Diverse values of nature for sustainability.

Twenty-five years since foundational publications on valuing ecosystem services for human well-being1,2, addressing the global biodiversity crisis3 still implies confronting barriers to incorporating nature's diverse values into decision-making. These barriers include powerful interests supported by current norms and legal rules such as property rights, which determine whose values and which values of nature are acted on. A better understanding of how and why nature is (under)valued is more urgent than ever4. Notwithstanding agreements to incorporate nature's values into actions, including the Kunming-Montreal Global Biodiversity Framework (GBF)5 and the UN Sustainable Development Goals6, predominant environmental and development policies still prioritize a subset of values, particularly those linked to markets, and ignore other ways people relate to and benefit from nature7. Arguably, a 'values crisis' underpins the intertwined crises of biodiversity loss and climate change8, pandemic emergence9 and socio-environmental injustices10. On the basis of more than 50,000 scientific publications, policy documents and Indigenous and local knowledge sources, the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES) assessed knowledge on nature's diverse values and valuation methods to gain insights into their role in policymaking and fuller integration into decisions7,11. Applying this evidence, combinations of values-centred approaches are proposed to improve valuation and address barriers to uptake, ultimately leveraging transformative changes towards more just (that is, fair treatment of people and nature, including inter- and intragenerational equity) and sustainable futures.

Body Composition Measurement in Bronchiectasis: Comparison between Bioelectrical Impedance Analysis, Skinfold Thickness Measurement, and Dual-Energy X-ray Absorptiometry before and after Pulmonary Rehabilitation.

BACKGROUND: In individuals with bronchiectasis, fat-free mass depletion may be common despite a low prevalence of underweight and is considered a risk factor for increased morbidity and mortality. Techniques to adequately estimate fat-free mass and its changes over time are needed. OBJECTIVE: The purpose of this study was to assess agreement among values obtained with three different body composition techniques: skinfold thickness measurement (STM), bioelectrical impedance analysis (BIA), and dual-energy x-ray absorptiometry (DXA). DESIGN: The study was a secondary analysis of data from a randomized controlled trial. PARTICIPANTS/SETTING: A respiratory rehabilitation program was administered for 3 months to individuals with bronchiectasis from the bronchiectasis unit of the Regional University Hospital in Malaga, Spain, from September 2013 to September 2014. Individuals with a body mass index (calculated as kg/m2) >18.5 who were aged 65 years or younger and those with a body mass index >20 who were older than 65 years were included. MAIN OUTCOME MEASURES: At baseline and at 3 and 6 months, body composition was determined by DXA and STM. STATISTICAL ANALYSES PERFORMED: Statistical concordance was assessed with the intraclass correlation coefficient (ICC), kappa coefficient, and the degree of agreement using the Bland Altman method. For comparison of the quantitative variables at baseline vs at 3 months and 6 months, the paired sample t test (or the Wilcoxon test) was used. RESULTS: Thirty participants were included. Strong agreement was observed between body composition values determined by BIA and DXA in fat mass (ICC: 0.92) and fat-free mass (ICC: 0.87). Strong agreement was observed between STM and DXA in the values for fat-free mass (ICC: 0.91) and fat mass (ICC: 0.94), and lower agreement was observed for the longitudinal data and in the regional values. The mean difference between fat-free mass determined by BIA and DXA was + 4.7 with a standard deviation of 2.4 kg in favor of BIA. The mean difference between fat-free mass determined by STM and DXA was +2.3 with a standard deviation of 2.7 kg in favor of STM. Six individuals were classified as having a low fat-free mass index (20%) by DXA vs four by STM (13%; kappa: 0.76) and only two by BIA (6.6%; kappa: 0.44) compared with DXA. CONCLUSIONS: Despite good statistical agreement among values obtained with DXA, STM, and BIA, the study findings indicate that STM and BIA, above all, tended to overestimate fat-free mass compared with DXA.

Inflammation and Oxidation Biomarkers in Patients with Cystic Fibrosis: The Influence of Azithromycin.

OBJECTIVE: In addition to their antibiotic effect, macrolides appear to modulate the inflammatory response in cystic fibrosis (CF) and could influence oxidative stress. The objective of this study was to assess oxidation biomarkers and levels of inflammation and to determine whether there is an association between these parameters and the intake of macrolides. MATERIALS AND METHODS: The subjects included in this cross-sectional study were, on the one hand, clinically stable patients with CF and, on the other, healthy controls. The following serum and plasma inflammatory and oxidative stress biomarkers were measured: interleukin-6 (IL-6), reactive C protein (RCP), tumor necrosis alpha (TNF-α), glutathione peroxidase (GPx), total antioxidant capacity (TAC), catalase (CAT), and superoxide dismutase (SOD), together with markers of lipid peroxidation (8-isoprostanes and thiobarbituric acid reactive substances [TBARS]). Clinical, anthropometric, lung function, radiological, and analytical variables (albumin, prealbumin, vitamins, and zinc) were also recorded. RESULTS: We studied 36 adults with CF and 41 controls. No differences were observed in age, gender, or anthropometric variables. The patients had significantly higher levels of IL-6, TNF-α, RCP, TBARS, and isoprostanes, and lower levels of SOD than the controls. Twenty-three of the patients were treated with azithromycin, and they had more severe clinical and radiological parameters than those who were not but nevertheless presented significantly lower levels of TNF-α. No differences were observed in the markers of oxidation. CONCLUSION: Inflammation and oxidation biomarkers were increased in patients with CF compared with controls. The use of azithromycin was associated with reduced TNF-α levels and did not influence oxidation parameters.

Programa de intervención para promoción de salud mental en una comunidad de personas mayores / Intervention program to promote mental health on an elderly community

En Chile muchas veces la atención primaria no es capaz de profundizar en los programas educativos hacia la Salud Mental. Por esto, es importante que los profesionales de salud logren desarrollar su rol educativo en contacto estrecho con la comunidad. Dentro del curso de Enfermería en Salud Mental y Psiquiatría II del Certificado Académico de Salud Mental y Psiquiatría de la Escuela de Enfermería de la Pontificia Universidad Católica de Chile, internos realizaron un programa de promoción de salud mental. Este fue dirigido a adultos mayores, por lo que se basó en el Modelo de educación para adultos propuesto por la Dra. Jane Vella. Se realizaron doce sesiones de una hora y treinta minutos en un lugar facilitado por la comuna de Estación Central. A través de un diagnóstico participativo se identificaron variados temas de interés, como el envejecimiento saludable, la memoria, la depresión, las redes de apoyo, relaciones saludables, cuidados del cuidador, utilizando la psicoeducación con un enfoque promocional. Se obtuvieron resultados positivos en relación a la obtención de herramientas para el autocuidado en salud mental. Como elemento negativo a destacar se encuentra la convivencia entre los participantes durante las sesiones debido a opiniones contradictorias, aspecto a tener en cuenta al implementar programas educativos futuros. En conclusión, esta intervención basada en la educación para adultos, demostró ser efectiva para abarcar temas de salud mental, promoviendo el envejecimiento saludable, el autocuidado y las relaciones interpersonales, en una población de personas mayores con diversos niveles educacionales y estilos de vida.

The Chilean Primary Care services are not able to deepen their educational programs towards Mental Health. It is therefore important that health professionals manage to develop their educational role in close contact with the community.In the context of a nursing mental health class of Pontificia Universidad Católica de Chile, 7 interns developed a health promotion intervention, which was created focusing in elderlypopulation. The intervention was based on Adult EducationalModel proposed by Jane Vella. There were 12 sessions of 1 hour anda half, conducted at Casa de la Mujer in Estación Central.The themes of the program were decided through a participative diagnosis. The themes chosen were healthy aging, memory, depression, support system, and caregive-care, which were treated using psychoeducation with a promotional emphasis.There were achieved positive results in relation to obtaining tools for self-care in mental health. As a negative element to highlight were the interactionsbetween the participants during the sessions due to conflicting opinions, aspect to be taken into account when implementing future educational programs.In conclusion, this intervention based on adult education proved to be effective in addressing mental health issues, promoting healthy aging, self-care and interpersonal relationships in a population of older people with different educational levels and lifestyles.

Spatial heterogeneity of water quality in a highly degraded tropical freshwater ecosystem.

Awareness of environmental heterogeneity in ecosystems is critical for management and conservation. We used the Xochimilco freshwater system to describe the relationship between heterogeneity and human activities. This tropical aquatic ecosystem south of Mexico City is comprised of a network of interconnected canals and lakes that are influenced by agricultural and urban activities. Environmental heterogeneity was characterized by spatially extensive surveys within four regions of Xochimilco during rainy and dry seasons over 2 years. These surveys revealed a heterogeneous system that was shallow (1.1 m, SD=0.4 ), warm (17 degrees C, SD=2.9), well oxygenated (5.0 mg l(-1), SD=3), turbid (45.7 NTU SD = 26.96), and extremely nutrient-rich (NO(3)-N=15.9 mg l(-1), SD=13.7; NH(4)-N=2.88 mg l(-1), SD=4.24; and PO(4)-P=8.3 mg l(-1), SD=2.4). Most of the variables were not significantly different between years, but did differ between seasons, suggesting a dynamic system within a span of a year but with a high resilience over longer periods of time. Maps were produced using interpolations to describe distributions of all variables. There was no correlation between individual variables and land use. Consequently, we searched for relationships using all variables together by generating a combined water quality index. Significant differences in the index were apparent among the four regions. Index values also differed within individual region and individual water bodies (e.g., within canals), indicating that Xochimilco has high local heterogeneity. Using this index on a map helped to relate water quality to human activities and provides a simple and clear tool for managers and policymakers.