso evaluado subjetivamente, que puede no corresponder al peso medido objeti-vamente. Las estadísticas muestran que entre el 14 % y el 83 % de los padres tienen una percepción inadecuada del estado del peso de sushijos, predominando la subestimación.Objetivo: comparar la precisión del método categórico y la del visual e identificar los factores y prácticas de alimentación asociados a la sub-estimación del exceso de peso.Material y métodos: se realizó un estudio transversal en cinco estados de México con 1,845 díadas madre-hijo de niños de 2-11 años. Lasmadres fueron entrevistadas sobre su percepción del peso con un método visual y uno categórico. El Cuestionario de Alimentación Infantil iden-tificó las prácticas de alimentación. El peso y la altura se clasificaron con los criterios de la OMS. Se estimó la kappa de Cohen y se utilizaron laregresión logística multivariada y las pruebas de Mann-Whitney.Resultados: más madres identificaron correctamente el peso de sus hijos con el método categórico que con el visual (68 % vs. 42 %, p <0,0001). La subestimación del exceso de peso fue menor (49 % vs 82 %, p <0,0001) y el grado de concordancia mayor con el método categórico(kappa: 0,39 y 0,08). Los resultados se mantuvieron independientemente de la edad. La edad de 2-5 años aumentó la probabilidad de subestimarel sobrepeso/obesidad. Las prácticas de alimentación difirieron por categoría de percepción del peso, edad del niño y método de evaluación.Conclusiones: el método categórico fue más preciso. El reconocimiento de la correcta percepción del peso constituye una de las primerasacciones para el control del sobrepeso/obesidad infantil.(AU)

Síntesis de teoría de la percepción materna del peso corporal del hijo / Síntese da teoria da percepção materna do peso corporal do filho / Theory synthesis of maternal perception of her child’s body weight

To build a middle range theory of maternal perception of her child´s body weight. Thismiddle range theory was built deductively from the concept of social perception and from researchliterature published following the steps of theory synthesis. This theory has inputs, and the maternal perception of her child´s body weight is the outcome, that influence on maternal attitudes, andbehaviors related to the child’s body weight. This theory offers an explanation how mothers builda judgement about their child’s body weight. The professionals could work with the factors thatinfluence the maternal perception of her child´s body weight.(AU)

Desarrollar una teoría de rango medio de la percepción materna del peso corporal delhijo. Esta teoría fue desarrollada de forma deductiva a partir del concepto de percepción social y dehallazgos científicos publicados, siguiendo los pasos de síntesis de teoría. Esta teoría tiene elementos de entrada y la percepción maternal del peso del hijo es el resultado, que influye en las actitudesy conductas maternas relacionadas al peso corporal del hijo. Esta teoría ofrece una explicación decómo las madres construyen el juicio respecto al peso corporal de su hijo. Los profesionales podríantrabajar con los factores que influyen en la percepción materna del peso corporal del hijo.(AU)

Desenvolver uma teoria de classe média da percepção materna do peso corporal do filho.Essa teoria foi desenvolvida dedutivamente a partir do conceito de percepção social e descobertascientíficas publicadas, seguindo as etapas de síntese da teoria. Essa teoria tem elementos de entradae o resultado é a percepção materna do peso corporal do filho, que influencia as atitudes e comportamentos maternos relacionados ao peso corporal do filho. Essa teoria oferece uma explicação decomo as mães constroem seu julgamento sobre o peso corporal do seu filho. Os profissionais poderiam trabalhar com os fatores que influenciam a percepção materna sobre o peso corporal do filho.(AU)

Estrés de la crianza, estilos maternos de alimentación y su relación con el índice de masa corporal del preescolar / Parenting stress, maternal feeding styles related to preschooler body mass index

Introducción: el exceso de peso en la infancia se ve influenciado por múltiples factores; la crianza podría contribuir a este problema, dado que durante la etapa infantil son los padres y principalmente la madre los responsables de proporcionar alimento y de alimentar a sus hijos. Objetivo: explorar la relación del estrés de la crianza y los estilos maternos de alimentación con el IMC del hijo preescolar. Materiales y métodos: estudio transversal. Participaron 382 díadas madre e hijo, los últimos de 3-5 años. Los hijos asistían a instituciones públicas de educación preescolar. Las madres participantes contestaron la Escala de Estrés de la Crianza y el Cuestionario de Estilos de Alimentación del Cuidador. Se midió peso, talla y se calculó el IMC del preescolar. Resultados: el 34 % de las madres utilizaban con mayor frecuencia un estilo indulgente y el 28,2 % de los hijos preescolares tenía sobrepeso-obesidad. Las madres con estilo autoritario presentaban el rango promedio más alto de estrés de la crianza comparado con las otras categorías (H = 15,302, gl = 3, p = 0,002). Se identificó que la escolaridad materna, la dimensión de la responsabilidad y la demanda contribuyen al IMC del hijo preescolar. Conclusión: el estrés de la crianza y los estilos de alimentación son variables que contribuyen al riesgo de sobrepeso-obesidad en los hijos preescolares. (AU)

Introduction: excess weight in childhood is influenced by multiple factors; parenting could contribute to this problem, given that during the infant stage the parents, and mainly the mother, are responsible for providing food and feeding their children. Objective: to explore the relationship of parenting stress and maternal feeding styles with preschool BMI. Materials and methods: a cross-sectional study. A total of 382 dyads, mother and child (3-5 years of age) participated. The children attended public preschool institutions. Participating mothers completed the Parenting Stress Scale and the Caregiver Feeding Styles Questionnaire. Weight and height were measured, and the child’s BMI was calculated. Results: 34 % of the mothers more frequently used an indulgent style, 28.2 % of the preschool children had overweight-obese. Mothers with an authoritative style had the highest mean range of parenting stress compared to other categories (H = 15.302, gl = 3, p = 0.002). Maternal schooling, responsibility and demand dimensions were identified as contributing to preschooler BMI. Conclusion: parenting stress and feeding styles are variables that contribute to the risk of overweight-obesity in preschool children. (AU)

Enduring deficits in sustained visual attention during withdrawal of intravenous methylenedioxymethamphetamine self-administration in rats: results from a comparative study with d-amphetamine and methamphetamine.

Although amphetamine-derived stimulants are widely associated with neurotoxicity, it is poorly understood whether extended exposure to such drugs produces lasting effects on neurocognitive function. This study investigates whether chronically self-administered d-amphetamine, methamphetamine (MA), or methylenedioxymethamphetamine (MDMA) leads to residual deficits in a rodent test of sustained visual attention and impulsivity. Rats were trained on a five-choice serial reaction time task and subsequently trained to self-administer d-amphetamine, MA, or MDMA (all 50 microg/infusion), intravenously, for 3 weeks. Effects on performance were evaluated 24 h after drug discontinuation and for several weeks thereafter, including various challenge sessions to increase the attentional demands of the task. The results indicate divergent patterns of self-administration among the three drugs tested with increasing rates of intake evident in rats self-administering amphetamine, but not MA, and widely fluctuating rates in the MDMA group. Withdrawal of MA resulted in severe behavioral disturbances, with significant effects on accuracy, omissions, response latency, and impulsivity that lasted up to 2 weeks in some cases. Amphetamine and MDMA withdrawal were associated with similar, but shorter-lasting effects on performance. However, when challenged with a high event rate session 6 weeks after drug discontinuation, rats previously exposed to MDMA continued to show deficits in the accuracy and speed of responding. These findings show that amphetamine-derived stimulants have both short- and long-term consequences for psychomotor functioning. The demonstration of residual deficits in rats chronically exposed to MDMA raises some concern about the potential harm caused by this drug in human ecstasy users.

The association between maternal perception of her child weight and maternal feeding styles / Asociación de la percepción materna del peso del hijo y estilos maternos de alimentación infantil.

Introduction: Mothers do not recognize when their child is overweight or obese (OW-OB), and the evidence suggests a relationship between inadequate maternal perception of her child weight (MPCW), and maternal feeding style (MFS). Objectives: a) To assess the reliability of the Caregiver Feeding Style Questionnaire (CFSQ); b) to verify association between MPCW and child' nutritional status; c) to describe the MFS; d) to verify differences between MPCW and child's body mass index (BMI); e) and to verify the association between MPCW and MFS. Methods: 566 dyads participated (mother/preschool child). Mothers circle the image that more resembled their child (MPCW), and answered the CFSQ. Cronbach alpha coeffi cient was calculated. V Cramer, ANOVA and Chi-square were applied. Results: The internal consistency of CFSQ was 0.88. The 8.4% (n = 12) mothers of children are OW-OB had adequate MPCW (V = 0.26, p = 0.001). The most frequent MFS was authoritarian (34.5%, n = 195), MFS uninvolved presented the highest child' BMI (F = 3.91, p < 0.05). When mothers perceive her child is OW-OB have a MFS uninvolved (χ2 = 15,384, df = 6, p < 0.05). Conclusions: Mothers of children with OW-OB have an inadequate MPCW and more frequently have a MFS authoritarian. When the mother perceive their child is OW-OB has MFS uninvolved. Interventions to help the mothers to recognize their child is OW-OB and teaching strategies that promote MFS authoritative are recommended.

Introducción: las madres no reconocen cuando su hijo presenta sobrepeso-obesidad (SP-OB) y existe evidencia de relación entre esta percepción (PMPH) no adecuada y el estilo materno de alimentación infantil (EMAI).Objetivos: a) evaluar la confiabilidad del Cuestionario Estilos de Alimentación del Cuidador (CFSQ); b) verificar la asociación entre la PMPH y el estado nutricio del hijo; c) describir el EMAI; d) verificar diferencias entre el EMAI y el IMC del hijo; e) verificar la asociación entre la PMPH y los EMAI. Métodos: participaron 566 diadas (madre/hijo preescolar). Las madres seleccionaron la imagen que representaba el peso del hijo (PMPH) y contestaron el CFSQ. Se calculó coeficiente alpha de Cronbach. Se aplicó V de Cramer, ANOVA y Chi-cuadrado. Resultados: la consistencia interna del CFSQ fue 0,88. El 8,4% (n = 12) de madres de hijos con SP-OB tuvieron PMPH adecuada (V = 0,26, p = 0,001). El EMAI más frecuente fue el autoritario (34,5%, n = 195), el EMAI no involucrado presentó IMC más alto del hijo (F = 3,91, p < 0,05). Cuando las madres perciben el SP-OB de sus hijos ejercen un EMAI no involucrado (χ2 = 15,384, gl = 6, p < 0,05). Conclusiones: las madres de hijos con SP-OB tienen una PMPH no adecuada y presentan con mayor frecuencia EMAI autoritario. Cuando perciben a sus hijos como con SP-OB tienen EMAI no involucrado. Se recomiendan intervenciones para reconocer el SP-OB del hijo y la enseñanza de estrategias que promuevan un EMAI con autoridad.