Challenges of health and well-being in the world according to SDG indicators. / Desafíos de salud y bienestar en el mundo según indicadores ODS.

This study reviews the current state of the good health and well-being indicators included in the Sustainable Development Goals (SDG), identifying the most significant challenges faced by countries in the world and in the Americas region. The HJ-Biplot multivariate technique is used to represent variances and covariances between 16 SDG 3 indicators, reported as of 2022, based on data from 176 countries, including 31 countries of the American continent. The findings show that indicators such as life expectancy at birth, universal health coverage and satisfied demand for family planning are key characteristics of developed countries. In contrast, developing countries still face significant challenges in terms of promoting maternal health, the well-being of children and the control of communicable and chronic diseases. For this reason, in the framework of the 2030 Agenda, it is necessary to continue working on public policy actions that enable making progress in the implementation of programs to improve the health and well-being of the population, especially in lower-income countries.

En este estudio se analiza el estado actual de los indicadores de salud y bienestar pertenecientes a los objetivos de desarrollo sostenible (ODS), identificando los desafíos más significativos que se presentan entre los países del mundo y en la región de las Américas. Se utiliza la técnica multivariante HJ-Biplot para representar las variaciones y covariaciones existentes entre 16 indicadores del ODS 3, reportados al año 2022, según datos de 176 países, entre ellos, 31 del continente americano. Los resultados obtenidos muestran que indicadores como la esperanza de vida al nacer, la cobertura sanitaria universal y la demanda de planificación familiar satisfecha, caracterizan a los países desarrollados. En contraste, los países en vía de desarrollo aún registran retos importantes para favorecer la salud materna, el bienestar de los niños y en el control de enfermedades trasmisibles y crónicas. Por ello, en el marco de la Agenda 2030, es necesario continuar trabajando en acciones de política pública que permitan avanzar en la implementación de programas para mejorar la salud y el bienestar de la población, en especial entre las naciones de menores ingresos.

Providers' Experiences and Perspectives in Treating Patients With Co-Occurring Opioid and Stimulant Use Disorders in the Hospital.

BACKGROUND: The overdose crisis is increasingly characterized by opioid and stimulant co-use. Despite effective pharmacologic treatment for both opioid use disorder (OUD) and contingency management for stimulant use disorders, most individuals with these co-occurring conditions are not engaged in treatment. Hospitalization is an important opportunity to engage patients and initiate treatment, however existing hospital addiction care is not tailored for patients with co-use and may not meet the needs of this population. METHODS: Semi-structured interviews were conducted with hospital providers about their experiences and perspectives treating patients with opioid and stimulant co-use. We used directed content analysis to identify common experiences and opportunities to improve hospital-based treatment for patients with co-use. RESULTS: From qualitative interviews with 20 providers, we identified 4 themes describing how co-use complicated hospital-based substance use treatment: (1) patients' unstable circumstances impacting the treatment plan, (2) co-occurring withdrawals are difficult to identify and treat, (3) providers holding more stigmatizing views of patients with co-use, and (4) stimulant use is often "ignored" in the treatment plans. Participants also described a range of potential opportunities to improve hospital-based treatment of co-use that fall into 3 categories: (1) provider practice changes, (2) healthcare system changes, and (3) development and validation of clinical tools and treatment approaches. CONCLUSIONS: We identified unique challenges providing hospital addiction medicine care to patients who use both opioids and stimulants. These findings inform the development, implementation, and testing of hospital-based interventions for patients with co-use.

Desafíos de salud y bienestar en el mundo según indicadores ODS / Challenges of health and well-being in the world according to SDG indicators

Resumen En este estudio se analiza el estado actual de los indicadores de salud y bienestar pertenecientes a los objetivos de desarrollo sostenible (ODS), identificando los desafíos más significativos que se presentan entre los países del mundo y en la región de las Américas. Se utiliza la técnica multivariante HJ-Biplot para representar las variaciones y covariaciones existentes entre 16 indicadores del ODS 3, reportados al año 2022, según datos de 176 países, entre ellos, 31 del continente americano. Los resultados obtenidos muestran que indicadores como la esperanza de vida al nacer, la cobertura sanitaria universal y la demanda de planificación familiar satisfecha, caracterizan a los países desarrollados. En contraste, los países en vía de desarrollo aún registran retos importantes para favorecer la salud materna, el bienestar de los niños y en el control de enfermedades trasmisibles y crónicas. Por ello, en el marco de la Agenda 2030, es necesario continuar trabajando en acciones de política pública que permitan avanzar en la implementación de programas para mejorar la salud y el bienestar de la población, en especial entre las naciones de menores ingresos.

Abstract This study reviews the current state of the good health and well-being indicators included in the Sustainable Development Goals (SDG), identifying the most significant challenges faced by countries in the world and in the Americas region. The HJ-Biplot multivariate technique is used to represent variances and covariances between 16 SDG 3 indicators, reported as of 2022, based on data from 176 countries, including 31 countries of the American continent. The findings show that indicators such as life expectancy at birth, universal health coverage and satisfied demand for family planning are key characteristics of developed countries. In contrast, developing countries still face significant challenges in terms of promoting maternal health, the well-being of children and the control of communicable and chronic diseases. For this reason, in the framework of the 2030 Agenda, it is necessary to continue working on public policy actions that enable making progress in the implementation of programs to improve the health and well-being of the population, especially in lower-income countries.

Technology-Based Obesity Prevention Interventions Among Hispanic Adolescents in the United States: Scoping Review.

BACKGROUND: Given that today's adolescents are digital front-runners, technology-based obesity prevention strategies are age-appropriate for this population. The use of remote and wireless technologies may be suitable for extending the reach and engagement of obesity prevention efforts among high-risk Hispanic youths, as this subgroup is disproportionately affected by barriers that limit participation in traditional, in-person interventions. OBJECTIVE: The purpose of this scoping review was to examine the intervention and sample characteristics of technology-based obesity prevention interventions among Hispanic adolescents. We also examined feasibility criteria to assess the acceptability and appropriateness of technology-based strategies among Hispanic youths. METHODS: A comprehensive search of Embase and PubMed identified 7 studies that met the inclusion criteria. Data were extracted by 2 independent reviewers. RESULTS: Of the 7 included studies, half (n=4, 57%) used a randomized control trial design, with equal implementation in school (n=3, 43%) and clinic (n=4, 57%) settings. Studies commonly targeted improvements in diet (n=4, 57%) and physical activity (n=7, 100%), with only 1 (14%) study focused on sedentary behaviors. Just 2 (29%) studies reported the use of behavioral theories or models. Studies focused primarily on youths in early (n=5, 71%) or middle (n=6, 86%) adolescence, and there was limited information reported on socioeconomic status. Only 3 (43%) study conducted formative work, and few (n=3, 43%) reported on acceptability. Only 1 (14%) study reported that materials were available in Spanish and English, and only 1 (14%) study used culturally tailored content. Additionally, 3 (43%) studies used strategies that considered social determinants of health. CONCLUSIONS: To increase our understanding of the feasibility and effectiveness of technology-based obesity prevention strategies among Hispanic adolescents, there is a need for more feasibility studies that are theoretically grounded and comprehensively report on feasibility-related outcomes. Future studies should also leverage technology to simultaneously address multiple health behaviors beyond diet and physical activity. The result of this review can be used to guide the development of future technology-based obesity prevention strategies among Hispanic adolescents. TRIAL REGISTRATION: CliniclaTrials.gov NCT04953442; https://clinicaltrials.gov/ct2/show/NCT04953442.

[Multidimensional analysis of the evolution of the COVID-19 pandemic in countries of the AmericasAnálise multidimensional da evolução da pandemia da COVID-19 em países das Américas]. / Análisis multidimensional de la evolución de la pandemia de la COVID-19 en países de las Américas.

Objective: To evaluate the evolution of the COVID-19 pandemic in countries of the Americas, comparing health system data from before the appearance of the virus in the Region, accumulated cases and deaths before the deployment of public immunization strategies, and the current state of vaccination. Methods: An HJ-Biplot multivariate analysis and cluster analysis were performed for 28 countries in the Region of the Americas at three points in time: December 2019, December 2020, and December 2021. Results: In the Americas, heterogeneity was observed in the actions implemented to contain the pandemic, and this was reflected in different groups of countries. Conclusions: Not all countries in the Region of the Americas had the health conditions necessary to contain COVID-19. At the end of 2019, the United States, Canada, Brazil, and Cuba had advantages over other countries in the Region; however, actions implemented during 2020 to contain the pandemic created different groups of countries in terms of the prevalence of infections and deaths. At the end of 2020, Bolivia, Ecuador, and Mexico had critical levels of mortality. At the end of 2021, after the implementation of vaccination plans, more than 60% of the population of Argentina, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Panama, the United States, and Uruguay had completed the vaccination schedule.

Objetivo: Avaliar a evolução da pandemia da COVID-19 entre os países das Américas, comparando os dados dos sistemas de saúde antes da chegada do vírus à região em relação aos casos e mortes acumuladas antes da implementação de estratégias de imunização da população e a situação atual da vacinação. Métodos: Foi realizada uma análise multivariada HJ-Biplot e uma análise de agrupamentos para 28 países da região das Américas, em três períodos: dezembro de 2019, de 2020 e de 2021. Resultados: No continente americano, observa-se heterogeneidade nas ações implementadas para conter a pandemia, o que se reflete nos diferentes grupos de nações. Conclusões: Nem todos os países da região das Américas contavam com as condições sanitárias necessárias para conter a COVID-19. No fim de 2019, Estados Unidos, Canadá, Brasil e Cuba tinham uma vantagem sobre os demais países da região. No entanto, a pertinência das ações implementadas durante o ano de 2020 para conter a pandemia gerou diferentes grupos de países segundo a prevalência de contágios e mortes. Naquele momento, Bolívia, Equador e México apresentavam níveis críticos de letalidade. No fim de 2021, após a implementação dos planos de vacinação, Argentina, Brasil, Canadá, Chile, Colômbia, Costa Rica, Cuba, Panamá, Estados Unidos e Uruguai registravam mais de 60% de sua população com esquema vacinal completo.

Análisis multidimensional de la evolución de la pandemia de la COVID-19 en países de las Américas

[RESUMEN]. Objetivo. Evaluar la evolución de pandemia de la COVID-19 entre los países de las Américas, comparando datos de los sistemas de salud previo a la llegada del virus a la Región, frente a los casos y muertes acumuladas antes del despliegue de las estrategias de inmunización de la población, y el estado actual de la vacunación. Métodos. Se realizo un análisis multivariante HJ-Biplot y análisis de cluster, para 28 países de la Región de las Américas, en tres momentos del tiempo: diciembre de los años 2019, 2020 y 2021. Resultados. En el continente americano se observa heterogeneidad en las acciones implementadas para contener la pandemia, la cual se refleja en diferentes grupos de naciones. Conclusiones. No todos los países de la Región de las Américas contaban con las condiciones de salubridad necesarias para afrontar la contención de la COVID-19. A cierre de 2019 Estados Unidos, Canadá, Brasil y Cuba se observaban con ventajas frente a los demás países de la Región, sin embargo, la pertinencia de las acciones implementadas durante el año 2020 para contener la pandemia, generaron diferentes grupos de países según la prevalencia de contagios y muertes. En tal momento, Bolivia, Ecuador y México, presentaban niveles críticos de letalidad. A cierre de 2021, tras la implementación de los planes de vacunación, Argentina, Brasil, Canadá, Chile, Colombia, Costa Rica, Cuba, Panamá, Estados Unidos y Uruguay registran más del 60% de su población con el esquema de vacunación completo.

[ABSTRACT]. Objective. To evaluate the evolution of the COVID-19 pandemic in countries of the Americas, comparing health system data from before the appearance of the virus in the Region, accumulated cases and deaths before the deployment of public immunization strategies, and the current state of vaccination. Methods. An HJ-Biplot multivariate analysis and cluster analysis were performed for 28 countries in the Region of the Americas at three points in time: December 2019, December 2020, and December 2021. Results. In the Americas, heterogeneity was observed in the actions implemented to contain the pandemic, and this was reflected in different groups of countries. Conclusions. Not all countries in the Region of the Americas had the health conditions necessary to contain COVID-19. At the end of 2019, the United States, Canada, Brazil, and Cuba had advantages over other countries in the Region; however, actions implemented during 2020 to contain the pandemic created different groups of countries in terms of the prevalence of infections and deaths. At the end of 2020, Bolivia, Ecuador, and Mexico had critical levels of mortality. At the end of 2021, after the implementation of vaccination plans, more than 60% of the population of Argentina, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Panama, the United States, and Uruguay had completed the vaccination schedule.

[RESUMO]. Objetivo. Avaliar a evolução da pandemia da COVID-19 entre os países das Américas, comparando os dados dos sistemas de saúde antes da chegada do vírus à região em relação aos casos e mortes acumuladas antes da implementação de estratégias de imunização da população e a situação atual da vacinação. Métodos. Foi realizada uma análise multivariada HJ-Biplot e uma análise de agrupamentos para 28 países da região das Américas, em três períodos: dezembro de 2019, de 2020 e de 2021. Resultados. No continente americano, observa-se heterogeneidade nas ações implementadas para conter a pandemia, o que se reflete nos diferentes grupos de nações. Conclusões. Nem todos os países da região das Américas contavam com as condições sanitárias necessárias para conter a COVID-19. No fim de 2019, Estados Unidos, Canadá, Brasil e Cuba tinham uma vantagem sobre os demais países da região. No entanto, a pertinência das ações implementadas durante o ano de 2020 para conter a pandemia gerou diferentes grupos de países segundo a prevalência de contágios e mortes. Naquele momento, Bolívia, Equador e México apresentavam níveis críticos de letalidade. No fim de 2021, após a implementação dos planos de vacinação, Argentina, Brasil, Canadá, Chile, Colômbia, Costa Rica, Cuba, Panamá, Estados Unidos e Uruguai registravam mais de 60% de sua população com esquema vacinal completo.

Evaluation of improvement of functional independence in a multicentre cohort of rehabilitation outpatients with neurological conditions.

PURPOSE: The objectives were to examine: (1) the changes in independence in basic activities of daily living (ADL) following an outpatient occupational therapy (OT) intervention in people with neurological conditions; (2) the factors associated with good relative functional gain (RFG) and with good OT efficiency; (3) and the effects on instrumental activities of daily living (IADL) and caregiver assistance. MATERIALS AND METHODS: A prospective observational study examining changes in a multicentre cohort (three urban hospitals). Ninety-eight adults were assessed on admission and after intervention. Barthel Index was the primary outcome (ADL). RESULTS: Acquired brain damage (ABI) was the most frequent diagnosis (84.7%). There was an improvement in ADL (p < 0.001); the effect size (r) was large (r = 0.59). RFG was good for 88.8% of participants. A good RFG was significantly associated with ABI, a lower number of hours of caregiver assistance, and a greater intensity of OT. The OT efficiency was good for 43.9% of participants. Factors significantly associated with good efficiency were being young and male patients, and receiving fewer hours of caregiver assistance. Secondary measures were improved: IADL (p < 0.001) and hours of caregiver assistance (p < 0.001). CONCLUSIONS: This study suggests that the intervention is an effective approach to improve functional independence.Implications for rehabilitationLittle is known about the outcomes of outpatient occupational therapy intervention in neurorehabilitation services for the adult population with neurological diseases.In a multicentre cohort of neurorehabilitation outpatients, the occupational therapy intervention can lead to improvements in the level of independence in basic and instrumental daily activities, as well as reducing the hours of caregiver assistance.A good relative functional gain is associated with acquired brain injury, a lower number of hours of assistance, and a greater intensity of occupational therapy.The factors associated with good efficiency are being younger, male patients, and receiving fewer hours of assistance.

Examining 24-Hour Activity and Sleep Behaviors and Related Determinants in Latino Adolescents and Young Adults With Obesity.

Background. Few studies have examined 24-hour activity and sleep behaviors and their contribution to type 2 diabetes (T2D) in Latino adolescents and young adults with obesity. Aim. This study included quantitative data on T2D risk and 24-hour activity and sleep behaviors and qualitative data on individual, social, and environmental behavioral determinants. Method. A 7 day, 24-hour, wrist-worn accelerometer protocol assessed moderate-to-vigorous physical activity (PA), sedentary behaviors (SB), sleep, and sleep regularity, in adolescents (N = 38; 12-16 years) and young adults (N = 22; 18-22 years). T2D-related outcomes included adiposity (BMI, BF%, waist circumference), fasting, and 2-hour glucose. A subsample of participants (N = 16 adolescents, N = 15 young adults) completed interviews to identify behavioral determinants. Results. High levels of PA were observed among adolescents (M = 103.8 ± 67.5 minutes/day) and young adults (M = 96.8 ± 78.8 minutes/day) as well as high levels of SB across both age groups (≥10 hours/day). Sleep regularity was negatively associated with adiposity (all ps < .05) in both age groups as well as fasting and 2-hour glucose in young adults (all ps < .05). Social support was associated with PA in both age groups as well as SB in younger youth. Auditory noises, lights, and safety inhibited sleep in both age groups. Conclusion. PA is critical for disease reduction, yet reducing SB and improving sleep are also important targets for reducing T2D risk in Hispanic adolescents and young adults. Future health promotion and disease prevention strategies should leverage qualitative findings regarding behavioral determinants.

Análisis multidimensional de la evolución de la pandemia de la COVID-19 en países de las Américas / Multidimensional analysis of the evolution of the COVID-19 pandemic in countries of the Americas / Análise multidimensional da evolução da pandemia da COVID-19 em países das Américas

RESUMEN Objetivo. Evaluar la evolución de pandemia de la COVID-19 entre los países de las Américas, comparando datos de los sistemas de salud previo a la llegada del virus a la Región, frente a los casos y muertes acumuladas antes del despliegue de las estrategias de inmunización de la población, y el estado actual de la vacunación. Métodos. Se realizo un análisis multivariante HJ-Biplot y análisis de cluster, para 28 países de la Región de las Américas, en tres momentos del tiempo: diciembre de los años 2019, 2020 y 2021. Resultados. En el continente americano se observa heterogeneidad en las acciones implementadas para contener la pandemia, la cual se refleja en diferentes grupos de naciones. Conclusiones. No todos los países de la Región de las Américas contaban con las condiciones de salubridad necesarias para afrontar la contención de la COVID-19. A cierre de 2019 Estados Unidos, Canadá, Brasil y Cuba se observaban con ventajas frente a los demás países de la Región, sin embargo, la pertinencia de las acciones implementadas durante el año 2020 para contener la pandemia, generaron diferentes grupos de países según la prevalencia de contagios y muertes. En tal momento, Bolivia, Ecuador y México, presentaban niveles críticos de letalidad. A cierre de 2021, tras la implementación de los planes de vacunación, Argentina, Brasil, Canadá, Chile, Colombia, Costa Rica, Cuba, Panamá, Estados Unidos y Uruguay registran más del 60% de su población con el esquema de vacunación completo.

ABSTRACT Objective. To evaluate the evolution of the COVID-19 pandemic in countries of the Americas, comparing health system data from before the appearance of the virus in the Region, accumulated cases and deaths before the deployment of public immunization strategies, and the current state of vaccination. Methods. An HJ-Biplot multivariate analysis and cluster analysis were performed for 28 countries in the Region of the Americas at three points in time: December 2019, December 2020, and December 2021. Results. In the Americas, heterogeneity was observed in the actions implemented to contain the pandemic, and this was reflected in different groups of countries. Conclusions. Not all countries in the Region of the Americas had the health conditions necessary to contain COVID-19. At the end of 2019, the United States, Canada, Brazil, and Cuba had advantages over other countries in the Region; however, actions implemented during 2020 to contain the pandemic created different groups of countries in terms of the prevalence of infections and deaths. At the end of 2020, Bolivia, Ecuador, and Mexico had critical levels of mortality. At the end of 2021, after the implementation of vaccination plans, more than 60% of the population of Argentina, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Panama, the United States, and Uruguay had completed the vaccination schedule.

RESUMO Objetivo. Avaliar a evolução da pandemia da COVID-19 entre os países das Américas, comparando os dados dos sistemas de saúde antes da chegada do vírus à região em relação aos casos e mortes acumuladas antes da implementação de estratégias de imunização da população e a situação atual da vacinação. Métodos. Foi realizada uma análise multivariada HJ-Biplot e uma análise de agrupamentos para 28 países da região das Américas, em três períodos: dezembro de 2019, de 2020 e de 2021. Resultados. No continente americano, observa-se heterogeneidade nas ações implementadas para conter a pandemia, o que se reflete nos diferentes grupos de nações. Conclusões. Nem todos os países da região das Américas contavam com as condições sanitárias necessárias para conter a COVID-19. No fim de 2019, Estados Unidos, Canadá, Brasil e Cuba tinham uma vantagem sobre os demais países da região. No entanto, a pertinência das ações implementadas durante o ano de 2020 para conter a pandemia gerou diferentes grupos de países segundo a prevalência de contágios e mortes. Naquele momento, Bolívia, Equador e México apresentavam níveis críticos de letalidade. No fim de 2021, após a implementação dos planos de vacinação, Argentina, Brasil, Canadá, Chile, Colômbia, Costa Rica, Cuba, Panamá, Estados Unidos e Uruguai registravam mais de 60% de sua população com esquema vacinal completo.

Family-Based Obesity Prevention Interventions among Hispanic Children and Families: A Scoping Review.

This scoping review examined intervention and sample characteristics of family-based obesity prevention interventions among Hispanic youth. This review also examined the degree to which existing interventions were culturally-adapted, acknowledged social determinants of health (SDoH), and collaborated with community stakeholders. A comprehensive search across Medline Ovid, Embase, Scopus, PsycInfo, and Pubmed was used to identify 13 studies primarily based in the U.S. (92.3%). Data was extracted by two independent reviewers. Most used a randomized control trial design (69.2%), a behavior change theory (84.6%), and reported moderate to high (≥70%) retention (69.2%). Studies targeted improvements in physical activity (69.2%) and fruit and vegetable intake (92.3%) through nutrition education, cooking demonstrations, and tastings. Younger children from low socioeconomic backgrounds (61.5%) were well represented. Most interventions were culturally-adapted (69.2%), all studies reported collaboration with stakeholders, yet only half used strategies that acknowledged SDoH (46.2%). To increase our understanding of the underlying mechanisms by which family-based approaches can reach and engage Hispanic youth and families, future studies should rigorously evaluate theoretical constructs, family processes, and SDoH that influence program participation and health behaviors. This information will guide the design and development of future interventions aimed at reducing obesity disparities among Hispanic youth.

Associations between Screen-Based Activities, Physical Activity, and Dietary Habits in Mexican Schoolchildren.

Screen-based activities are associated with increased risk of obesity and contribute to physical inactivity and poor dietary habits. The primary aim of this study was to examine the associations among screen-based activities, physical activity, and dietary habits in school-aged children in Guadalajara, Puerto Vallarta, and Mexico City, Mexico. The secondary aim was to examine these associations across sex. The School Physical Activity and Nutrition survey was used to assess screen-based activities (TV watching, video game use, computer use), physical activity, and dietary habits. Organized activity/sports participation, unhealthy dietary habits, and household income were correlated with screen-based activities. While TV watching was associated with decreased participation in organized activity/sports participation, computer and video game use was associated with increased organized activity/sports participation. Boys engaged in more TV watching and video game use compared to girls. All screen-based activities were associated with age among boys; whereas video game and computer use were associated with higher income among girls. These findings suggest a need for sex- and age-specific strategies that acknowledge the differential use of screen-based activities across sex and age. Future research should continue to identify underlying correlates linking screen-based activities with health behaviors to inform strategies to reduce screen-time in Mexican children.

Chronic Augmentation of Endocannabinoid Levels Persistently Increases Dopaminergic Encoding of Reward Cost and Motivation.

Motivational deficits characterized by an unwillingness to overcome effortful costs are a common feature of neuropsychiatric and neurologic disorders that are insufficiently understood and treated. Dopamine (DA) signaling in the nucleus accumbens (NAc) facilitates goal-seeking, but how NAc DA release encodes motivationally salient stimuli to influence effortful investment is not clear. Using fast-scan cyclic voltammetry in male and female mice, we find that NAc DA release diametrically responds to cues signaling increasing cost of reward, while DA release to the reward itself is unaffected by its cost. Because endocannabinoid (eCB) signaling facilitates goal seeking and NAc DA release, we further investigated whether repeated augmentation of the eCB 2-arachidonoylglycerol with a low dose of a monoacylglycerol lipase (MAGL) inhibitor facilitates motivation and DA signaling without the development of tolerance. We find that chronic MAGL treatment stably facilitates goal seeking and DA encoding of prior reward cost, providing critical insight into the neurobiological mechanisms of a viable treatment for motivational deficits.SIGNIFICANCE STATEMENT Decades of work has established a fundamental role for dopamine neurotransmission in motivated behavior and cue-reward learning, but how dopaminergic encoding of cues associates with motivated action has remained unclear. Specifically, how dopamine neurons signal future and prior reward cost, and whether this can be modified to influence motivational set points is not known. The current study provides important insight into how dopamine neurons encode motivationally relevant stimuli to influence goal-directed action and supports cannabinoid-based therapies for treatment of motivational disorders.

Humanización de los servicios de salud en Iberoamérica: una revisión sistemática de la literatura / Humanizing Health Care Services in Ibero-America: A Systematic Review of Literature / Humanização dos serviços de saúde na Ibero-América: uma revisão sistemática da literatura

Resumen La humanización es un imperativo ético que contribuye a salvaguardar la dignidad humana en armonía con los principios bioéticos y la reglamentación deontológica que regulan las prácticas en un contexto de salud. El presente estudio tiene como objetivo conocer los avances sobre el abordaje de la humanización en salud en Iberoamérica en los últimos diez años, a través de una revisión sistemática. Frente a los hallazgos, se evidencia que los avances apuntan a la comprensión del fenómeno a partir de las aproximaciones teóricas, el creciente interés por el tema en los últimos años y la generación de políticas, programas y estrategias que deben fortalecerse desde una mirada integral del ser humano.

Abstract Humanization is an ethical imperative that contributes to safeguarding human dignity in harmony with bioethical principles and deontological regulations that govern health care practices. The present study aims to explore the advances in the humanization of Ibero-American health care in the last ten years through a systematic review. Results show that such advances point to understanding the phenomenon based on theoretical approaches, a growing interest in the subject in recent years, and the creation of policies, programs and strategies that should be strengthened from a comprehensive view of the human being.

Resumo A humanização é um imperativo ético que contribui para salvaguardar a dignidade humana em harmonia com os princípios bioéticos e com a regulamentação deontológica que determinam as práticas em um contexto de saúde. Este estudo tem o objetivo de conhecer os avanços sobre a abordagem da humanização em saúde na Ibero-América nos últimos dez anos, por meio de uma revisão sistemática da literatura. Diante dos resultados, torna-se evidente que os avanços apontam à compreensão do fenômeno a partir das aproximações teóricas, do crescente interesse pelo tema nos últimos anos e da criação de políticas, programas e estratégias que devem ser fortalecidos sob um olhar integral do ser humano.

Nivel de Seguridad Alimentaria en beneficiarios de Comedores Comunitarios del programa Cruzada Nacional contra el Hambre (México) / Level of Food Security in households of community kitchen of the National Crusade against Hunger program (Mexico)

Fundamentos: Se entiende por Seguridad Alimentaria cuando todas las personas tienen acceso físico, social y económico a suficientes alimentos para satisfacer sus necesidades alimenticias. El objetivo fue comparar el nivel de seguridad alimentaria de los beneficiarios de Comedores Comunitarios con y sin huerto comunitario pertenecientes al programa de la Cruzada Nacional contra el hambre. Métodos: Se realizó un estudio transversal y comparativo en tres comedores comunitarios, seleccionados con huerto (n=1) y sin huerto (n=2). Se utilizó la Escala Latinoamericana y Caribeña de Seguridad Alimentaria, un cuestionario de caracterización y de características del huerto. Se obtuvieron datos sobre el acceso a otros programas sociales, servicios básicos de salud, educación, características del huerto y seguridad alimentaria. Resultados: La frecuencia de seguridad alimentaria de los comedores con y sin huerto fue de 16,67% y 10,00% respectivamente. La inseguridad alimentaria severa se presentó en 10,00% y 25,00% respectivamente. Según la ELCSA, el 48,93% de los hogares beneficiarios de comedores con huerto reportaron tener variedad de alimentos, mientras que en hogares de comedores sin huerto se reportó el 14,28% (p=0,003). Los principales alimentos cultivados fueron frijol, verduras y maíz). Conclusiones: El grupo con huerto reportó mayor seguridad alimentaria y menor inseguridad alimentaria severa en hogares sin menores de 18 años

Background: Food Security is when all people have physical, social and economic access to enough food to meet their dietary needs. The objective was to compare the level of food security of the beneficiaries of community kitchens with and without community orchard belonging to the National Crusade against Hunger program. Methods: A cross sectional and comparative study was carried outin three community kitchens, selected with community orchard (n = 1) and without community garden (n = 2). It was used the Latin American and Caribbean Scale of Food Security, a characterization questionnaire and garden characteristics questionnaire. Data on access to other social programs, basic health services, education, orchard characteristics and food security were obtained. Results: The frequency of food security of the community kitchens with and without orchard was presented in 16.67% and 10.00% respectively. Severe food insecurity was presented in 10.00% and 25.00% respectively. According to the ELCSA, an 48.93% of beneficiary households with garden reported having a variety of food, while households without orchard reported 14.28% (p= 0.003). The main foods grown in the community garden were beans, vegetables and corn. Conclusions: The orchard group reported greater food security and less severe food insecurity in households without children under 18

Word-wide meta-analysis of Quercus forests ectomycorrhizal fungal diversity reveals southwestern Mexico as a hotspot.

Quercus is the most diverse genus of ectomycorrhizal (ECM) host plants; it is distributed in the Northern and Southern Hemispheres, from temperate to tropical regions. However, their ECM communities have been scarcely studied in comparison to those of conifers. The objectives of this study were to determine the richness of ECM fungi associated with oak forests in the Cuitzeo basin in southwestern Mexico; and to determine the level of richness, potential endemism and species similarity among ECM fungal communities associated with natural oak forests worldwide through a meta-analysis. The ITS DNA sequences of ECM root tips from 14 studies were included in the meta-analysis. In total, 1065 species of ECM fungi have been documented worldwide; however, 812 species have been only found at one site. Oak forests in Europe contain 416 species, Mexico 307, USA 285, and China 151. Species with wider distributions are Sebacinaceae sp. SH197130, Amanita subjunquillea, Cenococcum geophilum, Cortinarius decipiens, Russula hortensis, R. risigallina, R. subrubescens, Sebacinaceae sp. SH214607, Tomentella ferruginea, and T. lapida. The meta-analysis revealed (1) that Mexico is not only a hotspot for oak species but also for their ECM mycobionts. (2) There is a particularly high diversity of ECM Pezizales in oak seasonal forests from western USA to southwestern Mexico. (3) The oak forests in southwestern Mexico have the largest number of potential endemic species. (4) Globally, there is a high turnover of ECM fungal species associated with oaks, which indicates high levels of alpha and beta diversity in these communities.

Synthetic Peptides Derived from Bovine Lactoferricin Exhibit Antimicrobial Activity against E. coli ATCC 11775, S. maltophilia ATCC 13636 and S. enteritidis ATCC 13076.

Linear, dimeric, tetrameric, and cyclic peptides derived from lactoferricin B-containing non-natural amino acids and the RWQWR motif were synthesized, purified, and characterized using RP-HPLC, MALDI-TOF mass spectrometry, and circular dichroism. The antibacterial activity of peptides against Escherichia coli ATCC 11775, Stenotrophomonas maltophilia ATCC 13636, and Salmonella enteritidis ATCC 13076 was evaluated. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined. The synthetic bovine lactoferricin exhibited antibacterial activity against E. coli ATCC 11775 and S. enteritidis ATCC 13076. The dimeric peptide (RRWQWR)2K-Ahx exhibited the highest antibacterial activity against the tested bacterial strain. The monomeric, cyclic, tetrameric, and palindromic peptides containing the RWQWR motif exhibited high and specific activity against E. coli ATCC 11775. The results suggest that short peptides derived from lactoferricin B could be considered as potential candidates for the development of antibacterial agents against infections caused by E. coli.

Addenbrooke's Cognitive Examination-Revised: Effects of Education and Age. Normative Data for the Spanish Speaking Population.

OBJECTIVE: Addenbrooke's Cognitive Examination-Revised is a brief test battery for the detection and classification of mild cognitive impairment and dementia. The aims were to investigate the influence of age and education on the Spanish version of the ACE-R and to propose normative data for the Spanish speaking population. METHOD: Three hundred thirty-four normal healthy volunteers were included in the study. They were classified in three age groups (48-64, 65-75, and 75-89 years of age) and four educational level groups (≤3; 4-8; 9-12, and ≥13 years of education). They were assessed with the version of ACE-R validated in Argentina with some modifications in order to adapt it to the Spanish population. RESULTS: Significant differences were obtained between all age groups in Total ACE-R, Memory, Fluency, and Language indexes. Differences were observed among the 48-64 and 76-89 age groups in the Attention-Orientation and Visuospatial indexes. Regarding education, significant difference between ≤3 years of education and the remaining groups were obtained in Total ACE-R and in all the indexes. Additionally, the group of 4-8 years of education performed significantly worse than the 9-12 and ≥13 groups in Total, Memory, Fluency, and Language indexes. Adjusted scores by education were obtained and percentiles for each age group were calculated. CONCLUSIONS: The results show that both age and education have an important effect on ACE-R performance. Consequently, age and education should be taken into account when interpreting results in ACE-R to improve diagnostic accuracy.

An electrically assisted device for protein crystallization in a vapor-diffusion setup.

A new easy-to-use device has been designed and implemented for electric field-induced protein crystallization in a vapor-diffusion configuration. The device not only controls crystal nucleation by means of the electrical current, but also favors crystal growth owing to its vapor-diffusion setup. Crystallization was conducted in the presence of an internal electric field and direct current. The proteins investigated were lysozyme, as model protein, and 2TEL-lysozyme (a synthetic protein consisting of two tandem alpha helix motifs connected to a lysozyme moiety). Lysozyme crystals that grew attached to the cathode were larger than those grown attached to the anode or in the absence of an electric current. On the other hand, crystals of 2TEL-lysozyme qualitatively showed a better X-ray diffraction pattern when grown in the presence of an electric current.

Características clínicas del paciente diabético después de un evento de cetoacidosis / Clinical characteristics of the diabetic patient after a ketoacidosis event

Objetivo. Describir las características clínicas y terapéuticas de los pacientes después de un evento de cetoacidosis diabética (CAD). Material y métodos. Estudio descriptivo, tipo serie de casos. Se revisó 127 historias clínicas de pacientes con diagnóstico de crisis hiperglicémicas, 90 de los cuales tuvieron diagnóstico de CAD, en el Hospital Nacional Arzobispo Loayza de Lima. Cuarenta pacientes fueron ubicados, firmaron el consentimiento informado y fueron entrevistados. Se evaluó los siguientes parámetros clínicos y metabólicos: sexo, edad, glicemia, hemoglobina glicosilada (Hb1Ac), nuevo evento de CAD, índice de masa corporal (IMC) y tratamiento postevento (dieta y tratamiento). Resultados. Veintisiete (67,5%) fueron mujeres. La edad promedio fue 49,53 ± 14,88 años. El tiempo de enfermedad de diabetes mellitus (DM) promedio fue 60,5 ± 70,45 meses y el tiempo después del evento de CAD promedio fue 21,3 ± 8,47 meses. En 50% de pacientes fue un debut de DM. La glucosa promedio fue 157,50 ± 83,24 mg/dL, el nivel de Hb1Ac promedio fue 8,05 ± 2%. El IMC promedio fue 28,01 ± 5 kg/m2. La terapia recibida postevento de CAD fue: 9 (22,5%) pacientes con insulinoterapia, 19 (47,5%) antidiabéticos orales (todos tenían DM-2); 2 (5%) recibieron solo dieta y ejercicio y 10 (25%) no seguían ningún tratamiento. Tres (7,5%) presentaron un nuevo evento de CAD (dos pacientes tenían DM-1 y uno tenía DM-2). Conclusión. En el seguimiento, postevento de CAD, la mayoría de los pacientes tenía un comportamiento clínico como de DM-2.

Objetive. To describe the clinical and therapeutic characteristics of patients after an event of diabetic ketoacidosis (DKA). Material and methods. A descriptive, case series. We reviewed 127 medical records with diagnosis of hyperglycemic crisis, 90 of whom had a diagnosis of DKA, in the Hospital Nacional Arzobispo Loayza, Lima. Forty patients were contacted, signed an informed consent and were interviewed. We evaluated the following clinical and metabolic parameters: sex, age, blood glucose, Hb1Ac, new event of DKA, body masss index (BMI) and the treatment after the event of DKA (diet and treatment). Results. Twenty-seven (67,5%) were women. The mean age was 49,53 ± 14,88 years. The mean disease duration of diabetes mellitus (DM) was 60,5 ± 70,45 months and the mean time after the event of DKA 21,3 ± 8,47 months. A debut of DM ocurred in 50% of DKA cases. The mean glucose was 157,50 ± 83,24 mg/dL, the mean BMI was 28,01 ± 5 kg/m2. The therapy given after the event of CAD was: 9 (22,5%) patients with. 19 (47,5%) oral agents (all of whom had DM2), 2 (5%) only diet and exercise and 10 (25%) without any treatment. There (7,5%) had new DKA event, 2 patients had DMI and DM2 1 had. Conclusions. On follow up, after an episode of DKA the majority of patients have a similar clinical behavior as patients with diabetes mellitus type 2.